Mary Elizabeth Hughes

Loneliness as a specific risk factor for depressive symptoms: cross-sectional and longitudinal analyses.

The extent to which loneliness is a unique risk factor for depressive symptoms was determined in 2 population-based studies of middle-aged to older adults, and the possible causal influences between loneliness and depressive symptoms were examined longitudinally in the 2nd study. In Study 1, a nationally representative sample of persons aged 54 and older completed a telephone interview as part of a study of health and aging. Higher levels of loneliness were associated with more depressive symptoms, net of the effects of age, gender, ethnicity, education, income, marital status, social support, and perceived stress. In Study 2, detailed measures of loneliness, social support, perceived stress, hostility, and demographic characteristics were collected over a 3-year period from a population-based sample of adults ages 50-67 years from Cook County, Illinois. Loneliness was again associated with more depressive symptoms, net of demographic covariates, marital status, social support, hostility, and perceived stress. Latent variable growth models revealed reciprocal influences over time between loneliness and depressive symptomatology. These data suggest that loneliness and depressive symptomatology can act in a synergistic effect to diminish well-being in middle-aged and older adults.

A Short Scale for Measuring Loneliness in Large Surveys: Results From Two Population-Based Studies

Most studies of social relationships in later life focus on the amount of social contact, not on individuals’perceptions of social isolation. However, loneliness is likely to be an important aspect of aging. A major limiting factor in studying loneliness has been the lack of a measure suitable for large-scale social surveys. This article describes a short loneliness scale developed specifically for use on a telephone survey. The scale has three items and a simplified set of response categories but appears to measure overall loneliness quite well. The authors also document the relationship between loneliness and several commonly used measures of objective social isolation. As expected, they find that objective and subjective isolation are related. However, the relationship is relatively modest, indicating that the quantitative and qualitative aspects of social relationships are distinct. This result suggests the importance of studying both dimensions of social relationships in the aging process.

Marital Biography and Health at Mid-Life

This article develops a series of hypotheses about the long-term effects of ones history of marriage, divorce, and widowhood on health, and it tests those hypotheses using data from the Health and Retirement Study. We examine four dimensions of health at mid-life: chronic conditions, mobility limitations, self-rated health, and depressive symptoms. We find that the experience of marital disruption damages health, with the effects still evident years later; among the currently married, those who have ever been divorced show worse health on all dimensions. Both the divorced and widowed who do not remarry show worse health than the currently married on all dimensions. Dimensions of health that seem to develop slowly, such as chronic conditions and mobility limitations, show strong effects of past marital disruption, whereas others, such as depressive symptoms, seem more sensitive to current marital status. Those who spent more years divorced or widowed show more chronic conditions and mobility limitations.

Health in Household Context: Living Arrangements and Health in Late Middle Age

People living in some arrangements show better health than persons in other living arrangements. Recent prospective studies document higher mortality among persons living in particular types of households. We extend this research by examining the influence of household structure on health using longitudinal data. We theorize that individuals experience role-based household relations as sets of resources and demands. In certain household structures, individuals are more likely to perceive that the demands made on them outweigh the resources available to them. This perceived imbalance poses a risk to individual health. We test our expectations by analyzing the relationship between living arrangements and health using data from waves 1 and 2 of the Health and Retirement Study. We focus on persons ages 51-61 and explore gender differences. We find prospective links between household structure and self-rated health, mobility limitation, and depressive symptoms. Married couples living alone or with children only are the most advantaged; single women living with children appear disadvantaged on all health outcomes. Men and women in other household types are disadvantaged on some health outcomes. Our results suggest that the social context formed by the household may be important to the social etiology of health. In addition, they qualify the well-known link between marital status and health: The effect of marital status on health depends on household context.

Interacting effects of multiple roles on women's health

Our study tests several hypotheses concerning the effects of employment, marriage, and motherhood on womens general physical health. These hypotheses predict how the health effect of each role varies, depending on specific role characteristics and the other roles a woman holds. Our analyses utilize longitudinal panel data for 3,331 women from the National Longitudinal Surveys of Young Women (follow-up intervals: 1978-83 and 1983-88). The Role Substitution Hypothesis proposes that employment and marriage provide similar resources (e.g., income and social support), and consequently, employment and marriage can substitute for each other in their beneficial effects on health. As predicted, we found that employment had beneficial effects on health for unmarried women, but little or no effect for married women. Similarly, marriage had beneficial effects on health only for women who were not employed. The Role Combination Strain Hypothesis proposes that employed mothers experience role strain, resulting in harmful effects on health. However, we found very little evidence that the combination of employment and motherhood resulted in harmful health effects. Contrary to the predictions of the Quantitative Demands Role Strain Hypothesis, it appears that neither longer hours of employment nor having more children resulted in harmful effects on health. As predicted by the Age-Related Parental Role Strain Hypothesis, younger age at first birth, particularly a teenage birth, appeared to result in more harmful health effects.

Grandparents Providing Care to Grandchildren: A Population-Based Study of Continuity and Change

This study examines transitions in grandchild care and the characteristics of grandparents making these transitions, using longitudinal data from a nationally representative sample of 13,626 grandparents in the 1998-2008 Health and Retirement Study. More than 60% of grandparents provided grandchild care over the 10-year period; more than 70% of those did it for 2 years or more. Grandparents with fewer functional limitations and more economic resources were more likely to start or continue nonresidential care, whereas relatively disadvantaged grandparents were more likely to start and continue coresidential care. Grandparents who were African American, younger, married, living with fewer minor children of their own, or had more grandchildren were more likely to start care, particularly nonresidential care. African Americans and Hispanics were more likely than Whites to start and continue coresidential care. These findings demonstrate the heterogeneity of caregiving and point to the lack of resources among those who provide coresidential care.

Home economics: Metropolitan labor and housing markets and domestic arrangements in young adulthood

I examine the relationship of labor and housing market conditions to marriage, living alone, living with a partner, living with roommates, or living with parents among persons aged 18-30. Although the residential choices available to contemporary young adults undermine the uniqueness of marriage, I find that marriage retains a high material standard. I also find that the material foundations of nonmarital arrangements differ. Housing costs are strongly associated with domestic arrangements: in areas with higher housing costs, relatively expensive arrangements are less common. These patterns appear in broad brush for blacks and whites and males and females; however, I also observe important racial differences. My results suggest that the interaction of structural context with consumption aspirations is an important influence on domestic life in the transition to adulthood.

Maternal Sociodemographic Characteristics, Experiences and Health Behaviors Associated with Postpartum Care Utilization: Evidence from Maryland PRAMS Dataset, 2012–2013

Objectives Postpartum visits are increasingly recognized as a window of opportunity for health care providers to counsel new mothers and promote healthy behaviors, including increasing contraceptive use and screening for postpartum depression. In Maryland, there is a lack of research on postpartum visit (PPV) attendance and the specific risk factors associated with not receiving postpartum care. In this study, we estimated the proportion of mothers in Maryland who attended a PPV and assessed maternal sociodemographic characteristics and health behaviors associated with PPV non-attendance. Methods Data were analyzed from the 2012 and 2013 Maryland Pregnancy Risk Assessment Monitoring System (nu2009=u20092204). Bivariate and multivariable logistic regression were performed to examine the association between covariates and PPV non-attendance. Results Overall, 89.6% of women reported PPV attendance. Bivariate analyses between maternal sociodemographic and health behavior characteristics and PPV non-attendance indicated that being unmarried (OR 3.03, 95% CI 2.12–4.31), experiencing infant loss (OR 7.17, 95% CI 2.57–19.97), working during pregnancy (OR 0.44, 95% CI 0.31–0.63) and not receiving dental care (OR 2.03, 95% CI 1.43–2.88) as significant risk factors for PPV non-attendance. After controlling for known and theoretical confounders, experiencing an infant loss (aOR 5.18, 95% CI 1.54–17.4), not receiving dental care (aOR 1.54, 95% CI 1.06–2.26) and working during pregnancy (aOR 0.61, 95% CI 0.41–0.93) emerged as strong predictors of PPV non-attendance. Conclusionsxa0for Practice Mothers who recently experienced an infant death were at greatest risk for not attending a PPV, suggesting the need to establish comprehensive support networks, including grief counseling and additional service reminders for mothers who experienced an infant death.