I aim to develop a Stata program that estimates multistate life table quantities and their confidence intervals while controlling for covariates of interest, as well as adjusting for complex survey ...designs. Using the Health and Retirement Study (HRS) (2000-2016), I use the new program to estimate US females' total, healthy, and unhealthy life expectancies and their intervals by race/ethnicity at age 52 (the youngest age in the sample), while adjusting for education. Using the nonparametric bootstrap technique (with replacement), the present study offers and validates an age-inhomogeneous first-order Markov chain multistate life table program. The current proposed Stata program is the maximum likelihood version of Lynch and Brown's Bayesian approach to the multistate life table method, which has been developed in R. (3) I use the estimates from the Bayesian approach to validate the estimates from the unweighted bootstrap approach. I also account for the HRS complex survey design using the HRS baseline survey design indicators (clustering, strata, and sample weights). I utilize the estimates from the unweighted and weighted bootstrap models to evaluate the extent to which ignoring the HRS complex survey design alters the estimates. The health expectancy estimates obtained from the unweighted bootstrap approach are consistent with estimates from the Bayesian approach, which ignores complex survey designs. This indicates that the bootstrap approach developed in the current paper is valid. Also, the results show that ignoring the HRS complex survey design does not meaningfully alter the estimates.
Fertility and mortality decline are major drivers of Iran’s population aging. A rapid and sharp fall in fertility rates over the past three decades as well as a substantial rise in life expectancy ...are causing rapid aging of Iran’s population. The present paper uses the 2015 United Nations Population Division data to discuss the trends, determinants and the implications of population aging in Iran. According to the medium fertility variant, people age 60 and older will represent 31% (almost 29 million people) of Iran’s population by 2050. The population age 65 and older is projected to be 22% (more than 20 million) and that of aged 80 and older 3.8% (around 3.5 million) in 2050, that are almost four-times higher than the corresponding figures in 2015. Data on the speed of population aging show that Iran is the second fastest aging country in the world in terms of the percentage point increase in the population age 60 and over between 2015 and 2050; Iran is second only to South Korea, by less than .01%. The rapid population aging of Iran has significant implications for all societal institutions and decision makers that have to be addressed by the Iranian society. Gender-related issues and socio-economic security in old age are two key issues resulting from such a fast population aging. As with many rapidly aging populations, Iran needs a strategy for social and economic supports for an aging population that will not promote views of aging people as a burden.
Objectives
Despite adverse physical and mental health outcomes related to caregiving, family caregivers also experience lower mortality rates compared to noncaregivers. However, research has not yet ...examined the role of caregiving intensity and religiosity with health and mortality among spousal caregivers.
Methods
Data include spousal caregivers (n=5,214 person-wave observations) and noncaregivers (n=50,311 person-wave observations) from the Health and Retirement Study (2004–2014 waves). Multinomial logistic regression was used to explore how caregiving intensity and religiosity were associated with health and mortality among spousal caregivers, compared health and mortality between caregivers and noncaregiving peers, and examined gender differences in these mechanisms.
Results
Greater religious salience and attending religious services, although dependent on gender and caregiving intensity, are protective for caregivers’ health and mortality.
Discussion
Religiosity may buffer adverse effects of caregiving on health and mortality for spousal caregivers. Continuation of prior religiosity may enhance positive aspects of caregiving and decrease caregiver burden.
Using the random-effects meta-analysis model, we investigated the effect of informal caregiving on all-cause mortality across 12 longitudinal population-based studies (seven United States; five ...international: United Kingdom, Northern Ireland 2, Japan, and Australia). Across the studies, the combined effect of informal caregiving on all-cause mortality was 16% lower in favor of caregivers. Subgroup analyses revealed that the relationship between informal caregiving and all-cause mortality was not significant among the U.S. studies, in contrast to the international studies. Also, the mortality advantage of informal caregivers was not evident among those studies in which informal caregiving was operationalized precisely (Activity of Daily ADL/Instrumental Activity of Daily Living IADL assistance) as opposed to more broadly. Furthermore, studies in which the kinship tie between the informal caregiver and care recipient was unspecified tended to find a mortality advantage in favor of caregivers. When covariates were considered, the results of this meta-analysis provided more support for stress theory than the healthy caregiver hypothesis.
Although the Ohio Family Satisfaction Survey (OFSS) has been around since 2002 as an important indicator of long-term care facilities’ performance, the validity of this scale has not been evaluated. ...Using the Robust Maximum Likelihood Estimator Method in Mplus, psychometric analysis involving second-order construct validity or hierarchical construct validity was conducted using responses from 1636 facilities including nursing homes and residential care facilities (N = 32,424). The results showed that OFSS retained the 7-factor structure for the 7 domains and the factor loadings for each domain were above 0.5. It is crucial to include families’ input regarding quality of long-term care facilities as some older residents, especially those with moderate to severe cognitive impairments may be unable to provide consistent and comprehensive inputs about the quality of care and services they receive. Therefore, validation of the OFSS has an important implication for quality improvement practice.
This study compared differences in overall family satisfaction, specific satisfaction domains, and correlates of satisfaction between nursing homes (NHs) and residential care facilities (RCFs), using ...data from the 2016 Ohio Long-Term Care Family Satisfaction Survey. Satisfaction was higher for RCFs overall and within nearly every domain, with the largest difference observed in the environment domain. In both facility types, higher satisfaction was associated with male respondents, older respondent age, White race, less-frequent visitation, longer anticipated length of stay, less help provided during visits, smaller facilities, lower Medicaid-reliant resident percentage, and nonprofit status. Resident age, visitation frequency, perceived assistance required, and kinship tie were differentially related to satisfaction between facility types. NH administrators should focus on the environment and the moving in process. All administrators should address how residents spend time and should be aware that residents’ and their family members’ characteristics may affect satisfaction levels.
The rise in working-age mortality rates in the United States in recent decades largely reflects stalled declines in cardiovascular disease (CVD) mortality alongside rising mortality from ...alcohol-induced causes, suicide, and drug poisoning; and it has been especially severe in some U.S. states. Building on recent work, this study examined whether U.S. state policy contexts may be a central explanation. We modeled the associations between working-age mortality rates and state policies during 1999 to 2019. We used annual data from the 1999-2019 National Vital Statistics System to calculate state-level age-adjusted mortality rates for deaths from all causes and from CVD, alcohol-induced causes, suicide, and drug poisoning among adults ages 25-64 years. We merged that data with annual state-level data on eight policy domains, such as labor and taxes, where each domain was scored on a 0-1 conservative-to-liberal continuum. Results show that the policy domains were associated with working-age mortality. More conservative marijuana policies and more liberal policies on the environment, gun safety, labor, economic taxes, and tobacco taxes in a state were associated with lower mortality in that state. Especially strong associations were observed between certain domains and specific causes of death: between the gun safety domain and suicide mortality among men, between the labor domain and alcohol-induced mortality, and between both the economic tax and tobacco tax domains and CVD mortality. Simulations indicate that changing all policy domains in all states to a fully liberal orientation might have saved 171,030 lives in 2019, while changing them to a fully conservative orientation might have cost 217,635 lives.
Abstract
Prior research has indicated that religiosity may buffer against the deleterious effects of caregiving. However, research is lacking in examining the role of religiosity and caregiving ...intensity in the context of caregiver wellbeing and mortality. Data come from the Health and Retirement Study (2004-2014 waves) and consisted of spousal caregivers and noncaregivers (n= 49,638 person-spells). Pearlin’s Stress Process Model (1990) informed this study to analyze how religiosity impacts caregiver self-rated health and mortality by comparing the intensity of provided care among spousal caregivers and spousal noncaregivers. This study used two indicators to measure religiosity: 1) the importance of religion in life and 2) frequency of attending religious services. Bivariate probit model was used to model the impact of caregiving intensity and religiosity on self-rated health and all-cause mortality. After controlling for sociodemographic and health covariates, results showed that only the importance of religion in life predicted a better self-rated health among high intense spouse caregivers defined by providing >=14 hours of care per week. Findings suggest religiosity may buffer the adverse effect of caregiving stress on health for high intense spousal caregivers. Development and maintenance of religiosity may enhance positive aspects of caregiving and decrease caregiver burden.
The present study addressed gender inequality in unpaid domestic housework and childcare activities and its presumed impact on childbearing decisions in Iran. We used the second Iran's Time Use Study ...(2014-2015), representing the urban population to investigate how the number of small children (aged seven and lower) affected the time devoted to unpaid domestic housework as well as childcare activities of urban employed couples in Iran.
The present study addressed gender inequality in unpaid domestic housework and childcare activities and its presumed impact on childbearing decisions in Iran. We used the second Iran's Time Use Study ...(2014-2015), representing the urban population to investigate how the number of small children (aged seven and lower) affected the time devoted to unpaid domestic housework as well as childcare activities of urban employed couples in Iran. The univariate analysis provided sufficient evidence of increasing workload with the number of small children for employed women, while men's workload remained almost unchanged across all parities. The results indicated that an increase in the number of small children significantly increased the workload of urban employed women, while men's meager participation in such chores suggested the existence of a significant gender gap in these activities. For example, urban employed men with no small children spent 8 hours and 43 minutes while those with one or two small children spent 8 hours and 40 minutes on paid and unpaid domestic work. In comparison, employed women with no small children spent 9 hours and 7 minutes, while those with one small child spent 9 hours and 20 minutes, and those with two small children spent 9 hours and 45 minutes on mentioned activities. Thus, the gender inequality in allocated time to paid and unpaid work peaked at 1 hour and 5 minutes in families with two and more small children. Based on the data presented, it can be concluded that along with an increasing amount of unpaid work a less gender egalitarian division of labor exists. Gender inequality in unpaid domestic work among employed couples might lead to continued low fertility and an even further reduction of it in the future in Iran.
PDF
