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Biomedical subjects

S Crystal

Publications and source records attributed to S Crystal.

7 recordsLinked to original sources

Educational attainment, occupational history, and stratification: determinants of later-life economic outcomes.

Determinants of economic well-being among men 25-44, 45-64, and 65+ were examined using data from the 1984 panel of the Survey of Income and Program Participation. A path analysis explored race, education, and occupational history effects on income adjusted for annuitized assets, household composition, and underreporting of unearned income. Direct and total education effects were undiminished among elderly persons, whose income derived mainly from benefits and assets, as compared with the nonelderly subjects whose income was dominated by earnings; education explained more of the variance in adjusted income for the elderly group than for the nonelderly. While Social Security income exerts an equalizing effect across educational attainment groups, private pensions and other important retirement income sources were highly education-dependent, producing a high overall degree of stratification on early-established socioeconomic characteristics.

Adult

A room of one's own: the SRO and the single elderly.

A survey of 485 single-room occupancy housing (SRO) residents in New York City found elderly residents strongly preferred to remain in centrally located neighborhoods where apartment housing was beyond their means; did not wish to share a housing unit; and had little confidence that they could find acceptable housing if they lost their present unit. For many elderly residents, SROs meet needs not easily met by available alternatives. Results suggest the need to maintain this housing option for older persons and replace losses that have accompanied gentrification in many central city areas.

Aged

Cumulative advantage, cumulative disadvantage, and inequality among elderly people.

It is often asserted that economic inequality narrows after age 65 when benefit programs replace labor markets as principal income sources. However, analysis of recent Census data suggests inequality is greatest among elderly people. The worst off one-fifth of the elderly (disproportionately unmarried women, minorities, and the physically impaired) receives 5.5% of the elderly's total resources, whereas the best off one-fifth receives 46%. Equalizing effects of Social Security are more than outweighed by private pensions, asset income, and other sources. Findings suggest a process of cumulative economic advantage and disadvantage throughout the life course.

Aged

AIDS contact notification: initial program results in New Jersey.

As part of an 1988-89 evaluation of New Jersey's newly established HIV Notification Assistance Program (NAP), data were collected concerning number of HIV+ persons providing contact names; contact characteristics; reactions to NAP of HIV counselors, their clients, and of notified contacts; and program costs. There was initial resistance to the program both from HIV counselors and their clients. By mid-1989, acceptance of the program by referring HIV counselors had increased. The proportion of HIV+ clients who referred contacts was still low, but had increased to 10%. 160 contacts were notified: 72% sexual contacts and 28% needle sharing contacts, 59% male and 41% female, 58% black, 29% white, 13% Hispanic. 67% considered themselves at moderate or high risk for HIV; 31% stated that they had already been tested for HIV, with 7% having tested positive. Cost per notified contact was $2,260; cost per contact not previously tested HIV+ and unaware of risk was $3,014. Findings suggest that persuading counselors at HIV counseling and testing sites of the program's value is a key prerequisite for success, in situations where notification is carried out by a separate agency. Once the program has been in place for a time and has established credibility, the opportunity exists for initial resistance to be overcome.

AIDS Serodiagnosis

Diagnostic patterns in hospital use by an urban homeless population.

Because patterns of disease and health care system usage by the homeless constitute a neglected area of research in the medical literature, we undertook a retrospective analysis of inpatient records on medically indigent adults, controlling for housing status, to add to the growing body of research in the area of homeless health care. Data on all 4,243 indigent patients admitted over 2 fiscal years (1985 and 1986) under the county medical services program of San Diego County, California, revealed 5.3% (226) to be homeless. The commonest major diagnostic category among the homeless discharges was "diseases and disorders of the skin, subcutaneous tissue, and breast," constituting 21.2% as compared with only 8.7% of the discharge diagnoses for housed indigent persons. Within this major diagnostic category, the predominant diagnosis-related group was cellulitis, accounting for 12.8% of diagnoses in the homeless and only 4.0% of discharge diagnoses in other medically indigent persons. A homeless housing status was also correlated with a higher percentage of discharges with the major diagnostic category of "substance use and substance-induced organic mental disorders" but was negatively correlated with that of "diseases and disorders of the circulatory system."

Delivery of Health Care