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Civic Engagement by Older Adults: Potential import of the social capital of an aging society. Workshop on Measuring Social Activity and Civic Engagement: May, 2007 Linda P. Fried, M.D., M.P.H. Professor and Director, The Johns Hopkins Center on Aging and Health. One vision….

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civic engagement by older adults potential import of the social capital of an aging society

Civic Engagement by Older Adults: Potential import of the social capital of an aging society

Workshop on Measuring Social Activity and Civic Engagement:

May, 2007

Linda P. Fried, M.D., M.P.H.

Professor and Director,

The Johns Hopkins Center on Aging and Health

one vision
One vision…
  • “Successful aging”…
    • The intersection of physical and cognitive/psychological health, and social engagement
    • Rowe and Kahn, Science 1987
potential importance of social engagement for older adults
Potential Importance of Social Engagement for Older Adults
  • Roleless old age vs. productivity, meaningful activities, wisdom/growth
  • Import of generativity to successful aging
  • Evolution in images of aging
  • Social capital: the benefits (c/w “costs”) of an aging society
  • Vehicle for health promotion
population based approaches to compression of morbidity and successful aging
Population-based approaches to compression of morbidity - and successful aging
  • What people DO matters with aging:
    • Generativity through engagement
    • Wisdom
    • Loneliness/Isolation
    • Social networks, support
    • Regular structured activities
    • Physical activity
    • Cognitive activity
feelings of usefulness as a predictor of disability mortality over 7 years in the mssa
Feelings of Usefulness as a Predictor of Disability & Mortality Over 7-Years in the MSSA

p < .05, ** p < .01, *** p < .001; N = 1,030

a no change/slight improvement in disability used as reference category in analyses

b high feelings of usefulness reference category in analyses

c model 2 adds age, years of education d model 3 adds physical activity, alcohol use, smoking,

volunteerism, social integration, depressed mood, and self-efficacy

Gruenewald et al., J of Gerontology, 2007

physical activity and health in aging
Physical activity and health in aging:
  • Strong associations with prevention of disease, cognitive decline, disability, mortality
  • Little success in motivating Americans >50 years to adopt physically active lifestyles: ¼ active; 1/3 sedentary
  • Community-based, multilevel approaches needed
ho generative roles might
HO: Generative roles might:
  • Be a vehicle to attract and retain more – and more diverse - older adults than standard exercise programs
  • Be intentionally designed to enhance physical, cognitive and social activity, providing stimulating environments, generalizable activities
  • Population-based approach to health promotion?
one model for such a win win experience corps
One Model for such a Win-Win: Experience Corps
  • High intensity volunteering for older adults
  • High impact roles in public elementary schools improving outcomes for children
  • Critical mass of older adults:
    • Shift outcomes for schools
    • Force for social benefit
    • Social networks and friendships
  • Health promotion program embedded
          • Fried et al, 2004
slide10

Early elementary school years are a critical period predicting subsequent educational, occupational, physical and mental health outcomes

experience corps model
Experience Corps model
  • Volunteers 60 and older
  • Serve in public elementary schools: K-3
  • Meaningful roles; important unmet needs
  • High intensity: 15 hours per week
  • Sustained dose: full school year
  • Critical mass, teams in each school
  • Monthly stipend to reimburse for expenses
  • Health behaviors: physical, social and cognitive activity
  • Diversity
    • Freedman M, Fried LP; Experience Corps monograph, 1997
roles for older volunteers experience corps
Roles for Older Volunteers- Experience Corps -
  • Academic support:
    • Literacy support
    • Opening/maintaining school libraries
    • Math support
    • Computer support
  • Behavioral support:
    • conflict resolution, positive attention
  • School attendance
  • Parental outreach
  • Public Health: Asthma club
  • More roles to come…
slide13

Causal Pathway: Experience Corps

Performance-based measures Secondary outcomes and intermediate mechanisms

Primary/ [Self Report] Outcomes

Primary Pathways

Intervention

Mechanisms

Falls

Strength, balance

Physical Activity

↑ or preserved function or delayed decline in:

Walking Speed

Experience Corps Participation-

Generative Role Performance

Frailty

Mobility Function

Cortical plasticity;

Memory

Executive function

Complex task performance

Cognitive Activity

IADLs

Social Integration & Support

Generativity

Social Activity, Engmnt.

Psycho-Social Well-being

baseline characteristics of experience corps participants
Baseline Characteristics of Experience Corps Participants

Age ( Range: 60-91) 60-65 31%

66-70 33%

> 71 36%

Gender Male 18%

Race Black 92%

White 8%

Married 24%

Education High school or less 82%

Health Excellent/very good 29%

Good 60%

Fair 12%

can a high intensity multimodal volunteer role contribute to improved health in aging
Can a high intensity, multimodal volunteer role contribute to improved health in aging?
  • Disability: mobility
  • Frailty
  • Falls
  • Cognitive function: memory, executive function
randomized controlled trial of experience corps in baltimore
Randomized, Controlled Trial of Experience Corps in Baltimore
  • Funded by NIA BSR
  • Randomize:
    • 1046 people 60 and older to EC or control
    • Randomize 48 public elementary schools to EC or controls
  • Outcomes:
    • Primary: Disability: mobility
    • Secondary: IADL disability; memory, frailty, falls
import and implications
Import and Implications:
  • Social model for health promotion
  • Compression of morbidity
  • Health disparities
  • Benefits of an aging society
data considerations
Data Considerations
  • Aspects of civic engagement:
    • Social capital;
    • Arenas of contribution
    • Health promotion
    • Benefits/costs: per program; societally
    • Motivators;
    • Facilitators
    • Health impacts; compression of morbidity effects
data considerations potential measures
Data considerations: Potential measures
  • Paid Work: full/part-time
  • Volunteering:
    • With or without reimbursement/stipend
    • Number of hours per week
    • Role/venue
    • Activities related to prior work history
    • Motivations
    • Facilitators
    • Sociodemographic characteristics?
    • Out of pocket costs
    • Generative?
    • Impact?
the future of successful aging
The Future of Successful Aging
  • “We maintain that the future of old age depends to a significant degree on making images of aging more positive, empowering people to live healthy lives, and redesigning society to include more age-friendly technology and opportunities for challenging and meaningful roles in old age.” (Baltes, Smith, & Staudinger, 1992)
slide28

Causal Pathway

Child Outcomes

Intervention

Primary Pathways

Mechanisms

PrimaryOutcomes

 vocabulary

 alphabet recognition

Academic

Stimulation

 reading

Reading/

Academic Performance

Experience Corps Participation-

Generative Role Performance

 disciplinary removals

 aggression

Behavioral

Management

 social skills

 school attendance

Classroom

Behavior

 motivation to learn

 concentration/

readiness

Readiness

For Learning

 school service utilization

slide29

Causal Pathway

School Outcomes

Intervention

PrimaryPathways

Mechanisms

Primary Outcomes

Child Parameters:

Literacy Skills

Readiness to learnBehavioral disruptions

Improved aggregate academic performance

Child building pathway

(direct impact on children K-3 from face-to-face interaction)

Experience Corps Participation-

Generative Role Performance

Cost Benefits:

Children

School

Improved school climate

Teacher parameters:

Teacher efficacy

Teacher moraleTime on task

Improved

teacher retention

Social capital pathway

(indirect impact on the school)

School Parameters:

Community resources

Parent participationCollective efficacy

Improved volunteer retention

Higher program satisfaction

Higher personal and collective efficacy

hypothesized outcomes for children and schools
Hypothesized Outcomes for Children and Schools
  • Selective improvements in reading/ academic performance, classroom behavior, and readiness-to-learn among urban children participating in the EC program
  • Help reduce student absenteeism
  • School climate will improve
  • Increased teacher retention
  • Direct positive association between improved school performance and older EC volunteer retention and satisfaction
implications volunteering designed as a social model for health promotion
Implications: Volunteering Designed as a Social Model for Health Promotion
  • Cost-benefit: Investing in older adults to invest in children
  • Opportunity to invest in health promotion for older adults, while not pitting generations against each other for resources
  • Brings health promotion into community to groups not typically reached; health disparities
older adults as a source of social capital for urban education
Older Adults as A Source of Social Capital for Urban Education
  • Urban public schools:
    • education to the majority of children in the US.
    • Most under-resourced and lack the human capital to meet their educational mission.
  • Older adults can offer:
    • the stability, consistency, and caring which are essential to learning,
    • their experience and presence as role models.
    • the social capital needed to support the educational needs of children directly on a large scale.