Health shocks and retirement: the role of welfare state institutions.
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ABSTRACT:
SUBMITTER: Datta Gupta N
PROVIDER: S-EPMC5546283 | biostudies-other | 2007 Sep
REPOSITORIES: biostudies-other
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Project description:BackgroundChina is facing the challenge of rising prevalence and ballooning burden of chronic non-communicable diseases (NCDs); however, the Chinese middle- and older-aged population considerably lack preventive behaviors. Health shocks (HS), widely defined as sudden health deterioration brought on by diseases or accidents, bring a "teachable moment" to motivate changes in preventive behaviors.ObjectiveThis study aims to examine the effect of HS on changes in preventive behaviors, including personal health practices and preventive care utilization.MethodsHS was defined as any five chronic disease diagnoses (cancer, heart disease, stroke, diabetes, and hypertension). The impacts of HS on smoking, drinking, and exercise, physical examination were estimated. The panel data of 13,705 respondents were obtained from the latest two waves of the China Health and Retirement Longitudinal Study (CHARLS) in 2015 and 2018. A multilevel propensity score match difference-in-difference (multilevel PSM-DID) model was constructed.ResultsHS significantly decreased smoking (OR = 0.59, p < 0.05) and drinking (OR = 0.62, p < 0.01) and increased the utilization of auxiliary inspection in physical examination (OR = 1.19, p < 0.1). Major HS had significantly considerable and specific effects on reducing smoking and drinking (OR = 0.37 and 0.56, p < 0.01), while minor HS had relatively small effects on reducing smoking (OR = 0.74, p < 0.05) and drinking (OR = 0.69, p < 0.01), but extensive effects on initiating exercise (OR = 1.32, p < 0.05), physical examination (OR = 1.18, p < 0.1), and auxiliary inspection (OR = 1.30, p < 0.05).ConclusionAfter HS, there is a teachable moment to promote positive changes in preventive behaviors. Guided by the 5A's brief intervention model (Ask, Advise, Assess, Assist, Arrange), tailored interventions should be targeted at these populations to reduce the risk of the progression and complications of existing diseases, prevent the related comorbidity, and prolong the expected life-span.
| S-EPMC9363769 | biostudies-literature
Project description:BackgroundThe past decade has witnessed a growing body of research on welfare state characteristics and health inequalities but the picture is, despite this, inconsistent. We aim to review this research by focusing on theoretical and methodological differences between studies that at least in part may lead to these mixed findings.MethodsThree reviews and relevant bibliographies were manually explored in order to find studies for the review. Related articles were searched for in PubMed, Web of Science and Google Scholar. Database searches were done in PubMed and Web of Science. The search period was restricted to 2005-01-01 to 2013-02-28. Fifty-four studies met the inclusion criteria.ResultsThree main approaches to comparative welfare state research are identified; the Regime approach, the Institutional approach, and the Expenditure approach. The Regime approach is the most common and regardless of the empirical regime theory employed and the amendments made to these, results are diverse and contradictory. When stratifying studies according to other features, not much added clarity is achieved. The Institutional approach shows more consistent results; generous policies and benefits seem to be associated with health in a positive way for all people in a population, not only those who are directly affected or targeted. The Expenditure approach finds that social and health spending is associated with increased levels of health and smaller health inequalities in one way or another but the studies are few in numbers making it somewhat difficult to get coherent results.ConclusionsBased on earlier reviews and our results we suggest that future research should focus less on welfare regimes and health inequalities and more on a multitude of different types of studies, including larger analyses of social spending and social rights in various policy areas and how these are linked to health in different social strata. But, we also need more detailed evaluation of specific programmes or interventions, as well as more qualitative analyses of the experiences of different types of policies among the people and families that need to draw on the collective resources.
| S-EPMC3909317 | biostudies-literature
Project description:BACKGROUND:Research has recently suggested that retirement may decrease cognitive engagement, resulting in cognitive aging. Few studies have systematically documented whether or how selectivity into retirement shapes the relationship between retirement and cognitive aging. METHODS:We draw on data from the Health and Retirement Study (1998-2012) to examine the relationship between cognition and retirement for 18,575 labor force participants. Longitudinal regression discontinuity modeling was used to examine performance and decline in episodic memory. Models differentiated three forms of selection bias: indirect and direct selection as well as reverse causation. To further interrogate the disuse hypothesis, we adjust for confounding from health and socioeconomic sources. RESULTS:Results revealed that individuals who retired over the course of the panel were substantially different in terms of health, wealth and cognition when compared to those who remained employed. However, accounting for observed selection biases, significant associations were found linking longer retirement with more rapid cognitive decline. DISCUSSION:This study examined respondents who were in the labor force at baseline and transitioned into retirement. Analyses suggested that those who retired over the course of the panel had worse overall functioning, but also experienced more rapid declines after retirement that increased the rate of aging by two-fold, resulting in yearly losses of 3.7% (95% CI = [3.5, 4.0]) of one standard deviation in functioning attributable to retirement. Results are supportive of the view that retirement is associated with more rapid cognitive aging.
| S-EPMC5400287 | biostudies-literature
Project description:ObjectiveTo analyze whether there was an increase in retirement or in part-time work among older workers after January 2014, when new health insurance coverage options became available because of the Affordable Care Act (ACA).MethodWe analyze trends in retirement and part-time work for individuals aged 50-64 years in the basic monthly Current Population Survey from January 2008 through June 2016. We test for a break in trend in January 2014. We also test for differences in trends, both before and after 2014, in states that expanded their Medicaid programs in January 2014 under the ACA compared with those that did not.ResultsWe find that there was no change in the probability of retirement or part-time work among older workers in 2014 and later, either overall or in Medicaid expansion states relative to nonexpansion states.DiscussionAlthough many observers had predicted that an unintended consequence of health reform would be reduced labor supply, we find no evidence of this for older workers in the first 2.5 years after the law's major coverage provisions took effect.
| S-EPMC6019028 | biostudies-literature
Project description:A body of research dating back to Durkheim has linked religious environments to population health and mortality rates. Scholars have argued that local religious subcultures influence population health through important pathways, including a community's propensity to invest in health-shaping institutions - such as public hospitals. A noticeable shortcoming of this literature, however, is a lack of evidence that these mechanisms exist as proposed. This study uses county-level data from the 2010 Religious Congregations and Membership Study and the 2012 U.S. Census of Governments to examine contextual religion's relationship with public investment in health-shaping institutions. Findings suggest that associations between religious traditions and institutional investment explain a significant and notable portion of the total effect of these traditions on mortality rates. This manuscript applies a more refined approach to studying health-shaping investment, and the results suggest interesting new directions in the study of cultural determinants of population health.
| S-EPMC7492463 | biostudies-literature
Project description:It remains unclear whether retirement circumstances are associated with better or worse post-retirement health. This is partly due to confounding between measures of retirement circumstances and a tendency to account only for covariates around retirement age. The present study examined the contributions of both retirement age and retirement type, independently, to post-retirement health around age 77 years. It also examined whether these contributions remain once earlier life-course factors - social class, cognitive ability and education - were accounted for. Our sample was 742 Scottish people who took part in the Scottish Mental Survey 1947. In a path model including life-course predictors, retirement type (reason), but not age, significantly predicted post-retirement health, with ill-health retirement associated with poorer physical (β = 0.455, 95% CI [0.313, 0.597], p < 0.001) and mental health (β = 0.339, 95% CI [0.191, 0.486], p < 0.001), and redundancy retirement associated with poorer physical health only (β = 0.200, 95% CI [0.069, 0.331], p = 0.004). Of the life-course predictors, higher adult social class was associated with later retirement (β = 0.115, 95% CI [0.034, 0.196], p = 0.006) and higher childhood cognitive ability was associated with increased odds of voluntary retirement (OR = 1.054, 95% CI [1.005, 1.105], p = 0.032), but no indirect contribution to health (mediated by retirement circumstances) was significant. At the same time, higher childhood cognitive ability directly predicted better post-retirement physical health (β = -0.110, 95% CI [-0.216, -0.004], p = 0.041), independently of retirement circumstances. This study demonstrates the importance of considering retirement circumstances beyond age, and of accounting for confounding between retirement circumstances and earlier life-course factors.
| S-EPMC6580092 | biostudies-literature
Project description:The tremendous job loss and wage cuts during the COVID-19 pandemic raises concerns about the mental health of the population. The impacts of income shocks on mental health may differ across U.S. states during the pandemic, as states have different policy contexts that likely influence mental health. The present study uses survey data from the Census Bureau's Household Pulse Survey (April-July 2020) to examine whether mental health outcomes vary across U.S. states and to what extent specific state-level contexts moderate the associations between household income shocks and depression (n = 582,440) and anxiety (n = 582,796). We find that the prevalence of depression and anxiety differs across states by household income shock status. For individuals, living in a state with supportive social policies - primarily those related to Medicaid, unemployment insurance, and suspended utility shut offs during the pandemic - weakens the association between household income shocks and mental health. Findings suggest that the lack of a strong federal response to the pandemic alongside the devolution of federal power to states over the past 40 years contributes to inequalities in mental health across states. We provide insight about how specific existing and emergency-related policies can reduce adverse mental health consequences of household income shocks.
| S-EPMC7781085 | biostudies-literature
Project description:The stigmatizing nature of the US welfare system is of particular importance not only because it has shown to deter eligible applicants from participating in public assistance programs despite facing economic hardship, but also because stigma is an important fundamental cause of health inequities. Although scholars agree stigma is shaped by individual and contextual dimensions, the role of context is often overlooked. Given the heterogeneous nature of US state welfare environments, it may be critical to consider the ways in which state policy, social and economic contexts condition the relationship between welfare stigma and health. Using a multilevel lens, this study first examined the impact of experienced and perceived welfare stigma on self-reported health among female public assistance recipients with children. Second, we assessed the moderating effect of uneven state TANF policies, income inequality, and negative public welfare attitudes in shaping these associations. Using data from the Fragile Families and Child Wellbeing Study merged with state-level economic and social measures, we employed a series of multilevel logit models with random effects. Findings show experiences and perceptions of welfare stigma are significantly linked to poor health regardless of state contexts, and outcomes vary markedly by race, ethnicity and education. States with strong anti-welfare attitudes amplified the relationship between experienced welfare stigma and poor health for Black and Hispanic mothers, and state economic contexts modified the relationship between experienced welfare stigma and poor health for mothers with less than a high school education. TANF generosity had no moderating effect on health suggesting state policy environments have limited ability to protect welfare recipients against the stigmatizing effects of the US welfare system. Results have implications for explaining stigma related disparities in health within the context of U.S. welfare environments and informing policies that may be key levers for reducing health inequities.
| S-EPMC9127679 | biostudies-literature
Project description:Many articles have shown the benefits of operant conditioning training techniques in the care and welfare of several species of nonhuman primates; however, the information regarding their use in strepsirrhine species is scarce. We assessed the development and current status of training programs with these species in North American institutions. An online survey was distributed through members of the Association of Zoos and Aquariums using a multiple-choice format. We collected information related to training program details; animals, behaviors, and techniques; the evaluation process; and the impact of training. Seventy-one organizations completed the survey, with the results showing that 97% of respondents trained their strepsirrhines with the main objective of husbandry and veterinary care (around 80%). Sixty-eight percent of organizations did not report any risk in training these species. The benefits reported include increases in positive human-animal interactions (97%), psychological well-being (88%), and staff awareness of animal behaviors (90%). However, a multi-dimensional approach to measure the efficacy of training could provide a deeper understanding of its impact on the welfare of strepsirrhine primates. We hope that the data offered in this survey can help in this future assessment.
| S-EPMC8388707 | biostudies-literature
Project description:<p><b>Description:</b> The University of Michigan Health and Retirement Study (HRS) is a longitudinal survey of a representative sample of Americans over the age of 50. Supported by the National Institute on Aging (NIA U01AG009740) and the Social Security Administration, the HRS is designed to provide reliable data on the decisions, choices, and behaviors of people as they age and respond to changes in public policy, the economy, and health.</p> <p>The study obtains information every two years about income and wealth, health and use of health services, work and retirement, and family connections. Through its unique and in-depth interviews, the HRS provides an invaluable and growing body of multidisciplinary data that researchers can use to address important questions about the challenges and opportunities of aging. Because of its innovation and importance, the HRS has become the model and hub for a growing network of harmonized longitudinal aging studies around the world.</p> <p><b>Origins of the HRS.</b> As the population ages it is increasingly important to obtain reliable data about aging and topics that are relevant to a range of policy issues in aging. To address this need, the National Institutes on Aging (NIA) established a cooperative agreement with the University of Michigan Institute for Social Research to collect such data. The HRS launched data collection in 1992 and has re-interviewed the original sample of respondents every two years since then. By adding new cohorts and refreshing the sample, the HRS has grown to become the largest, most representative longitudinal panel study of Americans 50 years and older.</p> <p><b>HRS Study Design.</b> The target population for the original HRS cohort includes all adults in the contiguous United States born during the years 1931-1941 who reside in households, with a 2:1 oversample of African-American and Hispanic populations. The original sample is refreshed with new birth cohorts (51-56 years of age) every six years. The sample has been expanded over the years to include a broader range of birth cohorts as well. The target population for the AHEAD survey consists of United States household residents who were born in 1923 or earlier. Children of the Depression (CODA) recruits households born 1924-1930, Warbabies 1942-47, Early Boomers 1948-53, and Mid-Boomers 1954-59. The current sample is over 26,000 persons in 17,000 households.</p> <p>Data collection includes a mixed mode design combining in-person, telephone, mail, and Internet. For consenting respondents, HRS data is linked at the individual level to administrative records from Social Security and Medicare claims.</p> <p><b>Genetic Research in the HRS.</b> The HRS is now genotyping 2.5 million single nucleotide polymorphisms (SNPs) on respondents using Illumina's Human Omni2.5-Quad (Omni2.5) BeadChip methodology. The genotyping is being performed by the NIH Center for Inherited Disease Research (CIDR). Saliva was collected on half of the HRS sample each wave starting in 2006. In 2006, saliva was collected using a mouthwash collection method. In 2008, the data collection method switched to the Oragene kit. Saliva completion rates were 83% in 2006 and 84% in 2008. Based on prior rates of consent and completion, we expect an additional 6,000 Oragene samples to be added by 2012, including a substantial expansion of the minority sample. </p> <p><b>HRS Phenotypic data.</b> Phenotypic data are available on a variety of dimensions. Health measures include physical/psychological self-report, various health conditions, disabilities; cognitive performance; health behaviors (smoking, drinking, exercise), physical performance and anthropomorphic measures, and biomarkers (HbA1c, Total Cholesterol, HDL, CRP, Cystatin-C). Data are also available on health services including utilization, insurance and out-of-pocket spending with linkage to Medicare records. Economic measures include employment status/history, earnings, disability, retirement, type of work, income by source, wealth by asset type, capital gains/debt, consumption, linkage to pensions, Social Security earnings/benefit histories. There is also extensive information on family structure, proximity, transfers to/from of money, time, social and psychological characteristics, as well as a wide range of demographics.</p> <p>Performance on a cognitive test combining immediate and delayed word recall was selected as an example trait for the dbGaP data release. In the immediate word recall task the interviewer reads a list of 10 nouns to the respondent and asks the respondent to recall as many words as possible from the list in any order. After approximately five minutes of asking other survey questions, the respondent is asked to recall the nouns previously presented as part of the immediate recall task. The total recall score is the sum of the correct answers to these two tasks, with a range of 0 to 20. </p> <p>Researchers who wish to link to other HRS measures not in dbGaP will be able to apply for access from HRS. A separate Data Use Agreement (DUA) will be required for linkage to the HRS data. See the HRS website (<a href="http://hrsonline.isr.umich.edu/gwas" target="_blank">http://hrsonline.isr.umich.edu/gwas</a>) for details.</p>
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