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Americans’ Changing Lives Study. Principal Investigators: James S. House, Ph.D. Paula M. Lantz, Ph.D. History. Original Team at U-M : James House James Lepkowski, Ron Kessler, Regula Herzog et al. Funded by NIA (NIH) and Robert Wood Johnson Foundation . Purpose.

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Americans’ Changing Lives Study

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Americans changing lives study l.jpg

Americans’ Changing Lives Study

Principal Investigators:

James S. House, Ph.D.

Paula M. Lantz, Ph.D.


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History

  • Original Team at U-M :

    • James House

    • James Lepkowski, Ron Kessler, Regula Herzog et al.

  • Funded by NIA (NIH) and Robert Wood Johnson Foundation


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Purpose

  • To increase understanding of how individual, household and contextual socioeconomic and psychosocial factors combine to create health and health disparities across the adult life course.

  • Driven by societal goals:

    • Reducing social inequalities in health

    • Postponing morbidity and functional limitations into closing years of the life span (compression of morbidity)


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ACL Study Design

  • Longitudinal cohort study

  • Stratified multistage area probability sample:

    • Age 25 and older (non-institutionalized)

    • Contiguous U.S.

    • Over-sampled 2:1 people 60+ and Blacks

  • Representative of July, 1986 U.S. population by sex, age and region


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ACL Wave 1

1986

Face-to-face interviews (~86 minutes)

N=3,617

Response rate: 70% households

68% individuals


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ACL Wave 2

1989

Face-to-face interviews

N=2,867

Response rate: 83% of survivors


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ACL Wave 3

1994

Telephone Interviews

N=2,562

Response rate: 83% of survivors


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ACL Wave 4

2001-2002

Telephone Interviews

N=1,787

Response rate: 77% of survivors


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Health Outcomes Variables

Mortality

Self-rated health (5 category)

Functional impairment (physical)

Chronic Conditions

Cognitive impairment

Depressive symptoms


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ACL Mortality

Annual searches using National Death Index

Probable matches are certified with death certificates from states

Cause of death coded from death certificates (ICD-9 and ICD-10)

Death by Wave 4:1,184 respondents

32.7% of weighted sample

21.4% of unweighted sample


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Self-Rated Health

Wave 1:

Excellent/Very good64.2%

Good20.6%

Fair/Poor15.2%


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Functional Impairment

No limitation84.7% (weighted)

Difficult/unable to do heavy

work around house (Low) 6.8%

Difficult/unable to climb stairs

or walk a few blocks (Moderate) 5.3%

Confined to bed or chair (Severe) 3.2%


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Chronic Conditions

Life Threatening and Debilitating

046.6% (weighted)

126.0%

214.5%

3 7.7%

4+ 5.4%


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Socioeconomic Position

  • IncomeR and spouse

  • EducationWave 1 only

  • Wealth

  • Work status

  • Occupation

  • Sociodemographics


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ACL Baseline


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Health Risk Behaviors

  • Cigarette smoking

  • Alcohol use

  • Body Mass Index

  • Physical Activity


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ACL Baseline


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Psychosocial Risk Factors

  • Social integration (informal and formal)

  • Life Satisfaction

  • Social Relationships and Supports

  • Marital Relationships and Events

  • Personality Traits

  • Productive Activities

  • Paid/Unpaid Work


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Psychosocial Risk Factors

  • Stress: job, financial, marital, parental

  • Negative Life Events

  • Religion and World Views

  • Perceptions of Discrimination

  • Physical/Social Environment

  • Residential History


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Contextual Variables

  • Non-public at this point

  • Addresses at all 4 waves geocoded and linked to

    • 60+ census tract variables for Census before and after wave

    • Environmental Protection Agency Toxic Release Inventory (TRI) geocoded data of polluting and hazardous waste business es and sites


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Articles by ACL Investigators

  • Burgard SA. Brand JE. House JS. Toward a better estimation of the effect of job loss on health. Journal of Health & Social Behavior. 48(4):369-84, 2007

  • Herd P. Goesling B. House JS. Socioeconomic position and health: the differential effects of education versus income on the onset versus progression of health problems. Journal of Health & Social Behavior. 48(3):223-38, 2007

  • Robert SA. Ruel E. Racial segregation and health disparities between Black and White older adults. Journals of Gerontology Series B-Psychological Sciences & Social Sciences. 61(4):S203-11, 2006


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Articles by ACL Investigators

  • Lantz PM. House JS. Mero RP. Williams DR. Stress, life events, and socioeconomic disparities in health. Journal of Health & Social Behavior. 46(3):274-88, 2005

  • House JS. Lantz PM. Herd P. Continuity and change in the social stratification of aging and health over the life course. Journals of Gerontology Series B-Psychological Sciences & Social Sciences. 60 Spec No 2:15-26, 2005

  • Everson-Rose SA. House JS. Mero RP. Depressive symptoms and mortality risk in a national sample: confounding effects of health status. Psychosomatic Medicine. 66(6):823-30, 2004


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Other ACL Articles

  • Shultz KS. Wang M. The influence of specific physical health conditions on retirement decisions.International Journal of Aging & Human Development. 65(2):149-61, 2007

  • Schnittker J. Look (closely) at all the lonely people: age and the social psychology of social support. Journal of Aging & Health. 19(4):659-82, 2007

  • Hinterlong JE. Race disparities in health among older adults: examining the role of productive engagement.Health & Social Work. 31(4):275-88, 2006 Nov.


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Other ACL Articles

  • Burr JA. Choi NG. Mutchler JE. Caro FG. Caregiving and volunteering: are private and public helping behaviors linked? Journals of Gerontology Series B-Psychological Sciences & Social Sciences. 60(5):S247-56, 2005

  • Collins AL. Smyer MA. The resilience of self-esteem in late adulthood.Journal of Aging & Health. 17(4):471-89, 2005

  • McKee SA. Maciejewski PK. Falba T. Mazure CM. Sex differences in the effects of stressful life events on changes in smoking status. Addiction. 98(6):847-55, 2003


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Relative Risk of Adjusted Mortality by Income, U.S. Adults, 1986-2002


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Relative Risk of Adjusted Mortality by Income, U.S. Adults, 1986-2002


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1.000

0.900

0.800

0.700

0.600

Probability of No Limitations

0.500

0.400

0.300

Low Educ

Med Educ

0.200

High Educ

0.100

-

25

35

45

55

65

75

85

95

Age

Compression of Morbidity: Evidence from ACL


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