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Measuring Social Activity and Civic Engagement among Older Americans. There is not one…… but there must be one. The current indices. Population (6) Numbers, Race/ethnicity, marital status, education, living arrangement, older veterans Economics (6)

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measuring social activity and civic engagement among older americans

Measuring Social Activity and Civic Engagement among Older Americans

There is not one……

but there must be one

the current indices
The current indices

Population (6)

Numbers, Race/ethnicity, marital status, education, living arrangement, older veterans

Economics (6)

Poverty, income, income sources, net worth, labor force, housing expenditure

Health status (8)

Life expectancy, mortality, health conditions, sensory impairments, memory impairment, depressive symptoms, disability, health status

Health risks and behaviors (7)

Vaccinations, mammography, dietary quality, physical activity, obesity, cigarette smoking, air quality

Health Care (10)

Use of services, health care expenditures, prescription drugs, sources of health insurance, out-of-pocket expenditures, sources of payment for services, veterans health care, nursing home utilization, residential services, caregiving and assistive devices

conceptual model
Conceptual model

Health conditions

Demographics

and

Economics

Health status

Life expectancy

Mortality

Self-rated health

Disability

Impairments

Health behaviors

Health care utilization

adding civic engagement social network social support
Adding civic engagement, social network, social support

Health conditions

Demographics

and

Economics

(some descriptors

social network)

Life expectancy

Mortality

Health status

Perceived quality of life

Health behaviors

Social engagement

Social activity

Civic participation

Volunteering

Disability

Impairments

Social relationships

Social integration

Health care utilization

importance of these concepts
Importance of these concepts
  • Increase accuracy of well-being portrait (shape images of aging; not just costs but benefits of aging society; need to shift national perception)
  • Increase social component of a heavily biomedical portrait
  • Add concepts that are correlated with health outcomes (substantial research)
  • Add intermediate outcomes; targets of interventions to improve health outcomes
  • Vehicle for health promotion, new social equation
slide6
Civic engagement(social-purpose work, volunteering, community membership, political involvement; mutual aid)

Old deal: we will reward you (or punish you) to stop your productive engagement

New deal: if you are willing to contribute longer and use your experience for social benefit, we will make it worth your while (retool, make pathways, give opportunity to use skills)

Expressed through: working longer, retooling for social-purpose encore careers, interested in civically-meaningful outcome

New stage of life: between leaving career job and retirement; work that is chosen freely

“Fiddling with the old” will not work

civic engagement
Civic engagement
  • What people do affects how they age
  • Staying physically, socially, and cognitively active is related to health outcomes
  • Feeling of usefulness is predictive of mortality
  • More engaged communities do better in terms of school participation, crime, disaster assistance, political participation
  • Programs can offer a population approach to health promotion (high intensity/sustained dose); programs can reduce health disparity
  • Civic engagement is essential, not just nice
  • Virtuous circle
civic engagement indicators and data
Civic engagement: Indicators and Data
  • Paid work: full or part time
  • Volunteering (yes/no just minimal)
  • Stipended volunteering
  • Length of volunteering
  • Types of volunteer activities
  • Settings of activities
  • Level of engagement in activities (number of hours volunteered per year)
  • Regularity of activity
  • Monetary contributions
  • Mutual aid; helping neighbors; informal helping
  • Time living in community
  • Involvement in community organization; clubs
  • Memberships, attendance
  • Voting; civic knowledge
  • Social trust (level of trust in neighbors, not available in US)
  • Time use: commuting, TV watching
  • Costs/benefits of an aging society
  • Purpose in life
  • Usefulness
social network
Social network

Social network: web of social relations/ties that surround us

Social networks determine/shape health (social isolation related to mortality and if you get the common cold; also cognitive decline)

People need all levels of connection: intimate, effective, nominal, and extended connections

From networks flow resources (social support, access to resources & information, social engagement, social influence); behaviors mechanisms that are pathways to health

Material, emotional, and information resources stem for social networks

Some social ties negatively affect health (caregiving, influence of peers with bad health behaviors; not good information shared)

Interventions need to be broad and not aimed at high risk groups

Dangerous ground if we do not let older adults define what is best

Perceive quality of life is critical indicator

social network indicators and data
Social network: Indicators and data

size of network; density

number of contacts; frequency of contacts

number of contacts with mother, father, grandkids, etc. (face to face or phone)

geographic proximity

reciprocity

intimate ties, informal ties, voluntary associations

Informal and formal (group/membership) social integration

social influence

social isolation

social roles (high contact social roles)

social connections in a residential area

residential characteristics

Perceived quality of life

Costs of caregiving

Needs to be multiple domains

Needs to look cross-cultural to understand situation in US (does busy ethic exists in other cultures); international comparability is desirable because of cultural and policy differences that may explain differences in social networks and health outcomes

NHANES and GSS have range of network measures

social support
Social support

Social network, social support, support quality (broader term social relations)

Instrumental aid, affective support, affirmation (information/confirmation)

Convoys over the life course

Social relationship affects self-efficacy, self esteem; pathways to outcomes

SES - health link is influenced by social relationships

Measurement is very hard, there are multiples sources of data and methods for gathering; objective vs perceived

social support indicators and data
Social support: Indicators and Data
  • Community organization membership
  • Religious involvement
  • Confiding in child
  • Giving and receiving (life time; current; perceived, actual)
  • Positive relationship with child
  • Perceived ability to get sick care
  • Perceived ability to get financial help
  • Married people with best friends
  • Network quality; low spouse quality
  • Having a confident
  • Do you receive less support than you provide
newer hrs measures combines social network and social support
Newer HRS measures:combines social network and social support
  • How spend money and time (volunteer hours, hours helping others, times spent attending meetings/clubs)
  • Social participation (still engaged in world)
  • Social network and social support: Who, how many, and quality
  • Close relationship with spouse and how much burden
current data sources
Current data sources

Consumer Expenditure Survey

Current Population Survey

Health and Retirement Study

Medical Expenditure Panel Survey

Medicare Current Beneficiary Survey

National Health Interview Survey

National Health/Nutrition Examination Survey

National Long Term Care Survey

National Nursing Home Survey

National Survey of Veterans, 2001

National Vital Statistics System

Panel Study of Income Dynamics

Population Projections

Survey of the Aged 1963

Survey of Demographic and Economic Characteristics of the Aged, 1968

Survey of Veteran Enrollees’ Health and Reliance upon VA, 2003

potential data sources
Potential data sources
  • Duke EPESE
  • General Social Survey
  • National Social Relation Survey
  • (other data sources were on Dr. Antonucci’s list)

New school ….of plastics

  • Cell phones, blackberries
  • Myspace; facebook
  • The sociometer
  • Sensors will do for social-behavioral health sciences what the genome project did for genetics
research gaps
Research gaps
  • What is “correct dose” of civic involvement to get positive response?
  • What is adequate duration of engagement for positive outcome?
  • How do we ensure inclusion?
  • How work and volunteering work in tandem?
  • How do we change social structure to reduce structural lag?
  • Where is the life course perspective?
  • How do we intervene to improve social network/social connections?
longer term considerations
Longer term considerations

Health status (ultimate outcomes) could be expanded to include quality of life or life satisfaction

Psychological indicators (self efficacy, mastery, etc) as important intermediaries