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Older African Americans may underutilize mental health services, although they experience mental health problems at rates comparable with those of whites. Untreated mental disorders contribute to increased risk of morbidity and mortality and decreased quality of life, and therefore, understanding the factors that influence racial disparities in service use is critical. This study examined whether county characteristics were associated with mental health service use by older African Americans after the analyses adjusted for individual characteristics.This study combined individual-level data from the 2008-2012 Medical Expenditure Panel Survey with county-level data for 2008-2012 from the 2013-2014 Area Health Resources Files and county-level data from the 2008-2012 Chronic Conditions Report of the Chronic Conditions Data Warehouse for 1,567 community-dwelling African Americans ages 60 and older. Multilevel logistic regressions were used to examine the role of county characteristics on mental health services use with adjustment for individual-level risk factors.At the county level, individuals living in a county with a higher proportion of African Americans were less likely to use mental health services. At the individual level, higher income and mental health status were associated with mental health service utilization.Among older African Americans, the racial composition of one's county of residence played a role in mental health service use, indicating the need for future research focusing on the relationship between an area's racial composition and mental health service use. Programs may be able to ameliorate racial disparities in mental health care by targeting areas with a higher percentage of African Americans.

Intervention efforts include social support as a mechanism to promote well-being in diverse communities. Cultivating support can be complex, particularly in disadvantaged urban communities. This complexity is compounded by a lack of studies that attempt to map associations between urban neighborhood environments and social support exchanges. Authors address this gap by analyzing data from the Healthy Aging in Neighborhoods of Diversity across the Life Span study (Wave 1, 2004–2009), a 20-year epidemiological investigation of African American and White adults living in Baltimore City. Results of ordinary least squares linear regression models (N = 2,002) indicate that individuals who report that their neighborhoods have more social resources (p = .03), social order (p < .001), social cohesion (p = .002), and social control (p = .001) tend to exchange more social support. Respondents in neighborhoods with more social disorder report providing more support (p = .02), but receive less (p = .004). Neighborhood social environment is more consistently associated with support received from friends or other kin compared with spouses and children. These findings suggest that neighborhood social environments may be a key contextual consideration for social work intervention efforts and indicate need for macro-level interventions to complement existing micro-level interventions.

Naturally Occurring Retirement Community Social Service Programs (NORC programs) and Villages focus on strengthening community-based systems to support aging in place. This study examined data from...

Transportation is critical to older adults’ ability to participate in social activities in their community. We examined the association between modes of transportation and restrictions in social activity (i.e.visiting with others, religious attendance, clubs and organised activities, and going out for enjoyment), with particular attention to the moderating effects of economic vulnerability. We used logistic regression to analyse data from 7,197 community-dwelling older adults from the 2011 wave of the National Health and Aging Trends Study, a representative sample of adults aged 65 and over in the United States of America. Economic vulnerability moderated the association between transportation mode and social activity restrictions. Findings suggest that even when economically vulnerable older adults have access to driving, walking or public transit, they may be at a higher risk for social exclusion than their counterparts with more financial resources.

Age-friendly community initiatives (AFCIs) are a promising approach to supporting physical, cognitive, mental, and social health in later life, but to date, there are gaps in our understanding of these initiatives' development, implementation, sustainability, and effectiveness. In this article we describe existing scholarship on age-friendly community initiatives, focusing attention on conceptual and empirical knowledge development regarding what age-friendliness and AFCIs are, as well as AFCIs' inputs (i.e., the process of age-friendly community change), outputs (i.e., organizational and community changes), and outcomes (i.e., changes in individual older adults). We then discuss some of the barriers to integrating research and practice in this field, including AFCIs' multifaceted approach and limited funding for evaluation and research. We conclude with steps to advance knowledge that can help to promote more evidence-informed age-friendly policies and practices. Additional scholarship regarding ...

While the term “age-friendly” has become ubiquitous in the field of social gerontology, a clear definition of the term remains elusive. In an effort to clarify the role of age-friendly initiatives, Menec and colleagues presented a framework focused on social connectivity within an ecological model. The articles in this special issue address issues raised by this approach and its implications for policy, programs and scientific research.

Guided by resource dependence theory, this mixed-methods study examined organizational characteristics contributing to the perceived sustainability of Villages, a rapidly proliferating grassroots approach for promoting social participation and service access for community-dwelling older adults. Surveys conducted with leaders of 86% of Villages in the United States in 2012 found that higher predicted confidence in their Village’s 10-year survival was associated with greater financial reserves, human resources, number of Village members, formal policies and procedures, and formal collaboration agreements. Respondents’ explanations of their confidence ratings revealed additional themes of organizational leadership and perceived community need. Member resource inputs were not found to be as salient for Village leaders’ perceptions of sustainability as was anticipated given the Village model’s emphasis on consumer involvement. Despite the lack of longitudinal prospective data, study findings suggest potential limitations of consumer-driven organizational models such as Villages, including the need for a more stable resource base.

Villages, which are community-based initiatives designed to help older adults age in place through a combination of services, participant engagement, and peer support, have expanded rapidly since their initial development in the early 2000s. Using a sample of Villages in the United States, we examined variations from characteristics of the Village model as portrayed by media and organizational leaders. Results indicate there is no uniform Village model that can be implemented and evaluated by policy makers, funders, service providers, and researchers. Based on the extent of member involvement, methods of service provision, and funding sources, we developed a conceptually and empirically informed typology of Villages that reflects the model’s focus on consumer involvement. Descriptive analyses indicate potential differences in member, community, and organizational characteristics. This emerging typology has implications for understanding the implementation and sustainability of Villages, including whether specific Village types are best suited to certain community contexts.

A growing number of cities and towns are implementing “friendly” initiatives to change the community’s social and physical infrastructure to address the needs of a particular vulnerable segment of their population. Three prominent examples are aging-friendly, child-friendly, and immigrant-friendly initiatives. Although the limited but growing literature describes these initiatives as promising strategies to improve the quality of life of the targeted population, to date there has been little written about the underlying goals, values, and assumptions of these efforts. Using the value-critical approach, this article aims to better understand these aspects of population-friendly initiatives by examining the scholarly and grey literature. Social workers engaged in community and policy practice can play a key role in these efforts and call attention to the ways they may alleviate or exacerbate inequities. Future research is needed to assess the effects of these initiatives on their targeted population...

Some older adults are more vulnerable to housing concerns due to physical and cognitive challenges, including those with a neurocognitive disorder who need extensive support. Environmental gerontology frameworks, including Wiseman’s (1980) Behavioral Model of Elderly Migration, have informed scholarship on aging in place and relocation. It remains unclear, however, the extent to which this conceptual work informs services and supports for older adults, and the Wiseman model has not been applied to people with a neurocognitive disorder. Understanding Wiseman’s model, including considerations for working with families confronting a neurocognitive disorder, can help practitioners ensure that older clients live in settings that best meet their wants and needs.

Well-being has been conceptualized as a two-dimensional construct that includes both hedonic and eudaimonic components. To date, existing measures of well-being may not adequately capture both of these components for older adults, and limited literature has explored whether the two constructs can be integrated into one factor to measure well-being in this population.This study examined the factor structure of the 11 well-being items from the National Health and Aging Trends Study (NHATS), a nationally representative panel study of Medicare recipients in the US. Using data from the 2011 wave, we divided the community-dwelling sample into two random subsamples, testing our theory in sample 1 (n = 3305) and examining the replicability of the solution in sample 2 (n = 3297).We conducted confirmatory factor analyses using a correlated uniqueness approach to account for the frequency and negatively worded method effects. The findings from sample 1 indicated that the single factor structure was a superior fit to the data, and the solution was confirmed by sample 2 [χ(2)(33) = 85.002, p.001, RMSEA = 0.022 (90% CI = 0.016-0.028), CFI = 0.993, TLI = 0.989, WRMR = 0.831].Findings suggest that although the hedonic and eudaimonic components of well-being may be conceptually distinct, they are highly correlated in the NHATS well-being measures and should be measured as a single construct. Implications for future research using the NHATS and research using other data sources and focusing on other populations are discussed.

In recent decades, a growing number of cities and towns have implemented aging-friendly community initiatives (AFCIs), which aim to create places where older adults are involved, valued, and supported (Alley et al., Journal of Gerontological Social Work 49(1–2):1–18, 2007). Aging-friendly communities promote a better person–environment fit by modifying the physical and social environment to support older adults’ health, well-being, and the ability to age in place. AFCIs reflect a shift among foundations, advocacy groups, and researchers toward reframing (Frameworks Institute, Aging, 2016) or disrupting aging (Jenkins, Disrupt aging: A bold new path to living your best life at every age. Public Affairs, New York, 2016) by focusing attention not only on the challenges but also on the benefits of an aging society for individuals, families, and communities. The ultimate purpose of aging-friendly efforts is to allow community residents to live full and meaningful lives across the life course, even in the face of not only age-related physical and cognitive changes but also psychological and social changes.

A major focus of U.S. aging policies and programs is supporting the ability of older adults to age in place, based on evidence that neighborhoods become increasingly important in later life due to place attachment and the belief that aging in place can lead to optimal health and well-being. Gentrification, which occurs when more affluent residents move into a neighborhood that was previously occupied by lower-income residents, has received limited attention in gerontological scholarship. The percent of neighborhoods experiencing gentrification has increased in the U.S., and therefore the ramifications of gentrification are receiving more attention from policymakers, researchers, and the media, yet the potential repercussions for older adults are often ignored. To address this gap, this symposium will examine the consequences of neighborhood renewal for two groups of older adults: those who are involuntarily displaced, and those who continue to age in place. The first two papers will discuss a qualitative study of low-income senior housing residents in Detroit, Michigan who have been involuntarily relocated because of their building’s conversion to market rate rents in a deliberate strategy of neighborhood gentrification. The third paper will present findings from a study combining data from the National Health & Aging Trends Study and the U.S. Census to examine the quality of life of older adults living in gentrifying neighborhoods, particularly for those with limited financial resources. The co-coordinator for Age-Friendly Portland, a city experiencing particularly high rates of neighborhood gentrification, will serve as the discussant.

Neighborhood age composition is an understudied area. Furthermore, existing empirical and conceptual work is conflicting, with some scholarship-indicating neighborhoods with older adults are beneficial and other scholarship suggesting it can be detrimental. Combining data from 7,197 older adults from the first wave (2011) of the National Health & Aging Trends Study and census tract data from the National Neighborhood Change Database, the purposes of our study were to: 1) identify the characteristics of neighborhoods experiencing different types of changes in age composition, and 2) examine the association between neighborhood age composition and self-rated health. Findings indicate that neighborhoods experiencing Concentration (where the number of older adults are declining but their percentage of the total population are increasing), the majority of which are in urban areas, have less aggregate economic resources, more indicators of neighborhood disorder, and less access to services and supports. Regression models also suggest older adults living in Concentration neighborhoods reported lower self-rated health compared to those living in the other three neighborhood types. Findings point to the importance of considering neighborhood age composition when targeting interventions and resources, and the potential consequences of being stuck in place in a neighborhood that does not meet elders' needs.

Modifying neighborhood environments to target well-established risk factors for cardiovascular disease may reduce health disparities by complementing clinical services. Prior research, however, includes limited measures of neighborhoods and does not adequately account for individual-level processes known to mediate health outcomes. We combine baseline data from the Healthy Aging in Neighborhoods of Diversity Across the Life Span (HANDLS) dataset with neighborhood-level data to yield a diverse sample of Black and white middle-aged and older residents of Baltimore City (N=2707). We use structural equation modeling to examine associations between neighborhood environments and obesity (BMI>=30), focusing on individual-level mediators. Initial direct associations between neighborhoods and obesity (e.g., presence of businesses, β=-0.062) are mediated by healthcare access and health behaviors. Additional indirect pathways exist through health behaviors (e.g., neighborhood disorder, access to parks). These findings highlight the importance of considering indirect pathways to cardiovascular health promotion among aging adults in different neighborhood contexts.

Social isolation is a critical public health issue that socially isolated individuals are at increased risk for mortality and deteriorated health. Those who acquire hearing loss in later life experience difficulties with communication, potentially leading to social isolation. However, less is known about the social consequences of age-related hearing loss, and few studies have assessed the influence of environmental factors on hearing loss and social isolation. The aims of this study are to examine: (1) the association between hearing loss and social isolation of older adults over time, and (2) the moderating effects of perceived neighborhood social cohesion and disorder on this relationship. We analyzed 2,080 community-dwelling Medicare beneficiaries aged 65 or above from Round 1 to 3 of National Health and Aging Trends Study. We conducted random coefficient models, entering hearing loss as a random coefficient. Older adults with hearing loss were less socially isolated than those without hearing loss. However, the effect of hearing loss on social isolation varied depending on perceived neighborhood social cohesion. Older adults with hearing loss who reported high neighborhood cohesion had significantly lower social isolation compared to those without hearing loss, while those with hearing loss who perceived low social cohesion had significantly higher social isolation. Our findings suggest neighborhood social cohesion can serve as a potential protective factor for older adults with hearing loss. This poster will propose neighborhood-level interventions that could supplement other services for those with hearing loss, such as assistive devices that are rarely covered by health insurance.

Self-rated health is a multidimensional construct that includes not only physical health but also emotional and social well-being. Previous research has demonstrated that multiple factors contribute to individual self-rated health, including income. Because income is a somewhat limited indicator of older adults' financial circumstances, alternative measures such as housing cost burden may enhance our understanding of contributors to self-rated health. Further, because homeowners and renters may have a different attachment to their home and neighborhood, homeownership may moderate the association between housing cost burden and self-rated health. This study examined these relationships using data from 3,212 older adults in round 7 (2017) of the National Health & Aging Trends Study. Findings from multiple linear regression models indicate that the housing cost burden is associated with lower self-rated health, and this association is stronger for renters compared to homeowners. The findings indicate the potential for reduced housing cost burden to have a positive effect on health. The poster will conclude with practice and policy implications, including the potential benefits of expanding rental assistance programs to older adults who may not meet current income requirements but are experiencing high housing cost burden, as well as research implications, including the need for longitudinal approaches.

The purpose of this study was to assess the extent to which cities, county departments of adult and aging services, county transportation authorities, and public transit agencies in the San Francisco Bay Area have in place age-friendly policies, programs, and infrastructure in the areas of community design, housing, transportation, health care and supportive services, and opportunities for community engagement. The most common age-friendly features include those that target alternative forms of mobility (for example, incentives for mixed-use neighborhoods and changes to improve the accessibility of public transit), while the least common policies and programs are those that aim to help older adults continue driving, such as driver education programs, driver assessment programs, and slow-moving vehicle ordinances. The article concludes with policy and research implications of these findings.

This article explores the potential role of the Village model, a social initiative that emphasizes member involvement and service access, in helping communities to become more age-friendly. A survey of 86.3% of operational Villages examined activities designed to help members access a variety of supports and services consistent with the World Health Organization's (WHO) Global Network of Age-Friendly Cities and Communities program model, as well as other potential contributions to community age friendliness. Analysis revealed that 85.5% of Villages provided assistance with at least six of the eight WHO domains, but only 10.1% implemented features of all eight; more than one-third were engaged in direct or indirect efforts to improve community physical or social infrastructures or improve community attitudes toward older persons. These findings suggest that Villages and other social organizations may have untapped potential for enhancing their members' ability to age in place consistent with the goals of age-friendly initiatives while also promoting constructive changes in the overall community.

Background and objectives In the United States, the older adult population and the proportion of neighborhoods experiencing gentrification are both growing. However, there is limited scholarship on the effects of gentrification on older adults, with most work focusing on those who leave rather than stay. This study examines the effects of remaining in a gentrifying neighborhood on older adults' self-rated health and mental health, with particular attention to outcomes for those who are economically vulnerable. Research design and methods Data are from 6,810 community-dwelling respondents in metropolitan areas from the first wave of the National Health & Aging Trends Study combined with the 1970-2010 National Neighborhood Change Database. We estimate the effects of gentrification on self-rated health and mental health separately using a quasi-experimental approach and comparing two methods: matching design and linear regression. Results Economically vulnerable older adults in gentrifying neighborhoods reported higher self-rated health than economically vulnerable older adults in low-income neighborhoods. Both economically vulnerable and higher-income older adults in gentrifying neighborhoods had more depression and anxiety symptoms than those living in more affluent areas. Higher-income older adults in gentrifying neighborhoods had poorer mental health than their counterparts in low-income neighborhoods. Discussion and implications Findings call attention to the complexity of gentrification, and the need for more research examining how the intersection of neighborhood and individual characteristics influences older adults' health. Results reinforce the need for neighborhood-level interventions as well as relocation support to promote health in later life and caution against an overemphasis on aging in place.

Synthesising the social capital and ageing-friendly communities literature, this paper describes how efforts to make communities more ageing-friendly can promote social inclusion among older adults. Making existing communities more ageing-friendly involves physical and social infrastructure changes that enable older adults to pursue lifelong activities, meet their basic needs, maintain significant relationships, participate in the community in personally and socially meaningful ways, and develop new interests and sources of fulfilment. Such efforts can enhance bonding, bridging and linking capital, and thereby promote social inclusion. The authors discuss the link between ageing-friendly communities and social inclusion, and provide examples of programmes with potential to change existing communities into ones that promote the social inclusion of older adults.

A growing paradigm shift emphasizes efforts to promote aging in place not only by helping aging individuals and families, but also by addressing and engaging communities. This paper explores the idea of developing community supports for aging in place by examining two models that incorporate this approach into practice: Naturally Occurring Retirement Community Supportive Service Programs (NORC programs) and Villages. Drawing on research regarding social–relational aspects of communities and later-life health and well-being, we present an integrative conceptual framework positing three categories of activities and services (civic engagement and empowerment activities; social relationship building activities; services to enhance access to resources)–as well as the initial outcomes and intermediate outcomes–through which the NORC program and Village models potentially achieve their long-term goal of promoting aging in place. Based on this framework, we conclude with directions for future research on community initiatives that support aging in place.

A growing number of initiatives across the country are working to bring about comprehensive changes in community physical and social environments to help older persons meet their long-term care needs and age in place. This study seeks to address gaps in the literature by developing a typologyof community aging initiatives and examining variations in community change processes, including the methods they use, roles of participants, funding sources, and challenges. Based on responses to online surveys and the existing community change literature, 124 initiatives were grouped into 5 categories: (a) communitywide planning, (b) consumer-driven support networks, (c) cross-sector systems change initiatives, (d) residence-based support services, and (e) single-sector services. This emerging typology may serve as a useful organizing framework from which to develop future evaluations of the effectiveness and sustainability of these initiatives.

Purpose of the study: To examine the characteristics associated with city government adoption of community design, housing, and transportation innovations that could benefit older adults. DESIGN AND METHODS: A mixed-methods study with quantitative data collected via online surveys from 62 city planners combined with qualitative data collected via telephone interviews with a subsample of 18 survey respondents. RESULTS: Results indicate that advocacy is an effective strategy to encourage city government adoption of these innovations. Percent of the population with a disability was positively associated, whereas percent of the population aged 65 and older was not associated or negatively associated, with innovation adoption in the regression models. Qualitative interviews suggest that younger individuals with disabilities are more active in local advocacy efforts. IMPLICATIONS: Results suggest that successful advocacy strategies for local government adoption include facilitating the involvement of older residents, targeting key decision makers within government, emphasizing the financial benefits to the city, and focusing on cities whose aging residents are vulnerable to disease and disability. Language: en

On Lok is a pioneering nonprofit organization that has delivered services to the frail and elderly since its founding in 1971. The agency began as a grassroots effort focused on improving the health care available to older adults living independently in the community. Over its 40-year history, On Lok has evolved into a $70 million nonprofit human service organization with a national reputation for innovation as a leading provider of care to frail elderly. The agency has developed its own model of care that has been replicated in cities around the country. The history of On Lok represents the important impact that donor and community support plays in an organization's long-term success.

This study examines racial and ethnic variations in the types and sources of support caregivers receive. We conducted telephone surveys of 1,643 randomly selected respondents in California who provided care to someone age 50 or over. African-American, Asian/Pacific Islander, Hispanic/Latino, and white caregivers were compared with regard to support received from formal and informal sources. Patterns of support use were found to vary by racial/ethnic group, with Asian and Pacific Island caregivers most likely to receive help from informal sources only, white caregivers most likely to receive help from formal sources only, and African-American caregivers most likely to rely on a combination of formal and informal support. Results from this study underscore the importance of developing culturally appropriate systems of caregiver support that reflect the needs and practices of diverse caregiver groups. Further research is needed regarding the intersection of race, ethnicity, and other personal or environmenta...

Assessment of elder mistreatment is hindered by a myriad of factors, including inconsistent definitions, divergent and untested theories of causation, and limited research attention to the problem. In addition to these difficulties, professionals encounter complex situations requiring considerable clinical assessment skills and decision-making capacity. Adult Protective Services (APS) workers, as well as mandated reporters such as healthcare providers and social workers, need an assessment tool that can reliably and accurately assess for elder mistreatment. Based on a structured review of screening and assessment instruments, this article discusses the psychometric properties of 15 instruments and the relevance to APS. Implications of the findings for future research, practice, and policy are discussed.

This article describes an online conference and supporting Web site designed to help communities become better places in which to age. The “Creating Aging-Friendly Communities” online conference was designed to capture the emerging knowledge being accumulated by researchers, advocacy groups, grassroots organizations, and local governments across the country, and make it available to others who were interested in learning what they could do to make their communities more aging friendly. The article begins with a brief overview of the concept of “aging-friendliness,” followed by evidence regarding the effectiveness of online modalities as mechanisms for knowledge dissemination. It then describes the innovative conference format, examining the extent to which the conference goals were achieved. The article concludes with implications for online learning modalities in general and efforts to foster aging-friendly communities in particular.

Objectives: This article examines whether race and ethnicity contribute to the differential use of caregiver support services, when controlling for caregiver and care recipient characteristics, as represented by predisposing, enabling, and need factors included in the Behavioral Model of Health Services Use. Methods: The study includes 1,508 individuals who provide care to an ill or disabled adult aged 50 or older, identified through a random digit dial telephone survey of California households. Logistic regression analysis is utilized to examine factors that predict use of caregiver support services. Results: Race and ethnicity do not contribute significantly to caregiver service utilization, when controlling for relevant covarying factors such as age, education, emotional support, family contribution, care recipient service use, and care recipient impairment. A significant interaction exists between ethnicity and family closeness, with reduced rates of service use among Asian and Pacific Island caregivers whose families are brought closer by the caregiving experience. Discussion: These findings suggest that racial and ethnic disparities in caregiver service use found at the bivariate level are attributable to covarying predisposing, enabling, and need factors. Further research and theoretical development are suggested to clarify the impact of sociocultural factors on caregiver service use.

Social work education, practice, and research are heavily influenced by theories developed by psychologists. A review of the literature was conducted to identify theories of poverty emerging from the field of psychology. In general, until 1980, psychological theories of poverty emphasized the role of the individual or group to explain the causes and impact of poverty. Between 1980 and 2000, psychologists began to consider the structural and societal factors that contribute to poverty and moved beyond the explanations of individual pathology. At the beginning of the twenty-first century, an increasing number of psychological theorists acknowledge the role of social, political, and economic factors in the creation and maintenance of poverty. Implications for social work education, practice, and future research are discussed.

Social work is distinguished from other helping professions and social science disciplines by its primary concern with poverty. It is unclear, however, how well social work students understand various theories of poverty or how this understanding informs their practice with those who live in poverty. This article attempts to begin answering this question through an analysis of poverty content in 14 frequently assigned textbooks in Human Behavior and the Social Environment (HBS (2) The extent to which the theme of poverty is diffused throughout the textbook; (3) The extent to which poverty is viewed in terms of the interaction between human behavior and the social environment; and (4) The extent to which poverty is described as a universal condition. In general, the 14 textbooks devote little space to poverty content and fail to address these four criteria. The analysis concludes with recomm...

The social science discipline of political science focuses on the study of political systems and political behavior. While political science has not developed a comprehensive theory of poverty, this article reviews political science perspectives related to the causes of poverty (culture of poverty and neo-Marxist theories of class), the role of government in addressing poverty (theories of distributive justice and public support for antipoverty policies), and political participation. The article concludes with recommendations for future research and implications for Human Behavior and the Social Environment curriculum.

Concerns have been raised regarding the sustainability of Villages, a rapidly-expanding set of organizations that typically use a participant-directed approach to improve older adults’ quality of life and ability to age in place. Using online survey and telephone-interview data from a 2013 follow-up study of Villages across the United States, this study examined organizational leaders’ perceptions of the major challenges to sustainability. Major challenges identified included: (a) funding, (b) membership recruitment, (c) leadership development, (d) meeting members’ service needs, and (e) limitations of the Village model itself. Findings point to a number of important considerations for the development, implementation, and sustainability of the Village model, including the role of social workers in addressing these challenges.

Villages, which are community-based initiatives designed to help older adults age in place through a combination of services, participant engagement, and peer support, have expanded rapidly since their initial development in the early 2000s. Using a sample of Villages in the United States, we examined variations from characteristics of the Village model as portrayed by media and organizational leaders. Results indicate there is no uniform Village model that can be implemented and evaluated by policy makers, funders, service providers, and researchers. Based on the extent of member involvement, methods of service provision, and funding sources, we developed a conceptually and empirically informed typology of Villages that reflects the model's focus on consumer involvement. Descriptive analyses indicate potential differences in member, community, and organizational characteristics. This emerging typology has implications for understanding the implementation and sustainability of Villages, including whether specific Village types are best suited to certain community contexts.

Palliative care is an interdisciplinary model that focuses on the comprehensive management of physical, psychological, social, and spiritual needs of individuals with lifelimiting illness. Although palliative care is increasingly common in acute care settings, regulatory, financial, and educational barriers often bar nursing home residents from access to palliative care services.The purpose of the Palliative Care Services in Pennsylvania Nursing Homes Survey was to describe existing palliative care services within nursing homes in Pennsylvania, and to classify these services by level of care delivery.Ninety-one nursing home administrators throughout the state of Pennsylvania participated in the mailed survey. Multiple logistic regression analysis was used to investigate the association between various organizational characteristics and provision of palliative care services.Results reveal that urban facilities were more likely to provide palliative care services than rural facilities. Urban facilities cited the need for bereavement training most frequently, whereas rural clinical cited the need for training in pain management. Larger facility size was associated with an increased likelihood of pain management practices, even after adjusting for regional differences.These pilot findings are consistent with and extend previous findings suggesting that palliative care practice in nursing homes is strongly influenced by nonclinical factors and invites further investigation.

This study investigated whether transitioning into the role of activities of daily living (ADL) spousal caregiver is associated with increased depressive symptoms for older husbands and wives among a sample of coresiding community-dwelling older couples. Using data from the Health and Retirement Study, we estimated a two-level linear model to examine the association between change in caregiver status and respondents’ depressive symptoms at follow-up, controlling for other factors identified in Pearlin’s stress process model (PSPM). Results indicate that both husbands and wives who become ADL caregivers have more follow-up depressive symptoms than noncaregivers. Furthermore, wives continuing as caregivers have more follow-up depressive symptoms than wives who do not provide care. Finally, the physical health of the spousal caregiver is related to depressive symptoms at follow-up. We conclude with policy and practice implications of these three main findings.

While a number of organizations and government entities have encouraged the development of more “age-friendly” environments, to date there has been limited research linking these environment features to elder outcomes. Using a representative sample of older adults living in Detroit, this study examined the association between age-friendly environment factors and self-rated health. Results indicated that access to health care, social support, and community engagement were each associated with better self-rated health, while neighborhood problems were associated with poorer self-rated health. Moreover, individual-level income and education no longer predicted self-rated health once age-friendly environment factors were taken into account. These findings highlight the need for more research documenting the effects of age-friendly environments, particularly across diverse contexts and populations.

Framed by Pearlin’s Stress Process Model, this study prospectively examined the effects of three primary stress factors reflecting the duration, amount, and type of care (ADL, IADL, both) on the depressive symptoms of spousal caregivers over a two-year period. This study also measured whether the effects of these stressors differ between husbands and wives. We analyzed data from the 2004 and 2006 waves of the Health and Retirement Study, a nationally-representative sample of adults ages 50 and over in the U.S. The analytic sample included 774 community-dwelling respondents who were married/partnered and providing help to their spouses for Activities of Daily Living (ADLs) and/or Instrumental Activities of Daily Living (IADLs). We used multivariate regression models to examine the direct effects of primary stressors on depressive symptoms among the total sample and for husbands and wives. We found that none of the primary stressors were associated with depressive symptoms within the total sample. However, when examining these issues for husbands and wives, wives providing only personal care (ADLs) had significantly more depressive symptoms than wives providing only instrumental care, while husbands providing different types of care showed no significant differences in depressive symptoms. We conclude that wife caregivers’ increased vulnerability to depressive symptoms when providing personal care may reflect different gender roles in caregiving. Future studies that directly address couples’ relational dynamics and gendered experiences in personal care, including emotion work, may further illuminate strategies for reducing depressive symptoms experienced by wife caregivers engaged in personal care assistance.

Using cardiovascular disease (CVD) risk as an example, this paper discusses conceptual and methodological developments to advance research about neighborhood effects on health across the life course. CVD is a leading cause of morbidity and mortality, and modifying the neighborhood physical and social environment is a promising strategy for reducing racial and income disparities in CVD risk. However, empirical evidence of the specific pathways through which environments influence CVD risk is limited because previous studies: 1) measure only a few neighborhood characteristics rather than multiple indicators, 2) assess cardiovascular health primarily through self-reported measures or mortality rather than clinical biomarkers of risk, 3) do not consider intermediary pathways, and 4) analyze predominantly white samples.

This paper will provide an introduction to “age-friendly” as an emerging international field of research, policy, and practice. The presenters will provide a history of the age-friendly movement, including the World Health Organization’s initiative and how age-friendly efforts have emerged across diverse national contexts over the past decade. The presenters will then describe knowledge development concerning age-friendly community initiatives, noting that much of what has been written in this area has been published in the “gray” literature. While peer-reviewed publications on age-friendly efforts are growing in number, many remain descriptive or theoretical. Based on a review of the literature, this paper will identify opportunities for researchers to employ both qualitative and quantitative research methodologies to deepen systematic knowledge building concerning age-friendly community initiatives. The authors will describe how such knowledge development has the potential to strengthen age-friendly policies and practices, while also making meaningful advances to gerontological research more broadly.

Using the Andersen-Newman model, we investigated the prevalence of activities of daily living (ADLs) limitations in married couples, and couple characteristics associated with ADL help-receipt. In this sample of 3,235 couples age 65+ in the 2004 Health and Retirement Study, 74.3%, 22.1%, and 3.6% were couples in which neither partner, one partner, or both partners had limitations, respectively. Logistic regression results indicate that help-receipt was associated with certain health needs in the couple, but not with their predisposing characteristics or enabling resources. Social workers could target couples most in need of assistance by assessing both partners’ health problems.

Currently there is limited evidence linking age-friendly characteristics to outcomes in elders. Using a representative sample of 1,376 adults aged 60 and older living in Detroit (MI, USA), this study examined the association between age-friendly social and physical environmental characteristics and the expectation to age in place, and the potential differences between low- and higher-income elders. Based on U.S. Environmental Protection Agency's (EPA) age-friendly guide, we identified six factors reflecting age-friendly characteristics. Logistic regression models indicated that regardless of income level only neighborhood problems were significantly associated with expecting to age in place. Low-income elders were more likely to expect to age in place than their higher-income counterparts, and it is unclear whether this resulted from a desire to remain in the home or that there is no place else to go. Future research should address the ways in which financial resources affect the choices, expectations, and outcomes of aging in place. Language: en