Suzanne Kunkel

Longevity Increased by Positive Self-Perceptions of Aging

This research found that older individuals with more positive self-perceptions of aging, measured up to 23 years earlier, lived 7.5 years longer than those with less positive self-perceptions of aging. This advantage remained after age, gender, socioeconomic status, loneliness, and functional health were included as covariates. It was also found that this effect is partially mediated by will to live. The sample consisted of 660 individuals aged 50 and older who participated in a community-based survey, the Ohio Longitudinal Study of Aging and Retirement (OLSAR). By matching the OLSAR to mortality data recently obtained from the National Death Index, the authors were able to conduct survival analyses. The findings suggest that the self-perceptions of stigmatized groups can influence longevity.

A World Apart? Bridging the Gap Between Theory and Applied Social Gerontology

This article is based on the premise that there is inadequate attention to the link between theory and applied research in social gerontology. The article contends that applied research studies do not often or effectively employ a theoretical framework and that theory-based articles, including theory-based research, are not often focused on questions related to applied social gerontology. We explore the extent to which theory and applied research could reasonably be expected to overlap, present data from an analysis of 5 years of articles in three leading journals, and posit some possible explanations for the current divide between theory and applied social gerontology research. We argue that the divide weakens research and inhibits the functions that theory can play in helping to organize the accumulation of knowledge, and we offer some suggestions about how the field can address this challenge, including changes to the journal review and submission process to reflect the importance of the link between theory and/or conceptual models and research, and an expansion of professional conference opportunities to link research and practice.

An international comparison of the association among literacy, education, and health across the United States, Canada, Switzerland, Italy, Norway, and Bermuda: implications for health disparities.

The relationship between education and health is well-established, but theoretical pathways are not fully understood. Economic resources, stress, and health behaviors partially explain how education influences health, but further study is needed. Previous studies show that health literacy mediates the education–health relationship, as do general literacy skills. However, little is known whether such mediation effects are consistent across different societies. This study analyzed data from the International Assessment of Adult Literacy and Life Skills Survey conducted in Canada, the United States, Italy, Norway, Switzerland, and Bermuda to investigate the mediation effects of literacy on the education–health relationship and the degree of such mediation in different cultural contexts. Results showed that literacy skills mediated the effect of education on health in all study locations, but the degree of mediation varied. This mediation effect was particularly strong in Bermuda. This study also found that different types of literacy skills are more or less important in each study location. For example, numeracy skills in the United States and prose (reading) literacy skills in Italy were stronger predictors of health than were other literacy skills. These findings suggest a new direction for addressing health disparities: focusing on relevant types of literacy skills.

Everyone’s Talking About It, But Does It Work? Nursing Home Diversion and Transition

In response to increasing Medicaid expenditures and consumer preferences, states are reforming their long-term care systems to provide more community-based services. One popular reform is renewed efforts to prevent unnecessary long-term nursing home placement (diversion) and to provide nursing home residents an opportunity to return to the community (transition). Nearly 3,800 individuals, 60 years old and older, participated in Ohio’s statewide nursing home diversion and transition initiative between March 2010 and May 2011. This research tracked outcomes for consumers and evaluated the implementation of the new program. Nearly 80% of diversion and transition participants who were still living at the time of their 6-month follow-up were residing in the community. An agency-level process analysis revealed innovative intervention strategies, promising practices, and barriers. Process results found that Area Agencies on Aging (AAAs) have become more proactive in working with high-risk individuals, with agencies identifying new at-risk consumers through hospital and nursing home interventions.

Geographic Access to Healthy and Unhealthy Foods for the Older Population in a U.S. Metropolitan Area

Poor nutrition is known to be associated with a number of adverse health outcomes; adequate nutrition is related to a large number of factors, including geographic access to healthy foods. Access to healthy foods can be especially challenging for older people with any kind of transportation or mobility limitations. In addition, some older populations may have reduced access to healthy foods because of the unavailability of food outlets in their neighborhoods. Using the geographic information system (GIS), this study assessed census block level geographic accessibility to healthy and unhealthy food outlets in one county in Ohio. It was found that there was a noticeable disparity in geographic access to food outlets in this older population, depending on which part of the county they live in. These findings have implications for future public health research and policy planning.

Sample size requirements for studying small populations in gerontology research

Calculating sample sizes required to achieve a specified level of precision when estimating population parameters is a common statistical task. As consumer surveys become increasingly common for nursing homes, home care agencies, other service providers, and state and local administrative agencies, standard methods to calculate sample size may not be adequate. Standard methods typically assume a normal approximation and require the specification of a plausible value of the unknown population trait. This paper presents a strategy to estimate sample sizes for small finite populations and when a range of possible population values is specified. This sampling strategy is hierarchical, employing first a hypergeometric sampling model, which directly addresses the finite population concern. This level is then coupled with a beta-binomial distribution for the number of population elements possessing the characteristic of interest. This second level addresses the concern that the population trait may range over an interval of values. The utility of this strategy is illustrated using a study of resident satisfaction in nursing homes.

Care managers as research interviewers: A test of a strategy for gathering consumer Satisfaction information

Care managers from local Area Agencies on Aging, operating Ohio’s home- and community based waiver program (PASSPORT), were trained as research interviewers to collect consumer satisfaction data from clients receiving in-home services using the Home Care Satisfaction Measure (Geron, Smith, Tennstedt, Jette, Chassler, & Kasten, 2000). The data for homemaker and home health aide scales were comparable to those collected by independent research interviewers for interrater reliability and showed no significant difference between the two groups. The scores on the home-delivered meals index obtained by care managers were slightly but significantly higher than those obtained by the research interviewers. A slight, but significant, difference was found on the home-delivered meals index, although differences between most individual items were not significant. Overall, findings indicate that care managers, when appropriately trained, can collect reliable, scientifically sound data, providing a cost-effective method for collecting satisfaction information from consumers receiving in-home care.

Globalization of gerontology education: current practices and perceptions for graduate gerontology education in the United States.

The purpose of this study is to document current practices and understandings about globalization of gerontology education in the United States. Better understanding of aging requires international perspectives in global communities. However, little is known about how globalization of gerontology education is practiced in U.S. graduate-level degree programs. The authors conducted qualitative interviews with representatives of the Association for Gerontology in Higher Education, the major national organization supporting higher education in gerontology, graduate program directors, and students. Although all respondents expressed their interest in globalizing gerontology education, actual practices are diverse. The authors discuss suggested conceptualization and strategies for globalizing gerontology education.

Wanted Dead or Alive: Implication of Death Classification on Longevity.

To determine who is dead or alive, many researchers, policy makers, and corporations have relied on the National Death Index (NDI). This study investigates the impact of using NDI information to establish mortality status upon longevity analyses. A community sample of 694 individuals, enrolled in the Ohio Longitudinal Study of Aging and Retirement in 1975, participated. The authors compared the survival of two groups of these participants: those for whom death information came from clear matches with NDI and those for whom death information was based on both NDI information and supplementary information, such as community informants. Those in the expanded group tended to have significantly shorter survival than those in the strict group. Findings suggest that using limited NDI information alone may falsely increase longevity. Use of NDI offers numerous benefits, but incomplete or inaccurate classification of mortality status may affect study results.

Marking our passagesFerraroKenneth F.2018. The Gerontological Imagination: An Integrative Paradigm of Aging. New York, NY: Oxford University Press, 204 pp. ISBN: 978-0-19-066534-0.

Ferraro’s (1990) new book is a welcome expansion of pivotal ideas that he first articulated in a book chapter more than 25 years ago. The evolving refinement of the tenets of the gerontological imagination (GI) in subsequent editions of the book continued to shape numerous conversations about the scope and unique domain of the field of gerontology. The Gerontological Imagination is organized around the six axioms of the original formulation but adds significant depth, finds some common ground on enduring debates, and makes stronger claims about the unifying dimensions of the field. In doing so, this book marks an important stage in the evolution of gerontology as a rigorous and unique field of research and education. The debate about whether gerontology is a discipline and who gets to decide continues with strong opinions on either side. Ferraro remains steadfast in his claim that gerontology is not a discipline, but he makes an eloquent case for the maturity of the multidisciplinarity of the field. He argues that there is a “paradigm in the making,” a shared view of our subject matter that can be used as a gauge for the extent to which gerontology is “more than a collection of scientific specializations.” The point at which a scholarly endeavor can and should claim disciplinary status continues to be open for debate, and I continue to disagree with my esteemed colleagues. That disagreement does not minimize the value of this new book in its entirety or its significance for the continued progression of the field. Here, I highlight four specific ideas presented in the book because of their heuristic and conceptual power and because of their potential for further dialogue and development of the emerging paradigm Ferraro presents.