Zachary Zimmer

Whether to Go and Where to Go: Identification of Important Influences on Seniors' Decisions to Travel

This study focuses on discerning the differences between older adults who travel and those who do not, and also on distinguishing between destination choices. Data show that several variables account for differences among older adults, and consideration is given to the role of continuity theory as one possible explanation of the outcomes.

Family Size and Support of Older Adults in Urban and Rural China: Current Effects and Future Implications

Change in China’s age structure is creating concerns about whether reductions in family size undermine traditional support mechanisms for older adults. Future generations may expect less support as the availability of children declines. In this article, the association between number of children and the receipt of instrumental and financial support is examined for rural and urban populations. Probabilities are modeled as bivariate probits. Coefficients are used to conduct simulations in which support is examined across hypothetical distributions of number of children. The results show that the number of children is an important determinant of support, but future reductions in support may not be as dramatic as anticipated.

A cross-national examination of the determinants of self-assessed health.

Self-assessed health measures are often utilized in surveys of older adults, and these have been found to be powerful predictors of other health indicators and future health. However, there is still much that is puzzling about the measure. Few studies use comparative techniques to ascertain the determinants of self-assessed health across diverse settings. Using recent data from the Philippines, Taiwan, and Thailand, the current study tests whether determinants of self-assessed health are similar across samples and whether there are distinct country effects acting upon the association. Ordered probit models reveal that, on the one hand, the determinants of self-assessed health are relatively similar across the three countries, while, on the other, the overall probabilities of reporting favorable self-assessed health remain differentiated even when controlling for a broad series of determinants. The results suggest that cultural variation in the interpretation of health may be a factor and that more subtle measures should be included in future studies of this nature.

Socioeconomic status and health among older adults in rural and urban China.

Objective: The association between socioeconomic status (SES) and health, which has proven to be quite robust, is rarely tested in societies where levels of economic development and systems of stratification differ from those in Western developed countries. This article examines associations in rural and urban China. Method: Techniques include logit equation estimates of separate and pooled samples. The latter employ interaction terms to test rural and urban effects. Socioeconomic indicators include those more customarily used in these types of studies (e.g., education) and several that are less traditional (e.g., pension eligibility). Results: Results indicate associations exist in China. Bank savings is the strongest predictor. Some unexpected results are also found, including a positive association between socioeconomic status and chronic conditions (e.g., cardiovascular disease) among older adults in urban China. Discussion: Use and access to a health care professional might explain part of this anomaly.

Receptivity to new technology among older adults

PURPOSE Both absolute and relative increases in the older adult population are occurring concurrently with the growth of high technology. Technological devices offer sophisticated solutions to some of the problems associated with ageing. This study borrows from the health utilization literature in order to develop and test a model for understanding receptivity to specific technological products by older adults. RESULTS Receptivity is directly influenced by predispositional, need and social support factors, as well as by ones level of concern for problems that could be alleviated through the use of technology. Hierarchical regression equations reveal that this latter variable, concern, has the strongest influence on receptivity, while need factors display strong indirect effects. Those with unsatisfactory contact with others are also more receptive, suggesting that the lack of social support acts as a need factor. Contrary to past research, women are more receptive to technology than men. CONCLUSIONS The results indicate that new technology geared toward enhancing the quality of life of seniors in their homes would be welcomed by many.

Educational attainment and transitions in functional status among older Taiwanese

Despite considerable research examining the influence of socioeconomic status on health, few studies have considered this relationship as it pertains to older adults in non-Western societies. We attempt to ascertain the influence of education on changes in physical functioning in a rapidly developing country. Data come from the 1989 Survey of Health and Living Status of the Elderly in Taiwan and a follow-up interview in 1993 (N = 4,049, age = 60+). Individuals are conceptualized to be in a state of functional independence or functional limitation at the time of origin, based on their ability to perform three physical functioning tasks. The outcome at the follow-up interview is categorized as functionally independent, limited, or dead, allowing for six probabilities, one from each state of origin to each outcome. These are calculated using a multinomial logit model, controlling for other factors often thought to be associated with health transitions. High levels of educational attainment result in a decreased incidence of functional limitation for those originating in a state of independence. Contrary to expectations, however, education has little influence on those who originate functionally limited. Thus, higher education plays a substantial role in primary prevention of morbidity, delaying the onset of disability, but other factors are more important once limitations begin. We speculate on the reasons behind these findings, including that the results may be culturally dependent.

Socioeconomic status and health among older adults in Thailand: an examination using multiple indicators

A survey of 14,000 Thais, 50 and older, is utilized to test hypotheses about the association between socioeconomic status (SES) and health previously derived through observation of Western populations. Central among hypotheses is the notion that an inverse association can be uniformly detected across a matrix of SES indicators and health outcomes. Indicators of SES in this study include the traditional education, occupation and income measures, and a measure of household possessions. This later indicator may be particularly useful in a non-Western setting such as Thailand. Health outcomes were derived in order to represent a subjective, a social, and a medical conceptualization of health and included measures for self-assessed health, functional disorders and chronic health conditions. All health indicators were dichotomously coded as existence or non-existence. Also tested are associations throughout ordered categories of SES. Results generally support hypotheses. Unadjusted for other SES covariates, all four indicators of status strongly related to two of the three health measures, when controlling for other important covariates. When adjusted for each other, a number of the associations remained strong. There were also several notable exceptions. Little association existed between SES and chronic health disorders. The results may serve to highlight the distinct social environment acting upon the association.

Older Adults in Sub-Saharan Africa Living With Children and Grandchildren

Using data from Demographic and Health Surveys, we examine the composition of households containing older adults in 24 countries of sub-Saharan Africa, with a focus on those living with children and grandchildren. Overall, 59 per cent live with a child and 46 per cent with a grandchild. Men are more likely to live in nuclear households and women in extended households and alone. Regression analyses show that individual-level determinants of household composition differ by sex. For example, living with children and grandchildren is tied to living with a spouse for men, but for women the effect is either not significant or in the opposite direction. Households with an older adult and a grandchild, but no adult children, are common. Usually the adult child lives elsewhere, though about 8 per cent of older adults live with a grandchild who has at least one deceased parent. Older adults are more likely to be living with double-orphans in countries with high AIDS-related mortality.

Changes in functional limitation and survival among older Taiwanese, 1993, 1996, and 1999

Using data from the Survey of Health and Living Status of the Elderly in Taiwan, we investigate changes in difficulties in walking and climbing stairs, tasks that represent basic lower-body movements less likely to be influenced by changes in environment and social roles than are activities and instrumental activities of daily living. Results are shown for unadjusted prevalence rates and rates adjusted for changes in population composition. The findings indicate that Taiwan does not appear to be experiencing the improvements in functioning witnessed recently in the United States. Prevalence of functional limitation increased between 1993 and 1996 and between 1996 and 1999. One possible reason is the change in old-age survival, which appears to have benefited those who have functional limitations, especially in a severe form. The Universal Health Insurance programme, established in 1995, may have increased access to care and thus the survival of those in poorest health.

Mobility Restriction and the Use of Devices among Seniors

A growing population of seniors in North America, coupled with increasing life expectancies, means there will likely be increased future demand for products to alleviate mobility problems commonly faced by elders. Although past research has documented the prevalence of mobility restriction among elderly populations, and the tendency of some to seek personal assistance to alleviate their difficulties, there is little research that looks at the use of assistive devices. This study examines use among those faced with at least one of four common mobility problems. Logistic regression and analysis of variance reveal the overwhelming importance of the sheer number of mobility restrictions in determining the likelihood that an individual is a device user, over and above factors such as the severity of problems, social network characteristics, and predisposition factors.