Racial-Ethnic Gaps in Pandemic-Related Economic Hardship: Age Differences among Older Adults.

OBJECTIVES: Racial-ethnic disparities in experiences of economic hardship during the pandemic are well documented in the population overall and among older adults. Existing research shows that this economic hardship was much less common at older than younger ages. Little is known about the intersection of racial-ethnic and age disparities in pandemic-related hardship in later life. This research report investigated racial-ethnic gaps in economic hardship by age group among older adults. METHODS: Data were from the 2018 and 2020 U.S. Health and Retirement Study (HRS) including the 2020 COVID-19 module. We estimated Heckman-corrected linear probability models to examine differences in experiences of pandemic-related economic hardship in the 2020 HRS by race-ethnicity (non-Hispanic White, non-Hispanic Black, U.S.-born Hispanic, foreign-born Hispanic) across age groups (55-64, 65-74, 75+). In the multivariable analysis, we controlled for sociodemographic characteristics, participation in social programs, preexisting health conditions and behaviors, and economic resources from the 2018 HRS. RESULTS: Experiences of economic hardship declined with age within each racial-ethnic group. Racial-ethnic gaps in hardship remained at older ages without any controls. However, when all controls were added, racial-ethnic gaps in economic hardship were eliminated for those ages 75+. Individual characteristics prior to the pandemic explained racial-ethnic differences in hardship for the oldest adults (75+) but did not explain gaps for those ages 55-74. DISCUSSION: Results point to structural factors generating new racial-ethnic gaps in pandemic-related economic hardship among those approaching retirement (ages 55-74) that did not affect the oldest adults (ages 75+).

Age Differences in Experiences of Pandemic-Related Health and Economic Challenges Among Adults Aged 55 and Older.

BACKGROUND AND OBJECTIVES: The oldest adults faced the highest risk of death and hospitalization from coronavirus disease 2019 (COVID-19), but less is known about whether they also were the most likely to experience pandemic-related economic, healthcare, and mental health challenges. Guided by prior research on vulnerability versus resilience among older adults, the current study investigated age differences in economic hardship, delays in medical care, and mental health outcomes among adults aged 55 and older. RESEARCH DESIGN AND METHODS: Data were from the COVID-19 module and Leave Behind Questionnaire in the 2020 Health and Retirement Study (HRS). We estimated linear probability models to examine differences in experiences of pandemic-related economic and health challenges by age group (55-64, 65-74, 75+) with and without controls for preexisting sociodemographic, social program, health, and economic characteristics from the 2018 HRS. Models accounting for differential mortality also were estimated. RESULTS: Adults aged 65-74 and 75+ experienced fewer economic and mental health challenges and those aged 75+ were less likely to delay medical care than adults aged 55-64. Age gradients were consistent across a broad range of measures and were robust to including controls. For all age groups, economic challenges were less common than delays in medical care or experiences of loneliness, stress, or being emotionally overwhelmed. DISCUSSION AND IMPLICATIONS: Even though the oldest adults were at the greatest risk of death and hospitalization from COVID-19, they experienced fewer secondary pandemic-related challenges. Future research should continue to explore the sources of this resilience for older adults.

The Changing Demography of Late-Life Family Caregiving: A Research Agenda to Understand Future Care Networks for an Aging U.S. Population.

Repeated claims that a dwindling supply of potential caregivers is creating a crisis in care for the U.S. aging population have not been well-grounded in empirical research. Concerns about the supply of family care do not adequately recognize factors that may modify the availability and willingness of family and friends to provide care to older persons in need of assistance or the increasing heterogeneity of the older population. In this paper, we set forth a framework that places family caregiving in the context of older adults' care needs, the alternatives available to them, and the outcomes of that care. We focus on care networks, rather than individuals, and discuss the demographic and social changes that may alter the formation of care networks in the future. Last, we identify research areas to prioritize in order to better support planning efforts to care for the aging U.S. population.

The Strength of Parent-Adult Child Ties in Biological Families and Stepfamilies: Evidence From Time Diaries From Older Adults.

We examine older partnered parents' time spent with adult children in biological and step families, treating time together as an indication of relationship strength. Using a unique national sample of U.S. time diaries from the Panel Study of Income Dynamics, we investigate time with all adult children combined and with each adult child. We find that time together depends on family structure and parent-adult child dyadic relationship type embedded in family structure. In analyses of all adult children combined, an older parent is more likely to spend time with adult children in biological families than in stepfamilies only when there is no shared biological child in the stepfamily. In dyadic analyses, a parent's tie with an adult child who is a biological child of both partners is stronger in stepfamilies than in biological families. Moreover, among stepfamilies, ties are not uniformly stronger with biological children relative to stepchildren; differences emerge only in more complex families when each partner has biological children from previous relationships. Our findings challenge the view that ties with older parents are always weaker with stepchildren in stepfamilies and point to the importance of considering parent-child relationships in the broader family context.

Care Received and Unmet Care Needs Among Older Parents in Biological and Step Families.

OBJECTIVES: Increased likelihood of having step children among more recent cohorts of older adults, alongside lower levels of assistance from step children, has led to concerns about greater unmet needs for older parents in step families. However, few studies have directly examined family structure and unmet needs. We examined the associations between having step children (vs. only biological children) and receiving care from adult children, and unmet needs for assistance. METHODS: Using the 2015 National Health and Aging Trends Study, we investigated among older parents with care needs whether levels of care received from adult children and unmet needs differed between those with biological versus step families. We also explored whether a partner or paid care compensated for observed differences. RESULTS: Older parents in need of care were more than twice as likely to receive care from their adult children if they had biological instead of step families. Unmet needs among older parents did not differ by family structure, nor did levels of partner or paid care. DISCUSSION: Results illustrate that concerns about the implications of the rising prevalence of step families for care parents receive from their children may be warranted. However, there is a lack of evidence of greater unmet need for care for older parents in step families, as risks of unmet needs are high for older parents regardless of family type.

Political affiliation and risk taking behaviors among adults with elevated chance of severe complications from COVID-19.

This study determines whether COVID-related risk-taking behavior was different among Republicans, Democrats, and Independents, in adults with elevated chance of severe complications from COVID-19. Using US national survey data collected September 30-October 27, 2020 (N = 6095), behaviors in the prior week examined were: 7 potentially risky activities, mask wearing anywhere, and mask wearing while undertaking each activity. Differences among political affiliations were estimated for adults with 0 and with ≥1 medical risk factors for severe complications, adjusting for sociodemographic factors. Among adults with medical risk factors, the adjusted number of potentially risky activities was higher among Republicans (3.83) but not Independents (3.17) relative to Democrats (2.98). The adjusted percentage of adults with medical risk factors who wore a mask anywhere in the past week was lower for Republicans (87%) and Independents (91%) than for Democrats (97%). While undertaking each specific activity, the adjusted percentage of at-risk adults never wearing a mask was higher for Republicans than Democrats: 24% vs 8% at bar/club; 6% vs 0% at grocery/pharmacy; 63% vs 30% visiting at friend's home; 68% vs 41% hosting visitors; 30% vs 5% at gathering of ≥10 people; 25% vs 11% while within 6 ft of someone they do not live with. Rates of mask wearing among political Independents were between rates among Democrats and Republicans. Efforts to reduce COVID-related risky behavior should recognize that although Republicans take more risks, rates of mask wearing at common activities are low across political affiliations, even for populations vulnerable to severe complications.

Association Between Risk Factors for Complications From COVID-19, Perceived Chances of Infection and Complications, and Protective Behavior in the US.

Importance: It is unknown whether adults who are susceptible to severe complications from COVID-19 recognize their susceptibility and modify behavior to reduce exposure. Objective: To determine whether adults with risk factors for COVID-19 complications perceive an elevated chance of complications and undertake fewer higher infection risk behaviors. Design, Setting, and Participants: This cross-sectional analysis, adjusted for sociodemographic characteristics, included civilian noninstitutionalized US adults of wave 18 of the Understanding America Study collected from November 11 to December 9, 2020. Exposures: US Centers for Disease Control and Prevention-identified medical risk factors for COVID-19 complications and older age. Main Outcomes and Measures: Primary outcomes were perceived percentage chance of infection and hospitalization and death if infected; whether 9 potentially higher infection risk activities were undertaken in the past week and, if so, whether a mask was worn; whether a mask was worn anywhere in the past week; and attitudes toward 12 aspects of mask wearing. Results: In Understanding America Study wave 18 (n = 5910 participants with nonmissing data), the mean age was 48 years, and 52% were women. The response rate was 77%. Adults with 7 of 9 medical risk factors and aged 70 years and older reported a higher perceived chance of complications if infected. Adjusted mean perceived chance of hospitalization if infected ranged from 23.9% (95% CI, 22.2%-25.5%) for those with high blood pressure to 40.4% (95% CI, 34.6%-46.2%) for those with chronic lung disease and was associated with number of medical risk factors: 17.6% (95% CI, 16.4%-18.8%) and 41.8% (95% CI, 38.7%-45.0%) for adults with 0 vs 3 or more medical risk factors, respectively. Fewer potentially higher infection risk activities were undertaken by adults with 3 or more vs 0 risk factors: 2.83 (95% CI, 2.66-2.99) vs 3.12 (95% CI, 3.02-3.22). Wearing a mask sometime last week was nearly universal (90.1%). But during only 1 specific activity (visiting a grocery store or pharmacy) did more than half always wear a mask, and for only 1 activity (visiting a grocery store or pharmacy) was mask wearing more common among adults with 3 or more vs 0 conditions. Conclusions and Relevance: In this cross-sectional survey study, adults with risk factors for COVID-19 complications reported higher perceived susceptibility to complications. During common activities, including visiting with friends, the majority of adults, including the highly susceptible, did not consistently wear masks.

Spatial Distance between Parents and Adult Children in the United States.

OBJECTIVE: This brief report presents contemporary national estimates of the spatial distance between residences of parents and adult children in the United States, including distance to one's nearest parent and/or adult child and whether one lives near all of their parents and adult children. BACKGROUND: The most recent national estimates of parent-child spatial proximity come from data for the early 1990s. Moreover, research has rarely assessed spatial clustering of all parents and adult children. METHOD: Data are from the 2013 Panel Study of Income Dynamics on residential locations of adults 25 and older and each of their parents and adult children. Two measures of spatial proximity were estimated: distance to nearest parent or adult child, and the share of adults who have all parents and/or adult children living nearby. Sociodemographic and geographic differences were examined for both measures. RESULTS: Among adults with at least one living parent or adult child, a significant majority (74.8%) had their nearest parent or adult child within 30 miles, and about one third (35.5%) had all parents and adult children living that close. Spatial proximity differed substantially among sociodemographic groups, with those who were disadvantaged more likely to have their parents or adult children nearby. In most cases, sociodemographic disparities were much higher when spatial proximity was measured by proximity to all parents and all adult children instead of to nearest parent or nearest adult child. CONCLUSION: Disparities in having all parents and/or adult children nearby may be a result of family solidarity and also may affect family solidarity. This report sets the stage for new investigations of the spatial dimension of family cohesion.

Disparities in vulnerability to complications from COVID-19 arising from disparities in preexisting conditions in the United States.

The COVID-19 pandemic has magnified U.S. health disparities. Though disparities in COVID-19 hospitalization by race-ethnicity are large, disparities by income and education have not been studied. Using an index based on preexisting health conditions and age, we estimate disparities in vulnerability to hospitalization from COVID-19 by income, education, and race-ethnicity for U.S. adults. The index uses estimates of health condition and age effects on hospitalization for respiratory distress prior to the pandemic validated on COVID-19 hospitalizations. We find vulnerability arising from preexisting conditions is nearly three times higher for bottom versus top income quartile adults and 60 % higher for those with a high-school degree relative to a college degree. Though non-Hispanic Blacks are more vulnerable than non-Hispanic Whites at comparable ages, among all adults the groups are equally vulnerable because non-Hispanic Blacks are younger. Hispanics are the least vulnerable. Results suggest that income and education disparities in hospitalization are likely large and should be examined directly to further understand the unequal impact of the pandemic.

Disparities in Vulnerability to Severe Complications from COVID-19 in the United States.

This paper provides the first nationally representative estimates of vulnerability to severe complications from COVID-19 overall and across race-ethnicity and socioeconomic status. We use the Panel Study of Income Dynamics (PSID) to examine the prevalence of specific health conditions associated with complications from COVID-19 and to calculate, for each individual, an index of the risk of severe complications from respiratory infections developed by DeCaprio et al. (2020). We show large disparities across race-ethnicity and socioeconomic status in the prevalence of conditions which are associated with the risk of severe complications from COVID-19. Moreover, we show that these disparities emerge early in life, prior to age 65, leading to higher vulnerability to such complications. While vulnerability is highest among older adults regardless of their race-ethnicity or socioeconomic status, our results suggest particular attention should also be given to the risk of adverse outcomes in midlife for non-Hispanic Blacks, adults with a high school degree or less, and low-income Americans.

Family Change and Changing Family Demography.

Increases in life expectancy, high rates of movement into and out of couple relationships, and increasing exposure to stepfamilies raise new questions about who is in a family, the distinction between who lives together and who is a family member, and the extent to which family members are expected to meet the long-term obligations that define kinship. These questions are important because families have traditionally served as a vital private safety net for family members. Demographic changes increase family members' uncertainty about their relationships. Family ties are less stable and more uncertain among the economically disadvantaged, and uncertainty may exacerbate these disadvantages by weakening individuals' ability to rely on family members' support to alleviate hardship. I argue that demographers should focus on individuals' family relationships to gain insight into living arrangements and family dynamics. I also outline the development of family concepts and improvements in study design to identify principles that demographers should incorporate in new research to shed light on families' support for their members.

Stepfamily Structure and Transfers Between Generations in U.S. Families.

Unstable couple relationships and high rates of repartnering have increased the share of U.S. families with stepkin. Yet data on stepfamily structure are from earlier periods, include only coresident stepkin, or cover only older adults. In this study, we use new data on family structure and transfers in the Panel Study of Income Dynamics (PSID) to describe the prevalence and numbers of stepparents and stepchildren for adults of all ages and to characterize the relationship between having stepkin and transfers of time and money between generations, regardless of whether the kin live together. We find that having stepparents and stepchildren is very common among U.S. households, especially younger households. Furthermore, stepkin substantially increase the typical household's family size; stepparents and stepchildren increase a household's number of parents and adult children by nearly 40 % for married/cohabiting couples with living parents and children. However, having stepkin is associated with fewer transfers, particularly time transfers between married women and their stepparents and stepchildren. The increase in the number of family members due to stepkin is insufficient to compensate for the lower likelihood of transfers in stepfamilies. Our findings suggest that recent cohorts with more stepkin may give less time assistance to adult children and receive less time assistance from children in old age than prior generations.

Step-grandparenthood in the United States.

Objectives: This study provides new information about the demography of step-grandparenthood in the United States. Specifically, we examine the prevalence of step-grandparenthood across birth cohorts and for socioeconomic and racial/ethnic groups. We also examine lifetime exposure to the step-grandparent role. Methods: Using data from the Panel Study of Income Dynamics and the Health and Retirement Study, we use percentages to provide first estimates of step-grandparenthood and to describe demographic and socioeconomic variation in who is a step-grandparent. We use life tables to estimate the exposure to step-grandparenthood. Results: The share of step-grandparents is increasing across birth cohorts. However, individuals without a college education and non-Whites are more likely to become step-grandparents. Exposure to the step-grandparent role accounts for approximately 15% of total grandparent years at age 65 for women and men. Discussion: A growing body of research finds that grandparents are increasingly instrumental in the lives of younger generations. However, the majority of this work assumes that these ties are biological, with little attention paid to the role of family complexity across three generations. Understanding the demographics of step-grandparenthood sheds light on the family experiences of an overlooked, but growing segment of the older adult population in the United States.

Parent-Child Relationships at the Transition to Adulthood: A Comparison of Black, Hispanic, and White Immigrant and Native-Born Youth.

Parents play a key role in launching their children into adulthood. Differences in the resources they provide their children have implications for perpetuating patterns of family inequality. Using data on 6,962 young adults included in the National Longitudinal Survey of Youth 1997, we examine differences in the support parents provide to young adult children by immigrant status and race/ethnicity and whether and how those differences are explained by parent resources and young adult resources and roles. Immigrant status and race/ethnicity are associated with patterns of support in complex ways. We find that racial/ethnic and immigrant disparities in perceptions of support, financial support, and receiving advice from parents about education or employment are explained by family socioeconomic resources. Group differences in whether young adults say they would turn to a parent for advice and coresidence persist after accounting for these factors, however. Young adult resources and roles also shape parental support of young adults in the transition to adulthood, but taking account of these characteristics does not explain immigrant and racial/ethnic group differences. Our findings highlight the need to consider both race/ethnicity and immigrant status to understand family relationships and sources of support.

Risky sexual behavior of foreign and native-born women in emerging adulthood: The long reach of mother-daughter relationships in adolescence.

Parents' influence on young adult sexual behavior receives little attention compared to influence on adolescent behavior. Yet effective parenting should have lasting effects. Even fewer studies examine parents' influence on sexual behavior of both foreign and native-born young adults. Using the National Longitudinal Study of Adolescent to Adult Health (Add Health) Waves I (1994-95) and III (2001-02), we examine longitudinal associations among mother-daughter relationship quality and nativity during adolescence and young adults' risky sexual behaviors of condom use at last intercourse, number of sexual partners, and STI diagnoses (N = 4460). Women, 18-26 years old, who had good mother-adolescent daughter relationships have fewer partners and STIs in the past year. Second generation women have worse mother-adolescent daughter relationships, compared to third generation. Relationship quality does not explain associations between nativity and risky behavior. Lasting associations between relationship quality and risk behaviors suggest that reproductive health interventions should enhance mother-adolescent relationships.

The Effects of Vignette Placement on Attitudes Toward Supporting Family Members.

Vignettes are useful for measuring norms and beliefs, but little is known about how vignette placement affects responses to subsequent attitude questions. We investigate how the placement of a vignette about parents and adult children living together affects answers to subsequent questions about family obligations in a survey of the U.S. POPULATION: We randomly assigned the order of the vignette and three single-statement attitude questions. For the single-statement question about family members living together, the effect of vignette placement depended on respondents' original attitudes. For individuals with ambivalent or positive attitudes, asking the vignette before the attitude questions doubled reports of favorable attitudes. Vignette placement had no effect for those with negative attitudes. For the single-statement attitude questions about financial support between parents and adult children, vignette placement had no effect, suggesting that vignette placement may only influence subsequent questions about the same topic.

Assessing the need for a new nationally representative household panel survey in the United States.

We introduce this special issue on the critical matter of whether the existing household panel surveys in the U.S. are adequate to address the important emerging social science and policy questions of the next few decades. We summarize the conference papers which address this issue in different domains. The papers detail many new and important emerging research questions but also identify key limitations in existing panels in addressing those questions. To address these limitations, we consider the advantages and disadvantages of initiating a new, general-purpose omnibus household panel in the U.S. We also discuss the particular benefits of starting new panels that have specific targeted domains such as child development, population health and health care. We also develop a list of valuable enhancements to existing panels which could address many of their limitations.

Intergenerational family support processes from young adulthood through later life: Do we need a new national survey?

I argue that the United States needs new survey data on intergenerational relationships in light of the dramatic demographic changes in parent-child and couple relationships that were not anticipated when many major family datasets were designed. Increases in nonmarital childbearing, the instability of parents' relationships and high rates of repartnering challenge conventional approaches to data collection on families. Large race-ethnic and socioeconomic differences in the extent of these changes and their impact on intergenerational support may contribute to growing inequality. A new study must collect data on both household relationships and relationships among family members who live apart because most U.S. parents and adult offspring do not co-reside. The survey should obtain information on the timing of family transitions and include multiple cohorts to take account of differences in societal conditions that influence family experiences. A longitudinal design would show how parent-child relationships unfold over time and build on past histories. The paper identifies the dimensions of intergenerational ties that should be measured and explains why existing data cannot address the need for a new study.