@article {10175, title = {Influence of senior housing types on cognitive decline and nursing home admission among lower-income older adults.}, journal = {Aging \& Mental Health}, volume = {24}, year = {2020}, pages = {1579-1588}, type = {Journal}, abstract = {Focusing on unique ageing populations in subsidized senior housing for lower-income older adults, this study contributes to literature on housing and aging; provides initial understanding of existing housing types; and explores the extent to which living in different housing types may influence changes in cognitive function and likelihood of nursing home admission. Data came from seven waves (2002-2014) of the Health and Retirement Study. A latent-class clustering approach was used to identify senior-housing types among lower-income older people; We identified four discernible housing types among lower-income older adults: (1) High physical \& Low service, (2) Low physical \& Low service, (3) High physical \& High service, and (4) Medium physical \& High service. Individuals in Medium physical \& High service and High physical \& Low service types were likely to have higher cognitive-function levels at baseline ( = 0.58, < .001; 0.58, < .001) and slower rates of decline over time ( = 0.42, < .001; = 0.32, < .01). Older adults in High physical \& High service are significantly less likely to be admitted to a nursing home (OR = 0.55, < .00). The mismatch between health needs and lack of service and support suggests that current residents in each housing type relocate, based on knowledge of subsidized housing or availability. Future studies should examine possible mismatches between health needs and housing environment.}, keywords = {Cognitive Ability, Financial Health, Nursing homes}, issn = {1364-6915}, doi = {10.1080/13607863.2019.1650888}, author = {So Jung Park and BoRin Kim and Kwon, Eunsun and Kown, Goeun} } @article {10210, title = {Effects of the Affordable Care Act on Health Insurance Coverage Among Middle-Aged Adults}, journal = {International Journal of Health Services}, volume = {49}, year = {2019}, note = {doi: 10.1177/0020731419865117}, month = {07/2019}, pages = {712 - 732}, abstract = {Access to insurance coverage is challenging for middle-aged adults with higher perceived insurance needs (e.g., declining health status) and higher barriers to coverage (e.g., unstable employment and income status). Focusing on middle-aged adults, this study investigated the extent to which employment, financial, and health statuses are associated with changing patterns of insurance status following implementation of the Affordable Care Act (ACA). Seven waves (2002{\textendash}2014) of the Health and Retirement Study, combined with the RAND Center for the Study of Aging data, were used. Four patterns of insurance status change emerged: constantly insured, constantly uninsured, insured after ACA, and uninsured after ACA. Compared to constantly insured, other subgroups were associated with unstable employment, unskilled labor, and part-time employment. The role of public insurance might be nearly negligible for those who were in unstable employment status and needed to shift to other forms of private coverage. More attention is needed to better understand how the insurance market functions and policy changes that could improve it. There were demographic patterns in those who remained chronically uninsured: constantly low income and poor health conditions. This suggests a much-needed practical underpinning for policymaking efforts regarding this high-risk group entering old age with catastrophic health care costs.}, keywords = {Affordable Care Act, insurance status change, uninsured middle-aged adults}, isbn = {0020-7314}, doi = {https://doi.org/10.1177/0020731419865117}, url = {https://journals.sagepub.com/doi/full/10.1177/0020731419865117$\#$}, author = {Kwon, Eunsun and So Jung Park and Timothy D McBride} } @article {10130, title = {Home and community-based services and life satisfaction among homebound and poor older adults.}, journal = {Journal of Gerontological Social Work}, year = {2019}, abstract = {Little evidence exists regarding the role of Home and Community-Based Services (HCBS) utilization on life satisfaction among older people who are both homebound and low-income. Guided by the personal-environment (-E) fit perspective, this study aims to: (1) describe characteristics of older people with homebound and low-income status; (2) investigate how the combination of homebound and low-income status is associated with life satisfaction; and (3) examine whether HCBS utilization moderates the association between homebound and low-income status and life satisfaction. Data were drawn from the 2012 Health and Retirement Study, and the sample included respondents who were 51+ years who completed a questionnaire for HCBS utilization (= 1,662). Results describe sociodemographic, health-related, and environmental characteristics of older adults. Combined homebound and low-income status was a significant predictor of lower life satisfaction ( = -0.15, < .05), but better life satisfaction when they used HCBS ( 0.33, .10). These findings suggest that promoting HCBS utilization is a promising strategy to enhance well-being among those homebound and poor. Further studies are needed to test the effectiveness of HCBS with longitudinal data and to investigate the details of effective HCBS utilization such as frequency of use and types of services.}, keywords = {Community-based services, Depressive symptoms, Well-being}, issn = {1540-4048}, doi = {10.1080/01634372.2019.1639094}, author = {Chen, Qingru and Amano, Takashi and So Jung Park and BoRin Kim} } @article {10389, title = {Home Environment, Living Alone, and Trajectories of Cognitive Function Among Older Adults With Functional Limitations}, journal = {Environment and Behavior}, year = {2019}, note = {doi: 10.1177/0013916519879772}, month = {2019/10/16}, pages = {0013916519879772}, abstract = {This study aimed to investigate the effects of Person-Environment Fit on trajectories of cognitive function. Data came from the Health Retirement Study (1998-2010), focusing on those aged 65 and above who had at least one limitation in activities of daily living. Using longitudinal mixed-effect modeling, we analyzed the effects of living in supportive home environments on trajectories of cognitive function over time. Disabled older individuals living alone were likely to experience a decline in cognitive function over time. However, the detrimental effects of living alone were moderated when the home was equipped with supportive features and accessibility. The findings reveal the importance of home modifications for socially and physically vulnerable elders.}, keywords = {Cognition, Functional limitations, home environment, Loneliness}, isbn = {0013-9165}, url = {https://doi.org/10.1177/0013916519879772}, author = {So Jung Park and BoRin Kim and Amano, Takashi and Chen, Qingru} } @article {Shin2019, title = {Nature of Retirement and Loneliness: The Moderating Roles of Social Support}, journal = {Journal of Applied Gerontology}, year = {2019}, note = {cited By 0}, abstract = {Drawing from the social convoy model, this study investigates whether the nature of retirement (voluntary or involuntary) influences loneliness among retirees, and how different social support types may affect this association. Data come from the 2014 Health and Retirement Study (N = 2,055). Five social support types were identified: weak, ambivalent, strong positive, children strain, and family strain. Involuntary retirement was associated with a higher level of loneliness; however, involuntarily retired individuals with strong positive social support had a relatively lower level of loneliness. Findings from this study suggest that social support may alleviate the negative impacts of involuntary retirement. Our research provides a theoretical basis for developing a practical program to reduce the negative impacts of involuntary retirement on well-being. {\textcopyright} The Author(s) 2019.}, keywords = {Loneliness, Retirement, Social Support}, issn = {07334648}, doi = {10.1177/0733464819886262}, author = {Shin, O. and So Jung Park and Amano, T. and Kwon, E. and BoRin Kim} } @article {10043, title = {Person-environment fit approach to trajectories of cognitive function among older adults who live alone: Intersection of life-course SES disadvantage and senior housing.}, journal = {Journals of Gerontology, Series B: Psychological Sciences \& Social Sciences}, year = {2019}, abstract = {

OBJECTIVES: Drawing from life course and environmental perspectives, we examined the trajectory of cognitive function and how senior housing moderates the effects of life-course socioeconomic status (SES) disadvantage among older people living alone over time.

METHOD: Six waves of the Health and Retirement Study (HRS) were used with multilevel growth modeling to analyze developmental patterns of cognitive function over time and how various forms of life-course SES disadvantage affect cognitive function depending on senior housing residency status.

RESULTS: At baseline, we found a positive role of senior housing in four subgroups: SES disadvantage in childhood only, unstable mobility pattern (disadvantage in childhood and old age only), downward mobility (no disadvantage in childhood, but in later two life stages), and cumulative disadvantage (all three life stages). Over time, the positive role of senior housing for the unstable and the most vulnerable group persisted.

DISCUSSION: Our findings provide a much-needed practical and theoretical underpinning for environmental policy-making efforts regarding vulnerable elders who live alone.

}, keywords = {Cognition \& Reasoning, Housing, Living arrangements, Socioeconomic factors}, issn = {1758-5368}, doi = {10.1093/geronb/gbz025}, author = {So Jung Park and Kwon, Eunsun and BoRin Kim and Han, Yoonsun} } @article {9996, title = {Health insurance and poverty in trajectories of out-of-pocket expenditure among low-income middle-aged adults}, journal = {Health Services Research}, volume = {53}, year = {2018}, pages = {4332-4352}, abstract = {Objective To assess the effects of longitudinal patterns of health insurance and poverty on out-of-pocket expenditures among low-income late middle-aged adults. Data Sources/Study Setting Six waves (2002{\textendash}2012) of the Health and Retirement Study, in combination with RAND Center for the Study of Aging data, were used. Study Design A random coefficient regression analysis was conducted in a multilevel growth curve framework to estimate the impact of health insurance and poverty on out-of-pocket expenditures. Principal Findings At baseline, individuals with private insurance or unstable coverage were more likely to have out-of-pocket expenditures and financial burdens than public insurance holders. Over time, the poor who had no insurance, unstable coverage, or insurance type change had higher out-of-pocket expenditures; private coverage holders had higher odds of financial burden. Conclusions Unstable insurance coverage had a discernible effect on the long-term, out-of-pocket expenditures among low-income adults. Findings have an important policy implication to protect poor late middle-aged population; as this population enters old age, the high financial burden it faces may exacerbate persistent socioeconomic health disparity among older people with unstable insurance coverage.}, keywords = {Medicare/Medicaid/Health Insurance, Out-of-pocket payments}, issn = {00179124}, doi = {10.1111/hesr.2018.53.issue-610.1111/1475-6773.12974}, author = {Kwon, Eunsun and So Jung Park and Timothy D McBride} } @article {9634, title = {Health Insurance and Poverty in Trajectories of Out-of-Pocket Expenditure among Low-Income Middle-Aged Adults.}, journal = {Health Services Research}, volume = {53}, year = {2018}, pages = {4332-4352}, abstract = {

OBJECTIVE: To assess the effects of longitudinal patterns of health insurance and poverty on out-of-pocket expenditures among low-income late middle-aged adults.

DATA SOURCES/STUDY SETTING: Six waves (2002-2012) of the Health and Retirement Study, in combination with RAND Center for the Study of Aging data, were used.

STUDY DESIGN: A random coefficient regression analysis was conducted in a multilevel growth curve framework to estimate the impact of health insurance and poverty on out-of-pocket expenditures.

PRINCIPAL FINDINGS: At baseline, individuals with private insurance or unstable coverage were more likely to have out-of-pocket expenditures and financial burdens than public insurance holders. Over time, the poor who had no insurance, unstable coverage, or insurance type change had higher out-of-pocket expenditures; private coverage holders had higher odds of financial burden.

CONCLUSIONS: Unstable insurance coverage had a discernible effect on the long-term, out-of-pocket expenditures among low-income adults. Findings have an important policy implication to protect poor late middle-aged population; as this population enters old age, the high financial burden it faces may exacerbate persistent socioeconomic health disparity among older people with unstable insurance coverage.

}, keywords = {Low income, Medicare/Medicaid/Health Insurance, Out-of-pocket payments}, issn = {1475-6773}, doi = {10.1111/1475-6773.12974}, author = {Kwon, Eunsun and So Jung Park and Timothy D McBride} } @article {9125, title = {Heterogeneous trajectories of depressive symptoms in late middle age: Critical period, accumulation, and social mobility life course perspectives.}, journal = {Journal of Aging and Health}, volume = {30}, year = {2018}, pages = {1011-1041}, abstract = {

OBJECTIVE: This study investigated patterns of depressive symptoms and whether socioeconomic status (SES) across the life course affects these trajectories using the critical period, accumulation, and social mobility models.

METHOD: This study uses data from 8,532 adults, age 51 to 64, collected over 12 years from the Health and Retirement Study (observations = 25,887). A latent class analysis was performed to examine distinct depressive symptom trajectories; life course models were studied with multinomial logistic regression.

RESULTS: Four heterogeneous latent classes were identified for depression: Declining, Low, Increasing, and High and Increasing. The High and Increasing group was associated with a disadvantaged childhood SES, accumulated exposure to socioeconomic risks, and persistent SES disadvantage supporting the three life course models.

DISCUSSION: There was evidence of distinct profiles of depressive symptoms in late middle age and of interrelated life course mechanisms underlying the influences of childhood SES on later life depression.

}, keywords = {Depressive symptoms, Life trajectories, Socioeconomic factors}, issn = {1552-6887}, doi = {10.1177/0898264317704540}, author = {Kwon, Eunsun and BoRin Kim and Lee, Hyunjoo and So Jung Park} } @article {9462, title = {Postretirement work and volunteering by poverty groups informed by role theory.}, journal = {Journal of Gerontological Social Work}, volume = {61}, year = {2018}, pages = {243-260}, abstract = {This study uses role theory to examine the association between postretirement work and volunteering among retirees and to determine whether this association varies across poverty status. Data came from the 2012 wave of the Health and Retirement Study (HRS). The sample was restricted to respondents of older retirees (N = 6,619). We found that postretirement work positively influenced volunteering. However, poverty can be a risk factor of volunteering among older retirees. The positive effect of post-retirement work was found to be more significant in the near-poverty group. We provide an empirical foundation to help inform volunteer programs for retirees.}, keywords = {Volunteerism}, issn = {1540-4048}, doi = {10.1080/01634372.2017.1416719}, author = {Joonyoung Cho and BoRin Kim and So Jung Park and Jang, Jakyung} } @article {9008, title = {Community-based services and depression from person-environment fit perspective: Focusing on functional impairments and living alone.}, journal = {Journal of Gerontological Social Work}, volume = {60}, year = {2017}, pages = {270-285}, abstract = {As communities encourage aging-in-place, community-based services for older adults are expanding. Guided by the Person-Environment Fit perspective, this study investigated the extent to which personal dimension factors (functional limitations, living alone) and environmental dimension factors (community-based services) influence depression among community-dwelling adults. The data came from the 2012 Health and Retirement Study, a nationally representative survey of individuals over 51~years old. Our sample was restricted to respondents who participated in the special questionnaire about community-based service utilization (N~=~1,710). Logistic regressions examined associations between functional limitations/living alone and depression, and how community-based services moderate these associations. Both functional limitations (OR~=~1.470; p~<~.001), and living alone (OR~=~1.724; p~<~.05) were significantly associated with depression. Community-based service participants tended to be more vulnerable populations, but regression results showed community-based service was not significantly associated with depression after controlling for covariates. However, respondents with functional limitations and those living alone were less likely to be depressed when using community-based services (OR~=~0.633; p~<~.05). This study demonstrates that the associations between community-based services and depression differ depending on personal needs. It discusses the importance of community-based services for aging-in-place policy, particularly among vulnerable populations.}, keywords = {Cognitive Ability, Depressive symptoms, Disabilities}, issn = {1540-4048}, doi = {10.1080/01634372.2017.1310166}, author = {BoRin Kim and So Jung Park and Bishop-Saucier, Jennifer and Amorim, Carrie} } @article {9122, title = {Heterogeneous trajectories of physical and mental health in late middle age: Importance of life-course socioeconomic positions.}, journal = {International Journal of Environmental Research and Public Health}, volume = {14}, year = {2017}, month = {2017 May 30}, abstract = {Drawing on life course and cumulative disadvantage theory, this study examines heterogeneous trajectories of functional limitations and depressive symptoms among late middle-aged individuals. This study used prospective data from 6010 adults, 51 to 64 years old, collected over a 12-year-period from the Health and Retirement Study. Considering the empirical proposition that several physical and mental trajectories may exist, Latent Class Growth Modeling was used. Five heterogeneous patterns of joint trajectories (Relatively healthy, Moderately improving, Steadily deteriorating, Steeply deteriorating, and Persistently high comorbid) were identified. Early life adversity was related to an increasing risk of declines in physical and mental health. The Persistently high comorbid class was characterized by a concentration of disadvantages over the life course. The development of public health interventions could help reduce co-existing physical and mental health problems, especially during late middle-age.}, keywords = {Depressive symptoms, Life trajectories, Socioeconomic factors}, issn = {1660-4601}, doi = {10.3390/ijerph14060582}, author = {Kwon, Eunsun and So Jung Park} } @article {9000, title = {Life Course Trajectories of Later-Life Cognitive Functions: Does Social Engagement in Old Age Matter?}, journal = {International Journal of Environmental Research and Public Health}, volume = {14}, year = {2017}, month = {2017 Apr 07}, abstract = {This study identified differential patterns of later-life cognitive function trajectories and examined to what extent life course factors and social engagement are associated with group trajectories. Data came from seven waves of the Health and Retirement Study (HRS 1998-2010; n = 7374; Observations = 41,051). Latent class growth analysis identified cognitive function trajectory groups, and multinomial logistic regression was used to examine the factors associated with group trajectories. Five heterogeneous trajectories were identified: stable high, stable moderate, stable low, high-to-moderate, and moderate-to-low. Findings suggest that, after adjusting for life course factors, individuals who became volunteers were more likely to belong to one of the two least vulnerable trajectories, stable high or high-to-moderate. Our findings suggest that, despite the cumulative life course factors evident in cognitive decline, social engagement in old age may serve as a potential protective resource.}, keywords = {Cognitive Ability, Older Adults, Social Relationships, Trajectories}, issn = {1660-4601}, doi = {10.3390/ijerph14040393}, author = {So Jung Park and Kwon, Eunsun and Lee, Hyunjoo} } @article {8138, title = {The Effect of Community-Based Services on Functional Limitations of American Older Adults in Retirement Community}, journal = {Korea Social Welfare Research}, volume = {40}, year = {2014}, pages = {129-158}, publisher = {40}, abstract = {Being discussed among the various environmental factors for the year, with an independent discourse on successful aging, we examine the relationship between health and community services for the elderly using American study. The review is limited in most cases to be vulnerable older people to explore the relationship between the two previous studies, which focused on the effectiveness of many individual services. The present study was derived using the Health and Retirement Study (1998 2008) panel data, and the use of the service pattern of the individual review of the relevant health service use patterns and trends. In addition, the effect of the use of service resources and informal health services were analyzed with the factors that affect the relationship between health map. Was limited to senior living senior housing community with information about the service analysis, we used the daily living skills scores about healthy level and trend are (instrumental). Configured to use the pattern for the official services (housework, care, care, transportation, meals) in the community through the cluster analysis results did not use all the services a large number of elderly (group 1), in addition to using all of the services that the elderly could be classified as elderly (groups 3 and 4), although the nature (group 2), most of the details to use the service. Analysis of the relation of the health services through a growth curve model (Growth Curve Model) results, in the group compared to the group with all of the services that are not used at all, the service tends to be deteriorated health. But if you take advantage of the informal resources around them showed that mitigation is steep trend deteriorating health. The significance of that is then used to present the major reasons for this study is that no magazine to help in maintaining the health community service use, its extent. Suggests that informal, to study the effect of an integrated formal resources and medical necessity of the service area to review the impact of community service than what it.}, keywords = {Health Conditions and Status, Healthcare, Methodology, Public Policy}, author = {So Jung Park and Kim, Min Hee} }