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Economic Fragility of Older Adults: Factors Contributing to a Continuing Crisis. 老年人的经济脆弱性:造成持续危机的因素。
IF 2 3区 社会学 Q2 GERONTOLOGY Pub Date : 2024-08-27 DOI: 10.1080/08959420.2024.2384190
David B Miller, Khalil M Brown, Kathryn Betts Adams

With rapid population aging in the U.S. a greater number of older adults now experience economic insecurity, a situation disproportionately affecting older people of color. The COVID pandemic, rising inflation, and increasing economic inequality have reduced the purchasing power of both wages and fixed incomes. Compared with prior cohorts, the current cohort of adults at or nearing retirement age faces higher levels of secured and unsecured debt burden from mortgages, home equity loans, student loans, credit cards, and out-of-pocket medical costs. Long-standing disparities in opportunities and generational wealth have resulted in more outstanding debt for Black older adults than their white counterparts. This "financial fragility" may result in older people foregoing proper nutrition, doctor's visits, needed medications, or home or car repairs, while stress about finances may contribute to chronic health and mental health conditions. Along with programs to educate and advise older adults on their pressing financial concerns, practitioners who interact with older people in many settings should incorporate needed financial assessment and referrals into their work with this population. Professional and continuing education should ensure financial literacy and awareness of financial fragility for those working with older adults.

随着美国人口的快速老龄化,越来越多的老年人现在面临经济不安全的问题,这种情况对有色人种老年人的影响尤为严重。COVID 大流行、通胀加剧以及经济不平等的加剧降低了工资和固定收入的购买力。与之前的群体相比,目前处于或接近退休年龄的成年人群体面临着更高的抵押贷款、房屋净值贷款、学生贷款、信用卡和自付医疗费用等有担保和无担保债务负担。机会和代际财富方面的长期差距导致黑人老年人的未偿债务高于白人老年人。这种 "财务脆弱性 "可能导致老年人放弃适当的营养、就医、所需药物或房屋或汽车修理,而财务压力可能导致慢性健康和心理健康问题。除了针对老年人迫切的财务问题开展教育和提供建议的计划外,在多种场合与老年人打交道的从业人员也应在其工作中为老年人提供必要的财务评估和转介服务。专业和继续教育应确保为老年人服务的人员具备财务知识,并认识到财务的脆弱性。
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引用次数: 0
Frailty and Health-Related Quality of Life Among European Older Adults: The Moderating Effect of Human Development Index. 欧洲老年人的虚弱和与健康相关的生活质量:人类发展指数的调节作用。
IF 2 3区 社会学 Q2 GERONTOLOGY Pub Date : 2024-08-27 DOI: 10.1080/08959420.2024.2384179
Tiago D Ribeiro, Helena Carvalho, Élvio Rúbio Gouveia, Marcelo Nascimento, Miguel Peralta, Adilson Marques

The Human Development Index (HDI) is a proxy for the social and economic level of countries, which is related to the health and well-being of older adults. This study aimed to examine the moderating effect of the HDI on the relationship between frailty and health-related quality of life among European older adults. Participants were 23,972 older adults (53.2% female, M = 74.2 years old, SD = 6.75 years old) from 24 European countries, joining wave 8 (2020) of the Survey of Health, Aging, and Retirement in Europe (SHARE). Multilevel modeling was used to analyze nested data. Significant differences in health-related quality of life among the several European Union countries were observed (intraclass correlation coefficient [ICC] = 0.18, LRT (1) = 5568.07, p < .001). The HDI has been shown to moderate the relationship between frailty and health-related quality of life among older adults, buffering the impact of frailty on the health-related quality of life. Since healthy aging is a priority for the European Union, policies mitigating the impact of HDI on the relationship between frailty and health-related quality of life should be implemented.

人类发展指数(HDI)是各国社会和经济水平的代用指标,与老年人的健康和福祉息息相关。本研究旨在探讨人类发展指数对欧洲老年人体弱与健康相关生活质量之间关系的调节作用。参与者是来自 24 个欧洲国家的 23,972 名老年人(53.2% 为女性,M = 74.2 岁,SD = 6.75 岁),他们参加了第八次(2020 年)欧洲健康、老龄和退休调查(SHARE)。采用多层次模型分析嵌套数据。结果显示,多个欧盟国家在与健康相关的生活质量方面存在显著差异(类内相关系数 [ICC] = 0.18,LRT (1) = 5568.07,P<0.05)。
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引用次数: 0
Factors Promoting a Sense of Home Among Older Adults in Residential Care Facilities in Italy. 促进意大利养老院中老年人家的感觉的因素。
IF 2 3区 社会学 Q2 GERONTOLOGY Pub Date : 2024-08-27 DOI: 10.1080/08959420.2024.2384323
Gabriella Facchinetti, Marzia Lommi, Giorgia Petrucci, Maria Matarese, Maria Grazia De Marinis, Michela Piredda

Understanding the housing needs of older adults is crucial for policy makers, service providers, and professional carers. Evidence about the factors that contribute to older adults' "sense of home" and their practical and policies implications are lacking. Semi-structured interviews were conducted with 78 community-dwelling older adults to investigate which structural and organizational requirements and relational-affective environments could contribute to their experiencing a sense of home. Through inductive content analysis 119 subcategories were derived and grouped into eight main categories: being considered as a person; a safe, quiet, welcoming, and personalizable environment; meaningful relationships; optional and stimulating activities; active involvement in the organization within the facility; competent care personnel; preserving life memories; facility open and integrated with the community. Findings suggest that multiple factors might influence "feeling at home," and many strategies can be adopted to facilitate older adults' successful adaptation. It is important that healthcare organizations consider these factors from a person-centered care perspective, and that care staff are trained in this type of care to enhance staff decision-making and older adults' wellbeing.

了解老年人的住房需求对于政策制定者、服务提供者和专业护理人员来说至关重要。目前还缺乏有关老年人 "家的感觉 "的因素及其实际和政策影响的证据。我们对 78 名居住在社区的老年人进行了半结构式访谈,以调查哪些结构和组织要求以及关系情感环境有助于老年人体验到家的感觉。通过归纳内容分析,得出了 119 个子类别,并将其归纳为八个主要类别:被视为一个人;安全、安静、温馨和可个性化的环境;有意义的关系;可选择的和激励性的活动;积极参与机构内的组织;有能力的护理人员;保留生活记忆;机构开放并与社区融合。研究结果表明,多种因素可能会影响 "宾至如归的感觉",可以采取多种策略来帮助老年人成功适应。重要的是,医疗机构应从以人为本的护理角度考虑这些因素,并对护理人员进行此类护理培训,以提高员工的决策能力和老年人的幸福感。
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引用次数: 0
Examining Health Differences Among Older Adults with Federal Rental Assistance in the United States. 研究美国领取联邦租金补助的老年人的健康差异。
IF 2 3区 社会学 Q2 GERONTOLOGY Pub Date : 2024-08-27 DOI: 10.1080/08959420.2024.2384197
Meghan Jenkins Morales

About 1.8 million older adults receive rental assistance in the United States, but surprisingly little is known about their health, especially among the growing number of older housing choice voucher (HCV) holders. This is the first known study to use nationally representative data (2006-2018) from the National Health Interview Survey merged with Department of Housing and Urban Development (HUD) administrative data to describe the health of older HUD renters (N = 4,582) living in public housing, multifamily housing, or receiving an HCV. Logistic regression models were used to examine potential health differences by HUD program type. Contrary to expectations, the results suggest that older HCV holders were more likely to experience health challenges compared to older adults with project-based assistance. The results bring awareness to the health challenges experienced by older HCV holders and emphasize the need for future research to examine why older HCV holders are more likely to experience these health challenges. Policy makers and program administrators must consider how the HCV program has significantly aged in the past two decades and consider what program and policy changes are necessary to ensure that older adults have access to affordable housing that matches their changing needs and preferences.

在美国,约有 180 万老年人接受租房援助,但令人惊讶的是,人们对他们的健康状况知之甚少,尤其是在越来越多的老年住房选择券(HCV)持有者中。这是第一项利用国家健康访谈调查的全国代表性数据(2006-2018 年)与住房和城市发展部(HUD)的行政数据合并进行的研究,旨在描述居住在公共住房、多户住房或接受 HCV 的 HUD 老年租房者(N = 4,582 人)的健康状况。我们使用逻辑回归模型来研究 HUD 计划类型在健康方面的潜在差异。与预期相反,结果表明,与获得基于项目援助的老年人相比,持有 HCV 的老年人更有可能面临健康挑战。这些结果使人们意识到了持有高危住房的老年人所面临的健康挑战,并强调了未来研究的必要性,即研究为什么持有高危住房的老年人更有可能面临这些健康挑战。政策制定者和项目管理人员必须考虑 HCV 项目在过去 20 年中是如何显著老化的,并考虑有必要对项目和政策进行哪些调整,以确保老年人能够获得符合其不断变化的需求和偏好的经济适用房。
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引用次数: 0
Leveraging Higher Education in Our Age-Friendly World. 在老龄友好型世界中利用高等教育。
IF 2 3区 社会学 Q2 GERONTOLOGY Pub Date : 2024-08-27 DOI: 10.1080/08959420.2024.2384187
Kathy Black, Patricia Oh, Joann Montepare, Leonard Kaye

There is increasing interest in better understanding the connection between higher education and age-friendly community efforts. The global age-friendly community (AFC) movement calls for multi-sectoral engagement in a multi-year model encompassing four core phases (engage, plan, act, measure) to improve livability in domains of community life pertaining to the built, social, and service environment. However, there is limited empirical knowledge regarding the involvement of higher education and how it supports AFC efforts. We used qualitative inquiry to assess the engagement of U.S. institutions as reported by 80 AFCs that completed a five-year cycle of participation. We conducted directed content analysis using paired AFC action plans and progress reports (n = 56) and classified engagement using a priori indicators by higher educational core activities (teaching, research, and service), core phases (e.g. measure), and clustered domain areas (e.g. built environment). Results reveal engagement across all core activities of higher education with most efforts in research, in all areas of the AFC model with most reported in the action phase, and across all clustered domains of practice with the greatest amount identified in the social environment. We identify opportunities for greater engagement and leadership through higher education in our age-friendly world.

人们越来越希望更好地了解高等教育与老年友好社区工作之间的联系。全球老年友好社区(AFC)运动呼吁多部门参与到一个包含四个核心阶段(参与、规划、行动、测量)的多年期模式中,以改善与建筑、社会和服务环境相关的社区生活领域的宜居性。然而,关于高等教育的参与及其如何支持 AFC 工作的经验知识却很有限。我们采用定性调查的方法来评估美国院校的参与情况,80 个完成了五年参与周期的 AFCs 报告了这一情况。我们使用配对的 AFC 行动计划和进度报告(n = 56)进行了定向内容分析,并使用先验指标对高等教育核心活动(教学、研究和服务)、核心阶段(如措施)和集群领域(如建筑环境)的参与情况进行了分类。结果显示,高等教育的所有核心活动都有参与,其中研究领域的参与最多;AFC 模型的所有领域都有参与,其中行动阶段的参与最多;所有实践领域都有参与,其中社会环境领域的参与最多。我们发现,在我们这个老龄友好型世界中,通过高等教育提高参与度和领导力是大有可为的。
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引用次数: 0
Older people's Contributions During the COVID-19 Pandemic Response. 老年人在 COVID-19 大流行应对期间的贡献。
IF 2 3区 社会学 Q2 GERONTOLOGY Pub Date : 2024-08-26 DOI: 10.1080/08959420.2024.2384322
Merryn Gott, Janine Wiles, Tessa Morgan, Lisa Williams, Kathryn Morgan, Stella Black, Anne Koh, Elizabeth Fanueli, Jing Xu, Hetty Goodwin, Dihini Pilimatalawwe, Tess Moeke-Maxwell

During the COVID-19 pandemic, older people were identified as requiring additional support and protection. This multi-method qualitative study shifts this narrative by asking: how did older people contribute to the COVID-19 public health response? We conducted a reflexive thematic analysis of responses from 870 letter-writers and 44 interviewees who were older people living in Aotearoa, New Zealand during the COVID-19 pandemic. Older people made substantial contributions during the COVID-19 pandemic through: 1) volunteering; 2) nurturing; and 3) advocacy/activism. We argue that policy makers should take seriously the ways older people were providers of help and support in this period.

在 COVID-19 大流行期间,老年人被认为需要额外的支持和保护。这项采用多种方法的定性研究改变了这种说法,提出了以下问题:老年人是如何对 COVID-19 公共卫生响应做出贡献的?我们对 COVID-19 大流行期间居住在新西兰奥特亚罗瓦的 870 位写信者和 44 位受访者的回复进行了反思性专题分析。在 COVID-19 大流行期间,老年人通过以下方式做出了巨大贡献:1)志愿服务;2)养育;3)宣传/活动。我们认为,决策者应认真对待老年人在此期间提供帮助和支持的方式。
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引用次数: 0
Between Choice and Coercion? The Processes of Increased Economic Vulnerability Among Low-Income Older Workers. 在选择与胁迫之间?低收入老年工人经济脆弱性增加的过程。
IF 2 3区 社会学 Q2 GERONTOLOGY Pub Date : 2024-08-22 DOI: 10.1080/08959420.2024.2384327
Einat Lavee, Marjo Kuronen

The social phenomenon of extended working age has been subject to broad scholarly and social policy interest, as part of such trends as the aging of the population, increased life expectancy, shortage of the labor force, and policy debates on pension reforms. A major question about extending working age, or working after retirement, is whether it is a matter of choice, taking control of one's later life, or is coerced, part of entering the precariat. This study provides a nuanced examination of the social processes that direct labor market participation among older workers by conducting an analysis of in-depth interviews with 42 low-income older workers in Israel. The study exposed several institutional constraints that increase their economic vulnerability, demonstrating how interrelated structural factors related to the labor market, gender, and immigration shape the precarity of the life of older workers and coerce their continuous labor market participation. We conclude by emphasizing the responsibility of governments to ensure that older workers' labor market participation truly represents their "choice and control," rather than being a matter of coercion.

作为人口老龄化、预期寿命延长、劳动力短缺以及养老金改革政策辩论等趋势的一部分,延长工作年龄这一社会现象受到了学术界和社会政策的广泛关注。关于延长工作年龄或退休后工作的一个主要问题是,延长工作年龄或退休后工作是一种选择,是对自己晚年生活的掌控,还是被迫,是进入 "不稳定群体 "的一部分。本研究通过对以色列 42 名低收入老年劳动者的深入访谈分析,对引导老年劳动者参与劳动力市场的社会过程进行了细致的研究。研究揭示了增加老年工人经济脆弱性的几种制度性制约因素,说明了与劳动力市场、性别和移民相关的相互关联的结构性因素是如何形成老年工人生活的不稳定性并迫使他们持续参与劳动力市场的。最后,我们强调政府有责任确保老年工人参与劳动力市场真正代表了他们的 "选择和控制",而不是胁迫。
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引用次数: 0
Can Long-Term Care Insurance Change Eldercare Patterns? Evidence from China. 长期护理保险能否改变老年人护理模式?来自中国的证据。
IF 2 3区 社会学 Q2 GERONTOLOGY Pub Date : 2024-08-22 DOI: 10.1080/08959420.2024.2384183
Chenyang Shao, Yiwen Shangguan, Wenshun Li

Long-term Care Insurance (LTCI), providing care services and economic compensation to older adults with activity limitations, plays a crucial role in addressing the care needs of older adults and easing the burden on family caregivers. This article is based on the 2011-2018 China Health and Retirement Longitudinal Study (CHARLS) and uses China's LTCI pilot program as a quasi-experiment to examine the impact of LTCI on older adults' care patterns in China. It employs a staggered difference-in-differences (staggered DID) methodology to model the economic support, living arrangements and care, and spiritual comfort provided to older adults. Results indicate that LTCI significantly enhances the economic and emotional independence of older adults. On the one hand, LTCI effectively decreases the economic and emotional dependence of older adults on their children. On the other hand, LTCI raises the likelihood that older adults rely on social institutions and personnel for care. Additionally, LTCI is associated with achieving higher life satisfaction. Interestingly, the impact of LTCI varies significantly across sub-samples of different types of older adults and different policy regulations. Overall, findings indicate that LTCI shifts older adults' care patterns from family to socialized care, thereby reducing children's caregiving burden.

长期护理保险(LTCI)为活动受限的老年人提供护理服务和经济补偿,在满足老年人护理需求、减轻家庭护理者负担方面发挥着至关重要的作用。本文基于 2011-2018 年中国健康与退休纵向研究(CHARLS),以中国的长护险试点项目为准实验,探讨长护险对中国老年人护理模式的影响。研究采用交错差分法(staggered difference in-differences, staggered DID)对老年人的经济支持、生活安排和护理以及精神慰藉进行建模。结果表明,长期护理保险能显著提高老年人的经济和情感独立性。一方面,长期护理保险有效降低了老年人在经济和情感上对子女的依赖。另一方面,长期护理保险提高了老年人依赖社会机构和人员提供护理的可能性。此外,长期护理保险与获得更高的生活满意度有关。有趣的是,在不同类型的老年人和不同政策法规的子样本中,长期护理保险的影响有很大不同。总体而言,研究结果表明,长期护理保险将老年人的护理模式从家庭护理转变为社会化护理,从而减轻了子女的护理负担。
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引用次数: 0
A Review of Public Sector Engagement in Age-Friendly Community Initiatives. 公共部门参与老龄友好社区倡议回顾。
IF 2 3区 社会学 Q2 GERONTOLOGY Pub Date : 2024-08-19 DOI: 10.1080/08959420.2024.2376934
Natalie E Pope, Emily A Greenfield, Laura Keyes, Elizabeth Russell

The global age-friendly cities and communities (AFCC) movement has centered on the involvement of the public sector, calling on high-ranking authorities to commit to improving the built, social, and service environments of their localities. This interpretive review aimed to advance understanding of the ways in which the public sector is involved in AFCC efforts. Based on emergent themes from peer-reviewed articles from the United States and Canada published since 2010, we derived a two-dimensional framework for conceptualizing variability in public sector involvement, encompassing the internal/external (a) locus of responsibility for cross-sector change and (b) target for cross-sector change. We discuss implications for research, policy, practice, and further knowledge development in AFCC implementation.

全球老年友好型城市和社区(AFCC)运动的核心是公共部门的参与,呼吁高层当局致力于改善当地的建筑、社会和服务环境。本解释性综述旨在进一步了解公共部门参与老年社区和社区发展运动的方式。根据 2010 年以来美国和加拿大发表的同行评审文章中出现的主题,我们得出了一个两维框架,用于概念化公共部门参与的可变性,包括内部/外部(a)跨部门变革的责任定位和(b)跨部门变革的目标。我们讨论了对研究、政策、实践的影响,以及在实施 AFCC 过程中进一步开发知识的意义。
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引用次数: 0
Policy Responses to the Healthy Aging Challenge: Confronting Hybridity with Social Innovation. 应对健康老龄化挑战的对策:以社会创新应对混合性。
IF 2 3区 社会学 Q2 GERONTOLOGY Pub Date : 2024-08-01 DOI: 10.1080/08959420.2024.2384176
Jen Nelles, Lauren Tuckerman, Nadeen Purna, Judith Phillips, Tim Vorley

Tackling the issue of healthy aging in society is complex. It requires an interdisciplinary perspective and different forms of innovation. This article provides a commentary on the role of innovation policy in addressing healthy aging, particularly in the UK context. We argue that the wide range of economic activities related to healthy aging is part of a hybrid domain rather than a single sector. This represents a new generation of innovation policy for healthy aging which prioritizes understanding how different actors can be connected to support a spectrum of types of innovation which will contribute to providing better goods, services, and practices for older people. We explore social innovation as it relates to hybrid domains such as healthy aging and discuss the role of place in creating policy which generates both societal and market value. We recommend that policymakers use these concepts to build a better understanding of the economies that are evolving around healthy aging and where opportunities exist to better conceptualize, connect, and support actors, initiatives, and places to optimize economic potential and social outcomes.

解决社会中的健康老龄化问题十分复杂。它需要跨学科的视角和不同形式的创新。本文对创新政策在解决健康老龄化问题中的作用进行了评述,尤其是在英国的背景下。我们认为,与健康老龄化相关的广泛经济活动是混合领域而非单一部门的一部分。这代表了新一代的健康老龄化创新政策,它优先考虑了解如何将不同的参与者联系起来,以支持各种类型的创新,这将有助于为老年人提供更好的商品、服务和实践。我们探讨了社会创新与健康老龄化等混合领域的关系,并讨论了地方在制定既能产生社会价值又能产生市场价值的政策中的作用。我们建议政策制定者利用这些概念,更好地了解围绕健康老龄化发展的经济,以及存在哪些机会来更好地构思、连接和支持参与者、倡议和地方,以优化经济潜力和社会成果。
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引用次数: 0
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Journal of Aging & Social Policy
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