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Biomedical subjects

M Minkler

Publications and source records attributed to M Minkler.

At least 37 records · Page 2Linked to original sources
PubMed1993

The influence of health on family contacts and family feelings in advanced old age: a longitudinal study.

This study provides a longitudinal analysis of the influences of health, age, gender, and socioeconomic status on family contacts and family feelings in a sample of 62 members of the Berkeley Older Generation Study. Stability in family contacts and in family feelings was observed over 14 years of advanced old age. Of the four predictor variables, health and socioeconomic status accounted for the largest proportion of observed variance. Contrary to our hypotheses, study participants in better health had greater amounts of contact with family than did those in poorer health. The former also had more feelings of closeness to family members, a finding that may reflect greater possibilities for reciprocity between elders in good health and their family members.

Activities of Daily Living↗
PubMed1993

Community interventions to support grandparent caregivers.

Community interventions and service programs for grandparents raising grandchildren are being identified and tracked through the Brookdale Grandparent Caregiver Information Project. Based on the first year's examination of 124 such programs, an overview of community intervention effort is provided, with special attention to support groups and comprehensive multi-service programs for grandparent caregivers. Lack of funding and institutional support, and the consequent inability to provide child care, were among key obstacles faced, while sponsorship by health and social service agencies often played a vital role in providing in-kind support and part-time professional staff.

California↗
PubMed1992

Community organizing among the elderly poor in the United States: a case study.

This case study demonstrates the role of community organizing as a vehicle for enhancing individual and community-level empowerment. Building on social support theory, Freire's "education for critical consciousness," and the principles and strategies of community organization practice, the 12-year-old Tenderloin Senior Organizing Project reflects the World Health Organization definition of health promotion as a means of helping individuals and communities to take increasing control over the factors influencing their health. Through the Project, low-income elders have successfully identified and addressed shared problems in such areas as crime and safety, undernutrition, and tenants rights. They further have developed ongoing tenants' associations and other community-based organizations that have provided continuity over time and contributed to the development of a "competent community." Problems in areas such as funding, evaluation, and volunteer burnout are discussed, as are the potentials for project replication in other settings.

Aged↗
PubMed1992

The political and moral economy of aging: not such strange bedfellows.

The authors develop E.P. Thompson's concept of moral economy as a useful complement to contemporary political economic analysis in problem areas involving moral conflict. Defined as the shared assumptions underlying norms of reciprocity in which an economic system is grounded, moral economy is seen as holding particular relevance for the study of aging. The evolution of pension systems, the "senior revolt" against catastrophic coverage in the United States, and debates over the allocation of health resources between generations are used to illustrate the utility of a combined political and moral economy for enriching our understanding in these areas. Marx's concept of a "morality of emancipation" is described as holding particular promise for the development of a new moral economy of old age that would move beyond alienation by giving broad attention to quality of life issues at each stage of the life course.

Aged↗
PubMed1991

The short life and painful death of the Medicare Catastrophic Coverage Act.

This article draws upon a combined political and moral economy theoretical framework to explicate the rise and fall of the Medicare Catastrophic Coverage Act (CHI). Underlying factors, including the legacy of Medicare, the politics of austerity, and the declining political legitimacy of the aged in the 1970s and 1980s, are seen to have heavily shaped the unique characteristics of the legislation, such as its unpopular self-financing mechanism. Moral economy concerns with reciprocity, fairness, and just taxation are used to help explain the intensity of the "senior revolt" against CHI, which ultimately led to the legislation's repeal. The "Catastrophic catastrophe" is seen as having further eroded the political legitimacy of the old, while at the same time demonstrating the raw political muscle of this population group. Implications of the repeal of CHI for future health coverage legislation, and the impact of repeal on the states and other stakeholders, also are discussed.

Aged↗
PubMed1991

Generational equity and public health policy: a critique of "age/race war" thinking.

A potent new tool in the politics of fiscal retrenchment lies in the creation of a framework for policy analysis which implicitly or explicitly "blames" the old for poverty and economic hardships in the young. This paper examines the recent efforts to promulgate this generational equity or "age/race wars" perspective and demonstrates that opinion poll data fail to support the rhetoric of growing age/race group antagonisms over entitlement programs for the old. The assumptions underlying the generational equity framework are critiqued, and the race and ethnic issues embedded within this framework are examined. In particular, we explore spurious assumptions concerning the relative financial wellbeing of the elderly, escalating Social Security and Medicare costs as a primary cause of poverty in the young, and growing resentment of programs for the old among minorities and youth. Attempts to deligitimate the claims of the elderly through the advancement of the ideology of age/race wars are seen to have significant implications for public health policy, with the country's recent experience with the Medicare Catastrophic Coverage Act serving as an important case in point. The need for an alternative policy framework stressing the interdependence of generations is suggested, and some guiding principles put forward toward the development of such an alternative framework.

Age Factors↗
PubMed1989

Gold in gray: reflections on business' discovery of the elderly market.

Changes in the business sector's stereotype of the elderly population from a negligible consumer group to a $500 billion market are examined, with attention to both the positive and the problematic aspects of the new targeting of older consumers. Privatization, consumerism, and the rise of a geriatric social industrial complex are among the concepts used to understand recent trends. Questions are raised concerning the extensive targeting of the new elderly population market and the ethical dilemmas it may pose in a heavily consumer-oriented society.

Advertising↗
PubMed1989

Health education, health promotion and the open society: an historical perspective.

This article provides an historical perspective within which two recent, alternative directions for health education are examined. Each direction is seen as reflecting a unique vision of health promotion, with the first focusing primarily on personal behavior change and the latter on a broad empowerment/environmental model of health promotion. Key historical developments in the evolution of these two perspectives are examined, as are some of the assumptions and ideological values underlying these alternative approaches. The World Health Organization's "Healthy Cities Project" then is used to illustrate the broader vision of health promotion in practice. While recognizing that the health educator has contributions to make on both the micro and macro change levels, a case is made for moving the field of health education further in the direction of this broader model of health promotion, and roles for the health educator within such a paradigm are outlined.

Environment↗
PubMed1988

Continuity and change in social support between young-old and old-old or very-old age.

This longitudinal research examined continuity and change in social support in a sample of 74 old-old (74 to 84) or very-old (85 and over) members of the Berkeley Older Generation Study. Considerable continuity in extent of contact was found between 1969 and 1983 for the group as a whole, particularly with respect to family relationships. In beyond-family contacts, declines were observed for men but not women, and for the very-old but not the old-old. Important changes also were observed in involvement or subjective level of commitment: satisfaction with children increased, while involvement beyond the family declined.

Adult↗
PubMed1988

Assessing health differences in an elderly population: a five-year follow-up.

A sample of several hundred elderly residents of Alameda County was recontacted after 5 years to determine the effects over time of different social support and demographic variables on health status. The follow-up investigation demonstrated a strong relationship between respondents' social support resources in 1980 and their subsequent self-rated health. Indeed, social contacts in 1980, together with age and financial need, enabled us to correctly "predict" respondents' subsequent health status in close to two-thirds of the cases. As anticipated, however, the variable most strongly associated with self-rated health in the earlier cross-sectional study--illness of a mate during the preceding 6 months--disappeared as a predictor variable in the longitudinal study. This finding is in keeping with the literature on bereavement and other stressful life events which demonstrates that the health impact of such stressors is in most cases time-limited. The study findings support earlier research demonstrating the important role of social support for health maintenance and disease prevention in the elderly. They further underscore the need for intervention strategies designed to strengthen the network resources of those elders at high risk for social isolation.

Aged↗
PubMed1986

"Generational equity" and the new victim blaming: an emerging public policy issue.

Recent attempts to frame complex policy issues in terms of "justice between generations" and "intergenerational equity" are based on a series of questionable assumptions and economic calculations concerning the relative financial well-being of the elderly vis-à-vis other groups in U.S. society. On closer inspection, however, these assumptions--e.g., of a homogeneous and financially secure elderly population and of younger cohorts likely to become increasingly resentful of elderly entitlement programs--appear ill-founded. Census data revealing wide disparities in income among the elderly, and national opinion poll data suggestive of a large cross-generational and cross-ethnic group "stake" in Social Security and Medicare, are used to suggest that the intergenerational equity framework may well be an inappropriate one in the public policy arena. Such a framework, moreover, is seen as deflecting attention from more basic inequities in U.S. society and from the need for major policy shifts in response to these more fundamental problems.

Aged↗
PubMed1985

Supportive ties: a political economy perspective.

The growing body of evidence linking social support and health has important implications for health promotion, disease prevention and treatment. But serious unsolved problems remain in the areas of research, practice and policy. Key among these are the ethical issues which arise when the reality of the importance of social support is translated simplistically into a policy emphasis stressing individual and interpersonal responsibility for health and justifying major cutbacks in health and social programs. This article examines the interdependencies between supportive ties on the individual and community levels and the larger social and political environments within which social networks operate. The effectiveness of families and other micro level support systems is seen as heavily dependent upon the adequacy of programs and policies on the local state and national levels which provide help with income maintenance, housing, transportation and other basic necessities. The cutting back of these more basic programs and services will be seen to disrupt the delicate web of natural relationships. Professionals concerned with the application of social support and health findings need to look beyond the individual and interpersonal levels toward policy and institutional level interventions. They thus may make an important contribution in advocating on behalf of those policies and programs which are critical to the effective functioning of natural helping networks, and which are at the same time faced with cutbacks. By helping alert colleagues, policy makers and the public both to the promise of the social support and health findings, and to the interdependence of support on local, state and national levels, health educators and others in the health professions may help to facilitate the effective application of these findings in policy and practice.

Adaptation, Psychological↗
PubMed1985

Building supportive ties and sense of community among the inner-city elderly: the Tenderloin Senior Outreach Project.

For the low-income elderly residents of America's single room occupancy (SRO) hotels, poor health, social isolation, and powerlessness often are intimately connected. This article presents a case study of an attempt to address these interrelated problems by fostering social support and social action organizing among elderly residents of San Francisco's Tenderloin hotels. Following a brief look at the parameters of the problem, an overview of the Tenderloin Senior Outreach Project (TSOP) is presented. The Project's theoretical base is described, followed by a brief account of TSOPs genesis and growth from an informal University-sponsored project to a privately incorporated community-based organization. Examples of individual and community empowerment through TSOP are presented, as is a look at some of the dilemmas and compromises that are encountered as a community group trades its grassroots status for a more formal and bureaucratized structure. Problems in the areas of indigenous leadership development and community versus funding agency agendas are examined, as is the utility of combining social action and social planning approaches to community organizing. Finally, the potentials and limitations of Freire's "education for critical consciousness" as an organizing tool in this environmental context are discussed, with implications drawn for other projects attempting to build self-reliance and community cohesion among inner-city populations.

Aged↗
PubMed1984

Health promotion in long-term care: a contradiction in terms?

While health promotion potentially could play a significant role in improving the health and quality of life of nursing home residents, several major changes must take place if this concept is to hold relevance for the elderly in the long-term care environment. First, interpretations of the concept of health promotion must be broadened to include a focus on macro- as well as micro-level change and on a diversity of target groups including, importantly, policy makers and providers. Second, the "youth bias" inherent in many conventional health promotion efforts must be overcome, so that goals such as decreasing functional dependence in the frail elderly are seen as legitimate and appropriate health promotion foci. Third, viable alternative to nursing home placements must be developed and adequately funded for the many frail elders who would be better served in less intense care environments. And fourth, the dependency producing nature of institutional long-term care must undergo major changes compatible with the goals of promoting individual autonomy and enhancing quality of life. Nutrition, drug use and misuse, mental health, and staff training and retention are four areas examined in a closer look at specific changes needed to create nursing homes amenable to health promotion. Such changes on the institutional level, coupled with a strong national commitment to nursing home reform, are in keeping with Green et al.'s broad definition of health promotion as encompassing a variety of interventions on multiple levels designed to facilitate behavioral changes conducive to health. It is within this larger context that health promotion is seen as holding considerable promise for improving the health and quality of life of the institutionalized elderly.

Aged↗