Health-Care Utilization as a Proxy in Disability Determination


Book Description

The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.













Modern Epidemiology


Book Description

The thoroughly revised and updated Third Edition of the acclaimed Modern Epidemiology reflects both the conceptual development of this evolving science and the increasingly focal role that epidemiology plays in dealing with public health and medical problems. Coauthored by three leading epidemiologists, with sixteen additional contributors, this Third Edition is the most comprehensive and cohesive text on the principles and methods of epidemiologic research. The book covers a broad range of concepts and methods, such as basic measures of disease frequency and associations, study design, field methods, threats to validity, and assessing precision. It also covers advanced topics in data analysis such as Bayesian analysis, bias analysis, and hierarchical regression. Chapters examine specific areas of research such as disease surveillance, ecologic studies, social epidemiology, infectious disease epidemiology, genetic and molecular epidemiology, nutritional epidemiology, environmental epidemiology, reproductive epidemiology, and clinical epidemiology.




The Effect of Race on the Knowledge and Use of Health Services Among Rural Elderly


Book Description

This study was unique in that it focused on the rural elderly of both Black and White ethnicity's, explored differences between groups by comparing use and knowledge of health services, and controlled for gender, income, educational attainment, health status, age, and health beliefs - the independent variables of the study. Knowledge and use of health services were dependent factors. The Anderson behavioral model (Anderson, 1995) has been extensively used to examine health service utilization. It conceptualizes health care use as the outcome of a complex pattern of interactions between predisposing, enabling, and need-for care characteristics. The literature has supported the utility of the behavioral model for assessing the health care practices of rural older adults. Four questions were posed. These were translated into hypotheses for statistical testing purposes. Black and White elderly residents of one rural county in South Carolina comprised the target population. A sample of 150 elderly residents, 75 Black and 75 White, were randomly selected for participation. The multidimensional health locus of control scales were modified and used in the test instrument to assess health beliefs (both internal and external). Descriptive and background data were gathered from administration of the survey. Data were analyzed using SPSS statistical software. Analysis of variance (ANOVA) and the LSD (least significant differences) test, in addition to regression analysis, were used to compute and identify differences between and among groups of data. This research concluded that there was no correlation between use of services and knowledge of facilities. There were differences in utilization by race, with Whites making greater use of health care facilities. Educational levels, health status, income, household composition, type of insurance, and age influenced health care use. It was not influenced by gender, distance from facilities, and health beliefs. There was a statistically significant difference between knowledge and race, with Blacks having higher knowledge scores. Gender, health status, income, distance from facilities, and health beliefs did not influence knowledge. However, educational attainment, type of insurance, household composition, and age did. Service use and knowledge were adequate, in contrast to findings in the literature. Recommendations for further study were formulated.




Status of the rural elderly


Book Description




Healthy Longevity in China


Book Description

Key research in the world’s largest aging population – in China – has fed into this important new work, which aims to answer questions critical to older people worldwide. These include: is the period of disability compressing or expanding with increasing life expectancy and what factors are associated with these trends in the recent decades? And is it possible to realize morbidity compression with a prolongation of the life span in the future? Essential reading for gerontologists.




Social Isolation and Loneliness in Older Adults


Book Description

Social isolation and loneliness are serious yet underappreciated public health risks that affect a significant portion of the older adult population. Approximately one-quarter of community-dwelling Americans aged 65 and older are considered to be socially isolated, and a significant proportion of adults in the United States report feeling lonely. People who are 50 years of age or older are more likely to experience many of the risk factors that can cause or exacerbate social isolation or loneliness, such as living alone, the loss of family or friends, chronic illness, and sensory impairments. Over a life course, social isolation and loneliness may be episodic or chronic, depending upon an individual's circumstances and perceptions. A substantial body of evidence demonstrates that social isolation presents a major risk for premature mortality, comparable to other risk factors such as high blood pressure, smoking, or obesity. As older adults are particularly high-volume and high-frequency users of the health care system, there is an opportunity for health care professionals to identify, prevent, and mitigate the adverse health impacts of social isolation and loneliness in older adults. Social Isolation and Loneliness in Older Adults summarizes the evidence base and explores how social isolation and loneliness affect health and quality of life in adults aged 50 and older, particularly among low income, underserved, and vulnerable populations. This report makes recommendations specifically for clinical settings of health care to identify those who suffer the resultant negative health impacts of social isolation and loneliness and target interventions to improve their social conditions. Social Isolation and Loneliness in Older Adults considers clinical tools and methodologies, better education and training for the health care workforce, and dissemination and implementation that will be important for translating research into practice, especially as the evidence base for effective interventions continues to flourish.