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How people spend their time is an indicator of how they live their lives, with time use over the life course conditioned both by age and by participation in age-graded institutions. This chapter uses nationally representative data from the pooled 2008–2020 American Time Use Survey (ATUS) to evaluate how time use in 12 activity categories varies by age, gender, and disability status among 137,266 respondents aged 15 and older. By doing so, we quantify the “disability gap” in time use between men and women with and without disabilities, identifying at what age and by how much people with disabilities experience time differentials in activities of daily living (ADLs), instrumental activities of daily living (IADLs), and other indicators of social participation. Results indicate that – at many ages – patterns of time use for people with disabilities deviate from those of people without disabilities, with more pronounced differences in midlife. Further, the magnitude of women's disability gaps equals or exceeds men's for sleeping, and nearly all ADLs and IADLs, indicating that disability gaps are also gendered.

Research on women’s health has increased substantially in the past decade, but this has not been paralleled in the area of developmental disabilities. In developmental disabilities research, there has been little attempt to disentangle the impact of age, intellectual disabilities, and other developmental disabilities on women’s health. The 1994–1995 Disability Supplement to the National Health Interview Survey, administered to a representative sample of the U.S. population, was used to describe the aging process in the community for women age 30 and older with mental retardation (MR), developmental disabilities (DD) or both (MR/DD). Definitions of MR and DD consistent with professional and legal standards were developed and adapted to the NHIS-D questions. Approximately 77 million civilian, non-institutionalized women in the United States were age 30 and older at the time of the survey. Among these women an estimated 0.56% have mental retardation or developmental disability. Compared with women in general, women with these disabilities were disproportionately absent in the community, had negative perceptions of their health status, and their health indicators tended to support these perceptions. Most women with these disabilities were independent in activities of daily living (ADL), but instrumental activities of daily living (IADLs) posed more of a challenge, and limitations in major activities were common. Limitations in mobility were common among women with DD.

This study explores the social, biological, and genetic determinants of depression in later life. It adds complexity to the idea that later life depression is a natural outgrowth of vascular impairment, antagonistic pleiotropy, or compromised neuroanatomical structures, arguing instead for the importance of education as a fundamental cause.

The study uses the NAS-NRC Twin Registry of World War II Veterans. The use of twins permits the exploration of gene-environment interplay. A recent survey instrument associated with the registry contains numerous indicators of health, including a measure of depression.

The results show that education has a strong negative relationship with depression among those in their 70s and early 80s. Although this relationship is partly explained by lower rates of cardiovascular disease and diabetes among the well-educated, the relationship between education and many common physical illnesses is quite small. Most people of this age experience at least one chronic illness. The relationship between education and depression is explained, instead, by how education reduces impairments in activities of daily living. These impairments are not an inevitable outgrowth of declining health. The well-educated are better able to moderate the impact of poor health on daily functioning. Moreover, the well-educated are able to avoid the otherwise strong genetic risks for depression in later life. Gene × environment models show a high heritability for later life depression on average, but also reveal that this heritability declines with increasing education. Among those with a four-year college degree, the heritability of depression is very small.

These patterns are interpreted in light of compensatory gene × environment interactions, which emphasize the importance of especially enriched environments for overcoming genetic risk.

Arthritis is the most prevalent chronic condition in persons ages 65 and older and is projected to increase substantially as the population ages. The purpose of this research is to assess if age, duration of arthritis, and severity of arthritis exert independent effects on various aspects of the disability process: functional limitations, activities of daily living (ADL) limitations, and instrumental activities of daily living (IADL) limitations. Type of arthritis, socio-demographic factors, behavioral factors, and additional health statuses are also examined. Using longitudinal data from the Health and Retirement study, results show age and severity of arthritis are related to the number of functional limitations one has and to the odds of having ADL and IADL limitations. Duration of arthritis is positively related to functional limitations and to the odds of reporting ADL limitations. Duration of arthritis is not significantly related to IADL limitations, which are strongly linked to performing social roles and have less to do with physical functioning compared to ADL tasks and functional tasks. There is no difference between those with established arthritis compared to those who have had it for a shorter time period, suggesting those with arthritis adapt to social tasks better than physical tasks. The resources used to cope with IADL limitations may be more effective over time compared to those used to cope with functional limitations and ADL disability. Understanding the context of functional limitations and disability among those with arthritis may lead to improved support and care for those living with arthritis.

We identify the key social and political forces that brought about the Self Managed Attendant Service Direct Funding Pilot (SMAS-DFP). Attendant Services are services for people with physical disabilities (PWD) to assist with daily activities. Direct Funding means that individuals obtain funds through direct funding mechanisms and/or through third parties. Self-direction refers to consumers who know their attendant service needs and can instruct workers to meet these needs. Self-management refers to (PWD) who are employers under the law and are legally responsible for hiring, training, scheduling and paying their attendants. Our analysis of the success of the SMAS-DFP is based on pre-conditions and facilitating elements. The pre-conditions were the: (1) existence of social movements; (2) precedents to direct funding programs; (3) prior experience with the governance of attendant services; and (4) government health reform. Five elements facilitated the SMASD-FP: (1) a clear vision by the community; (2) a core group of leaders; (3) supporters of the SMAS-DFP came from inside and outside of the community; and (4) supporters provided key resources to be used and to deal with barriers. PWD successfully led the pilot (1994–1997) and continue to administer the expanded government program (began 1998).

Concepts of disability have evolved over the past few decades. The focus of attention has shifted from disability as a state, a consequence of disease, to disability being included as just one of many components of health. This has been realised in part through the implementation of the International Classification of Functioning, Disability and Health (ICF). Despite these developments and increased focus in recent years, reliable disability data, particularly from low-income countries, are lacking.We present an innovative approach to measuring disability in a population that is based on some conceptual elements of the ICF, namely activity limitations and participation restrictions. The results are derived from studies on the living conditions among people with disabilities in Namibia, Zimbabwe and Malawi conducted between 2001 and 2004. From the data analysis perspective, the research challenge lies in a shift in the dependent variable from a dichotomous outcome measure (disability as a state: disabled, not disabled) to a continuous measure of activity limitations and participation restrictions – mirroring the range of disability we see in society.These measures of activity limitations and participation restrictions must however not be interpreted in isolation, but as integral to the environment, society and culture from which they are derived. This will require an expanded view of disability data and effect substantially greater measurement challenges.