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Biomedical subjects

L A Wray

Publications and source records attributed to L A Wray.

7 recordsLinked to original sources
PubMed2001

Explaining the role of sex on disability: a population-based study.

PURPOSE: There is no clear consensus about how sex influences prevalent disability and through what mechanisms. We investigated whether sex had a direct independent effect on disability or whether sex had an interactive effect on the relationship between chronic diseases/conditions and disability, and whether these effects differed in middle-aged versus older adults. DESIGN AND METHODS: We used baseline data from two nationally representative health interview surveys, the Health and Retirement Study (HRS) and the Study of Asset and Health Dynamics Among the Oldest Old (AHEAD), and disability and covariate measures that were nearly identical in both surveys. Logistic regression models tested the contributions of diseases, impairments, and demographic and social characteristics on difficulties with prevalent activities of daily living (ADLs), mobility, and strength. RESULTS: Models demonstrated no direct sex effect for ADL disability in either age group after adjusting for key covariates. However, sex did exert an indirect effect on ADL disability in older adults via musculoskeletal conditions and depressive symptoms. In contrast, female sex remained strongly associated with mobility and strength disability in both age groups, net of covariates. Major interactions were also significant, including a female sex/body mass index (BMI) interaction for mobility difficulty and several sex-disease interactions for strength disability in the middle-aged group. IMPLICATIONS: The effect of sex on ADL difficulty is largely explained by social and health-related covariates in middle-aged and older adults. In contrast, the independent association of female sex with decreased strength and mobility in both groups cannot be explained by our models' social or health-related variables. In addition, the positive association of BMI with mobility difficulty is significantly worse for women than for men.

Activities of Daily Living↗
PubMed1998

The impact of education and heart attack on smoking cessation among middle-aged adults.

Considerable evidence supports the premise that higher levels of education lead to enhanced health, including protective health behaviors. This paper focuses on how education affects one health behavior known to lead to enhanced health: the cessation of smoking. In particular, the authors examine the extent to which education influences the decision by middle-aged adults to quit smoking following a heart attack, a potentially life-threatening health event. We first hypothesize that middle-aged adults with more formal education will stop smoking more readily than people with less formal education following the experience of a heart attack. Second, we ask what other factors might underlie and explain that hypothesized effect. Using longitudinal data, the authors track changes in individual smoking behaviors after a heart attack among preretirement-age Americans. We control for documented correlates of smoking and heart attack plus other factors associated with education, heart attack, and smoking that may also influence whether a person quits smoking. In addition to confirming evidence on the education-health association as well as the documented connection between heart attack and smoking cessation, this study provides a surprising twist on those links: Our results show that the move to quit smoking following the experience of a heart attack among middle-aged adults is significantly and dramatically moderated by their level of educational attainment.

Education↗
PubMed1996

The role of ethnicity in the disability and work experience of preretirement-age Americans.

Using the 1992 HRS, this study examines the effects of social and demographic risk factors, including ethnicity, as well as health and job characteristics on disability and work status among 8,701 preretirement-age Americans with work history. Analytic results indicated that non-Anglo ethnicity was not a significant predictor of disability status but that being African American was a strong significant predictor of being a past versus current worker. The primary predictors of disability and work status were health behaviors, effects of health conditions, job characteristics, and workplace adaptations, factors that lend themselves to policy manipulation.

Activities of Daily Living↗
PubMed1994

The relationship between retirement life cycle changes and older men's labor force participation rates.

This study probes the utility of older men's labor force participation rates (LFPRs) as indicators of the work-to-retirement transition. Specific attention is directed at how shifts in the retirement life cycle are related to LFPRs. Based on Current Population Survey data for the 1970s, a life table modeling approach showed that LFPRs are relatively weak indicators of the work-to-retirement transition. This was demonstrated by the relative stability in older men's age profiles of LFPRs despite significant changes in the timing and "organization" of the work-to-retirement transition. The 1970s evidenced a contraction of the main career and the expansion of both post-retirement work activity and retirement, yet none of these changes substantially altered the age profiles of older men's labor force participation rates.

Aged↗
PubMed1993

Funding and policies affecting geriatric rehabilitation.

Policy makers and practitioners are increasingly acknowledging the need to shift health care expenditures toward cost-effective strategies that reduce disability and dependency in older persons. That need is driven by current research on disability and population aging, disability interventions, and the inadequacy of the existing service delivery system for chronic care needs. How disability and dependency should be reduced most effectively and efficiently is a critical yet unanswered policy question.

Aged↗
PubMed1992

Health policy and ethnic diversity in older Americans. Dissonance or harmony?

The rapid growth and diversity of the older population have long-term implications for health care policies in the United States. Current policies designed for a homogeneous population are increasingly obsolete. To ameliorate obstacles that handicap many ethnic minority elders and to provide equal access to adequate and acceptable health care, several factors need to be considered. Enhanced data collection and analytic techniques are needed. The effects of race or ethnicity must be separated from other biologic, environmental, socioeconomic, cultural, and temporal factors on health status and behavior. Health care professionals and organizations serving minority elders must continue to expand their advocacy efforts to articulate the findings and their concerns to policymakers. Policymakers must understand and acknowledge the implications of an increasingly diverse society and determine what will constitute adequate, accessible, and acceptable health care within continuing fiscal constrains. Program planning, implementation, and evaluation methods must be revised to meet future health care needs effectively and efficiently.

Black or African American↗