Area Agencies on Aging are increasingly partnering with health care organizations to address the health-related social needs of older adults and contribute to multisector coalitions that promote ...community health. Using survey data for the period 2008-13, we examined the potential health impacts of establishing such partnerships. Partnerships with hospitals located in an agency's service county were associated with a reduction of $136 in average annual Medicare spending per beneficiary, while partnerships with mental health organizations in an agency's service county saw potentially avoidable nursing home use fall by 0.5 percentage points. When agencies were funded participants in livable community initiatives-multisector coalitions to promote the well-being and health of older adults-potentially avoidable nursing home use fell by nearly 1 percentage point. Our results suggest that investments in health and human services partnerships through Area Agencies on Aging can yield health returns among older adults, in the form of reduced health care use and spending.
This research found that older individuals with more positive self- perceptions of aging, measured up to 23 years earlier, lived 7.5 years longer than those with less positive self-perceptions of ...aging. This advantage remained after age, gender, socioeconomic status, loneliness, and functional health were included as covariates. It was also found that this effect is partially mediated by will to live. The sample consisted of 660 individuals aged 50 and older who participated in a community-based survey, the Ohio Longitudinal Study of Aging and Retirement (OLSAR). By matching the OLSAR to mortality data recently obtained from the National Death Index, the authors were able to conduct survival analyses. The findings suggest that the self-perceptions of stigmatized groups can influence longevity.
The relationship between education and health is well-established, but theoretical pathways are not fully understood. Economic resources, stress, and health behaviors partially explain how education ...influences health, but further study is needed. Previous studies show that health literacy mediates the education-health relationship, as do general literacy skills. However, little is known whether such mediation effects are consistent across different societies. This study analyzed data from the International Assessment of Adult Literacy and Life Skills Survey conducted in Canada, the United States, Italy, Norway, Switzerland, and Bermuda to investigate the mediation effects of literacy on the education-health relationship and the degree of such mediation in different cultural contexts. Results showed that literacy skills mediated the effect of education on health in all study locations, but the degree of mediation varied. This mediation effect was particularly strong in Bermuda. This study also found that different types of literacy skills are more or less important in each study location. For example, numeracy skills in the United States and prose (reading) literacy skills in Italy were stronger predictors of health than were other literacy skills. These findings suggest a new direction for addressing health disparities: focusing on relevant types of literacy skills.
Evidence-based health promotion programs can help older adults manage chronic conditions and address behavioral risk factors, and translating these interventions to population-scale impact depends on ...reaching people outside of clinical settings. Area Agencies on Aging (AAAs) have emerged as important delivery sites for health promotion programs, but the impacts of their expanded role in delivering these interventions remain unknown.
The objective of this study was to test whether evidence-based health promotion programs implemented by AAAs from 2008 to 2016 influenced health care use and spending by older adults and to examine how agencies' organizational capacity for implementation influenced these population-level impacts.
We used panel regression models to examine how the expansion of health promotion programs offered by AAAs over the course of 2008-2016 was associated with a change in health care use and spending by older adults in counties served by the AAAs. We examined impact separately for high capacity and low capacity agencies.
Across the full sample of AAAs, beginning to offer any health promotion program in the AAA was associated a with 0.94% percentage point reduction in potentially avoidable nursing home use in counties covered by the AAA (95% confidence interval=-1.58, -0.29), equivalent to a 6.5% change. Expanding the breadth of programs offered by the AAA was also associated with a significant reduction in potentially avoidable nursing home use. Stratified analysis showed that reductions in potentially avoidable nursing home use were evident only in places where the AAA had high implementation capacity. Expansion of health promotion programs offered by AAAs was not associated with the change in county-level hospital readmission rates, ambulatory care sensitive hospitalizations, or Medicare spending per beneficiary.
AAAs are an example of community-based organizations that can contribute to health care policy goals such as cost containment. Organizational development support may be needed to extend their ability to effect change in more regions of the country.
Greater distance to health care facilities is associated with poorer health care service utilization, yet little is known about how the ‘decay effect’ of distance influences the outcome of heart ...disease that requires frequent medical care. Heart disease has been a leading cause of death in the United States for a last few decades, even with significant improvements in treatment and management. In this study, we examined the association between physical distance to hospitals and heart disease mortality. The geographic information system (GIS) approach was taken to integrate, visualize and analyze data from multiple sources. Hospitals in the state of Ohio were geocoded and zonal statistics were computed to quantify geographical access to hospitals at the level of Ohio's 88 counties. Whereas the results of bivariate analysis showed a significant association between distance to hospitals and heart disease mortality, this relationship was not significant when accounting for socioeconomic and socio-demographic factors. This study demonstrates the usefulness of visualized health data and makes a case for further research on associations between disease outcomes and access to health care services.
Millions of older Americans depend on services provided by Area Agencies on Aging to support their nutritional, social, and health needs. Social distancing requirements and the closure of congregate ...activities due to COVID-19 resulted in a rapid and dramatic shift in service delivery modes. Area Agencies on Aging were able to quickly pivot due to their long-standing expertise in community needs assessment and cross-sectoral partnerships. The federal Coronavirus relief measures also infused one billion dollars into the Aging Network. As the pandemic response evolves, Area Agencies on Aging are poised to be key partners in a transformed health system.
Ageism has been recognized as a global problem leading to poorer health, isolation, and workplace discrimination toward people based on their age. Consequently, there are several tools that measure ...levels and types of ageism with a focus on the quantification of degrees and types of ageism. While such quantification is valuable, this paper describes the development of an inventory, created over four stages, designed to foster introspective and collaborative thinking about age-directed values. In Stage 1, 34 items were identified through a comprehensive literature review. In Stage 2, the items were evaluated and revised via a focus group discussion. In Stage 3, the revised ASI was administered to a representative U.S. sample (N = 513). Based on factor and conceptual analysis, a revised version was tested on a second sample (N = 507) (Stage 4) and again revised. The final ASI consists of 35 age-related statements: 22 psychometrically linked to one of four domains, six related to identity, and seven that, although not aligned with statistical results, are conceptually important. Rather than provide an ageism score, the ASI is a tool for introspection and reflection about individual values and judgements about age which can lead to customized strategies to address potential age biases.
Balancing Mission and Momentum Kunkel, Suzanne
Generations (San Francisco, Calif.),
01/2022, Volume:
45, Issue:
4
Journal Article
Peer reviewed
Area Agencies on Aging (AAAs) are entering a new phase marked by a heightened focus on social determinants of health. With a mission, a history, and a legislative mandate to serve as the local hub ...for a coordinated system of health- and independence-enhancing services, AAAs are well-positioned
to address needs related to the social determinants of health. Contracting with healthcare partners to meet these needs is an opportunity to expand their role in the communities, protect their mission, and communicate and reinforce their unique areas of expertise.
Global aging Kunkel, Suzanne R; Brown, J. Scott; Whittington, Frank J ...
2014., 2014, 20140101, 2014-02-03
eBook
Using a comparative, cross-national perspective, Global Aging: Comparative Perspectives on Aging and the Life Course explores the major topics in social gerontology worldwide and the demands that the ...aging population places on a society. This comprehensive and timely guide includes contributions from international gerontology scholars and illustrates both universal and socioculturally unique aspects of aging across nations. It is organized thematically for ease of use and includes an abundance of photographs and illustrations to highlight key points.
"This book's unfading preoccupation with social context, social processes, and social structures distinguishes itself and greatly contributes to the discourse in gerontology." -The Gerontologist This ...classic text, now in its fifth edition, is distinguished by its emphasis on social context, social processes, and social structures as part of a broader understanding of the sociology of aging and the life course. Presenting an objective view of the realities of aging, both positive and negative, the book examines aging from micro/macro, personal, community, societal, and global perspectives. This fifth edition describes important changes in the field of social gerontology and the growth in such topics as diversity, global aging, and the life course. It addresses major shifts in public policy, social institutions, and aging-related programming initiatives. There is a strong focus on the changing landscape of aging, particularly in regard to social engagement, employment and lifelong learning, enhanced health and independence, and livable communities for people of all ages. Additionally, the book includes new information on the Affordable Care Act and end-of-life issues. The text is uniquely organized, featuring theoretical discussions in each chapter and topical essays between chapters. Critical thinking and review questions foster an in-depth understanding of the material. Written in an engaging style, the text is for graduate and upper-level undergraduate students; it is also used effectively in introductory gerontology classes. In addition to an Instructor's Manual, the fifth edition now includes Power- Point slides > NEW TO THE FIFTH EDITION: * Provides updated data on aging and baby boomers in the United States and worldwide * Presents expanded focus on baby boomers' impact on the larger society * Discusses major public policy changes and innovative services and programs affecting older adults * Uses detailed examples to illustrate the challenges of sorting out age, period, and cohort effects in research on aging * Covers the Affordable Care Act and up-to-date information on Medicare * Features new information on end-of-life issues * Presents provocative essays on positive and contemporary issues not typically covered, including love, sex, creativity, media representations, LGBT aging, and crime * Focuses on enhanced health and independence and aging-in-place initiatives * Provides learning objectives in each chapter and web-based extracurricular activities * Includes PowerPoint slides in addition to an Instructor's Manual
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