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Background and Objectives Low access to food can have an adverse impact on health yet there is limited research on how it is related to coronavirus disease 2019 (COVID-19). The objective of this study was to (a) better understand how inadequate food access was associated with older adult mortality from COVID-19 and (b) determine the spatial distribution of mortality from low food access utilizing a socio-ecological framework. Research Design and Methods This study area was the larger Midwest, a region of the United States, which included the following states: Minnesota, Wisconsin, Iowa, Illinois, Indiana, Michigan, Ohio, and Pennsylvania. Data were aggregated from multiple sources at the county-level. Because the spatial data used in this study violated several assumptions of the global regression framework, geographically weighted regression (GWR) was employed. Results Results from GWR revealed low access to food was positively associated with mortality from COVID-19 for older adults but the association varied in (a) magnitude and (b) significance across the larger Midwest. More specifically, the socio-ecological framework suggested low access to food, female-headed households, and percentage Hispanic played a meaningful role in explaining older adult mortality for the western region of the larger Midwest. This was not as evident for the eastern portion. Discussion and Implications Such a finding calls attention to the importance of capturing the local context when devising policies to reduce mortality for older adults from COVID-19. Regional policymakers can collaborate with public health professionals when applying these results to formulate local action plans that recognize variations across geographic space. [ABSTRACT FROM AUTHOR]

Objectives The purpose of this study was to employ simulations to model the probability of mortality from COVID-19 (i.e. coronavirus) for older adults in the United States given at best and at worst cases. Methods This study first examined current epidemiological reports to better understand the risk of mortality from COVID-19. Past epidemiological studies from severe acute respiratory syndrome were also examined given similar virology. Next, at best and at worst mortality cases were considered with the goal of estimating the probability of mortality. To accomplish this for the general population, microdata from the National Health Interview Survey pooled sample (2016, 2017, and 2018 public-use NHIS with a sample of 34,881 adults at least 60 years of age) were utilized. Primary measures included age and health status (diabetes, body mass index, and hypertension). A logit regression with 100,000 simulations was employed to derive the estimates and probabilities. Results Age exhibited a positive association for the probability of death with an odds ratio (OR) of 1.22 (p <.05, 95% confidence interval [CI]: 1.05–1.42). A positive association was also found for body mass index (BMI) (OR 1.03, p <.01, 95% CI: 1.02–1.04) and hypertension (OR 1.36, p <.01, 95% CI: 1.09–1.66) for the at best case. Diabetes was significant but only for the at best case. Discussion This study found mortality increased with age and was notable for the 74–79 age group for the at best case and the 70–79 age group of the at worst case. Obesity was also important and suggested a higher risk for mortality. Hypertension also exhibited greater risk but the increase was minimal. Given the volume of information and misinformation, these findings can be applied by health professionals, gerontologists, social workers, and local policymakers to better inform older adults about mortality risks and, in the process, reestablish public trust. [ABSTRACT FROM AUTHOR]

Objectives Asian Americans are the fastest-growing minority group in the United States, yet little is known about their functional mobility. To overcome such a gap, this study examined the association between demographic/economic characteristics and functional limitations for middle-aged and older Asian Indians, Chinese, and Filipinos. Method This study utilized microdata from the National Health Interview Survey pooled sample (2010–2016 IPUMS NHIS with a sample size of 6,767 Asians). Logit regressions were used to examine factors associated with functional limitations. Measures include age, gender, currently married, education (categorized as less than high school, high school, some college, college, advanced degree), birth and citizenship status, household income, home ownership, types of health insurance (e.g., Medicaid, Medicare, private), and geographic region (i.e., Northeast, Midwest, South, and West). Results Chinese (odds ratio [OR] 0.57, p <.01) and Filipinos (OR 0.74, p <.05) had lower odds for any functional limitations relative to Asian Indians. Currently married and individuals with a higher income were also associated with reduced odds for limitations in the overall analysis. As for the subgroup analysis, there was a positive association between age and the presence of any functional limitations for Asian Indians (OR 1.05, p <.01), Chinese (OR 1.08, p <.01), and Filipinos (OR 1.03, p <.01). In terms of gender, Asian Indian men were less likely (OR 0.51, p <.01), whereas Filipino men were more likely to have limitations (OR 1.09, p <.05). Discussion Asian Indians appeared to have a poorer health profile for limitations in dressing, eating, walking, or working when compared with Chinese and Filipinos. A pronounced difference at older ages was also apparent for Asian Indians by gender and the likelihood of having any limitations increased much faster for Asian Indian women. For Chinese, there was a dramatic increase in functional limitations after age 75 (particularly for women) and the predicted probability for this subgroup approximated 20%. For Filipinos, men were more likely to have limitations. These findings raise interesting questions about the on-set of disability by age and gender for Asian subgroups. [ABSTRACT FROM AUTHOR]

Public health scholars and policy-makers are concerned that the United States continues to experience unmanageable health care costs while struggling with issues surrounding access and equity. To addresses these and other key issues, the National Academy of Medicine held a public symposium, Vital Directions for Health and Health Care: A National Conversation during September 2016, with the goal of identifying clear priorities for high-value health care and improved well-being. One important area was addressing social determinants of health. This article contributes to this objective by investigating the impact of wealth on older Black women's health. Employing the 2008/2010 waves of the RAND Health and Retirement Study on a sample of 906 older Black women, this panel study examined self-assessed health ratings of very good/good/fair/poor within a relaxed random effects framework, thereby controlling for both (i) observed and (ii) unobserved individual-level heterogeneity. This analysis did not find a statistically significant association with wealth despite a difference of approximately $75 000 in its valuation from very good to poor health. This also occurred after wealth was (i) readjusted for outliers and (ii) reformulated as negative, no change or positive change from 2008. This finding suggests that wealth may not play as integral a role. However, the outcome was significant for earnings and education, particularly higher levels of education. Scholars should further this inquiry to better understand how earnings/education/wealth operate as social determinants of health for minority populations. [ABSTRACT FROM AUTHOR]

Abstract Introduction While the Body Mass Index (BMI) did not change significantly for men from 2005 to 2014 in the United States, women exhibited an upward linear trend. Hispanic and Black women, in particular, showed a dramatic increase. Therefore, the objective of this study was to examine the association between BMI and mobility limitations for non-institutionalised middle-aged and older Black, Hispanic, and White women. Methods The International Classification of Functioning, Disability, and Health model was applied to a sample of 2865 Black, 1846 Hispanic, and 9721 White women categorised as middle-aged and older (i.e., at least 50 years of age) from the 2010 and 2014 Rand Health and Retirement Study. A random effects ordered logit was employed. Results After accounting for personal/activity characteristics, the analyses revealed Black women with greater BMI were associated with a higher likelihood for mobility limitations with an odds ratio of 1.11 [1.06–1.16, 95% CI]. A significant association was also found for Hispanic women with an odds ratio of 1.16 [1.11–1.23, 95% CI] and White women with an odds ratio of 1.16 [1.13–1.19, 95% CI]. Even after accounting for the possibility of endogeneity, BMI remained robust. Conclusion Higher-levels of BMI were associated with an increased probability for mobility limitations for Black, Hispanic, and White middle-aged and older women. Those with a vigorous exercise regimen were less likely to be in this category across all ranges of BMI. These results are useful for prioritising minority health policy, particularly given the limited amount of existing research in this specific area. [ABSTRACT FROM AUTHOR]

Purpose:The purpose of this study was to showcase an advanced methodological approach to model disability and institutional entry. Both of these are important areas to investigate given the on-going aging of the United States population. By 2020, approximately 15% of the population will be 65 years and older. Many of these older adults will experience disability and require formal care. Methods:A probit analysis was employed to determine which disabilities were associated with admission into an institution (i.e. long-term care). Since this framework imposes strong distributional assumptions, misspecification leads to inconsistent estimators. To overcome such a short-coming, this analysis extended the probit framework by employing an advanced semi-nonparamertic maximum likelihood estimation utilizing Hermite polynomial expansions. Results:Specification tests show semi-nonparametric estimation is preferred over probit. In terms of the estimates, semi-nonparametric ratios equal 42 for cognitive difficulty, 64 for independent living, and 111 for self-care disability while probit yields much smaller estimates of 19, 30, and 44, respectively. Conclusions:Public health professionals can use these results to better understand why certain interventions have not shown promise. Equally important, healthcare workers can use this research to evaluate which type of treatment plans may delay institutionalization and improve the quality of life for older adults. Implications for rehabilitationWith on-going global aging, understanding the association between disability and institutional entry is important in devising successful rehabilitation interventions.Semi-nonparametric is preferred to probit and shows ambulatory and cognitive impairments present high risk for institutional entry (long-term care).Informal caregiving and home-based care require further examination as forms of rehabilitation/therapy for certain types of disabilities. [ABSTRACT FROM AUTHOR]

With the on-going aging of the United States' population and an increase in the number of older men and women living in a divorced/separated state, examining the economic security of this group is a worthwhile undertaking. Utilizing the 2004 and 2010 waves of the RAND Health and Retirement Study, this study employed fixed effects (FE) regression to examine the effects of divorce/separation on total wealth for older men and women. Results suggested older divorced/separated individuals endured a significant loss in total wealth due to a martial disruption and women fared worse than men. However, older adults can take proactive steps to ease this financial setback. [ABSTRACT FROM AUTHOR]

Abstract: This paper utilizes the 2009 and 2010 American Community Survey (ACS) to examine spatial patterns of older adult in-migration. This focus area is timely given the Baby Boom generation entering retirement and the emergence of North Carolina as a select destination for older adults (see Vincent & Velkoff, 2010; and He & Schachter, 2003). Results from this paper reveal interesting trends, which can help shape policy relating to aging, health services, housing, and transportation. For example, the 65 and older population in North Carolina has increased from 10 to over 13 percent during the past, few decades (see Census Historical Decennial Reports, U.S. Census, 2002; and NC Office of State Budget and Management, 2010). If this trend holds, North Carolina may become demographically similar to Florida. More specifically, areas outside Asheville, Charlotte, and Greeneville have experienced large inflows and may become prime retirement communities. As Wilmoth (2010) succinctly states, “geographic areas that receive these types of older migrants [i.e., comfort] should expect more demand on programs and services that promote engaged, active lifestyles” (page 878). [Copyright &y& Elsevier]

Background and Objectives: The coronavirus disease of 2019 (COVID-19) adversely affected the health of middle-aged and older adults and altered their economic outlook. Several national polls revealed older adults felt stress about money and many reported difficulties in paying expenses during 2021. Although such descriptive reports have raised awareness, peer-reviewed studies utilizing panel data can offer additional insight. As such, the purpose of this study was to contribute to this growing literature by examining the demographic, economic, and health factors associated with employment and the perceived risk of running out of money for middle-aged and older adults during the pandemic., Research Design and Methods: This study utilized the April-May 2020, April-May 2021, and March 2022 waves of the Understanding America Study. Next, a dynamic panel data model was formulated to account for reverse causality and unobserved heterogeneity with a sample of 2,302 adults between the ages of 50 and 74., Results: Employment (-2.77, p < .05) was negatively associated with the perceived risk of running out of money. Male, higher education levels, currently married, and health insurance status also exhibited a negative association. Meanwhile, a positive association was found for non-White (6.79, p < .01)., Discussion and Implications: Financial well-being is an important consideration in later life and what role employment played during the COVID-19 pandemic is a worthwhile examination. A better understanding of which factors may be associated with the perceived risk of running out of money during the pandemic can be useful when devising policies which address financial security for middle-aged and older adults., (© The Author(s) 2024. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Objective: Institutional entry or long-term care (LTC) is an important area to investigate owing to global aging. This study examines which types of disabilities lead to institutionalization for older White and Black women in the United States., Methods: Using the 3-year (2009-2011) American Community Survey cross-sectional data, this study applies semi-nonparametric maximum likelihood estimation methods to examine the association between disability and institutional entry on a sample of 222,562 older White women and 19,229 older Black women. This approach provides consistent estimators because no assumptions are made about the distribution of the error terms., Results: For older White women, the risk of entering LTC is high in the presence of self-care and independent living difficulties (1.10 [p < .01] and 0.54 [p < .01], respectively). For older Black women, the risk of entering LTC is elevated in the presence of self-care difficulty and cognitive impairment (1.56 [p < .01] and 0.48 [p < .01], respectively) but widowed/divorced/separated marital states do not show this association., Conclusions: Disability, marital status, and race are important considerations for assessing the risk of institutional entry. Impairments that limit personal hygiene and self-care are associated with increased risk for older women. Additionally, limitations that affect reasoning and memory are associated with increased risk for older Black women., (Copyright © 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.)

Objective: This article examines health disparities between older Blacks/Whites by recognizing the importance of health services utilization. Although previous studies have examined health and utilization independently, this is among the first to (a) model its endogenous relation with utilization, and (b) use a continuous measure for health., Data: Household Component files from Medical Expenditures Panel Survey (MEPS) from 2004 and 2005, with 1,369 observations (1,169 for White and 200 for Black) between the ages of 61-69., Methods: The methods employed are two-equation modeling where Medicare eligibility functions as the identification criterion and also as an exogenous shock., Results: The results show older Blacks continue to remain in poorer health despite access to care and insurance status. The author shows underutilization accounts for some of this observed disparity and offers novel approaches to overcome this issue., Conclusion: With the baby-boom cohort approaching retirement, this area of research is timely. This work is also practical because the Department of Health and Human Services has launched various projects examining health care issues for Americans. One major project, Healthy People 2010, provides a "framework for prevention for the Nation [and is] designed to identify the most significant preventable threats to health and to establish national goals to reduce these threats" (http://www.healthypeople.gov/About/). Of the 28 areas, this article complements objectives relating to (a) disability and secondary conditions, and (b) access to quality health services. This article also supports Healthy People 2020, which sets a high priority on access to health care (one of 12 topic areas) and categorizes health disparities as part of the Leading Health Indicators Framework.