Rose M. Rubin

Race, disability and assistive devices: sociodemographics or discrimination

This research provides empirically‐based, detailed information on race as a determinant of the relationship between chronic illness/disability and assistive device use by elderly persons. The database is the 1994 wave of the National Long Term Care Survey. The important findings are: whites are more likely to use home modification devices and blacks are more likely to use portable devices; chronic conditions vary in their influence on the use of assistive devices; the joint presence of diabetes, heart conditions or hypertension with ADLs and IADLs motivates greater assistive device use; the relationships between chronic health conditions and assistive device use vary by race; for blacks, income has the largest impact on assistive device purchases; half of the racial differences in the probability of using assistive devices is explained by differences in sociodemographic characteristics and the rest is explained, in part, by discrimination.

Healthy Life Expectancy for Selected Race and Gender Subgroups: The Case of Tennessee

Objective: To analyze healthy life expectancy (HLE) for major racial and gender subgroups, based on the diverse population of Tennessee and compared with the United States. Materials and Methods: We use life table methodology and the HLE calculation model of the National Center for Health Statistics (NCHS), using two databases for 2001: NCHS National Vital Statistics Reports life tables and CDC Behavioral Risk Factor Surveillance System (BRFSS) survey. Results: For Tennessee, although average total life expectancy (TLE) is 73.6 years at birth, only 61.1 years of “good” health are expected. Substantial racial and gender differences are found in both TLEs and HLEs with black males having the lowest and white females the highest. Although females have longer TLE, they spend more years in an unhealthy state than males. Conclusions: The findings raise new challenges for researchers and health policy makers for accomplishing the dual goals of longer life expectancy and elimination of health disparities among population subgroups.

Economic adjustments of households on entry into retirement

This study focuses on economic adjustment to a major life-cycle turning point, the entry into full retirement, and its immediate impact on income and spending patterns. Cross-sectional data from the Bureau of Labor Statistics Consumer Expenditure Survey interview tapes are analyzed for 1984-1987. Tobit regression analysis of socioeconomic variables on 31 expenditure categories reveals significant increased proclivities to spend on transportation, health, entertainment, and trips immediately after retirement. Older retirees spend less than do younger retirees for all expenditure categories except health insurance and gifts. Singlefemales suffer the most substantial decline in postretirement income, but this is not offset by concurrent expenditure decreases. This unsustainable dissaving rate after retirement poses a severe problem for single women.

Delayed Effects of Obese and Overweight Population Conditions on All-Cause Adult Mortality Rate in the USA.

Currently, there are few studies separating the linkage of pathological obese and overweight body mass indices (BMIs) to the all-cause mortality rate in adults. Consequently, this paper, using annual Behavioral Risk Factor Surveillance System data of the 50 US states and the District of Columbia, estimates empirical regression models linking the US adult overweight (25 ≤ BMI < 30) and obesity (BMI ≥ 30) rates to the all-cause deaths rate. The biochemistry of multi-period cumulative adiposity (saturated fatty acid) from unexpended caloric intakes (net energy storage) provides the natural theoretical foundation for tracing unhealthy BMI to all-cause mortality. Cross-sectional and panel data regression models are separately estimated for the delayed effects of obese and overweight BMIs on the all-cause mortality rate. Controlling for the independent effects of economic, socio-demographic, and other factors on the all-cause mortality rate, our findings confirm that the estimated panel data models are more appropriate. The panel data regression results reveal that the obesity-mortality link strengthens significantly after multiple years in the condition. The faster mortality response to obesity detected here is conjectured to arise from the significantly more obese. Compared with past studies postulating a static (rather than delayed) effects, the statistically significant lagged effects of adult population BMI pathology in this study are novel and insightful. And, as expected, these lagged effects are more severe in the obese than overweight population segment. Public health policy implications of this social science study findings agree with those of the clinical sciences literature advocating timely lifestyle modification interventions (e.g., smoking cessation) to slow premature mortality linked with unhealthy BMIs.

The impact of Medigap insurance on out-of-pocket health expenditures by older Americans over the 1980s

This study presents a comparative analysis of out-of-pocket health expenditures over the 1980s by older Americans with and without Medigap (supplemental) insurance. The objective is to analyze changes during the 1980s in the pattern of health expenditures and in the financing of those health expenditures by households age 65 and over. Two-stage regression analysis shows that health goods and services are normal goods. Out-of-pocket health expenditures, excluding insurance premiums, are higher for those with Medigap insurance, which may be explained by the market failures of moral hazard and adverse selection.

The health insurance status of Texans: Determinants of uninsurance (summary)

This is a report of a statewide survey of the numbers and characteristics of the uninsured, giving a profile of the uninsured in Texas.

Power and decision making in health care

(1985). Power and decision making in health care. Forum for Social Economics: Vol. 15, No. 2, pp. 43-61.