The patterns of physical and behavioral health among older adults and its effects on older mental health service use : age cohort effects
"With increased longevity in the United States, the proportion of older adults living with multiple chronic conditions (MCC) also increases. As the large segment of baby boomers enters an older population, healthcare concerns for older adults have expanded, including not only physical but also behavioral health conditions. The lack of chronic health care for older patients with MCC is an urgent social need. In identifying the overall health conditions among older Americans, this study aims to provide a better understanding of older people's complex healthcare needs, examine the relationship between their perceived healthcare needs and helpseeking healthcare efforts, and suggest a better way to define chronic and comprehensive health care in old age. The study data were derived from national survey data, Midlife in the United States Wave Three (MIDUS III), and a total of 2,019 respondents aged 50 years or more were used for this study analysis. To identify their health profiles, 10 health indicators including physical and behavioral health conditions were assessed: heart disease, cancer, respiratory disease, diabetes, lung disease, kidney disease, depression or anxiety, daily drinking, and heavy drinking. The baby boomers' health conditions were compared to the pre-boomers' health conditions to examine whether there is a cohort difference in older populations. The relationship between older people's health profiles and their mental health service use and how the relationship might be modified by the age cohort were examined. Latent class analysis, multinomial logistic regression, and logistic regression were conducted using Stata SE 12 version or Mplus 7.4 version for the study analyses. The study results generated four health profiles among older Americans: Healthy, Physical MCC, Physical and Mental MCC, and Physical and Drinking MCC. When including both behavioral and physical health, the baby boomers were healthier than the pre-boomers: All three MCC groups showed higher proportions of pre-boomers than aging baby boomers while the healthy group was more associated with baby boomers. Older adults with physical MCC or physical and mental MCC were more likely to receive mental health care than the healthy people, but not those with physical and drinking MCC. The relationships between older individuals' health profiles and their mental health service use were not different between those of the aging baby boomers and the pre-boomers. This study highlights the existence of heterogeneity in older Americans' health profiles. Particularly, physical-mental comorbidity and problem drinking among community-dwelling older adults with MCC require attention. Because of the continuous, growing aging older population, the current geriatric healthcare systems should reflect the older individuals' complex healthcare needs, which can reduce the personal burden and public spending by providing effective healthcare services and increase the quality of life for older patients with MCC. More implications for social work practices and social policy are discussed."--Pages ii-iii.
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- In Collections
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Electronic Theses & Dissertations
- Copyright Status
- In Copyright
- Material Type
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Theses
- Authors
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Kwon, Ilan
- Thesis Advisors
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Woodward, Amanda T.
- Committee Members
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Freddolino, Paul P.
Cho, Hyunkag
Zhang, Zhenmei
- Date Published
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2018
- Subjects
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Older people--Mental health
Older people--Health and hygiene
Chronically ill--Mental health
- Program of Study
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Social Work - Doctor of Philosophy
- Degree Level
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Doctoral
- Language
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English
- Pages
- ix, 101 pages
- ISBN
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9780438338807
0438338804
- Permalink
- https://doi.org/doi:10.25335/3fep-xq05