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ObjectivesWe examined relationships between US women's exposure to midlife work-family demands and subsequent mortality risk.MethodsWe used data from women born 1935 to 1956 in the Health and Retirement Study to calculate employment, marital, and parenthood statuses for each age between 16 and 50 years. We used sequence analysis to identify 7 prototypical work-family trajectories. We calculated age-standardized mortality rates and hazard ratios (HRs) for mortality associated with work-family sequences, with adjustment for covariates and potentially explanatory later-life factors.ResultsMarried women staying home with children briefly before reentering the workforce had the lowest mortality rates. In comparison, after adjustment for age, race/ethnicity, and education, HRs for mortality were 2.14 (95% confidence interval [CI] = 1.58, 2.90) among single nonworking mothers, 1.48 (95% CI = 1.06, 1.98) among single working mothers, and 1.36 (95% CI = 1.02, 1.80) among married nonworking mothers. Adjustment for later-life behavioral and economic factors partially attenuated risks.ConclusionsSequence analysis is a promising exposure assessment tool for life course research. This method permitted identification of certain lifetime work-family profiles associated with mortality risk before age 75 years.

Objectives. Hip fractures can have devastating effects on the lives of older individuals. We determined the frequency of occurrence of hip fracture and the baseline factors predicting death and institutionalization at 6 months after hip fracture. Methods. A representative cohort of 2812 individuals aged 65 years and older was followed prospectively for 6 years. Hip fractures were identified, and the occurrence of death and institutionalization within 6 months of the fracture was determined. Prefracture information on physical and mental function, social support, and demographic features and in-hospital data on comorbid diagnoses, fracture site, and complications were analyzed to determine predictors of death and institutionalization after hip fracture. Results. Of 120 individuals suffering a hip fracture. 22 (18%) died within 6 months and 35 (29%) were institutionalized at 6 months. The predictors of death in multiple logistic regression included fracture site, a high number of complications, and poor baseline mental status. The primary predictor of institutionalization was poor baseline mental status. Conclusions. The frequency of death, institutionalization, and loss of function after hip fracture should prompt a reevaluation of the current approach to this problem. [ABSTRACT FROM AUTHOR]

Despite the importance of kin in caring for older relatives, few studies have examined the relationship between the family network and the risk of nursing home placement. Data from a cohort of noninstitutionalized elderly persons living in New Haven in 1982 were used to predict nursing home admission through 1985. Logistic regression analyses show that older persons who have regular contact with kin have a lower risk of institutionalization. For men, the spouse is most important in reducing the risk of entry; for women, having regular contact with at least one family member--of any relation--reduces the risk of entry. [ABSTRACT FROM AUTHOR]