Support for the medical profession among the aged

Age Differences in Lay Conceptions of Health and Self-Care Responses to Illness

This paper explores lay health care beliefs and practices. More specifically, the research tests the hypothesis that traditional “popular” health beliefs and self care practices are most likely to be found among older persons. Data were obtained through personal interviews with a randomly selected cross-sectional sample of 524 residents of Winnipeg, Canada. Statistical analysis was intended to assess the relationship between age and lay health care beliefs and practices, and to evaluate the relative explanatory power of age compared to other sociodemographic factors; self-reported health status; and medical care contact. The results suggest that the relationship between age and lay conceptions of health and self-care responses to illness is a rather complex one. Furthermore, respondents' age alone explained little of the variance in any of the dependent measures. Finally, this study revealed that although lay self-care beliefs and behaviour exist, they are not limited to older persons.

Neighborhood variations in the use of city-supported primary health care services by an elderly population

The purpose of this paper is to examine the elderly's use of city-supported primary health care services. The provision of free or low cost health care to the elderly population is a major health policy issue, especially as the size of the elderly population increases and there is a concomitant increase in the need for health services and increases in the out-of-pocket cost of health care. The data analyzed here are based on client records for approximately 6,000 persons 65 and older who utilized the City of Philadelphia's Family Medical Care Program in 1982. Demographic and socioeconomic characteristics, diagnoses and types of services used are examined for all clients citywide and by neighborhood. Elderly clients of the city primary care system tended to be 65-74, female and black. Most clients had low incomes, with about 75-87% having incomes below $6,000. The problems for which care is sought involve long-term, ongoing care. The data show that the elderly are underrepresented in the city-supported primary care system relative to their numbers in the general population. Our findings on diagnosis and services utilization characteristics of those elderly who do use city-supported primary health care services indicate that the elderly are likely to place demands on the existing system for a substantial amount of resources. The demands for such services are likely to increase especially as the size of the elderly population increases.

Issues in elderly patient-provider interactions

The current state of knowledge concerning relationships between elderly patients and their health care providers is reviewed in this article, chiefly in terms of physicians as providers. Characteristics of physicians, including age, gender, practice styles, and psychological attitudes, are shown to be relevant to the course and content of interactions. Equally critical are characteristics of the elderly patients, such as cohort membership, health status, gender, race, and health-related attitudes and beliefs. Also significant are the organizational settings in which interactions occur. Implications for elderly patient compliance and satisfaction, as well as health services utilization, are discussed in light of communication issues. The need for according elderly patients respect and dignity is stressed, particularly in light of ageist attitudes still prevalent among health practitioners and the society at large.