Tag Archives: Disability

Mastery and Health Over the Life Course

Much of my recent research has explored the links between mastery and health across the life course. In general, mastery, defined as feeling like you have control over your life circumstances, is a robust predictor of better health outcomes including morbidity and mortality (Latham-Mintus & Clarke, 2017; Latham-Mintus, Vowels, & Huskins, 2017; Pearlin et al., 2007).

Mastery is thought to be an important coping resource that encourages positive health behaviors and also alleviates the effects of stress on the body. Because of the connections between mastery and health-promoting behaviors, it is often viewed as a potential avenue for intervention among older adults.

My own research, along with Philippa J. Clarke, has demonstrated that high levels of life course mastery is predictive of mobility device use among older adults with functional limitations (Latham-Mintus & Clarke, 2017). Older adults with a history of high life course mastery were more likely to use mobility devices such as walkers, wheelchairs, or canes in the face of functional impairment (see figure below).  The use of assistive technology is a health-promoting behavior, which encourages independence and greater wellbeing among older adults. This research shows that mastery across the life course has the capacity to influence health behaviors and disease/impairment management in later life.

lifecoursemastery

More recent research, along with Katelyn M. Aman, examined the association between childhood disadvantage and recovery from mobility limitation (i.e., difficulty walking and climbing stairs) (Latham-Mintus & Aman, 2017). In general, economic and health disadvantage before age 16 was associated with lower odds of recovery from mobility limitation. However, we also investigated whether certain psychosocial factors buffered the effect of childhood disadvantage on recovery outcomes. Mastery was a significant moderator of childhood disadvantage (i.e., moving for financial reasons) and recovery (see figure below). Mastery may be able to diminish the negative effects of financial hardship in childhood on recovery outcomes in later life. However, it also underscores the particularly harmful effects of low mastery among those with childhood disadvantage experiences.

klmaman2017Source: Latham-Mintus, K. & Aman, K. M. (2017). Childhood Disadvantage, Psychosocial Resiliency, and Later Life Functioning: Linking Early-Life Circumstances to Recovery from Mobility Limitation. Journal of Aging and Health.

 

While it appears that mastery has the capacity to improve the health and wellbeing of older adults including encouraging adoption of assistive technology and buffering the adverse effects of childhood economic disadvantage, it also important to note that feelings of mastery reflect structural conditions. In other words, those who have been exposed to discrimination and constrained economic opportunities such as people with low socioeconomic status or minorities typically report less mastery (Latham-Mintus, Vowels, & Huskins, 2017).

Furthermore, it appears that the effect of mastery on health varies by sex and race. To illustrate, research completed with two IUPUI Sociology graduate students (Ashley Vowels and Kyle Huskins) documented that mastery was a strong predictor of healthy aging among older white men, but a weak predictor among older black men (see figure below).

jgps

Source: Latham-Mintus, K., Vowels, A. L., & Huskins, K. (2017). Healthy aging among Black and White older American men: What is the role of mastery? The Journals of Gerontology, Series B: Psychological Sciences.

 

We posit that mastery may be a less effective coping resource for reducing stress reactivity among older black men because of limited opportunities to exert control over their environment throughout the life course. Equally, a lack of mastery may be exceptionally detrimental to older white men’s health because there is a higher expectation of having control over their environment due to structural advantages over the life course.

In sum, mastery may hold the potential to improve health and wellbeing of older adults; however, it is vital to recognize that mastery is not equally distributed among populations (i.e., those with marginalized statuses tend to have less mastery) and that the health-promoting effect of mastery on health is concentrated among the advantaged.

Because mastery develops over the life course, it has its roots in childhood. Exposing children and young adults to environments that embolden feelings of confidence and perceptions of control may have long-lasting impact on health and health behaviors in older ages. Giving individuals in early life the opportunities to achieve status attainment in home, school, or work environments and exposing them to mastery experiences may promote high levels of mastery throughout their lives. Early investments in fostering life course mastery, particularly in socially disadvantaged groups, may have larger gains for population health in the long term.

This should not take away from policies and interventions that seek to enhance current mastery or sense of control among older adults. Interventions aimed at improving current mastery and increasing participation in health behaviors may ameliorate the impact of childhood disadvantage. For example, previous research has documented successful interventions by empowering older adults through peer-to-peer support, increasing knowledge, and fostering increased decision-making opportunities. Enabling people, old and young, to feel empowered in their lives may be an important piece of the puzzle for future population health promotion.

References

Latham-Mintus, K. & Aman, K. M. (2017). Childhood Disadvantage, Psychosocial Resiliency, and Later Life Functioning: Linking Early-Life Circumstances to Recovery from Mobility Limitation. Journal of Aging and Health.

Latham-Mintus, K. & Clarke, P. J. (2017). Linking Mastery across the Life Course to Mobility Device Use in Later Life. The Journals of Gerontology, Series B: Social Sciences.

Latham-Mintus, K., Vowels, A. L., & Huskins, K. (2017). Healthy aging among Black and White older American men: What is the role of mastery? The Journals of Gerontology, Series B: Psychological Sciences.

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New Research: Does Neighborhood Disorder Predict Recovery From Mobility Limitation?

Latham, K. & Williams, M. M. (2015). “Does neighborhood disorder predict recovery from mobility limitation? Findings from the Health and Retirement Study.” Advance access at Journal of Aging and Health. 

Recent research highlights the importance of neighborhood disorder for recovery from mobility limitation (i.e., difficulty walking and climbing stairs). Older adults who reported higher levels of neighborhood disorder (i.e., graffiti/vandalism, vacant/deserted homes, litter, and crime) were less likely to recover from mobility limitation. However, physical activity and psychosocial factors were significant mediators, which suggests neighborhood disorder influences recovery from physical impairment via psychosocial processes and barriers to physical activity.

Reducing neighborhood disorder may enhance older residents’ psychosocial well-being and improve participation in physical activity, thus increasing recovery from mobility limitation and preventing subsequent disability.

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New Research: Social Relationships, Gender, and Recovery From Mobility Limitation Among Older Americans

Latham, K., Clarke, P. J. & Pavela, G. (2015). Social relationships, gender and, recovery from mobility limitation among older Americans. Advanced access The Journals of Gerontology, Series B: Social Sciences.

New coauthored research, forthcoming in the Journals of Gerontology, Series B: Social Sciences, highlights the role of social relationships for recovery from mobility limitation (i.e., difficulty walking) among older Americans. Additionally, this research explores whether the influence of social relationships on recovery varies by gender.

Highlights from this research include:

  • Providing non-paid help to friends and family increased the odds of recovering from mobility limitation for both older men and women.
  • Having relatives living nearby decreased the odds of complete recovery for older men and women.
  • Partnered men were more likely to experience recovery relative to partnered women.
  • Women who said that they did not visit friends in their neighborhood were the least likely to experience partial recovery compared with both men and women who visited friends and men who did not visit friends in the neighborhood.

This research underscores the potential for social relationships to facilitate recovery from mobility limitation. Interventions aimed at encouraging older adults with mobility limitation to visit neighborhoods and provide help to peers may improve functional health outcomes.  Additionally, this research speaks to possible vulnerabilities among older women with limited social ties.

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WalletHub’s 2014’s Best & Worst Cities for People with Disabilities–“Ask the Experts” Response

WalletHub has created a list of the best and worst cities for people with disabilities. They reached out to me and other researchers to weigh in on financial and non-financial advice for residents with disabilities.

2014′s Best & Worst Cities for People with Disabilities

My responses can be found at the bottom of the  webpage or by clicking “Ask the Experts” link.  I focused my answers on the advantages of walkable communities because the policies that would directly benefit residents with disabilities would benefit all members of the community. Safe and walkable environments help promote the health and wellbeing of whole communities.

 

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Thinking about Disability over the Life Course: Aging with Disability Publications

Two recent publications highlight potential disparities among individuals with disabilities in childhood and young adulthood. Those aging with disability may experience greater socioeconomic disadvantage, poorer self-rated health, and higher levels of depressive symptoms in later life. (Clarke & Latham, 2014; Latham, 2014).  Individuals with early-onset of disability often have increased barriers to socioeconomic achievement, which may lead to fewer opportunities to manage the underlying condition(s). These publications underscore the importance of viewing disability with a life course lens.

Clarke, P. J. & Latham, K. (2014). Life course health and social economic profiles of Americans aging with disability. Disability and Health Journal, 7, 1, S15-S23.

Latham, K. (2014). The “long arm” of childhood health: Linking childhood disability to late midlife mental health. Research on Aging. Advance online publication.

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