Wendy M. Parker

Military Service and Men's Health Trajectories in Later Life

OBJECTIVES This study examines differences in the relationship between veteran status and mens trajectories of health conditions, activities of daily living limitations, and self-rated health. METHODS We use data on 12,631 men drawn from the 1992-2006 waves of the Health and Retirement Study to estimate growth curve models that examine differences in health trajectories between nonveterans and veterans, veterans with and without wartime service, and war service veterans who served during World War II, Korea, Vietnam, and multiple wars. RESULTS The results indicate that veterans have better health at the mean age of 66.2 years, but experience greater age-related changes in health than nonveterans. Similarly, men who served during wartime have better health at the mean age, but more age-related changes in health than men who did not serve during wartime. Among war veterans, Vietnam veterans are in poorer health at the mean age, but they experience less substantial age-related health changes than men who served during previous wars. DISCUSSION Although veterans experience better health relative to nonveterans around retirement age, they have poorer health than nonveterans among the oldest old. These findings inform our understanding of the veteran-nonveteran health-mortality paradox found in previous research and suggest a health crossover among veterans and nonveterans in later life.

How Money Matters: College, Motherhood, Earnings, and Wives’ Housework

Using new data from the American Time Use Survey (ATUS), the authors consider how educational and parental status influence the relationship between wives’ relative earnings and the time they devote to housework in a climate of heightened gender egalitarianism and growing similarity between women’s and men’s time use. The authors capitalize on the large samples in the American Time Use Survey to study four groups of wives whose varying educational and parental statuses strengthen tests of theoretical claims regarding bargaining, gender display, and wives’ autonomy. Among wives with children at home and without a college degree, the authors find that relative earnings bear a curvilinear relationship to housework time, supporting predictions derived from exchange and gender display theories. Among wives with children and a college degree, and among wives without children regardless of degree status, relative earnings are unrelated to housework. In contrast, wives’ own earnings are inversely related to housework time across all four groups. The authors’ analyses suggest that educational and parental contexts jointly shape the relationship between wives’ earnings and their housework and the relative importance of bargaining, gender display, and autonomy.

Gender, aging, and social policy

Publisher Summary The US has undergone substantial social and demographic changes over the last several decades, and many of the gender gaps have narrowed. This chapter reviews the theoretical, empirical, and policy-related research on gender differences in old age in the US. It summarizes two key socio-demographic trends—changes in marriage and care work—that shape gender differences in old age. It then examines gender differences in income and health, and explores the degree to which these are addressed by current old age policies in the US. Two key factors, increases in single parenting and the increasing intensity of unpaid care work, continue to shape gender inequality across the life course and well into old age. Gender differences in health, and in access to various types of health benefits, vary significantly across the life course. Finally, this chapter evaluates some policy solutions that could reduce gender inequality in old age. When analyzing gender inequality, old age scholars tend to highlight how social and economic factors constrain individual actions across the life course. Old age scholars will continue to analyze how the recent emphasis on cutting costs and on privatizing public benefits has overshadowed policy proposals that have the potential to make existing programs more responsive to changing social and demographic trends.

Incarceration and Living Arrangements: Findings From the National Health and Social Life Survey

The authors use data from the 1992 National Health and Social Life Survey to examine the association between incarceration and living arrangements, net of a range of sociodemographic and early life characteristics. Relative to living with a spouse and child(ren), there is evidence that a history of incarceration is strongly associated with several nonnuclear living arrangements, including living alone, as a sole adult with child(ren), with a partner and child(ren), with a partner but no child, and with other family but no spouse, partner, or child. These living arrangements may be indicative of lower levels of social integration, which have potentially serious consequences for these individuals as well as their families and communities. The authors discuss these results with reference to the decades-long, unprecedented mass incarceration that is ongoing in the United States today.

The Changing Worlds of Family and Work

In the United States, the worlds of family and work are often incongruent. Much has changed since the Leave It to Beaver era of the 1950s, when men worked primarily outside the home and women worked primarily inside the home. In the past several decades, aging and life course scholars have documented and analyzed unprecedented increases in single mothers raising children; widespread entry of women, particularly mothers of young children, into the labor force; and modest increases in men’s contributions to the unpaid house work and child care at home (Glass 2000). In some respects, these trends have narrowed gender gaps, but in other respects these trends have collided, leaving many women, and a growing share of men, feeling mounting pressures at home and at the office. Moreover, the efforts to juggle work and family responsibilities with few supports from the welfare state or employers leaves many ill prepared for the financial challenges of their own old age. This chapter explores these changing trends and their impact on the ways in which families balance paid and unpaid work over the life course. We pay special attention to differences between women and men and to differences among women by race, class, and marital status. We focus on how the presence of certain US policies, and the absence of others, shapes both the ways that families balance work and family obligations and the implications of that balance on economic security in later life.

Bad moms, blameless dads: The portrayal of maternal and paternal age and preconception harm in U.S. newspapers

ABSTRACT Background: Although much is known scientifically about maternally and paternally mediated fetal harms, there has been little research examining how these harms are portrayed in the media. The objective of this study was to examine how maternal and paternal age-related harm is portrayed in contemporary U.S. newspapers.Methods: A content analysis was undertaken of 64 newspaper articles after systematic searching and selection of articles based on inclusion criteria. A coding framework was developed and used to analyze articles for tone. The text of the articles was analyzed for one or more of eight tones, which were correlated with the main article focus and gender of author. Results: Most articles were maternally focused, and only 6% of articles were equally focused on both women and men. Most U.S. newspaper articles focused on maternal age-related harms, and negative tones were often used to describe older parents, especially for women. In contrast, paternal age-related harms were less likely to be discussed and tended to include more reassuring tones. Conclusions: Authors of newspaper articles should employ more balanced perspectives and gender-neutral tones when discussing age-related preconception harm.

Multidisciplinary views toward pharmacist-delivered medication therapy management services in dialysis facilities

OBJECTIVE To determine views of staff of dialysis centers toward pharmacist-delivered medication therapy management (MTM) services. DESIGN Focus group study. SETTING Three private, nonprofit, outpatient dialysis facilities. PARTICIPANTS Multidisciplinary dialysis staff. INTERVENTION Two focus group sessions were conducted using a semistructured interview guide. MAIN OUTCOME MEASURES Views of staff toward MTM services at a dialysis center. RESULTS A total of 13 staff members of dialysis centers participated in the study. Participants included nurses, patient care technicians, a social worker, dietitian, and administrative personnel. Key themes included: the need for access to MTM services in dialysis facilities exists; services should include medication reconciliation and patient education; services should be proactive, consistent, individualized, and covered by insurance; and that pharmacists are uniquely suited to provide MTM services. CONCLUSION Dialysis staff support the integration of MTM services in facilities. Further research is needed to identify barriers and opportunities in the implementation process, including patient perspectives.

The Use of Social Media to Recruit Participants With Rare Conditions: Lynch Syndrome as an Example

Background Social media is increasingly being used as a means of recruiting participants, particularly for investigators whose areas of interest involve rare conditions or hard-to-reach populations. However, much of the literature to date has focused on paid advertisement recruitment. Objective We used Lynch syndrome (LS), a rare hereditary cancer syndrome, as a model to demonstrate the successful partnership between researchers and a Web-based patient education and advocacy organization to facilitate participant recruitment. Methods Recruitment was undertaken in partnership with Lynch Syndrome International (LSI), an advocacy organization with a strong social media presence. After LSI published our study information, participants followed up via email or phone call. Following prescreening and consent, interested and eligible participants were then sent a secure survey link. Results Within 36 hours of a single Facebook post by the site administrators for LSI, over 150 individuals responded via phone or email. Sixty-five individuals were sent the survey link and 57 individuals completed the survey (88% response rate). Of note, these 57 individuals were geographically diverse within the Unites States, representing LS patients from 26 different states. Conclusions This approach has several advantages, including recruitment through a trusted source outside of a clinical setting, higher response rates, and cost-effectiveness with a small research team in a relatively short amount of time. Overall, social media recruitment with a trusted online partner can be highly effective in hard-to-reach clinical populations, such as patients with LS. However, this approach requires additional effort for eligibility screening.

Experiential Education Builds Student Self-Confidence in Delivering Medication Therapy Management

To determine the impact of advanced pharmacy practice experiences (APPE) on student self-confidence related to medication therapy management (MTM), fourth-year pharmacy students were surveyed pre/post APPE to: identify exposure to MTM learning opportunities, assess knowledge of the MTM core components, and assess self-confidence performing MTM services. An anonymous electronic questionnaire administered pre/post APPE captured demographics, factors predicted to impact student self-confidence (Grade point average (GPA), work experience, exposure to MTM learning opportunities), MTM knowledge and self-confidence conducting MTM using a 5-point Likert scale (1 = Not at all Confident; 5 = Extremely Confident). Sixty-two students (26% response rate) responded to the pre-APPE questionnaire and n = 44 (18%) to the post-APPE. Over 90% demonstrated MTM knowledge and 68.2% completed MTM learning activities. APPE experiences significantly improved students’ overall self-confidence (pre-APPE = 3.27 (0.85 SD), post-APPE = 4.02 (0.88), p < 0.001). Students engaging in MTM learning opportunities had higher self-confidence post-APPE (4.20 (0.71)) vs. those not reporting MTM learning opportunities (3.64 (1.08), p = 0.05). Post-APPE, fewer students reported MTM was patient-centric or anticipated engaging in MTM post-graduation. APPE learning opportunities increased student self-confidence to provide MTM services. However, the reduction in anticipated engagement in MTM post-graduation and reduction in sensing the patient-centric nature of MTM practice, may reveal a gap between practice expectations and reality.

Where Is the Pill for the “Reproductive Man?”: A Content Analysis of Contemporary US Newspaper Articles

We used content analysis methodology to examine the reasons newspaper articles (n = 121) provide for why we do not have new male contraceptives (NMCs). Articles were six times more likely to state that developing NMCs is good than bad. Yet half of all articles noted the safety or side effects of NMCs, which could leave the public with a sense of confusion or hesitation around the science and interest in NMCs. Our results indicate that while articles recognize the advantages of NMCs and are ostensibly supportive of them, we as a society are not yet culturally ready for them. We highlight the emergence of a new cultural narrative regarding men and contraceptive responsibility, which we refer as the “reproductive man” because he considers himself a reproductive being who needs to take ownership and responsibility for his reproductive activity and decisions.