%0 Journal Article %J Prehospital and Disaster Medicine %D 2019 %T Health Risk Behaviors after Disaster Exposure Among Older Adults %A Bell, Sue Anne %A Choi, Hwajung %A Kenneth M. Langa %A Theodore J Iwashyna %K BMI %K Health behaviors %K Risk Factors %B Prehospital and Disaster Medicine %V 34 %P 95-97 %G eng %U https://www.cambridge.org/core/product/identifier/S1049023X18001231/type/journal_articlehttps://www.cambridge.org/core/services/aop-cambridge-core/content/view/S1049023X18001231 %N 1 %! Prehosp. Disaster med. %R 10.1017/S1049023X18001231 %0 Journal Article %J Soc Sci Med %D 2015 %T Are older adults living in more equal counties healthier than older adults living in more unequal counties? A propensity score matching approach. %A Choi, Hwajung %A Sarah A. Burgard %A Irma Elo %A Michele M Heisler %K Aged %K Aged, 80 and over %K Female %K Health Status Indicators %K Health Surveys %K Healthcare Disparities %K Humans %K Logistic Models %K Male %K Middle Aged %K Propensity Score %K Self Report %K Socioeconomic factors %X

We assessed the potential contextual effect of income inequality on health by: 1) comparing individuals with similar socioeconomic status (SES) but who reside in counties with different levels of income inequality; and 2) examining whether the potential effect of county-level income inequality on health varies across SES groups. We used the Health and Retirement Study, a nationally representative study of Americans over the age of 50. Using propensity score matching, we selected SES-comparable individuals living in high-income inequality counties and in low-income inequality counties. We examined differences in self-rated overall health outcomes and in other specific physical/mental health outcomes between the two groups using logistic regression (n = 34,994) and imposing different sample restrictions based on residential duration in the area. We then used logistic regression with interactions to assess whether, and if so how, health outcomes differed among participants of different SES groups defined by wealth, income, and education. In bivariate analyses of the unmatched full sample, adults living in high-income inequality counties have worse health outcomes for most health measures. After propensity score matching, adults in high-income inequality counties had worse self-rated health status (AOR = 1.12; 95% CI 1.04-1.19) and were more likely to report diagnosed psychiatric problems (AOR = 1.08; 95% CI 0.99-1.19) than their matched counterparts in low-income inequality counties. These associations were stronger with longer-term residents in the area. Adverse health outcomes associated with living in high-income inequality counties were significant particularly for individuals in the 30(th) or greater percentiles of income/wealth distribution and those without a college education. In summary, after using more precise matching methods to compare individuals with similar characteristics and addressing measurement error by excluding more recently arrived county residents, adults living in high-income inequality counties had worse reported overall physical and mental health than adults living in low-income inequality counties.

%B Soc Sci Med %I 141 %V 141 %P 82-90 %8 2015 Sep %G eng %1 http://www.ncbi.nlm.nih.gov/pubmed/26256736?dopt=Abstract %2 PMC4550487 %4 income inequality/Socioeconomic Status/cross-national comparison %$ 999999 %R 10.1016/j.socscimed.2015.07.020 %0 Journal Article %J J Behav Med %D 2013 %T Adults with cardiovascular disease who help others: a prospective study of health outcomes. %A Michele M Heisler %A Choi, Hwajung %A John D Piette %A Ann Marie Rosland %A Kenneth M. Langa %A Stephanie Brown %K Activities of Daily Living %K Aged %K Cardiovascular Diseases %K depression %K Female %K Health Status %K Helping Behavior %K Humans %K Longitudinal Studies %K Male %K Middle Aged %K Prospective Studies %K Time Factors %X

Little is known about the health impact of helping behaviors among individuals with high-risk chronic diseases such as cardiovascular disease (CVD). Using a nationally representative, longitudinal survey, we examined the subsequent health of adults with CVD (n = 4,491) who spent time providing non-paid assistance to family and friends outside of their households compared with those who had provided no assistance. After both adjusting for baseline characteristics and using propensity score matching methods, spending up to 200 h over the prior 12 months helping others was associated with lower odds of experiencing a new CVD event or dying in the subsequent 2 years. Providing up to 100 h of assistance was associated with reporting fewer depressive symptoms. This threshold effect raises the question of whether assistance beyond a certain number of hours may impose a burden that mitigates health benefits from helping others. Health care providers could play an important role exploring ways that patients with CVD can provide beneficial levels of assistance to others in their own social networks or communities, thereby possibly also improving their own health.

%B J Behav Med %I 36 %V 36 %P 199-211 %8 2013 Apr %G eng %U http://search.proquest.com.proxy.lib.umich.edu/docview/1318045378?accountid=14667 %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/22481214?dopt=Abstract %4 Psychology/Cardiovascular disease/Chronic conditions/caregivers/Depressive Symptoms/health care policy %$ 68988 %R 10.1007/s10865-012-9414-4