Abstracts from the May 2007 Conference on Aging and Disability

All sessions took place in the Public Events Room, 220 Eggers Hall, Maxwell School, Syracuse University. All sessions were free and open to the public.

Keynote Address

Opportunities and Challenges Facing Older Disabled People

Judith E. Heumann, World Bank, Lead Consultant, Global Partnership for Disability and Development (GPDD)jheumann@worldbank.org

As a 59-year-old disabled person who has had my disability for most of my life I have seen significant changes made in our society to remove many physical barriers that previously had limited opportunities for disabled people of all ages. We have also seen many pieces of legislation prohibiting discrimination against disabled people that also have been creating new opportunities. We have a diverse population of older disabled people, those like myself who had their disability since they were young and those acquiring their disabilities later in life. Expectations for both groups are frequently different, based on what our views are toward disabled people. This presentation will focus on what some of these differences are and will explore opportunities to help bring these communities together to provide greater opportunities that will enable people to live active integrated lives.

Trends in Aging and Disability

Trends in Aging and Disability in the US

Chris Himes, Chair and Professor of Sociology, CPR Senior Research Associate, Syracuse University clhimes@syr.edu

Life expectancy in the United States continues to increase steadily for both men and women, and both whites and blacks. At the same time considerable evidence now exists that the prevalence of disability in later life in the United States has been declining. This decline has taken place despite an increase in the level of chronic disease among the same population. In this presentation I will present the national estimates for changes in mortality and life expectancy and review the evidence for disability decline. These concepts will be combined to examine the pattern of disability-free life expectancy in later life. While disability due to chronic conditions has declined at older ages, little change has been found for younger ages (under age 45). In addition, patterns of chronic disease are changing in young and middle life, with possible implications for later life disability. I will address the question of how disability at younger ages has changed over the past decade, explanations for the two divergent trends, and implications for later life.

The Measurement and Meaning of Disability at Older Ages: UK and European Perspectives

Emily Grundy, Center for Population Studies, London School of Hygiene & Tropical Medicine emily.grundy@lshtm.ac.uk

The first part of the presentation will set the scene by examining the dynamics of further population ageing and the possible implications for health, disability, and health care. Different approaches to measuring disability in surveys and the different results — both in terms of differences over time and differences by gender and by socio-economic status — yielded by these approaches will then be examined. The second part of the presentation will analyze how characteristics and behaviors such as age, gender, marital status, education and socio-economic status, and smoking status influence congruence between self-reported and observed indicators of disability or poor health. The main data source for this analysis will be the Health Survey for England, a nationally representative survey started in the early 1990s. Although questions included in this survey vary slightly year by year, it is valuable in including both observed (nurse measured) and self-reported measures. Some other analyses of data from the recently launched Survey of Health of Retirement in Europe will also be presented. This includes questions on self-rated health and self-reported disabilities and some observed measures, namely grip strength and a timed walk. The analysis will focus on examining congruence, and differences in extent of congruence, between observed and self-reported indicators with a view to elucidating how socio-economic and family status influence perceptions of disability. Results will be related to policy and advocacy issues.

 

Aging, Disability and Health

Everything We Know about Aging and Response Times: A Summary of Meta-Analyses of Age-Related Slowing in Response Times

Paul Verhaeghen, Associate Professor of Psychology, Syracuse University pverhaeg@syr.edu

This paper deals with the question: How many different mechanisms might one need to explain aging in response times? I conducted a series of meta-analyses, one on 1,354 (young, older) RT pairs culled from 135 studies, the other one on 210 (younger adult, older adult) RT pairs from 44 studies on iterative tasks. Three distinct age-related slowing factors were obtained: (a) lexical tasks showed positive age differences ('slowing' factor of 0.8); (b) sensorimotor tasks, enumeration tasks, and memory search tasks were modestly sensitive to aging (slowing factor of about 1.4); and (c) spatial tasks showed relatively large deficits with aging (slowing factor of about 1.9). Additional analyses reveal little evidence of age-differential speed-accuracy tradeoffs, and no evidence for age-differential practice effects or a specific age-related increase in between-subject variability. Slowing estimates were not moderated by measurement unreliability, participant age, or participant level of education. The need for dual task-set maintenance (as in dual-task performance and global task switching) led to additional age-related slowing; tasks of selective attention (i.e., Stroop, negative priming, and local task switching) were not found to be age-sensitive. The good news then is that verbal tasks seem to actually speed up with age — older adults are faster than younger adults, and that many cognitive tasks do not show slowing beyond slowing evident in the sensorimotor system. Additional good news is that there is clearly no general breakdown in cognitive control processes. These findings may have implications for design and engineering issues geared toward senior citizens.

The Effect of Income Supports on Disability among Elderly Americans

Pamela Herd, Assistant Professor of Public Affairs and Sociology, University of Wisconsin–Madison pherd@lafollette.wisc.edu

Increasing research on the relationship between socioeconomic factors and health suggests that non-health policies might substantially affect health, while another growing body of evidence suggests that medical care, the main focus of current health policy, is not the primary determinant of levels of population health. Thus, this research examines whether the Supplemental Security Income (SSI) program affects disability among the elderly. We use the 1990 and 2000 censuses, employing state and year fixed effect models, to test whether within state changes in maximum SSI benefits over time lead to changes in disability. The findings from this study support the hypothesis that increases in income supports through the SSI program lead to reductions in disability among single elderly individuals. Thus, income support policy may be a significant new lever for improving population health and reducing health disparities, especially among lower income persons.

Aging, Disability and Military Service

Variation in Functional Limitation and Disability by Veteran Status, Race, and Gender

Janet Wilmoth, Associate Professor of Sociology and CPR Senior Research Associate jwilmoth@syr.edu; Andrew London, Associate Professor of Sociology and CPR Senior Research Associate anlondon@syr.edu; and Wendy Parker, Graduate Student, Sociology, Syracuse University wparker@syr.edu

There are competing predictions regarding the relationship between military service, functional limitations, and disability. Some research suggests military service should lead to lower rates of functional limitations and disability, particularly for those from disadvantaged backgrounds, because it links individuals to education and health care resources that they might not otherwise be able to access in the community. Other research indicates military service, particularly service during war time, should increase the risk of functional limitations and disability. Although there are numerous studies on health conditions among veterans, there are very few studies that use national data to examine the differences in functional limitations and disabilities between veterans and nonveterans. Furthermore, there are no studies that consider how these relationships vary by race/ethnicity and gender. The purpose of this research is to examine these issues with census data from the 2000 Public Use Microdata Sample. The findings indicate that veterans are significantly more likely to have a functional limitation or disability than nonveterans. However, this relationship varies substantially across race/ethnicity and gender. Black, Native American, and multiracial veterans have significantly higher odds of having functional limitations and disabilities than their nonveteran counterparts and non-Hispanic, white veterans. Furthermore, female veterans overall, and in these three racial/ethnic groups in particular, have substantially higher odds of having functional limitations or disability than female nonveterans and males regardless of veteran status. Possible explanations for these observed differences are discussed.

Ethnicity, Disability, and Union Army Pensions

Larry Logue, Professor of History & Political Science, Mississippi College logue@mc.edu and Peter Blanck, University Professor, Chair Burton Blatt Institute, Syracuse University pblanck@syr.edu

This paper focuses on the experience of immigrants in the federal government's pension system for veterans of the Union army. In principle all ex-soldiers had access to the same pensions, but there were substantial differences in the behavior and treatment of foreign-born veterans. Immigrants were less likely to apply as long as pensions were tied to service-related disabilities. However, when the law was changed in 1890 to include disabilities arising after the Civil War, foreign-born veterans sought pensions as eagerly as did the native-born. When they did apply before 1890, foreign-born veterans were treated equally by the medical examiners who passed judgment on applicants. After 1890, however, possibly influenced by the general resurgence of nativism, examiners disproportionately rejected immigrants in a pattern that corresponded to nativists' 'racial' hierarchy. Since pensions provided a longevity benefit — the greater the pension income, the less likely a veteran was to die — discrimination against foreign-born veterans had significant consequences.

 

 

 

 

Work, Aging and Disability

Maintaining Older Workers with Disabilities in the Labor Force

Richard Burkhauser, Sarah Gibson Blanding Professor, Policy Analysis and Management, Cornell University rvb1@cornell.edu

This paper begins with a summary of the evidence documenting the dramatic decline in the employment of working-age people with disabilities, their increasing movement onto the Social Security Disability Insurance rolls, and the degree that changes in public policy are responsible for these phenomena. It then explores the role employer accommodation has played in delaying the movement of workers out of the labor force and onto the Social Security Disability Insurance rolls, and discusses how changes in current social policies could further encourage accommodation and longer participation in the workforce following the onset of a disability.

 

Civil Rights Trends/Political Activism

Political Engagement of Frail and Institutionalized Elders: The Implications of Dementia on the Right to Vote

Nina Kohn, Assistant Professor of Law, Syracuse University nakohn@syr.edu

Voting is widely recognized as a fundamental right and a critical manifestation of an individual's full membership in society. In light of recent election irregularities, however, concerns have been raised about persons with dementia voting, and some have argued that caregivers, long-term care institutions, and electoral officials should actively limit such persons' ability to vote. The speaker will assess the extent to which voting by persons with dementia poses a threat to the demographic system and will discuss whether such individuals should have their capacity to vote tested prior to being afforded access to the ballot or to assistance with ballot completion. The presentation will focus particular attention on the social and constitutional implications of selectively targeting certain classes of persons for disenfranchisement.

 

Keynote address

Disability and Ageing: Friends or Foes in Research and Politics?

Mark Priestley, Dr., Reader in Disability Studies, Centre for Disability Studies, University of Leeds, UK m.a.priestley@leeds.ac.uk

Both disability and old age have been produced as structural categories in modern societies through similar processes of social change, primarily as a consequence of exemption from participation in adult labor markets. There are also similarities in the way that disability and old age have been culturally constructed (for example, in terms of the impaired body, perceived vulnerability, or dependency). The parallel social significance of old age and disability is accentuated by the persistent ageing of world populations, and in many industrialized societies, the majority of disabled people are over retirement age. Disability is then something of a fact of life for older people. Despite this demographic truism, or perhaps because of it, older people with impairments are rarely regarded as 'disabled' in quite the same way that children, young people, and adults often are, and political activism around disability rights has tended to focus on issues affecting those of working age or below. There has been much recent discussion about the rights of older people, yet their voices and experiences have been under-represented in the accounts of the disabled people's movement and in disability politics. Within the political activism and campaigns of older and disabled people's movements there has been a distancing of what appear to be common interests at the expense of those in deepest old age and with the most significant impairments.

 

After dinner talk

The Nottingham Intergenerational Lifewriting Project

Eileen Schell, Associate Professor in the Writing Program, Syracuse University eeschell@syr.edu; Alethia Herbert and George Milman, members of the Nottingham Writing Group

This presentation will describe and analyze an intergenerational writing and shared reading program at the Nottingham Senior Living Community in Jamesville, New York. Involving Syracuse University undergraduates, graduate students, and faculty, the weekly writing and reading workshops encourage residents to tell, write, share, and revise their life stories in a supportive and reflective atmosphere with accommodations made for those who need an assistant or guide to help them through the process. In tandem with the writing program, we have launched a reading program that involves residents in listening to or reading memoirs, biographies, and historical works that involve significant components of lifewriting and critical analysis. A few members of the Nottingham Writing Group will be present to read brief excerpts from their work.

 

Policy Trends

Aging with a Disability: Reflections and Policy Trends

Fernando Torres-Gil, Director, UCLA Center for Policy Research on Aging Torres@spa.ucla.edu

This presentation examines the growing nexus of aging and disability through the use of a key linkage: aging with a disability. Increasingly, we will find that two groups will be joined together but not always with intended results: younger persons enjoying added longevity and older persons facing disabilities and mobility limitations as they live longer. Insights into the policy and programmatic implications of these trends can be gleaned from those who have been aging with a disability. I draw on my personal experiences as a gerontologist and a post-polio survivor to draw out the intellectual, disciplinary, and policy issues that can suggest how the public and private sector can respond to the growing numbers of individuals who will age and face some form of a disability. My thesis is that aging and disability, along with long-term care, may be the 'great equalizer' for aging baby boomers as they move toward a social and political consciousness that, in turn, can provide a leadership focus for the inevitable dilemmas they will face in the next 10 to 20 years.

Aging and HIV

The Graying of the HIV/AIDS Population

Marjorie Cantor, Professor and Brookdale Distinguished Scholar of the Graduate School of Social Service, Fordham University mhcantor@aol.com, and Stephen Karpiak, Associate Director for Research, AIDS Community Research Initiative of America skarpiak@acria.org

One decade after the introduction of highly active antiretroviral therapy (HAART) there have been a dramatic decrease in the mortality rates and increases in life expectancy among people living with HIV/AIDS. With new infection rates stable, the net result is an HIV population that is growing larger and older. Thus, 27% of all Americans living with AIDS are over age 50, while in New York City 30% of those with HIV are over 50 and fully 70% are age 40 or older. The graying of the HIV population has serious implications for health care now and in the future. In 2006, ACRIA completed the first large-scale study of the older HIV population in New York City. The Research on Older Adults with HIV (ROAH) study included a sample of 1,000 adults, with a mean age of 58. Highlights from this study will be presented, including demographic profile, physical and mental health status, sexual behaviors, substance abuse, social networks, issues of stigma, and psychological resources. Implications for health and social service systems will be discussed.

Living and Caring Arrangements

Studying the Impact of the Environment on Community Living and Participation with People Aging with Disabilities & Older Adults

Joy Hammel, Associate Professor, Occupational Therapy and Disability Studies, University of Illinois at Chicago hammel@uic.edu

The emerging trends related to healthy and livable communities and aging in place focus on the importance of being able to live in homes and communities of choice, over time, and the influence of this built environment on people's health, satisfaction, and continued participation. Further, civil rights legislation such as the Americans with Disabilities Act and resulting systems change initiatives have further spurred on long-term care rebalancing to support least restrictive, community-based options. Currently, there is a need for 1) research that examines how specific features of the built environment related to accessibility (physical, sensory, cognitive, social), integration, safety/security, and affordability influence the choice, control, and outcomes of people who are aging with disabilities and older adults; and 2) participatory methodologies to involve these constituents in all aspects of the research so knowledge gained can be effectively used within communities and within social action change to improve policies and systems related to long-term community living and participation. This presentation summarizes this emerging research, highlighting specific examples of participatory action research projects being done across three center grants.

Family Caregiving Policies and Practices

Tamar Heller, Professor and Head of DHD (Disability and Human Development), University of Illinois at Chicago, and Co-Director of the University Center of Excellence in Developmental Disabilities in Illinois theller@uic.edu

This presentation will discuss later life family support for adults with developmental disabilities from a life course perspective. It will take into account social trends and changes in service patterns and in attitudes of families. Key issues addressed include: 1) trends affecting family caregiving, 2) health and social outcomes of life long caregiving, 3) support needs of families, 4) family support policies and practices, and 5) recommendations for a research and policy agenda. While most families adapt well to life long caregiving for a family member with disabilities, some families are at risk for poorer physical and mental health outcomes. These include cultural minorities and families of adults with behavioral challenges. Caregiving does seem to negatively affect maternal employment as mothers often give up or cut back on employment to care for a child with developmental disabilities, who often continues to live in the family home throughout adulthood. Model family support programs and policies will be discussed, including federal and state initiatives through both the developmental disabilities and aging service systems.

Closing Session: Where have we been and where are we going?

 

Disability and Old Age: Analogies, Connections, and Intersections

Liat Ben-Moshe, Sociology and Disability Studies, Syracuse University

 

 

 

 

 

 

This conference was sponsored by the Gerontology Center; the Maxwell School of Citizenship and Public Affairs; Professor Douglas Wolf, Gerald B. Cramer Professor of Aging Studies; the College of Arts and Sciences; the Burton Blatt Institute; the College of Law; the School of Education; the College of Human Services and Health Professions; the Department of Sociology; and the Department of Psychology.
   

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