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Objectives. We examined the influence of neighborhood environment on the weight status of adults 55 years and older. Methods. We conducted a 2-level logistic regression analysis of data from the 2002 wave of the Health and Retirement Study. We included 8 neighborhood scales: economic advantage, economic disadvantage, air pollution, crime and segregation, street connectivity, density, immigrant concentration, and residential stability. Results. When we controlled for individual- and family-level confounders, living in a neighborhood with a high level of economic advantage was associated with a bower likelihood of being obese for both men (odds ratio [OR]=0.86; 95% confidence interval [CI]=0.80, 0.94) and women (OR=0.83; 95% CI=0.77, 0.89). Men living in areas with a high concentration of immigrants and women living in areas of high residential stability were more likely to be obese. Women living in areas of high street connectivity were less likely to be overweight or obese. Conclusions. The mechanisms by which neighborhood environment and weight status are linked in later life differ by gender, with economic and social environment aspects being important for men and built environment aspects being salient for women.

Objective. We sought to determine whether socioeconomic and racial/ethnic disparities in prevalence of disability over age 70 have widened or narrowed during the past 2 decades. Methods. We used data from the 1982-2002 National Health Interview Surveys, which are nationally representative cross-sectional surveys of the noninstitutionalized population of the United States. Participants included 172 227 people aged 70 years and older. The primary outcome measure was the average annual percentage change in the prevalence of 2 self-reported disability measures: the need for help with activities of daily living ('ADL disability') and need for help with either ADL or instrumental activities of daily living ('any disability'). Results. All groups experienced declines in the age- and gender-adjusted prevalence of any disability during the 1982 to 2002 period. However, the average annual percent declines were smaller for the least advantaged socioeconomic groups. Differences in trends across racial/ethnic groups were not statistically significant. ADL disability prevalence decreased for the more advantaged groups but increased among the lowest income and education groups. Non-Hispanic Whites and minorities experienced similar average annual percent declines in ADL disability. Conclusions. Racial/ethnic disparities in old-age disability have persisted over the last 20 years, whereas socioeconomic disparities have increased. (Am J Public Health. 2005;95:2065-2070. doi:10.2105/AJPH.2004.048744)

A variety of government programs in the United States are charged with ameliorating the consequences of disability, particularly as they relate to earnings capacity and economic well being. Less often, the programs involve rehabilitation and vocational services, medical care, employment protection, and increasing access to technology.

Support systems for people with disabilities include personal care services, technological assistance, and other strategies employed to accomplish daily task. These systems, whether at home or in group settings, make it possible for people with disabilities to carry out their daily lives, gain access to their world, and participate as citizens.

Disability depends on the health of an individual as well as the social and physical environment and the activities of interest. Some older people experience a rapid decline to dependence, others experience a gradual loss of function or remain largely independent, whereas a substantial proportion sees improvements in functional status.

The 2000 Census of the United States provides a broad overview of the extent of functional limitation and disability across the nation and by sex, age, and other demographic characteristics. Among the elderly, in contrast, physical functioning limitation is the most prevalent type of limitation or disability.

Disability exists when an individual's physical, cognitive, or psychological capacity does not fit the demands of a given task within a specific environment. In some instances, the term disability refers to how a task could be performed in a specific environment without technological or human assistance, in other cases, disability refers to a person's ability to function with such support.

Objectives. We examined the effect of demographic and socioeconomic factors on use of preventive services (prostate-specific antigen testing, colorectal cancer screening, and influenza vaccination) among elderly men enrolled in 2 Medicare+ Choice health plans. Methods. Data were derived from administrative files and a survey of 1915 male enrollees. We used multivariate logistic regression to assess the effects of enrollee characteristics on preventive service use. Results. Age, marital status, educational attainment, and household wealth were associated with receipt of one or more preventive services. However, the effects of these variables were substantially attenuated relative to earlier studies of Medicare. Conclusions. Some Medicare HMOs have been successful in attenuating racial and socioeconomic disparities in the use of preventive services by older men. (Am J Public Health. 2004;94:796-802)

Objectives. This report documents trends in functional limitations among older Americans from 1984 to 1993 and investigates reasons for such trends. Methods. We applied logistic regression to data for noninstitutionalized Americans aged 50 years and older from the Survey of Income and Program Participation. We focused on 4 functional limitation measures unlikely to be affected by changes in role expectations and living environments: reported difficulty seeing words in a newspaper, lifting and carrying 10 pounds, climbing a flight of stairs, and walking a quarter of a mile. Results. We found large declines in the crude prevalence of functional limitations, especially for those 80 years and olden Generally, changes in population composition explained only a small portion of the downward trends. Once changes in population composition and mobility-related device use were considered for difficulty walking, significant improvements in functioning remained for the 65- to 79-year-old group. Conclusions. Changes in population composition, device use, survey design, role expectations, and living environments do not appear to account completely for improvements in functioning. We infer that changes in underlying physiological capability--whether real or perceived--likely underlie such trends. (Am J Public Health. 1998;88: 1457-1462)