Moving for care: findings from the US HIV Cost and Services Utilization Study.

This paper examines sociodemographic and HIV-related factors associated with moving post-HIV diagnosis for non-care- and care-related reasons (versus never moving post-HIV diagnosis). Distinctions are made between those who move for informal care only, formal care only, or informal and formal care. Data come from the nationally representative US HIV Cost and Services Utilization Study (N=2,864). Overall, 31.8% moved at least once post-HIV diagnosis and 16.3% moved most recently for care. Among those who moved for care, 32.6% moved for informal care only, 26.8% for formal care only, and 40.6% moved for both. Post-HIV diagnosis moves for reasons unrelated to care were less likely among African Americans and older persons, and more likely among those with longer durations positive. Moves for care were less likely among African Americans, older persons, and persons with higher educational attainments, while they were more likely among those with an AIDS diagnosis and longer durations HIV-positive. Among those who moved for care, women and persons with higher incomes were less likely to move for formal or mixed care than informal care only. Given that moving for care may reflect disparities in access to care and unmet needs, additional analyses with more detailed data are warranted.

Living arrangements among older immigrants in the United States.

This analysis uses data from the 1990 5% Public Use Microdata Sample (PUMS) to identify the individual-level characteristics that influence residential dependence among immigrants age 60 and older in the United States. Particular attention is given to differences among 11 immigrant groups. Separate models are shown by gender and marital status. The results indicate that Hispanic and most Asian immigrants, particularly those from Mexico, Central or South America, India, and the Pacific Islands, are at a greater risk of living with family than non-Hispanic White immigrants. Although resource, need, and demographic characteristics influence the risk of living with Family, these individual-level characteristics do not explain the observed differences across the immigrant groups. These findings suggest that preferences that are shaped by the immigrant's experience as well as cultural background are an important determinant of immigrant living arrangements in later life.

Unbalanced social exchanges and living arrangement transitions among older adults.

Using an elaborated person-environment perspective, this research clarifies the role unbalanced social exchanges play in older adults' living arrangement transitions. Data from the National Survey of Families and Households (NSFH) are used to estimate destination-specific hazard models that include measures of baseline living arrangements, demographic characteristics, financial resources, family structure, and social exchanges. Distinctions are made between transitions that occur within the community and transitions into an institution or death. The results indicate that unbalanced exchange relationships are an integral part of the living arrangement transition process in later life.

Measuring morbidity: disease counts, binary variables, and statistical power.

OBJECTIVES: This study compares the use of the binary disease variables with counts of the same conditions in models of self-rated health to better understand the advantages and disadvantages of each approach. In particular, the analysis seeks to determine if statistical power is adequate for the binary variable approach. METHODS: Morbidity measures from adults in 2 large national surveys were used in both cross-sectional and longitudinal analyses. RESULTS: Although differences across the approaches are modest, the binary variable approach offers greater explanatory power and slightly higher R2 values. Despite these advantages, statistical power is insufficient in some cases, especially for conditions that are relatively rare and/or that manifest modest differences on the outcome variable. DISCUSSION: Statistical power estimates are advisable when using the binary variable approach, especially if the list of diseases and health conditions is extensive. Although a simple count of diseases may be useful in some research applications, separate counts for serious and nonserious conditions should be more useful in many research projects while avoiding the risk of inadequate statistical power.

Living arrangement transitions among America's older adults.

This analysis describes the relationship between age and transitions from four living arrangements: living alone, living with spouse only, living with a child, and living with a spouse and child. Data from the National Survey of Families and Households, collected in 1987-88 and 1992-93, are used to calculate destination-specific hazard rates by age and then construct multiple-decrement life tables. Living alone or with a spouse are the most stable living arrangements during the early stages of later life, whereas for the oldest-old, living with a child is the most stable living arrangement. The young-old tend to exit living arrangements through changes in coresidence, whereas transitions among the oldest-old are primarily due to institutionalization and death.

Motive and the geographic mobility of very old Americans.

The proposition that motives for migration are important in explaining geographic mobility of very old persons was explored in this study. Data from the biennial 1984 through 1990 rounds of the Longitudinal Study on Aging were used to predict the move/not-move behavior of a nationally representative sample of noninstitutionalized respondents aged 70 years and over in 1984. Six motives for elderly migration were identified: health, affiliation, economic security, comfort, functional independence, and getting on with life after family crisis. When incorporated within this motivational framework, reason-for-move data showed that health was not the dominant motive; responses were divided among the five other motive categories. The logistic regression analysis showed that increasing disability was positively related to mobility for respondents in only one of six motive categories. The results suggest that a motive-for-migration perspective broadens the debate on types of, and explanations for, migration behavior of noninstitutionalized very old Americans.