Financial Strain over the Life Course and Health among Older Adults
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kahn2006 - p. 18
We propose, then, that circumstances inimical to well-being are most prevalent among those groups having the highest rates of morbidity and mortality, and that some of these circumstances may originate far in advance of the health inequalities that become evident at midand late life.
kahn2006 - p. 18
Some of the power of these kinds of chronic or recurrent stressors may result from their ability to generate what has been referred to as “allostatic load,” a wear and tear on the organism that gradually makes resistance to health-damaging agents more difficult (Singer and Ryff 1999). Furthermore, the power of such chronic stressors may in part stem from the institutions in which they arise, such as the family, occupation, or economy
kahn2006 - p. 19
The data presented here are drawn from face-to-face interviews conducted in 2001–2002 with 1,167 people 65 years and older residing in the District of Columbia and two adjoining Maryland counties: Prince George’s and Montgomery.
kahn2006 - p. 19
Our analysis centers around the lifetime economic circumstances of respondents. In addition to their current incomes, these circumstances entail the financial difficulties people experienced during different stages of the life course.
kahn2006 - p. 19
“Thinking back to your years up to age 18, how difficult was it for your family to meet expenses for basic needs like food, clothing and housing?
kahn2006 - p. 20
In this study, we control for current economic circumstances using both objective and subjective measures.
kahn2006 - p. 20
Among the more objective indicators of health is one based on a series of questions asking respondents if, in the past five years, a health care provider has told them that they have any of a list of five chronic conditions: cancer, stroke, heart disease, high blood pressure, and diabetes.
kahn2006 - p. 20
A third health measure reflects illness, as distinct from disease, and is derived from questions about the frequency with which each of nine symptoms has been experienced during the past month: headaches, back pain, muscle aches, indigestion, constipation/diarrhea, incontinence, feelings of weakness, heart palpitations, and shortness of breath.
kahn2006 - p. 20
In order to measure the presence of functional limitations, our fourth health measure, we constructed a composite score based on two questions that are designed to assess the strength and stamina of the respondent: (1) “How long can you stand in line without sitting?” and (2) “How far can you walk without resting?” The answers to these queries are standardized and combined into a “functional impairment” scale ( = .81), where higher values reflect greater impairment.
kahn2006 - p. 20
Finally, as a measure of mental health, we construct a “depressive symptoms” scale ( = .77), comprising six items derived from the longer Hopkins Checklist (Lipman et al. 1969; Mouanoutoua and Brown 1995).