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Biomedical subjects

C F Longino

Publications and source records attributed to C F Longino.

At least 19 recordsLinked to original sources
PubMed2001

"Going home" or "leaving home"? The impact of person and place ties on anticipated counterstream migration.

PURPOSE: The probability of anticipated return migration in retirees is explored. DESIGN AND METHODS: Survey data were analyzed from interviews with a sample of elderly European Americans who migrated to a metropolitan city on Florida's east coast following retirement. RESULTS: Results are consistent with the specification of the 2nd move in E. Litwak and C. F. Longino's (1987) life course model of retirement migration. Respondents were unlikely to anticipate a return move unless ties to the back home community made such a move possible. IMPLICATIONS: Ties with children, both back home and in Florida, significantly influence consideration of a return move.

Activities of Daily Living↗
PubMed1999

Functional status, assistance, and the risk of a community-based move.

This study examined the effects of declining functional status and the availability of assistance on community-based residential mobility. Wolinsky and colleagues (1993), using data from the 1984, 1986, and 1988 waves of the Longitudinal Study on Aging, reported other transitions that result from increased health demand, namely those of nursing home placement and death. Using their functional health scales and recently available statistical techniques, we performed a two-stage analysis within a health behavior conceptual framework. We conclude that older adults who report several cognitive limitations in the absence of assistance in the home are more likely to make residential changes. Additionally, we determined that the independent effects of cognitive and lower body deterioration trigger, in this case, community-based moves even when adjusting for the effect of baseline levels of functional health and other factors in the model. Our analysis extends the earlier findings of Wolinsky and colleagues to encompass residential change as an ecological outcome of health decline in old age.

Activities of Daily Living↗
PubMed1998

The timing of change: patterns in transitions in functional status among elderly persons.

Data from the Longitudinal Study on Aging (LSOA) were analyzed to describe the heterogeneity of functional status transitions over 2-years (single-state model), and to explore whether changes in status in the previous two to four year period enhance the prediction of a subsequent transition (two-state model). Multivariate logistic regression with a robust estimate of variance was used to analyze a 7-category nominal response of: functional status (4 levels), institutionalization, death, and missing. Weighted percentages for functional status transitions and stability (unchanged status) showed that unchanged or improved functioning were at least as common as death or worsened functional status. Initial disability level, morbidities, and self-rated health were the strongest predictors of disability status after 2-years. The two-state model revealed that a previous transition (positive or negative) increases the risk for a subsequent transition, independent of initial disability level. The predictive and explanatory quality of the two-state model is substantially improved over single-state models, particularly from its ability to identify subgroups of individuals with marked functional status instability.

Activities of Daily Living↗
PubMed1998

The limits of scientific medicine: paradigm strain and social policy.

In this essay, the historical roots of the dominant medical worldview will be drawn and its tenets will be outlined. The existing paradigm may be called the Western Biomedical Model, whose doctrines include body-mind dualism, physical reductionism, the mechanical analogy, specific etiology and the body as the appropriate focus of regimen and control. Some of the pressures straining the paradigm will be discussed, especially the force of human and population aging and the accompanying dominance of chronic illness as a focus of health care. The tentative outlines of an emergent model will be described in the context of the current health policy debate. The mind, biography, surrounding environment, and culture are a few considerations that become very significant in a non-Cartesian world.

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PubMed1998

Women, marital status, and symptoms of depression in a midlife national sample.

Previous studies of the correlates of depression among women have not generally been based on adequate midlife samples or precision in the specification of marital status categories. The present analysis is designed to address these deficiencies and is based on data from the Health and Retirement Survey-Wave 1 (i.e., respondents 51 to 61 years old). Results indicate that married women are less likely to report symptoms of depression than their unmarried counterparts. The mental health benefits of marriage are greater for men than for women. Moreover, other variables, such as marital satisfaction, self-rated health, and employment status are more powerful predictors of emotional well-being in midlife than marital status per se. The quality of marriage affects depressive symptoms more strongly for women than men.

Age Factors↗
PubMed1997

Benefits of linkage to the National Death Index in the Longitudinal Study of Aging.

To reduce the potential bias resulting from differential loss to follow-up in the Longitudinal Study of Aging (LSOA), information obtained from household contact methods was supplemented with information from the National Death Index (NDI). This article examines the degree of agreement in the vital status data from two sources (reinterview contacts and the NDI system) and evaluates the potential gains of using the NDI data as a supplement to define participants' vital status. Results reveal that NDI information, used to supplement reinterview information, can substantially reduce bias due to the differential loss of participants to follow-up. Reliance on reinterview information alone was less likely to capture those deaths occurring in study participants who at the initial contact lived alone, were below the poverty index, were interviewed without use of a proxy, did not supply a phone number, and did not own a home.

Aging↗
PubMed1997

Ability, disability, and the oldest old.

A measure of range of ability is used to profile the 85-years-old-and-older (oldest old) population, including the highly disabled institutional population. This new measure uses two new questions available in the 1990 Decennial Census concerning a self-care limitation and a mobility limitation as well as the usual question concerning a work limitation. In addition to examining the extent of disability among the oldest old, the article examines the extent of care potentially available in the household as well as the economic characteristics of this age group. It is also profiled in terms of relevant personal characteristics, including age, gender, marital status, race, ethnicity, rural residence, education, and employment. A key question addressed is the need for help or care among the oldest old and how various long-term care proposals would meet such needs. A careful analysis of this unique and growing population is necessary to both allay fears of the cost of care or help as well as to dispel stereotypes of this age group as frail and dependent, and in need of institutional care.

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PubMed1997

The therapeutic role in later life: husbands, wives and couples.

The present study investigates the extent to which marital partners are different or similar in their ways of enacting the therapeutic, or supportive, role. Specifically, the article compares husbands and wives categorically as in non-dyadic studies and then as marital partners as in dyadic studies. In addition, this study, by using data from the Aging Couples Study, included only dual-earner couples so as to control for the effects of work life on marital relations. Results showed that studies of individual married men and women understate the differences between marital partners in that some wives "overbenefit" in the exchange of conjugal supports. However, husbands more often "overbenefit." Findings also indicated that the norm of reciprocity does not prevail regarding the extent of support, although it does for the types of support exchanged.

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PubMed1997

Pressure from our aging population will broaden our understanding of medicine.

This essay speculates about how medical philosophy may change to accommodate the technologic, organizational, and--in particular--population challenges of the future. The historical roots of the dominant medical world view are drawn and its tenets outlined. The existing paradigm may be called the Western biomedical model, whose doctrines include body-mind dualism, physical reductionism, the mechanical analogy, specific etiology, and the body as the appropriate object of regimen and control. Some of the pressures straining the paradigm are discussed, especially the force of human and population aging as it accelerates the dominance of chronic illness and focus of health care. The tentative outlines of an emergent paradigm are described. The mind, biography, surrounding environment, and culture are a few considerations that become very significant in a non-Cartesian world.

Aged↗
PubMed1995

Rural and urban differences in mortality among Americans 55 years and older: analysis of the National Longitudinal Mortality Study.

Previous research on rural and urban differences in risk of mortality has been inconclusive. This article used data from the National Longitudinal Mortality Study to establish whether all-cause mortality risk among persons 55 years and older varies by degree of urbanization, controlling for the potential sociodemographic confounders of age, gender, race/ethnicity, education, income, and marital status. Using the Cox Proportional Hazards Regression Procedure, the authors found that persons living in the most rural locales and those living in rural communities in standard metropolitan statistical areas (SMSAs) have the lowest risk of mortality, while those living in SMSA central cities had the highest risk of dying during the study period. The protective effect of rural residence declines in older age cohorts.

Age Factors↗
PubMed1994

How does the mobility of the elderly affect health care delivery in the U.S.A.?

This review essay explores the mobile elderly's impact upon health care services in the U.S.A. Particular attention is placed on the strategic decisions made by the elderly in preparation for their moves, the mediation of cost factors as they pertain to socioeconomic status and institutional provisions for illness treatment, and the extent to which provider services are responsive to changes in demand. The discussion is structured around five questions: 1) what health care strategies do international elderly seasonal migrants use; 2) do seasonal migrants in popular destination cities in the U.S.A. seasonally burden the service system; 3) does the concentration of retirees in rural communities burden the health care system over time; 4) can the territorial patterns of movement to nursing homes in rural counties be viewed in market terms; and 5) does the migration of older veterans have a measurable impact on the veterans administration in the U.S.A.? The most illustrative study to answer each question was reviewed.

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PubMed1993

Net worth and the economic diversity of the elderly.

Using data from the 1984 panel of the Survey of Income and Program Participation (SIPP), this article examines characteristics of the older population disaggregated by net-worth quintiles. The authors argue that income is not a sufficient measure of economic status for current policy discussions on issues such as changing Medicare co-payments, increasing the taxation of social security benefits, or means-testing under Medicaid. Net worth is a better measure of economic status, particularly for the elderly, because it represents the net value of assets accumulated over the life course. Their results indicate that there is considerable diversity in the economic status of the older population, which is masked by aggregate statistics (such as means and medians) typically used to summarize the economic status of population groups. Stereotypical views of the elderly based on such aggregates result in misdirected policy formulation. In the future, policymakers will need to formulate policies and programs using information on the distributions of income and assets among the older populations rather than relying on statistical aggregates.

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PubMed1992

Regional differences in the characteristics of elderly return migrants.

We examined return migrants age 60+ and argue from a regional analysis of their population characteristics that they fall into two primary types of movers: provincial return migrants and counterstream return migrants. When profiled as a whole, using 1980 census microdata, return migrants are older and more residentially dependent than nonreturn migrants. However, when regional variations are considered, this generalization breaks down. Perhaps return to one's state of birth is overemphasized in discussions of counterstream migration. Provincial return migration seems strongest in the South, with an interesting racial twist, and counterstream return migration seems strongest in the Northeast. Conceivably it is not a return to one's state of birth that is at issue among counterstream migrants, but rather a return from a Sunbelt retirement move to an earlier place of residence, regardless of whether one was born there.

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PubMed1992

Health and geographic mobility among the recently widowed.

The death of a spouse has been described as the most disruptive and difficult role transition that an individual confronts throughout the life course. Using data from the 1984 and 1986 waves of the Longitudinal Study of Aging conducted by the National Center for Health Statistics, we examined the probability of moving associated with changes in functional disability levels over a two-year period while controlling for recent widowhood. We found that the greater the increase in instrumental disability between 1984 and 1986, the greater the probability of a move. We also found that the event of becoming a widow greatly increases the probability of a move when health declines.

Activities of Daily Living↗
PubMed1992

Veteran interstate migration and VA health service use.

Resource allocations within the VA health care system are based in part on the number of veterans in an area plus the number of veterans expected to move into the area. This paper examines the relative importance of geographic mobility as a factor affecting the use of VA health services by the older veteran population in the U.S. Using a variety of secondary data sources, we found that the variation in state VA health service admission rates is better explained primarily by the characteristics of the resident nonmobile veteran population and the characteristics of veterans migrating to the state, not just by their numbers. Health care demand projections should take these findings into account.

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