Relative deprivation and perception of financial adequacy among the aged

Material-Psychosocial-Behavioral Aspects of Financial Hardship: A Conceptual Model for Cancer Prevention

Risk of cancer increases with age; and socioeconomic factors have been shown to be relevant for (predictive of) cancer risk-related behaviors and cancer early detection and screening. Yet, much of this research has relied on traditional measures of socioeconomic status (SES) to assess socioeconomic circumstances, which limits our understanding of the various pathways through which the socioeconomic environment affects cancer risk. Research on hardship and health suggests that concepts of financial hardship can uncover socioeconomic factors influencing health behaviors over and above traditional SES measures. Thus, consistently including measures of financial hardship in cancer prevention research and practice may help us further explicate the pathway between socioeconomic circumstances and cancer risk-related behaviors and cancer screening among older adults and help us identify intervention and policy targets. We present a conceptual model of financial hardship that can be applied to cancer prevention research among older adults to provide guidance on the conceptualization, measurement, and intervention on financial hardship in this population. The conceptual model advances a research agenda that calls for greater conceptual and measurement clarity of the material, psychosocial, and behavioral aspects of the socioeconomic environment to inform the identification of potentially modifiable socioeconomic factors associated with cancer risk-related behaviors among older adults.

Use of an Income-Equivalence Scale to Understand Age-Related Changes in Financial Strain

Income-equivalence scales (IES) provide distinct advantages over poverty indices to adjust family income for differences in family size, including improved specification of hypothesized causal relationships involving objective measures of economic well-being. In a novel IES application, cancer patients' out-of-pocket health costs are adjusted for differences in family income and size and, along with five other subindices, contribute to an overall index of "objective family financial stress." Age-related changes are modeled simultaneously within relationships between overall objective family financial stress and subjective patient perceptions about financial strain. Among the findings, the impact of age on one area of subjective financial strain, "difficulty paying bills," is negative and curvilinear. Regardless of adjusted out-of-pocket costs, as age advances, patients appear increasingly likely to accommodate to financial stress by reporting less difficulty paying bills. This phenomenon could serve to mask and isolate older adults who are foregoing needed yet unaffordable medical care and prescriptions.

Gender’s Effect on the Relationships Linking Older Americans’ Resources and Financial Satisfaction

This article tests the assumptions that the effect of resources on the financial satisfaction of older Americans is consistent (1) for different measures of income and wealth and (2) for men and women. Data are from a weighted subsample of those 65 and older from Waves I (1986) and II (1989) of the Americans’ Changing Lives Panel Study. Multivariate analyses contradict both assumptions with the following statistically significant findings: (1) Financial satisfaction in 1986 and not receiving food stamps are stronger predictors of financial satisfaction for men, whereas having interest and retirement/pension incomes are more important for women; and (2) a lowered number of chronic ailments is more important for women, whereas having a surviving spouse is more important for men. Findings support both George’s ideas of “control” and “illusion of control” and Moen’s ideas about gender-specific patterns of status transitions.

Perceived Income Adequacy among Elderly Retirees

Previous research indicates that elderly people generally find their incomes to be adequate, even when those incomes are relatively low. This article explores the relationship between household income and multiple measures of perceived income adequacy among elderly retirees. The authors also examine the effect of older people's assessments of health on perceptions of income adequacy. Results confirm previous findings that older people assess their financial resources as adequate. Older people who assess their health more negatively, or who had experienced recent declines in health status, assessed their financial resources as less adequate than respondents in better health who reported similar income levels.

When the Going Gets Tough

We examined the impact of anticipating poor economic conditions on financial risk taking. In Experiment 1, the salience of poor future economic prospects was manipulated among young adults. Those who were reminded of their poor future economic prospects were more likely to take the opportunity to gamble with their money than those in the control condition. In Experiment 2, we once again manipulated the salience of poor economic prospects. Extending the results of Experiment 1, participants who were reminded of their poor economic prospects bet more money on a spin of a roulette wheel than those in a control condition. Importantly, we show that the relationship between poor economic prospects and gambling is mediated by belief in the necessity of taking financial risks to make money. Implications of economic downturns for gambling and other forms of risk taking are discussed.

Financial Strain, Religious Involvement, and Life Satisfaction Among Older Mexican Americans

The purpose of this study is to see if financial strain affects the religious involvement and life satisfaction of older Mexican Americans. In the process, an effort was made to explore the factors that promote financial strain in this ethnic group, including immigration status and English language use. The data come from a nationwide survey of older Mexican Americans. Support was found for the following core relationships in the study model: (1) older adults who were born in Mexico will have less schooling; (2) less education will be associated with less frequent use of English; (3) less frequent use of English will be associated with greater financial strain; (4) greater financial strain leads to less formal involvement in the church; (5) older people who are less involved in the church will have a diminished sense of religious meaning; and (6) older adults with a lower sense of religious meaning will be less satisfied with life.

Money and happiness: does age make a difference?

Although the factors that influence people's perception of happiness have long been a focus for scholars, research to date has not offered conclusive findings on the relationships between income, age and happiness. This study examined the relationship between money and happiness across age groups. Analysing data from United States General Social Surveys from 1972 to 2006, this study finds that even after controlling for all the major socio-demographic variables, income (whether household income or personal equivalised income) had a significant positive association with happiness for young and middle-age adults, but it was not the same case with older adults. After controlling for the major socio-demographic variables, there was no evidence of a significant relationship between income (whichever definition) and happiness for older adults. The results also showed that the effect of household income on happiness was significantly smaller for older adults than for young or middle-age adults in the model controlling for major socio-demographic variables. The relationship between household income and happiness no longer differed significantly across age groups after social comparison variables were included. The relationship between equivalised income and happiness did not vary significantly by age group after controlling for the major socio-demographic variables.

The influence of age on perceptions of anticipated financial inadequacy by palliative radiation outpatients

OBJECTIVE

A consistent body of knowledge suggests that with advancing age, adults tend to report lower financial strain from their current economic condition. But are more negative perceptions shifted onto their expectations about their future economic condition? This study of seriously ill outpatients investigates whether advancing age is related to more negative expectations of future health-related financial strain, in which illness progression would necessitate greater health care consumption.

METHODS

Ordinal probit multivariate regression was conducted on survey findings from 268 outpatients initiating palliative radiation for recurrent cancer. Half were retirees age>/=65. Age comparisons are reported when there was no recent work transition.

RESULTS

As age advances (from 40 to 84), outpatients incurring low objective financial stress were more likely to reveal that their health insurance and finances would be less adequate to meet future health needs.

CONCLUSION

Previously, these outpatients were reported to minimize perceptions of current financial strain as age advances. Therefore, older outpatients may cope with current circumstances by displacing perceptions of financial inadequacy onto plausible future situations of cancer progression demanding greater healthcare consumption.

PRACTICE IMPLICATIONS

Financial strain may be hidden in older outpatients initiating palliative radiation. These outpatients appear at risk of foregoing appropriate healthcare. Targeted screening and advocacy are warranted.

Reports of financial disability predict functional decline and death in older patients discharged from the hospital

BACKGROUND

The financial ability to pay for food and medical care is needed to maintain health in older persons following a serious illness. Therefore, we hypothesize that the inability to pay for basic needs, which we call financial disability, predicts adverse health outcomes in older patients discharged from the hospital.

OBJECTIVES

To determine the frequency of reported financial disability in older adults being discharged from a hospital, to determine patient characteristics associated with financial disability, and to examine the relationship between financial disability and functional decline and mortality.

DESIGN

Prospective cohort study.

SETTING/PARTICIPANTS

Two thousand two hundred patients 70 years and older admitted to the general medicine services at two teaching hospitals in Ohio.

MAIN OUTCOME MEASURES

Respondents were interviewed at the time of discharge to determine patients' financial ability to pay for 6 needs: groceries, general bills, medications, medical bills, a small emergency, and a major emergency. We determined functional decline in ability to perform activities of daily living from discharge to 90 days post-hospital discharge, and death 1 year after hospital discharge.

RESULTS

Financial disability was reported to be severe (unable to pay for 3-6 needs) for 21% of patients and moderate (unable to pay for 1-2 needs) for 36%. Financial disability was more common and more severe (P<.001) in persons with an annual household income less than $10,000, in persons with fewer than 12 years of formal education, in African Americans, and in women. In patients with no financial disability, moderate financial disability, and severe financial disability, functional decline 3 months after hospital discharge occurred in 15%, 20%, and 25%, respectively (P=.001), and 1-year mortality rates were 24%, 27%, and 32%, respectively (P=.002). After adjustment for potential confounders, the association of financial disability with functional decline (P=.003) and mortality (P=.02) remained significant.

CONCLUSION

Reports of financial disability at hospital discharge identified vulnerable older adults with increased risk for functional decline and death. Interventions that alleviate financial disability may improve health outcomes in older adults discharged from hospital.

Income, age and financial satisfaction

Although the effects of income and age on subjective well-being have been widely studied, research on the effects of income and age on financial satisfaction, a major life domain to which income has direct relevance, remains limited. Analyzing data from the General Social Surveys, this article empirically examined the effects of income and age on financial satisfaction. These findings suggest that the social-psychological mechanisms underlying the age differences in the effects of income on financial satisfaction might not reflect a clear-cut status attainment versus status maintenance framework. The findings also served to caution future financial satisfaction research in the choice of income measures and the age grouping.

Trends in financial satisfaction: does poverty make a difference?

Gerontological studies on financial satisfaction have been limited by the dearth of longitudinal research and the lack of research that includes the concept of poverty. In order to bridge these gaps, this longitudinal study examines and compares the intracohort and intercohort effects on financial satisfaction trends by poverty status among Americans age 45 and above, using data from the General Social Surveys. The results suggest that for both the poor and the non-poor, changes in financial satisfaction trends are mostly due to strong negative intercohort effects, indicating that younger cohorts are less satisfied financially than the older ones. There appears to be a significant difference in the intercohort effects of financial satisfaction trends between the poor and the non-poor. However, such difference can be accounted for by the differences in the effects of education and social comparison (or relative deprivation) on financial satisfaction between the poor and the non-poor.

Correlates of financial satisfaction

The objectives of this study are to 1) assess the effects of major correlates of global subjective well-being on financial satisfaction, and 2) use empirical data to present the consequences of violating basic regression assumptions. Analyzing data from the General Social Surveys, 1972-1996 (Davis & Smith, 1996a) this study found that among Americans age forty-five and above, most of the major correlates of global subjective well-being show similar effects on financial satisfaction. The study's findings confirm a nonlinear effect of income on financial satisfaction. Comparing results from different analytical methods, this study also alerts researchers to the importance of taking into account the level of measurements of study variables, which have tended to be overlooked by previous subjective well-being research.

Trends in financial satisfaction among middle-age and old-age Americans, 1972-1996

Using data from the General Social Surveys (1972-1996), this study decomposes the trends in financial satisfaction into intercohort and intracohort patterns to assess the intracohort change and cohort replacement effects on financial satisfaction. The results suggest that a positive intracohort component of financial satisfaction trends, indicating more financial satisfaction with time; and a negative intercohort component, indicating that younger cohorts are less satisfied financially. The multivariate analysis further suggests that the change in financial satisfaction trends is mostly due to a strong intercohort replacement effect. That is, the change in financial satisfaction trends can be largely accounted for by the intercohort replacement effect of younger cohorts' being less satisfied financially.

Old age support in China: the role of the state and the family

This study investigates the relationship between some support factors and the well-being of the elderly in China. The analytical models identify and compare the effects of each type of factor on the sense of well-being of elderly Chinese across rural and urban settings. Pension, health care, size of family, and living arrangements are the factors found to be significantly related to the perception of happiness among aged people in general. The strength of the effects of children and living arrangements varies depending on places of residency. The findings indicate the continuous role of the family support, and the increasingly important role of state support in promoting a sense of well-being among elderly Chinese.

Financial Strategies of the Recently Retired

This study investigated the use by 450 recently retired men and women, of four financial strategies which might enhance financial resources. These strategies were change in expenditures, change in home production, change in assets, or post-retirement employment. Expenditure reduction was the most frequently used of these strategies. As with other research, subjective assessment of economic adequacy was more influential than actual income in affecting expenditure behaviours. The other strategies appeared to be less related to economic factors. Post-retirement employment was most influenced by work saliency. Education, used as a proxy for knowledge and skills, was found to positively correlate with changes in expenditure, home production, and assets. Perhaps the retired consider themselves powerless to improve their economic condition or do not perceive these as useful financial strategies.

Further investigation of the role of personality, lifestyle and arthritic severity in predicting pain

Lichtenberg et al. (1984) presented empirical research on elderly osteoarthritics that indicated that personality, specifically hypochondriasis, was the most powerful predictor of pain as compared with arthritic severity and recent life stress. This study investigated further the role of psychological predictors and arthritic severity ratings in accounting for perceived pain. The study included 70 subjects with an average age of 68 years. The results indicated that hypochondriasis was the predictor most highly related to pain. Arthritic severity ratings and other psychological predictors were also significantly related to pain. In a multiple regression analysis arthritic severity predicted 13 percent of pain variance whereas the psychological predictors accounted for an additional 41 percent of the variance. Age of the individual was related to several psychological variables. New possibilities for therapeutic intervention are discussed.

Political implications of the 'new ageism'

The research tradition of old age stereotypes has typically been limited to a social psychological perspective of their dysfunctional consequences. This exploratory study examines the possible functions served by such stereotypes from a sociocultural frame of reference, in particular, testing the hypothesis of Richard Kalish and Carroll Estes that problem-oriented conceptions of older persons are part of an emerging political ideology. Using the responses of the Louis-Harris-NOCA "The Myth and Reality of Aging in America" survey, the relation between aging stereotypes and attitudes toward federal support of the aged are reported.

An inquiry into the positive personal and social effects of old age stereotypes among the elderly

Much has been written or inferred about the detrimental consequences of old age stereotypes for elderly individuals. This paper presents and tests an alternative perspective called relative advantage. As the reciprocal counterpart of relative deprivation theory, this perspective claims that such stereotypes may be psychologically and sociologically functional for the old to believe. Using the results of the 1975 Louis Harris--NCOA "The Myth and Reality of Aging in America" survey, two hypotheses were tested: 1) those who feel other older individuals are worse off than themselves will have higher life satisfaction scores than those perceiving others to be as well or better off; 2) these imputations of others' difficulties correlate with one's likelihood to support and join coalitions on behalf of the old and to approve government taxing of all age groups to support them. The evidence presented raises some dysfunctional implications of debunking aging myths.

Application of the Theory of Relative Deprivation to Occupational Discrimination against Women

The theory of relative deprivation was tested by studying work satisfaction of white teachers, with women teachers representing an occupationally deprived group. Hypotheses were derived from Davis' (1959) theory of relative deprivation and from Crosby's (1976) extension of this theory. These were tested by applying the Job Description Index of Smith et at. (1969) and two personality measures to 100 female and 83 male teachers. Some of the predicted negative correlations between work satisfaction and both salary and teaching experience were found for junior women teachers, but not for those in senior posts. The predicted differences in work satisfaction between male and female teachers were also found only for junior teachers. These results partially support Davis' theory, but also point to one of its weaknesses. No support was found for Crosby's extension of the theory to include the effects of personality variables.