Wage determination and discrimination among older workers.

In this study, the determinants of the wage rates of a large sample of individuals aged 58 to 63 are first analyzed. Second, an explanation for the large discrepancies existing between the average wage rates earned by whites and nonwhites and by men and women is attempted. Human capital and geographic variables were found to be important wage determinants. Education, vocational training, years of job tenure, health, region of residence and local cost of living were significant explanators, especially for whites. Differences in these variables, however, cannot completely explain the wage differentials that exist by race and sex. There is a large unexplained component (especially in the male-female comparison) offering evidence of race and sex discrimination among older workers. In the case of sex discrimination, much of the problem appears to be occupational segregation--the crowding of women into low paying industries and occupations.     

Anemia and decline in physical performance among older persons

PURPOSE: Anemia is prevalent in old age and is potentially modifiable, but its effects on physical function have not been determined. We examined whether anemia in older persons increases the risk of subsequent decline in physical function, as measured by objective performance-based tests. METHODS: Participants in this 4-year prospective cohort study included 1146 participants, aged 71 years or older, living in Iowa and Washington counties, Iowa. Anemia was defined according to World Health Organization (WHO) criteria as a hemoglobin concentration below 12 g/dL in women and below 13 g/dL in men. An assessment of standing balance, a timed 2.4-m walk, and a timed test of five chair rises were used to assess physical performance; these were combined into a 0 (poor) to 12 (excellent) summary scale. RESULTS: After adjustment for baseline performance score, health status, and demographic characteristics, anemia was associated with greater mean decline in physical performance over 4 years; the adjusted mean decline was 2.3 (95% confidence interval [CI]: 1.7 to 2.8) in subjects with anemia and 1.4 (95% CI: 1.2 to 1.5) in those without anemia (P = 0.003). The association between anemia and greater physical decline was also present in participants who were free of diseases associated with anemia (cancer, infectious disease, and renal failure), and after adjustment for serum cholesterol, iron, and albumin levels. Persons with borderline anemia, a hemoglobin concentration within 1 g/dL above the WHO criteria, also showed greater mean physical decline (1.8; 95% CI: 1.5 to 2.2) than did those with higher hemoglobin concentrations (P = 0.02). CONCLUSION: This study suggests that anemia in old age is an independent risk factor for decline in physical performance.     

HIV-related behavioral risk factors among older female sex workers in Guangxi,China

Previous literature suggests a high rate of HIV infections among older female sex workers (FSWs) in China. However, limited data are available regarding HIV- related behavioral risk factors among this population. In the current study, we aim to examine the demographic and behavioral factors that place older FSWs at a high risk of HIV infection. We conducted secondary analysis of the 2010 National Sentinel Surveillance (NSS) data from Guangxi, China. A self-administered, standard behavioral surveillance survey was completed by a total of 12,622 FSWs in Guangxi, China. The Guangxi 2010 NSS sample included 19.4% FSWs aged 35 years or older (“older FSWs”). The overall HIV prevalence was 1.0% for the entire sample with 2.0% among older FSWs and 0.8% among younger ones. Older age was an independent predictor of unprotected sex, injection drug use, and a self-reported history of syphilis infection. Future HIV prevention interventions targeting FSWs should consider older FSWs' vulnerable status. Efforts are needed to address their financial needs and invest in skills for socio-economic empowerment.     

Health and labor force participation among older workers in Switzerland: a growth curve analysis

This study investigated how individual trajectories of self-rated health (SRH) and working hours among older workers in Switzerland are interrelated and how this relationship varies based on occupation. We used data from the Swiss Household Panel to analyze the long-term trajectories of older workers measured in terms of working hours and SRH. The sample included more than 4000 workers aged 50 to 65(men)/64(women). We ran a bivariate response multilevel model for growth that allowed the examination of between- and within-individual changes over time. On a between-individual level, we found that the upper non-manual workers were the most heterogeneous occupational group in terms of working hours and the lower non-manual workers were the most heterogeneous occupational group in terms of health. Within all occupational groups, we found a significant relationship between the level of working hours and level of SRH. The individual-level statistics showed consistently strongest effects for manual workers. This result confirms our hypothesis that labor force participation in individuals of the manual occupational group is more sensitive to their health status. Our findings contribute to the debate regarding the importance of older workers’ health in the context of the extension of working life.     

Two-year trends in physical performance following supervised exercise among community-dwelling older veterans

The extent to which exercise can delay the normal decline in physical performance associated with aging is unknown. We examined the impact of 2 years of supervised exercise on cardiovascular fitness, flexibility, and strength in a group of elderly (age 65-74) veterans. Seventy-five patients exercised 3 days/week for 90-minute sessions emphasizing aerobic, flexibility, and strength development. Thirty-six (47%) completed 2 years of a voluntary supervised exercise program (n = 16-25 with complete data). Over a 2-year follow-up period, cardiovascular outcome variables improved significantly: metabolic equivalents increased 20% (7.4 +/- 2.2 to 9.0 +/- 2.4, P less than 0.001) and submaximal heart rate decreased 7% (131.4 +/- 14.8 to 121.0 +/- 18.5 beats/minute, P = 0.06). Resting heart rate decreased 8% (68.5 +/- 8.0 to 63.6 +/- 8.4 beats/minute, P = 0.02) but this difference did not reach statistical significance. Flexibility, measured by hamstring length, improved 11% (57.5 +/- 15.1 to 64.0 +/- 11.1 degrees, P = 0.02). Strength variables did not improve. The study indicates that improvements in cardiovascular function and flexibility achieved by the elderly in the early stages of an exercise program can be maintained for at least 2 years.     

Two-year trends in physical performance following supervised exercise among community-dwelling older veterans

The extent to which exercise can delay the normal decline in physical performance associated with aging is unknown. We examined the impact of 2 years of supervised exercise on cardiovascular fitness, flexibility, and strength in a group of elderly (age 65-74) veterans. Seventy-five patients exercised 3 days/week for 90-minute sessions emphasizing aerobic, flexibility, and strength development. Thirty-six (47%) completed 2 years of a voluntary supervised exercise program (n = 25 with complete data). Over a 2-year follow-up period, cardiovascular outcome variables improved significantly: metabolic equivalents increased 20% (7.4 +/- 2.2 to 9.0 +/- 2.4, P less than 0.001) and submaximal heart rate decreased 7% (68.5 +/- 8.0 to 63.6 +/- 8.4 beats/minute, P = 0.02). Resting heart rate decreased 8% (131.4 +/- 14.8 to 121.0 +/- 18.5 beats/minute, P = 0.06), but this difference did not reach statistical significance. Flexibility, measured by hamstring length, improved 11% (57.5 +/- 15.1 to 64.0 +/- 11.1 degrees, P = 0.02). Strength variables did not improve. The study indicates that improvements in cardiovascular function and flexibility achieved by the elderly in the early stages of an exercise program can be maintained for at least 2 years.     

Airway function in lifetime-nonsmoking older asbestos workers

Previous studies of lung function in asbestos workers have documented airflow limitation in many of the workers, but the specific influence of asbestos exposure could not be clearly differentiated from the effects of the cigarette smoking habit. In this study, airway function was evaluated in lifetime-nonsmoking, long-term workers of the mines and mills of Québec. The 17 asbestos workers in this study had worked for an average of 28 years in the mines and mills of the local asbestos industry and did not have any other respiratory industrial dust exposure. They did not have a history of previous pulmonary disease and did not meet the usual diagnostic criteria for chronic bronchitis, emphysema, or asthma. Seven of the workers met the diagnostic criteria for asbestosis and 10 workers did not. The latter group of workers did not differ from a matched control group except in terms of a higher isoflow volume (p less than 0.05). The workers with asbestosis, however, had a restrictive pattern of lung function, increased isoflow volume, and increased upstream resistance at low lung volumes (p less than 0.01). Lung biopsy in three of the patients with the disease demonstrated peribronchiolar alveolitis and fibrosis with obliteration and narrowing of the small airways. These data on lifetime-nonsmoking, long-term asbestos workers provide further evidence of small airway obstruction associated with asbestos exposure and independent of the smoking habit. This airflow limitation was observed predominantly in workers with a restrictive pattern of lung function associated with peribronchiolar alveolitis. The lifetime-nonsmoking asbestos workers without restrictive patterns of lung function had minimal dysfunction of the peripheral airways.     

Discouraged older workers: an exploratory study

The research literature has documented the social and psychological consequences of unemployment for individuals in our country. Unfortunately, few studies have examined the impact of unemployment on the older worker. This exploratory study examined the characteristics and experiences of seventy-three older unemployed workers, age fifty and above, who were discouraged and had stopped searching for a full-time job. The findings portray the discouraged older worker as potentially at risk of both economic and psychological difficulties. Participants reported feeling mildly depressed about their current unemployment situation, socially isolated and embarrassed, and were experiencing low life satisfaction generally. They also tended to use a low number of social and employment-related community services. Younger participants in the sample under age sixty, those with higher levels of education, and those suffering longer periods of unemployment tended to report having the greatest adjustment difficulties. These results reflect the challenges faced by the discouraged older worker and the need for targeted employment and supportive services to aid this population group.     

Urban-rural differences in physical performance and health status among older Japanese community-dwelling women

Background/PurposeAssessment of physical performance allows the identification of health and functional independence among older adults. Several factors, such as environmental conditions, influence the results; therefore our objective was to compare the physical performance and the health status between older Japanese women living in urban and rural communities.MethodsThe Japanese women were aged ≥65 years, and recruited in urban (n = 41, age = 73.8 ± 3.92 years) and rural (n = 54, age = 73.8 ± 4.15 years) locations through the local press. Physical performance was assessed by the Timed Up and Go (TUG), one leg stand (OLS), repeated chair stands (CS) and handgrip strength (HGS) tests. Health status was investigated using socio-demographic characteristics; anthropometric measures and body composition; physical activity, a pedometer, Life-Space Assessment (LSA); Geriatric Depression Scale; incidence of falls, fear of falling; and medical information. Variables were compared by χ² test, Independent-Samples t test and Mann Whitney U-test.ResultsRural individuals presented a better performance in the HGS test (p = 0.01) than urban individuals, who had a better performance in the CS test (p < 0.001). No statistical differences were found in the TUG or OLS tests. Rural women also had a higher body mass index (p = 0.04), waist circumference (p < 0.01), and body fat percentage (p = 0.014) than urban women, who showed higher scores in LSA (p < 0.001). Concerning medical information, more rural women complained of low back pain (p = 0.01) and gastrointestinal problems (p = 0.02).ConclusionOur findings showed that the physical performance and health status varied according to the place. Rural individuals had worse results in the CS test, but a better performance in the HGS test than urban individuals. We emphasize that health interventions should address the specific demand of each location.     

The role of illness burden in theory of mind performance among older adults

Background/Study Context: Theory of Mind (ToM) reflects the ability to reason about mental states in order to understand and predict behavior. Research has identified links between increased pulse pressure, a measure of vascular health, and reduced cognitive ToM in older adults. However, the relationships between other vascular and nonvascular conditions and reduced ToM are unknown. We examined (1) illnesses as predictors of cognitive and affective ToM and (2) neurocognitive mediators of illness burden and ToM. Methods: We used hierarchical regression and mediation to investigate the effects of vascular illness burden (hypertension, Type 2 diabetes, high cholesterol, and high pulse pressure) and nonvascular illness burden (osteoporosis, osteoarthritis, rheumatoid arthritis, and thyroid dysfunction) on cognitive and affective ToM in N = 86 community-dwelling older adults (59 females; 27 males, M age = 71.74 years). Results: Vascular illness burden emerged as a significant predictor of older adults’ cognitive ToM (R² = .43, p < .001), and this relationship was mediated by executive functioning. Nonvascular illness burden did not predict cognitive nor affective ToM in this sample. Conclusion: Our findings highlight the specific importance of considering vascular health as a risk factor for declines in ToM in later life. Further elucidation of the associations between health, neurocognition, and ToM will be valuable in developing effective interventions for older adults given the high prevalence of vascular illness in later life.     

Job perceptions and intent to leave among direct care workers: evidence from the better jobs better care demonstrations

PURPOSE: We assess how perceived rewards and problems with caregiving work and supervision relate to intent to leave among direct care workers who are employed in provider organizations participating in the Better Jobs Better Care (BJBC) demonstration; we also examine how these relationships vary by provider type. DESIGN AND METHODS: Direct care workers from 50 skilled nursing facilities, 39 home care agencies, 40 assisted living facilities, and 10 adult day services in five states completed a paper survey administered prior to the implementation of the BJBC interventions in each organization. We include direct care workers (n = 3,039) with complete data in the analyses using multinomial regression clustered by provider organization to compare those not at all likely to leave and those very likely to leave in the next year with a middle referent group who are somewhat likely to leave. RESULTS: Logistic regression results were that work overload and lack of upward mobility increased intent to leave. Respondents with positive assessments of their supervisor, who valued helping others, and for whom the income was perceived as rewarding were less likely to be in the very likely to quit category and more likely to be in the stable category. Some differences between provider types are observed, especially between home care workers and those employed in facilities. IMPLICATIONS: These findings provide support for many of the management-practice improvements taking place in the field, including those implemented in the BJBC demonstration. Follow-up surveys will provide insight into their effectiveness.