@article {7129, title = {Use of preventive care by the working poor in the United States.}, journal = {Prev Med}, volume = {44}, year = {2007}, month = {2007 Mar}, pages = {254-9}, publisher = {44}, abstract = {

OBJECTIVE: Examine the association between poverty and preventive care use among older working adults.

METHOD: Cross-sectional analysis of the pooled 1996, 1998 and 2000 waves of the Health and Retirement Study, a nationally representative sample of older community-dwelling adults, studying self-reported use of cervical, breast, and prostate cancer screening, as well as serum cholesterol screening and influenza vaccination. Adults with incomes within 200\% of the federal poverty level were defined as poor.

RESULTS: Among 10,088 older working adults, overall preventive care use ranged from 38\% (influenza vaccination) to 76\% (breast cancer screening). In unadjusted analyses, the working poor were significantly less likely to receive preventive care. After adjustment for insurance coverage, education, and other socio-demographic characteristics, the working poor remained significantly less likely to receive breast cancer (RR 0.92, 95\% CI, 0.86-0.96), prostate cancer (RR 0.89, 95\% CI, 0.81-0.97), and cholesterol screening (RR 0.91, 95\% CI, 0.86-0.96) than the working non-poor, but were not significantly less likely to receive cervical cancer screening (RR 0.96, 95\% CI, 0.90-1.01) or influenza vaccination (RR 0.92, 95\% CI, 0.84-1.01).

CONCLUSION: The older working poor are at modestly increased risk for not receiving preventive care.

}, keywords = {Cost of Illness, Cross-Sectional Studies, Employment, Female, Health Promotion, Health Services Accessibility, Health Services Needs and Demand, Humans, Male, Mass Screening, Middle Aged, Patient Acceptance of Health Care, Poverty, Preventive Health Services, Risk Assessment, Socioeconomic factors, United States, Vulnerable Populations}, issn = {0091-7435}, doi = {10.1016/j.ypmed.2006.11.006}, author = {Joseph S. Ross and Bernheim, Susannah M. and Elizabeth H Bradley and Teng, Hsun-Mei and William T Gallo} } @article {7115, title = {The effect of recurrent involuntary job loss on the depressive symptoms of older US workers.}, journal = {Int Arch Occup Environ Health}, volume = {80}, year = {2006}, month = {2006 Nov}, pages = {109-16}, publisher = {80}, abstract = {

OBJECTIVES: The objective of this study was to assess whether recurrent involuntary job loss among US workers nearing retirement resulted in increasingly less severe changes in depressive symptoms with successive job losses.

METHODS: With data drawn from the US Health and Retirement Survey (HRS), we used repeated measures longitudinal analysis to investigate the effect of recurrent job loss on follow-up depressive symptoms, measured up to 2 years following job loss. Study participants include 617 individuals, aged 51-61 years at the 1992 study baseline, who had at least one job loss between 1990 and 2000. Our primary outcome variable was a continuous measure of depressive symptoms, constructed from the 8-item Center for Epidemiologic Studies-Depression (CES-D) battery administered at every HRS wave. A second, dichotomous outcome, derived from the continuous measure, measured clinically relevant depressive symptoms. The exposure (recurrent job loss) was defined by binary dummy variables representing two and three/four job losses. All job losses were the result of either plant closing or layoff.

RESULTS: Our main finding indicates that, after relevant covariates are controlled, compared to one job loss, two job losses result in a modest increase in the level depressive symptoms (not significant) at two-year follow-up. Three or more job losses result, on average, in a decline in depressive symptoms to a level near pre-displacement assessment (not significant). Somewhat in contrast, two job losses were found to be associated with increased risk of clinically relevant depressive symptoms.

CONCLUSIONS: The principal finding confirms our hypothesis that, among US workers nearing retirement, repeated exposure to job separation results in diminished effects on mental health. Adaptation to the job loss stressor may underlie the observed response, although other explanations, including macroeconomic developments, are possible.

}, keywords = {Adaptation, Physiological, depression, Employment, Female, Humans, Life Change Events, Longitudinal Studies, Male, Middle Aged, Retirement, Stress, Psychological, United States}, issn = {0340-0131}, doi = {10.1007/s00420-006-0108-5}, author = {William T Gallo and Elizabeth H Bradley and Teng, Hsun-Mei and Stanislav V Kasl} } @article {9743, title = {The impact of late career job loss on myocardial infarction and stroke: a 10 year follow up using the health and retirement survey}, journal = {Occupational and Environmental Medicine}, volume = {63}, year = {2006}, month = {Jun-06-2006}, pages = {683 - 687}, abstract = {Background: Involuntary job loss is a major life event associated with social, economic, behavioural, and health outcomes, for which older workers are at elevated risk. Objective: To assess the 10 year risk of myocardial infarction (MI) and stroke associated with involuntary job loss among workers over 50 years of age. Methods: Analysing data from the nationally representative US Health and Retirement Survey (HRS), Cox proportional hazards analysis was used to estimate whether workers who suffered involuntary job loss were at higher risk for subsequent MI and stroke than individuals who continued to work. The sample included 4301 individuals who were employed at the 1992 study baseline. Results: Over the 10 year study frame, 582 individuals (13.5\% of the sample) experienced involuntary job loss. After controlling for established predictors of the outcomes, displaced workers had a more than twofold increase in the risk of subsequent MI (hazard ratio (HR) = 2.48; 95\% confidence interval (CI) = 1.49 to 4.14) and stroke (HR = 2.43; 95\% CI = 1.18 to 4.98) relative to working persons. Conclusion: Results suggest that the true costs of late career unemployment exceed financial deprivation, and include substantial health consequences. Physicians who treat individuals who lose jobs as they near retirement should consider the loss of employment a potential risk factor for adverse vascular health changes. Policy makers and programme planners should also be aware of the risks of job loss, so that programmatic interventions can be designed and implemented to ease the multiple burdens of joblessness.}, keywords = {Economics, Job loss, Myocardial Infarction, Stroke, Unemployment}, issn = {1351-0711}, doi = {10.1136/oem.2006.026823}, url = {http://oem.bmj.com/cgi/doi/10.1136/oem.2006.026823https://syndication.highwire.org/content/doi/10.1136/oem.2006.026823}, author = {William T Gallo and Teng, H.M. and Tracy Falba and Stanislav V Kasl and Krumholz, H.V. and Elizabeth H Bradley} } @article {7099, title = {The Impact of Late-Career Job Loss on Myocardial Infarction and Stroke: A 10-year follow-up using the Health and Retirement Survey}, journal = {Occupational and Environmental Medicine}, volume = {63}, year = {2006}, pages = {683-7}, publisher = {63}, abstract = {OBJECTIVE: Involuntary job loss is a major life event associated with social, economic, behavioural, and health outcomes, for which older workers are elevated risk. Our aim in this study was to assess the 10-year risk of myocardial infarction (MI) and stroke associated with involuntary job loss among workers over 50 years of age. METHODS: Analyzing data from the nationally representative U.S. Health and Retirement Survey (HRS), we used Cox proportional hazards analysis to estimate whether workers who suffered involuntary job loss were at higher risk for subsequent MI and stroke than individuals who continued to work. Our sample included 4,301 individuals who were employed at the 1992 study baseline. RESULTS: Over the 10-year study frame, 582 individuals (13.5 of the sample) experienced involuntary job loss. After controlling for established predictors of our outcomes, we found that displaced workers had a more than two-fold increase in the risk of subsequent MI (Hazard ratio HR = 2.48; 95 Confidence Interval CI = 1.49, 4.14) and stroke (HR = 2.43; CI = 1.18, 4.98) relative to working persons. CONCLUSION: Our results suggest that the true costs of late-career unemployment exceed financial deprivation, and include substantial health consequences. Physicians who treat individuals who lose jobs as they near retirement should consider the loss of employment a potential risk factor for adverse vascular health changes. Policy makers and program planners should also be aware of the risks of job loss, so that programmatic interventions can be designed and implemented to ease the multiple burdens of joblessness.}, keywords = {Employment and Labor Force, Health Conditions and Status}, author = {William T Gallo and Teng, H.M. and Tracy Falba and Stanislav V Kasl and Krumholz, H.V. and Elizabeth H Bradley} } @article {7094, title = {The Persistence of Depressive Symptoms in Older Workers Who Experience Involuntary Job Loss: Results from the Health and Retirement Study}, journal = {Journals of Gerontology, Series B: Psychological and Social Sciences}, volume = {61}, year = {2006}, pages = {S221-8}, publisher = {61}, abstract = {Objectives. The purpose of this study was to investigate the association between involuntary job loss among workers nearing retirement and long-term changes in depressive symptoms. Methods. Analyzing data from the first four waves (1992 1998) of the Health and Retirement Survey, we used longitudinal multiple regression in order to assess whether involuntary job loss between Wave 1 and Wave 2 was associated with depressive symptoms at Wave 3 and Wave 4. The study sample included 231 workers who had experienced job loss in the Wave 1 Wave 2 interval and a comparison group of 3,324 nondisplaced individuals. We analyzed the effect of job loss on depressive symptoms both in the full study sample and in subsamples determined by wealth. Results. Among individuals with below median net worth, Wave 1 Wave 2 involuntary job loss was associated with increased depressive symptoms at Wave 3 and Wave 4. We found no effect of involuntary job loss for high net worth individuals at the later survey waves. Discussion. Our findings identify older workers with limited wealth as an important group for which the potential effect of involuntary job separation in the years preceding retirement is ongoing (enduring) adverse mental health.}, keywords = {Employment and Labor Force, Health Conditions and Status, Net Worth and Assets}, author = {William T Gallo and Elizabeth H Bradley and J. A. Dubin and Richard N Jones and Tracy Falba and Teng, H.M. and Stanislav V Kasl} } @article {6924, title = {The effect of spousal mental and physical health on husbands{\textquoteright} and wives{\textquoteright} depressive symptoms, among older adults: longitudinal evidence from the Health and Retirement Survey.}, journal = {J Aging Health}, volume = {16}, year = {2004}, month = {2004 Jun}, pages = {398-425}, publisher = {16}, abstract = {

OBJECTIVE: To estimate the effect of spousal depressive symptoms and physical health on respondents{\textquoteright} depressive symptoms in a national sample of older married couples.

METHOD: We used data on 5,035 respondent husbands and wives from the 1992 and 1994 waves of the Health and Retirement Survey. Multivariate regression models were estimated to examine the impact of spousal depressive symptoms and physical health on respondents{\textquoteright} depressive symptoms.

RESULTS: Adjusting for respondent mental and physical health and sociodemographic traits, having a spouse with more depressive symptoms was associated with significantly higher follow-up depressive symptoms in the respondent (p < .001). Controlling for spousal depressive symptoms, a decline in the spouses{\textquoteright} physical health was associated with a significant reduction in respondent depressive symptoms (p < .05).

DISCUSSION: Our findings suggest that health care providers treating older adults should be sensitive to the possibility that spouses may be affected when clients suffer poor mental or physical health.

}, keywords = {Aged, Caregivers, depression, Female, Health Status, Humans, Male, Mental Health, Models, Theoretical, Spouses, United States}, issn = {0898-2643}, doi = {10.1177/0898264304264208}, author = {Michele J. Siegel and Elizabeth H Bradley and William T Gallo and Stanislav V Kasl} } @article {6951, title = {Involuntary job loss as a risk factor for subsequent myocardial infarction and stroke: findings from the Health and Retirement Survey.}, journal = {Am J Ind Med}, volume = {45}, year = {2004}, month = {2004 May}, pages = {408-16}, publisher = {45}, abstract = {

BACKGROUND: The role of stress in the development of cardiovascular disease is well established. Previous research has demonstrated that involuntary job loss in the years immediately preceding retirement can be a stressful life event shown to produce adverse changes in physical and affective health. The objective of this study was to estimate the risk of myocardial infarction (MI) and stroke associated with involuntary job loss among workers nearing retirement in the United States.

METHODS: We used multivariable survival analysis to analyze data from the first four waves of the Health and Retirement Survey (HRS), a nationally representative sample of older individuals in the US. The analytic sample includes 457 workers who experienced job loss and a comparison group of 3,763 employed individuals.

RESULTS: The results indicate that involuntary job loss is not associated with subsequent risk of MI (adjusted HR = 1.89; 95\% CI = 0.91, 3.93); the risk of subsequent stroke associated with involuntary job loss is more than double (adjusted HR = 2.64; 95\% CI = 1.01, 6.94).

CONCLUSIONS: Our findings present new data to suggest that involuntary job loss should be considered as a plausible risk factor for subsequent cardiovascular and cerebrovascular illness among older workers.

}, keywords = {Female, Humans, Male, Middle Aged, Myocardial Infarction, Prospective Studies, Retirement, Risk Factors, Stress, Psychological, Stroke, Unemployment, United States}, issn = {0271-3586}, doi = {10.1002/ajim.20004}, author = {William T Gallo and Elizabeth H Bradley and Tracy Falba and J. A. Dubin and Cramer, L. and Stanislav V Kasl} } @article {6868, title = {Impact of Husbands{\textquoteright} Involuntary Job Loss on Wives{\textquoteright} Mental Health, Among Older Adults}, journal = {The Journals of Gerontology: Social Sciences}, volume = {58B}, year = {2003}, pages = {S30-S37}, publisher = {58B}, abstract = {Objectives. This study estimates the consequences of older husbands{\textquoteright} involuntary job loss for their wives{\textquoteright} mental healthMethods. Using longitudinal data from the 1992, 1994, and 1996 waves of the Health and Retirement Study, multivariate regression models were estimated to measure the impact of older husbands{\textquoteright} involuntary job loss on wives{\textquoteright} mental health. We created two longitudinal data sets of two waves each to use in our analysis. The first data set, or period, combined Waves I and 2 of the Health and Retirement Study and described the 1992-1994 experience of spouse pairs in our sample. It included the wives of 55 husbands who experienced involuntary job loss between these survey dates and a comparison group of wives of 730 continuously employed husbands. The second data set described the 1994-1996 experience of couples. In particular, it included the wives of an additional 38 husbands who were displaced from their jobs between Waves 2 and 3, and a compar ison group of wives of 425 husbands who were continuously employed from 1994 to 1996.Results. Husbands{\textquoteright} involuntary job loss did not have a statistically significant effect on wives{\textquoteright} mental health. We found no evidence that changes in husbands{\textquoteright} depressive symptoms modified the effect of his job loss on wives{\textquoteright} mental health. In the first period only, the effect of husbands{\textquoteright} job loss on wives{\textquoteright} mental health was more pronounced for wives who were more financially satisfied at baseline.Discussion. There is limited evidence among this cohort that husbands{\textquoteright} job loss increases wives{\textquoteright} subsequent depressive symptoms. However, the effect of husbands{\textquoteright} job loss on wives{\textquoteright} mental health appears to be magnified when wives report being financially satisfied pre-job loss. This suggests that, for subgroups of older couples, mental health services specifically targeted at displaced men should also be made available to wives.}, keywords = {Employment and Labor Force}, url = {http://psychsoc.gerontologyjournals.org/}, author = {Michele J. Siegel and Elizabeth H Bradley and William T Gallo and Stanislav V Kasl} } @article {6873, title = {Self-rated life expectancy as a predictor of mortality: evidence from the HRS and AHEAD surveys.}, journal = {Gerontology}, volume = {49}, year = {2003}, month = {2003 Jul-Aug}, pages = {265-71}, publisher = {49}, abstract = {

BACKGROUND: An extensive literature has demonstrated that self-ratings of health predict mortality, even after controlling for more objective measures of health, health habits and sociodemographic characteristics. We examine the role of a related concept, self-rated life expectancy, in predicting mortality.

OBJECTIVE: To assess whether self-rated life expectancy predicts mortality after controlling for measures of health, self-rated health, and sociodemographic characteristics.

METHODS: Using data from the 1992 Health and Retirement Survey (HRS), the 1993 Asset and Health Dynamics Among the Oldest Old (AHEAD) survey, and the second Tracker file (2.0), Cox proportional hazard models were estimated to assess whether self-rated life expectancy predicts mortality, after adjusting for self-rated health and several potential confounders that might otherwise explain this relationship. The AHEAD sample included 2,102 men and 3,160 women. During the 2 years of follow-up, 9\% (n = 185) of the men died and 5\% (n = 166) of the women died. The HRS sample was comprised of 4,090 men and 4,885 women. Four percent (n = 164) of the men died and 2\% (n = 99) of the women died in the 3 years of follow-up.

RESULTS: In the older, AHEAD sample, both self-rated life expectancy (p < 0.01) and self-rated health (p < 0.05) predicted mortality for both men and women, even when the two measures were included in the model together. In the younger, HRS sample, self-rated life expectancy was not significantly associated with mortality when self-rated health was included in the model.

CONCLUSION: Our findings suggest that, although self-rated life expectancy and self-rated health may be conceptually related, they have independent empirical effects on mortality.

}, keywords = {Aged, Female, Health Status, Health Surveys, Humans, Life Expectancy, Male, Mortality, Prognosis, Proportional Hazards Models, Self Concept, Sex Distribution, Survival Analysis}, issn = {0304-324X}, doi = {10.1159/000070409}, author = {Michele J. Siegel and Elizabeth H Bradley and Stanislav V Kasl} } @article {6753, title = {The Impact of Involuntary Job Loss on Subsequent Alcohol Consumption by Older Workers: Findings from the Health and Retirement Survey}, journal = {The Journals of Gerontology: Social Sciences}, volume = {56B}, year = {2001}, pages = {S3-9}, publisher = {56B}, abstract = {OBJECTIVE: To estimate the effect of involuntary job loss on subsequent alcohol consumption by older workers in the United States. METHODS: Using longitudinal data from the 1992 and 1994 waves of the Health and Retirement Survey, the authors estimated multivariate models to assess the impact of involuntary job loss on subsequent alcohol use. Two outcomes were investigated: reported daily alcohol consumption and onset of drinking. The analysis sample included 207 workers who experienced involuntary job loss between survey dates and a comparison group of 2,866 continuously employed workers. RESULTS: After baseline alcohol consumption and a variety of socioeconomic and illness-related covariates were controlled, involuntary job loss was not associated (p .05) with number of daily drinks consumed at follow-up. However, among those who did not consume alcohol at baseline, individuals who suffered involuntary job loss were twice as likely as continuously employed individuals to start drinking by follow-up (OR = 2.01; CI = 1.06-3.80). The majority of those who began drinking at follow-up reported drinking less than 1 drink per day. DISCUSSION: The findings provide evidence of a significant relationship between job loss and subsequent alcohol use among baseline nondrinkers. However, the magnitude of the changes in drinking was quite modest.}, keywords = {Demographics, Employment and Labor Force, Health Conditions and Status, Healthcare, Methodology, Other, Retirement Planning and Satisfaction, Risk Taking}, url = {http://psychsoc.gerontologyjournals.org/contents-by-date.0.shtml}, author = {William T Gallo and Elizabeth H Bradley and Michele J. Siegel and Stanislav V Kasl} } @article {6705, title = {Health effects of involuntary job loss among older workers: findings from the health and retirement survey.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {55}, year = {2000}, month = {2000 May}, pages = {S131-40}, publisher = {55B}, abstract = {

OBJECTIVES: To estimate the health consequences of involuntary job loss among older workers in the United States.

METHODS: Using longitudinal data from the 1992 and 1994 waves of the Health and Retirement Survey, multivariate regression models were estimated to assess the impact of involuntary job loss on both physical functioning and mental health. Our analysis sample included 209 workers who experienced involuntary job loss between survey dates and a comparison group of 2,907 continuously employed workers.

RESULTS: The effects of late-life involuntary job loss on both follow-up physical functioning and mental health were negative and statistically significant (p < .05), even after baseline health status and sociodemographic factors were controlled for. Among displaced workers, reemployment was positively associated with both follow-up physical functioning and mental health, whereas the duration of joblessness was not significantly associated with either outcome.

DISCUSSION: The findings provide evidence of a causal relationship between job loss and morbidity among older workers. This relationship is reflected in both poorer physical functioning and mental health for workers who experience involuntary job loss. In addition to the economic consequences of worker displacement, there may be important health consequences of job loss, especially among older workers.

}, keywords = {Activities of Daily Living, Adaptation, Psychological, Aging, Female, Geriatric Assessment, Health Status, Humans, Longitudinal Studies, Male, Middle Aged, Retirement, Unemployment, United States}, issn = {1079-5014}, doi = {10.1093/geronb/55.3.s131}, author = {William T Gallo and Elizabeth H Bradley and Michele J. Siegel and Stanislav V Kasl} }