TY - JOUR T1 - Mortgage delinquency and changes in access to health resources and depressive symptoms in a nationally representative cohort of Americans older than 50 years. JF - Am J Public Health Y1 - 2011 A1 - Dawn E Alley A1 - Jennifer Lloyd A1 - José A Pagán A1 - Craig E Pollack A1 - Michelle Shardell A1 - Carolyn Cannuscio KW - depression KW - Drug Costs KW - Economic Recession KW - Female KW - Health Services Accessibility KW - Health Status KW - Housing KW - Humans KW - Male KW - Medication Adherence KW - Middle Aged KW - Socioeconomic factors KW - Stress, Psychological KW - United States AB -

OBJECTIVES: We evaluated associations between mortgage delinquency and changes in health and health-relevant resources over 2 years, with data from the Health and Retirement Study, a longitudinal survey representative of US adults older than 50 years.

METHODS: In 2008, participants reported whether they had fallen behind on mortgage payments since 2006 (n = 2474). We used logistic regression to compare changes in health (incidence of elevated depressive symptoms, major declines in self-rated health) and access to health-relevant resources (food, prescription medications) between participants who fell behind on their mortgage payments and those who did not.

RESULTS: Compared with nondelinquent participants, the mortgage-delinquent group had worse health status and less access to health-relevant resources at baseline. They were also significantly more likely to develop incident depressive symptoms (odds ratio [OR] = 8.60; 95% confidence interval [CI] = 3.38, 21.85), food insecurity (OR = 7.53; 95% CI = 3.01, 18.84), and cost-related medication nonadherence (OR = 8.66; 95% CI = 3.72, 20.16) during follow-up.

CONCLUSIONS: Mortgage delinquency was associated with significant elevations in the incidence of mental health impairments and health-relevant material disadvantage. Widespread mortgage default may have important public health implications.

PB - 101 VL - 101 IS - 12 U1 - http://www.ncbi.nlm.nih.gov/pubmed/22021301?dopt=Abstract U2 - PMC3222434 ER - TY - JOUR T1 - Educational differentials in life expectancy with cognitive impairment among the elderly in the United States. JF - J Aging Health Y1 - 2008 A1 - Agnès Lièvre A1 - Dawn E Alley A1 - Eileen M. Crimmins KW - Aged KW - Aged, 80 and over KW - Cognition Disorders KW - Educational Status KW - Female KW - Humans KW - Life Expectancy KW - Male KW - United States AB -

OBJECTIVE: This article provides estimates of education differentials in life expectancy with and without cognitive impairment for the noninstitutionalized population aged 70 years and older in the United States.

METHOD: Life expectancy with cognitive impairment was calculated using multistate models, allowing transitions between cognitively intact and cognitively impaired states and from each of these states to death and allowing transition rates to vary across age and education. Four waves of the Assets and Health Dynamics of the Oldest Old survey were used.

RESULTS: Those with low levels of education are more likely to become cognitively impaired and do so at an earlier age. After age 70, persons with low educational levels can expect to live 11.6 years, and persons with high education 14.1 years, without cognitive impairment. Length of life with cognitive impairment differs by education (1.6 years and 1.0 years at age 70, respectively) but differs little by age.

DISCUSSION: Although those with higher education have lower rates of both cognitive impairment and mortality, those who do become cognitively impaired appear to be in poorer health, leading to a reduced probability of improved cognition and increased probability of mortality relative to those with lower educational levels.

PB - 20 VL - 20 IS - 4 U1 - http://www.ncbi.nlm.nih.gov/pubmed/18448687?dopt=Abstract U2 - PMC2966893 U4 - cognition Disorders/cognitive Impairment/educational Status/life Expectancy/education/MORTALITY ER -