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As individuals live longer with multiple health conditions, approaches to health care for older adults are increasingly focusing on chronic versus acute care models. Most of the research in this area focuses on physical, not behavioral health. However, co-occurring physical, mental, and substance use issues can lead to complex needs for services. The purpose of this study is to identify the profiles of physical and behavioral health conditions among adults aged 50 and older people, examine age-cohort difference in these profiles, and explore their effects on mental health service use. Data are from 1,279 respondents of Midlife in the United States (MIDUS) wave 3. Latent class analysis was conducted using physical health (i.e., heart, cancer, respiratory, stroke, diabetes, lung, high blood pressure) and behavioral health indicators (i.e., depression/anxiety, daily and heavy drinking) to identify three distinct patterns of health conditions: a healthy group, a physically vulnerable group, and group most at risk. Age cohort, gender, education, and income were significant indicators to these groups. Compared to pre-boomers, baby boomers were more likely to belong to the physically vulnerable group. The physically vulnerable group were less likely to use mental health services than healthy group. Identification of subgroups with multiple health conditions among older adults has important implications for older health policy and programs. By providing initial evidence on the heterogeneity among this population, our findings provide information that can improve our ability to address complex health care needs and quality of life among older adults.

Academic literature on elder care examines the quality of care, the structure of services, and the role of non-professional care. While fairly universal across developed countries, the cultural and social welfare contexts vary suggesting cross-country differences in how these issues are understood and addressed. The media both reflects and shapes what people regard as significant and is, therefore, one place to examine cross-cultural differences in approaches to care; however, studies that compare the discourse across countries with different social welfare structures are almost non-existent. In this study, we analyze print media published in four major newspapers in Finland and the United States. Using quality of care, structure of services, and non-professional care as our guiding framework, we conducted a thematic analysis of news reports, feature stories, and editorials published during May-June 2015 and March-April 2016. Quality of care was the most common theme in Finnish media with a focus on: 1) harmful or dangerous care practices, 2) neglect or lack of care, and 3) care falling behind set quality requirements. Despite the differences in the welfare regime, cost of care to the individual was a common theme in both countries as was a focus on increasing home care and informal care. There are weak signals in both countries of innovations that co-mingle aspects of informal and formal care such as intergenerational housing, employment opportunities for older adults, and co-locating day care and adult day care centers. These tend to be based on local initiative rather than strategic, governmental planning.