TY - JOUR T1 - Cognitive change and driving behavior among older drivers JF - Transportation Research Record: Journal of the Transportation Research Board Y1 - 2018 A1 - Laura A Fraade-Blanar A1 - James P Smith KW - Cognition & Reasoning KW - Driving AB - Per vehicle miles traveled, older adults have a high fatal crash rate. One factor is dementia. This study aims to assess how differences in cognition affect driving behavior among older drivers. We analyzed data from the Health and Retirement Study. Our study used cognition, demographics, and driving behavior from 2006 to 2014 for respondents aged 65 and above. Three levels of driving behavior were measured: whether the individual could drive, whether they had driven in the past month, and whether they drove long distances. Cognitive function was measured through the Telephone Interview for Cognitive Status. Additionally, individuals were coded as having no diagnosis of dementia, a diagnosis within 2 years, or a diagnosis more than 2 years previously. We estimated the likelihood of each driving behavior in association with cognition using a modified Poisson regression model for binary outcomes. Among respondents (N = 16,061), 79% could drive. Of these, 93% had driven in the past month, and of these, 64% drove long distances. Compared with no impairment, mild impairment was associated with a significant 12% decrease in probability of being able to drive, an 8% decrease in driving within the past month, and a 24% decrease in driving long distances. The decrease was larger among those with severe impairment. Results were in a similar direction and strength comparing individuals without dementia with individuals 0 to 2 years after diagnosis, and to more than 2 years after diagnosis. A strong positive association exists between lower cognition and lower driving exposure. VL - 2672 IS - 33 JO - Transportation Research Record ER - TY - CHAP T1 - Cognition and Economic Outcomes T2 - Explorations in the Economics of Aging Y1 - 2011 A1 - John J McArdle A1 - James P Smith A1 - Robert J. Willis ED - David A Wise KW - Health Conditions and Status JF - Explorations in the Economics of Aging PB - University of Chicago Press CY - Chicago U4 - cognition JO - Cognition and Economic Outcomes ER - TY - CHAP T1 - Consequences and Predictors of New Health Events T2 - Analyses in the Economics of Aging Y1 - 2005 A1 - James P Smith ED - David A Wise KW - Demographics KW - Health Conditions and Status AB - The emphasis in health research has been on understanding and disentangling the multiple ways in which socio-economic status may influence a variety of health outcomes. Consequently, much less is currently known about the impact health may have on SES. But at least for working-aged individuals, health feedbacks to labor supply, household income, and wealth may be quantitatively quite important. Therefore, one aim of this paper will be to estimate the effect of new health events on a series of subsequent outcomes that are both directly and indirectly related to SES. These outcomes will include out-of-pocket medical expenses, the intensive and extensive margins of labor supply, health insurance, and household income. JF - Analyses in the Economics of Aging PB - University of Chicago Press CY - Chicago UR - http://www.ifs.org.uk/publications.php N1 - ProCite field 6 : In ProCite field 8 : ed U4 - Health/Socioeconomic Status JO - Consequences and Predictors of New Health Events ER - TY - JOUR T1 - Can patient self-management help explain the SES health gradient? JF - Proc Natl Acad Sci U S A Y1 - 2002 A1 - Dana P Goldman A1 - James P Smith KW - Adolescent KW - Adult KW - Antiretroviral Therapy, Highly Active KW - Diabetes Mellitus, Type 1 KW - Educational Status KW - Female KW - Health Knowledge, Attitudes, Practice KW - HIV Infections KW - Humans KW - Insulin KW - Longitudinal Studies KW - Male KW - Patient Compliance KW - Population Surveillance KW - Prospective Studies KW - Randomized Controlled Trials as Topic KW - Self Care KW - Social Class AB -

There are large differences in health outcomes by socioeconomic status (SES) that cannot be explained fully by traditional arguments, such as access to care or poor health behaviors. We consider a different explanation-better self-management of disease by the more educated. We examine differences by education in treatment adherence among patients with two illnesses, diabetes and HIV, and then assess the subsequent impact of differential adherence on health status. One unique component of this research is that for diabetes we combine two different surveys-one cohort study and one randomized clinical trial-that are usually used exclusively by either biomedical or/and social scientists separately. For both illnesses, we find significant effects of adherence that are much stronger among patients with high SES. After controlling for other factors, more educated HIV+ patients are more likely to adhere to therapy, and this adherence made them experience improvements in their self-reported general health. Similarly, among diabetics, the less educated were much more likely to switch treatment, which led to worsening general health. In the randomized trial setting, intensive treatment regimens that compensated for poor adherence led to better improvements in glycemic control for the less educated. Among two distinct chronic illnesses, the ability to maintain a better health regimen is an important independent determinant of subsequent health outcomes. This finding is robust across clinical trial and population-based settings. Because this ability varies by schooling, self-maintenance is an important reason for the steep SES gradient in health outcomes.

PB - 99 VL - 99 IS - 16 U1 - http://www.ncbi.nlm.nih.gov/pubmed/12140364?dopt=Abstract U4 - Health Physical ER - TY - RPRT T1 - The Changing Economic Circumstances of the Elderly: Income, Wealth and Social Security Y1 - 1997 A1 - James P Smith KW - Health Conditions and Status KW - Income KW - Net Worth and Assets KW - Social Security AB - This Policy Brief looks at how the economic status of the elderly is changing and discusses their prospects for the future. While the economic status of the elderly has dramatically improved over the decades and there is evidence of modest wealth holdings by the typical older household, there still exists the reality of economic disparities. Many older Americans remain economically vulnerable and there are large inequalities in wealth. Wide disparities exist across racial and ethnic groups and across age groups, with the oldest households always faring worst, largely due to deaths of spouses. Evidence suggests that while income explains a significant part of the existing wealth disparities, it is not the sole factor. The other contributing factors are the significantly lower savings rates for low- and middle-income households, socioeconomic status and health, bequests motives, and Social Security. The brief ends with a discussion about the power of Social Security as a highly successful redistributive system and the reasons behind its need for reform. PB - Syracuse University UR - https://ideas.repec.org/p/max/cprpbr/008.html U4 - Economic Status/Wealth/Retirement Incomes/Income Inequality/Social Security/Health Status ER -