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An introduction is presented in which the editor discusses articles in the issue on topics including immigration, family, and macro and micro-economic changes and its impact on the quality of community life.

The article presents a cross-national study on the challenges in adapting existing old-age support systems in Mexico and the U.S. It looks at the potential complementary roles of governmental and non-governmental organizations in dealing the problem concerning old-age support systems as well as offers new approaches to the support and care of dependent older people. Recommendations for developing more effective old age policies are provided.

Objective: This study examines the potential effects of nativity and acculturation on active life expectancy (ALE) among Mexican-origin elders. Method: We employ 17 years of data from the Hispanic Established Population for the Epidemiologic Study of the Elderly to calculate ALE at age 65 with and without disabilities. Results: Native-born males and foreign-born females spend a larger fraction of their elderly years with activities of daily living (ADL) disability. Conversely, both foreign-born males and females spend a larger fraction of their remaining years with instrumental activities of daily life (IADL) disability than the native-born. In descriptive analysis, women with low acculturation report higher ADL and IADL disability. Men manifest similar patterns for IADLs. Discussion: Although foreign-born elders live slightly longer lives, they do so with more years spent in a disabled state. Given the rapid aging of the Mexican-origin population, the prevention and treatment of disabilities, particularly among the foreign born, should be a major public health priority. [ABSTRACT FROM AUTHOR]

In the United States, a woman health insurance coverage is largely determined by her employment and marital roles. This research evaluates competing hypotheses regarding how the combination of employment and marital roles shapes insurance coverage among Mexican-origin, non-Hispanic white, and African American women. We use data from the 2004 and 2006 March Supplements to the Current Population Surveys. Results show that these roles largely substitute for each other among non-Hispanic white and African American women, although marriage generally increases the odds of coverage slightly more than employment among non-Hispanic white women. In contrast, these roles cumulatively increase those odds among Mexican-origin women. Yet neither employment, nor marriage, nor their combination assures their coverage. Married Mexican-origin women are particularly disadvantaged. As women increasingly spend a smaller fraction of their lives in marriage, and as relatively few women are in benefits-rich occupations, stable and equitable coverage may require a universal health insurance system. [ABSTRACT FROM AUTHOR]

Using data from the Welfare, Children, and Families project (1999), a probability sample of 2,280 low-income women with children living in low-income neighborhoods in Boston, Chicago, and San Antonio, we examine the effects of relationship violence before age 18 and in the past year on frequency of adult intoxication. Results obtained from a series of ordered logistic regression models suggest that sexual coercion before age 18 and minor and severe physical assault in the past year are independently associated with greater frequency of intoxication, net of a range of sociodemographic controls. The study's limitations are noted. [ABSTRACT FROM AUTHOR]

Objectives: This study compares various dimensions of physical and emotional health between older Mexican-origin individuals in the United States and in Mexico. Method: The samples are drawn from the Mexican Health and Aging Study (MHAS) and the Hispanic Established Epidemiologic Study of the Elderly (H-EPESE) and include 3,875 Mexican residents with no history of residence in the United States and 2,734 Mexican-origin individuals 65 and older who live in the southwestern United States. Results: Both immigrant and native-born Mexican-origin elders in the United States report more chronic conditions than elderly Mexicans, but they report fewer symptoms of psychological distress. Longer residence in the United States is associated with higher body mass index scores. Discussion: The discussion addresses the possibility that access to care influences reports of diagnosed conditions and touches on issues of comparability in cross-cultural research and the difficulty in clearly distinguishing cultural and system-level factors in the production and measurement of health. [ABSTRACT FROM AUTHOR]

Women with few social resources are at elevated risk of partner abuse. Certain evidence suggests that African American and Hispanic women, who are overrepresented in the lower socioeconomic strata, are at particularly high risk. We compare women's risk of partner violence, defined as moderate and severe, among 2,400 low-income African American, Hispanic, and non-Hispanic Whites from “Welfare, Children and Families: A Three City Study” and find that these groups differ in their risk of degrees of violence. Specific nation-of-origin Hispanic subgroups also manifest important differences in their violence risk profiles. We argue that a better understanding of victimization requires more detailed ethnic categorization and a more refined understanding of the meaning of domestic violence for different groups. [ABSTRACT FROM AUTHOR]

Objectives. Studies in the area of religion and mortality are based primarily on data derived from samples of predominantly non-Hispanic Whites. Given the importance of religion in the lives of Hispanics living in the United States, particularly older Hispanics, we examine the effects of religious attendance on mortality risk among Mexican Americans aged 65 and older. Methods. We employ data from the Hispanic Established Populations for Epidemiologic Studies of the Elderly to predict the risk of all-cause mortality over an 8-year follow-up period. Results. Overall, the results show that those who attend church once per week exhibit a 32% reduction in the risk of mortality as compared with those who never attend religious services. Moreover, the benefits of weekly attendance persist with controls for sociodemographic characteristics, cardiovascular health, activities of daily living, cognitive functioning, physical mobility and functioning, social support, health behaviors, mental health, and subjective health. Discussion. Our findings suggest that weekly church attendance may reduce the risk of mortality among older Mexican Americans. Future research should focus on identifying other potential mediators of the relationship between religious involvement and mortality risk in the Mexican-origin population. [ABSTRACT FROM AUTHOR]

The objective of this study is to examine the influences of gender on long-term care service use among older Mexican American widows and widowers. Our analysis is based on a sample of 773 widows and 183 widowers from the Longitudinal Study of Elderly Mexican American Health (H-EPESE). In this sample widows resemble widowers in terms of demographic and health characteristics. However, widows report more financial strain than widowers and a greater welfare dependency (SSI) and Medicaid use. Among those who suffered diminished health, widows were more likely than widowers to use community-based long-term care services whereas widowers were more likely to enter a nursing home. Widows also had more instrumental and socioemotional support than widowers. Serious cognitive and functional impairment, though, places widows and widowers at the same risk of institutionalization. We end with a discussion of the policy implications of these findings. [ABSTRACT FROM AUTHOR]

In this analysis we compare the living arrangements and receipt of Supplemental Security Income (SSI) among older, non-institutionalised adults in five Asian and three Hispanic-origin groups in the United States. Living arrangements and SSI serve as indicators of structural incorporation and our primary objective is to identify the role of nativity (native versus foreign-born) and citizenship status (non-citizen versus naturalised citizen) on living arrangements and SSI receipt. We are also interested in identifying differences among these eight groups. In order to do so, we employ a combined sample from the 3 per cent 1990 United States Public Use Sample (PUMS) and a 5 per cent sample of individuals over 65 (PUMS-O) to achieve adequate coverage. The data reveal great diversity among the eight groups, but also reveal substantial similarity between naturalised citizens, that is, those who are foreign-born but who have become citizens, and the native-born. Our findings suggest that the process of structural incorporation is well under way among the naturalised foreign-born, and that it is important to differentiate between citizens and non-citizens in developing immigration and welfare policy. It is also increasingly clear that in the US context we must begin to differentiate among Asian-origin groups in the same way that we do among Hispanic groups in social scientific research. [ABSTRACT FROM AUTHOR]

In this study we first examine for Mexican Americans aged 65 or older the correlates of changes in living arrangements over a two-year period with special focus on the age at migration to the United States; and second, determine the predictors of headship status at the end of that period. Methods. We employ the 1993-95 Hispanic-EPESE (Established Population for Epidemiological Studies of the Elderly), a longitudinal data set that contains a representative sample of 3,050 older Mexican Americans residing in the Southwestern United States. Results. The results show that individuals who immigrate after age 50 are more likely to move in with others rather than have someone move in with them, especially when they become ill. Conclusions. The social policy implications of the recent eligibility restrictions on long-term care services and supports for older Mexican American immigrants and their families are discussed. [ABSTRACT FROM AUTHOR]

Presents a study which examined the impact of the age at which an individual immigrated to the United States on his sources of income and living arrangements, through the use of data on Mexican-origin individual from the Southern United States. Relationship between age and migration; Details on the Hispanic Established Population for Epidemiologic Studies of the Elderly; Results and discussion.

This article presents commentaries on Alan Wolfe's book One Nation, After All, during the 1998 meeting of the Pacific Sociological Association in San Francisco, California. Wolfe has received numerous laudatory reviews in the Washington Post and in the New York Times, among other places. The work has been praised by political figures as dissimilar as Paul Wellstone, William Bennett, and Al Gore. The core message of the book has been lauded as well in radio and television interviews, of which there have been many. At a time when sociologists complain that our research is ignored or mocked by the press and by policy makers, here is a study that has been embraced. Wolfe has written a remarkable and soothing book about middle-class America. It is remarkable because it took a stunning amount of effort and organization. The transcripts alone ran to nearly four thousand pages. It is soothing because those interviewed were so morally generous. To judge by this study, there is no seething middle-class resentment, heated by the widening gap between rich and poor, likely to flame into exclusionary religious fanaticism. On the contrary, these often solidly conservative Americans were reluctant to pass judgment on other people's behavior and choices.

Examines the extent of private and public health insurance coverage among adult Hispanic Americans. Influence of low levels of education, high rates of unemployment and underemployment on the lack of health insurance among Hispanics; High rate of nonparticipation in Social Security; Consequences of a lack of private health insurance.

Abstract: The ability of self-rated health status to predict mortality was tested with data from the National Health and Nutrition Examination Survey (NHANES-I) Epidemiologic Follow-Up Study (NHEFS), conducted from 1971-84. The sample consists of adult NHANES-I respondents ages 25-74 years (N = 6,440) for whom data from a comprehensive physical examination at the initial interview and survival status at follow-up are available. Self-rated health consists of the response to the single item, "Would you say your health in general is excellent, very good, good, fair, or poor?" Proportional hazards analyses indicated that, net of its association with medical diagnoses given in the physical examination, demographic factors, and health related behaviors, self-rated health at Time 1 is associated with mortality over the 12-year follow-up period among middle-aged males, but not among elderly males or females of any age. (Am J Public' Health 1990; 80:446-452.) [ABSTRACT FROM AUTHOR]

Studies of Hispanic adults in the United States have documented large differences in socioeconomic status and health between specific Hispanic groups. A growing body of research shows that Cuban Americans are similar to non-Hispanic whites in socioeconomic status; Puerto Ricans are similar to blacks; and Mexican Americans are intermediate. These differences are reflected in health levels of adults. The analyses of the Hispanic Health and Nutrition Examination Survey (HHANES) in this study indicate that these differences in socioeconomic status affect the health of children as well. The findings reveal that among Hispanic children, Puerto Ricans make up a seriously health-disadvantaged minority group. [ABSTRACT FROM AUTHOR]

Studies the aging trends of the Mexican Americans in Southwestern America. Demography of Mexican-American aging; Comparison of morbidity patterns among Americans of Mexican origin and other racial and ethnic groups; Social consequences of the Mexican-origin population for support systems.

Examines patterns of emotional and physical comorbidity and the uses of general medical and mental health services in young children in the United States. Range of emotional problems; Tendency for children with emotional problems to experience physical symptoms; Predictors of general medical and specialty mental health care use.

Back pain is a frequent cause of personal distress, use of health care resources, and work disability. It is commonly difficult for physicians to find a medical explanation for the severity of pain and disability associated with back complaints. Using data from The United States Health and Nutrition Examination Survey (HANES), we examined factors associated with complaints of back pain among a subsample of 2,431 respondents relative to physician fndings. We constructed an index that depicts the extent to which complaints of back pain exceed physician findings. Consistent with studies of health perceptions, older persons and those reporting greater psychological well-being were less likely to make invalidated complaints, controlling for other factors. Depressed mood was associated with both more complaints and more physical findings, suggesting that it was in part a consequence of back difficulties. The inclination of older persons to report less pain at comparable levels of physical findings was significant only among persons with higher levels of well-being. Distress, we believe, affects perceptions of pain and overall health because such complaints are cognitively structured in relative terms within particular social contexts. [ABSTRACT FROM AUTHOR]

Context: States face increasing Medicaid expenditures largely as a result of growing dual-eligible populations. In this article we examine self-reported community-based Medicaid participation among Medicare recipients 65 and older in California and Texas, with a particular focus on the older Mexican-origin population., Methods: We use six waves of the Hispanic Established Populations for the Epidemiologic Study of the Elderly (H-EPESE) covering the period from 1993-94 to 2010-11., Findings: The data reveal relatively high Medicaid participation rates by older individuals of Mexican origin, but significant differences between the two states. At baseline, 30% of older Mexican-origin Medicare beneficiaries in California reported receiving Medicaid compared to 41% in Texas., Conclusions: Despite California's more liberal eligibility criteria, community-dwelling Texans were more likely than Californians to report coverage at some point during the 17-year follow-up. Our data, as well as administrative data, reveal that California classifies nearly all of its community-dwelling Medicaid recipients as "full duals," meaning that they receive full benefits, whereas Texas is more likely to classify similarly poor and disabled individuals as "partial duals," meaning that they receive less coverage, thereby lowering overall program expenditures. Cost containment strategies that restrict access may be especially consequential for vulnerable Hispanic populations., (Copyright © 2019 by Duke University Press.)

Objectives: (a) To identify factors associated with different patterns of functional decline in a longitudinal sample of older Mexican-origin individuals, and (b) to determine the proportions of life after age 65 characterized by serious functional impairment., Methodology: We use the Hispanic Established Populations for Epidemiologic Studies of the Elderly to examine changes in objective Performance Oriented Mobility Assessments in a cohort of 3,050 Mexican-origin elders initially interviewed in 1993/1994 and recontacted 6 times over 17 years. This sample combined with an additional cohort of 902 individuals 75 and older added at wave 4 in 2004/2005 (combined sample = 3,952) is used in life table analyses to estimate the number of years after 65 characterized by serious functional impairment., Results: Three distinct patterns of functional decline emerge: (a) high initial functioning followed by decline, but not to the level of disability (48%); (b) moderate initial functioning followed by decline to the level of disability (37.5%); and (c) initial disability followed by continued poor functioning (14.5%). Life table analyses reveal that subjects spent over half of the period after 65 with serious functional limitations. Significant gender and nativity differentials emerge., Discussion: Protracted morbidity that accompanies increases in life expectancy has serious implications for the physical, social, and economic well-being of older individuals and their families, as well as for health and long-term care policy., (© The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Much like other racial/ethnic groups, Latinos are facing challenges to provide needed care to aging adults. Older Latinos underutilize nursing homes and home health care services and primarily rely on their families for assistance. While this general trend has been established, little attention has been paid to nativity differentials in patterns of caregiving for this segment of the aging population. The analyses are based on the latest wave (Wave 7) of the Hispanic Established Population for Epidemiologic Studies of the Elderly or H-EPESE (2010/2011) a sample of older Mexican-origin adults and their family caregivers living in the southwestern U.S. We examine 629 child caregiver/parent care recipient dyads using bivariate statistics and multinomial logistic regression analyses. The results reveal that while grown children of Mexican-origin elders play a critical role in providing instrumental and financial supports to their aging parents, the burden that the children of foreign-born parents bear is greater. Despite higher rates of disability, Mexican-born elders are more dependent on a child for help and far less likely to call upon other family members, relatives and community based-providers for help than the U.S. born. Given the recent and future growth of older Latinos, intervention strategies will need to focus on nativity status and acculturative processes in the context of caregiving and caregiver burden.

Introduction: largely a consequence of historical gender differences in labor force attachment in the United States, many women rely on their spouse for health insurance coverage, particularly during late middle age. Prior research finds that this creates a window of vulnerability for women during late middle age who may lose their (older) spouse's employment-based coverage when he retires from the labor force and enrolls in Medicare. However, the few studies that have examined this window of vulnerability have been based primarily on white adults., Methods: we used the 2004 and 2006 Annual Social and Economic Supplements to the Current Population Survey to examine whether the window of vulnerability exists among non-Hispanic Black, Mexican-origin, and non-Hispanic White women 55 to 64 years of age, and whether similar factors contribute to the vulnerability across these race/ethnic groups., Results: women 55 to 64 years of age married to men 65 years or older had an elevated risk of lacking coverage at a time of life when health problems are common and expensive. Among non-Hispanic White women, their husband's exit from full-time employment accounted for the higher risk, whereas a more complex and systemic set of social factors contributed to the higher risk among non-Hispanic Black and Mexican-origin women., Conclusion: ensuring adequate and affordable health insurance coverage among women during late middle age may require additional health care reforms such as extending Medicare eligibility to younger adults or basing Medicare age eligibility on the age of the older partner within a married couple., (2011 Jacobs Institute of Women's Health. Published by Elsevier Inc.)

Objective: In this article, we investigate the association between age at migration and mortality during a 13-year period in a sample of Mexican American immigrants 65 and older at baseline., Method: We employ the Hispanic Established Populations for Epidemiologic Studies of the Elderly (H-PESE) to control for mortality-related health and social factors., Results: Our analyses show that the immigrant generation does not represent a homogeneous mortality risk category. Individuals who migrated to the United States in mature adulthood have a considerably lower risk of death than individuals who migrated in childhood or midlife. Chronic conditions or functional capacity do not account for these differences., Conclusion: Our findings suggest that standard risk pools may differ significantly on the basis of genetic and unmeasured life-course factors. A better understanding of the late-life immigrant mortality advantage has important implications for more effective and targeted social and medical interventions.

Objectives: This study examines the joint impact of psychological and structural factors on Mexican and Mexican American elders' sense of personal control over important aspects of their lives and health in Mexico and the United States., Methods: We employ the Mexican Health and Aging Study (MHAS) and the Hispanic Established Populations for Epidemiologic Studies of the Elderly (H-EPESE) to explore patterns of association among structural factors, personal characteristics, indicators of material and physical vulnerability, and expressed locus of control., Results: The results suggest that an older individual's sense of personal control over important aspects of his or her life, including health, reflects real material and social resources in addition to individual predispositions. In Mexico, only the most privileged segment of the population has health insurance, and coverage increases one's sense of personal control. In the United States, on the other hand, Medicare guarantees basic coverage to the vast majority of Mexican Americans over 65, reducing its impact on one's sense of control., Discussion: Psychological characteristics affect older individuals' sense of personal control over aspects of their health, but the effects are mediated by the economic and health services context in which they are expressed.

Purpose: We compare the economic consequences of widowhood for pre-retirement age and early-retirement age Black, Hispanic, and non-Hispanic White women., Methods: We use the 1992 and 2000 waves of the Health and Retirement Study to assess the effects of widowhood on the household incomes and assets of non-Hispanic White, Black, and Hispanic women who were 51 years of age or older at baseline (N = 4,544)., Results: For women of all racial and ethnic groups, marital disruption, including widowhood, results in a substantial decline in household income and assets. Net of demographic controls, the relative loss is far greater for Black and Hispanic widows than for non-Hispanic White widows., Implications: The data reveal a substantial widowhood penalty for total household income and net worth for women in each racial and ethnic group. However, the findings suggest that minority widows are at a particularly high risk of poverty in late life, given that they have lower incomes and fewer assets to begin with. Implications of the results for the financial security of women approaching retirement are discussed.

During the last 4 decades, a rapid increase has occurred in the number of survey-based and epidemiological studies of the health profiles of adults in general and of the causes of disparities between majority and minority Americans in particular. According to these studies, healthful aging consists of the absence of disease, or at least of the most serious preventable diseases and their consequences, and findings consistently reveal serious African American and Hispanic disadvantages in terms of healthful aging. We (1) briefly review conceptual and operational definitions of race and Hispanic ethnicity, (2) summarize how ethnicity-based differentials in health are related to social structures, and (3) emphasize the importance of attention to the economic, political, and institutional factors that perpetuate poverty and undermine healthful aging among certain groups.

In this paper we examine the associations among perceived financial strain and various health measures--including self-rated health, self-reported functional capacity, performance-based mobility, and mortality--in a sample of older Mexican-origin individuals. We employ the Hispanic Established Population for Epidemiological Studies of the Elderly, an eight-year longitudinal survey of over 3,000 Mexican-origin individuals in five southwestern states who were initially interviewed in 1993 and 1994. Although financial strain is associated with actual income and poverty, it is also associated with cognitive capacity, depression, and self-esteem, and while it is strongly associated with subjective measures, it has a weaker association with more objective measures, such as performance-based mobility and mortality. Financial strain appears to be part of a package of cognitions and emotions indicative of low morale or demoralization that has adverse effects on subjective health.