Abstract
This study examined disability trends by marital status among older adults aged 60 and above from 1997 to 2010 in the U.S. We addressed two questions: (1) Has the relationship between marital status and disability changed over the study period? (2) Can the trends be explained by changes in socioeconomic status? We paid special attention to potential gender and racial variations in these patterns. Data were drawn from the National Health Interview Surveys (NHIS) 1997–2010 (N = 170,446). Consistent with previous literature, our results from logistic regression models suggested that the married had lower odds of reporting either ADL or IADL disability than the unmarried groups over the entire study period across all gender and racial subgroups examined. More importantly, we found that the ADL disability gaps of widowed white men, widowed white women, and divorced white women in comparison to their married white counterparts decreased from 1997 to 2010; the IADL disability gaps of widowed white men and widowed black women in comparison to their married counterparts also decreased, while the IADL disability gap between never married white men and married white men increased over time. Socioeconomic status could explain little of these trends. These results, coupled with the growth of unmarried elderly population, suggest that the national long-term care system needs to get prepared for the potentially significant increase in demand for their services among the vulnerable unmarried elderly (especially blacks) and provide affordable and adequate services to those in need.
Similar content being viewed by others
Notes
It is noteworthy that while marriage is a central source of financial, emotional, and social support for most people, poor marital qualify is associated with higher levels of stress and more risky health behaviors which increase the risks of chronic diseases and disabilities in comparison to getting divorced or never marrying (Williams 2003). Recent research further highlights the heterogeneity of the unmarried groups by suggesting different levels of marital resources associated with different unmarried groups including the divorced, widowed, and never married (Liu and Umberson 2008).
We calculated the predicted probabilities based on the formula, p = exp(X′b)/(1 + exp(X′b). Age was set at the mean and all other covariates were set to the reference group. Only significant coefficients in Model 2 of Tables 3 and 4 were used to calculate the predicted probabilities of reporting ADL or IADL disability since insignificant coefficients were not statistically different from zero.
If log(p/1 − p) = b0 + b1*X + b2*X 2, the formula for the minimum expected value is: −b1/2*b2. For white women: Optimum X = −log(0.951)/(2*log(1.004)) = 6.3. Since X = year − 1997, we added 1997, which yielded an optimum year of 2003.3. For black men: Optimum X = −log(0.911)/(2*log(1.008)) = 5.8. Since X = year − 1997, we added 1997, which yielded an optimum year of 2002.8.
References
Barrett, A. E. (2000). Marital trajectories and mental health. Journal of Health and Social Behavior, 41, 451–464.
Becker, G. S. (1991). A treatise on the family. Cambridge, MA: Harvard University Press.
Bird, C. E., & Rieker, P. P. (1999). Gender matters: An integrated model for understanding men’s and women’s health. Social Science and Medicine, 48(6), 745–755.
Bulanda, J. R., & Brown, S. (2007). Race-ethnic differences in marital quality and divorce. Social Science Research, 36(3), 945–967.
Casper, L., & Bianchi, S. (2001). Continuity and change in the American family. Thousand Oaks, CA: Sage Publications Inc.
Cohen, P. N. (1999). Racial-ethnic and gender differences in returns to cohabitation and marriage: Evidence from the current population survey. Population Division Working Paper No. 35.
Crimmins, E. M., & Saito, Y. (2000). Change in the prevalence of diseases among older Americans: 1984–1994. Demographic Research, 3(9), 1–20.
Demaris, A. (2004). Regression with social data: Modeling continuous and limited response variables. Hoboken, NJ: Wiley.
Durden, E. (2005). Does time moderate the association between marital status and self-reported health?. Philadelphia, PA: Paper presented at the annual meeting of the American Sociological Association.
Edin, K., & Kefalas, M. (2005). Promises I can keep: Why poor women put motherhood before marriage. Berkeley, CA: University of California Press.
Fischer, C. S. (2009). Comment on McPherson, Smith-Lovin, and Brashears, ASR, June 2006: The 2004 GSS finding of shrunken social networks: An artifact? American Sociological Review, 74(4), 657–669.
Freedman, V. A., Crimmins, E., Schoeni, R. F., Spillman, B. C., Aykan, H., Kramarow, E., et al. (2004). Resolving inconsistencies in trends in old-age disability: Report from a technical working group. Demography, 41(3), 417–441.
Freedman, V. A., Martin, L. G., & Schoeni, R. F. (2002). Recent trends in disability and functioning among older adults in the United States: A systematic review. The Journal of the American Medical Association, 288(24), 3137–3146.
Glenn, N. D., & Weaver, C. (1988). The changing relationship of marital status to reported happiness. Journal of Marriage and the Family, 50(2), 317–324.
Hughes, M. E., & Waite, L. J. (2009). Marital biography and health at mid-life. Journal of Health and Social Behavior, 50(3), 344–358.
Jamshidi, R., Oppenheimer, A. J., Lee, D. S., Lepar, F. H., & Espenshade, T. J. (1992). Aging in America: Limits to life span and elderly care options. Population Research and Policy Review, 11, 169–190.
Joung, I. M., van de Mheen, H. D., Stronks, K., van Poppel, F. W., & Mackenbach, J. P. (1998). A longitudinal study of health selection in marital transitions. Social Science and Medicine, 46(3), 425–435.
Lin, I., & Brown, S. (2012). Unmarried boomers confront old age: A national Portrait. The Gerontologist, 52(2), 153–165.
Liu, H. (2009). Till death do us part: Marital status and mortality trends, 1986–2000″. Journal of Marriage and Family, 71, 1158–1173.
Liu, H. (2012). Marital dissolution and self-rated health: Age trajectories and birth cohort variations. Social Science and Medicine, 74, 1107–1116.
Liu, H., & Reczek, C. (2012). Cohabitation and U.S. adult mortality: An examination by gender and race. Journal of Marriage and Family, 74, 794–811.
Liu, H., & Umberson, D. (2008). The times they are a changing’: Marital status and health differentials from 1972 to 2003. Journal of Health and Social Behavior, 49, 239–253.
Lynn, F. B., Schneider, B., & Zhang, Z. (Forthcoming). The changing relationship between fertility and educational expectations: Adolescents in the 1970s versus the 1980s. Journal of Family Issues.
Magaziner, J., Zimmerman, S. I., Gruber-Baldini, A. L., Hebel, J. R., & Fox, K. M. (1997). Proxy reporting in five areas of functional status: Comparison with self-reports and observations of performance. American Journal of Epidemiology, 146(5), 418–428.
Martin, L. G., Schoeni, R. F., Freedman, V. A., & Andreski, P. (2007). Feeling better? Trends in general health status. Journal of Gerontology, 62, S11–S12.
McPherson, M., Smith-Lovin, L., & Brashears, M. E. (2006). Social isolation in America: Changes in core discussion networks over two decades. American Sociological Review, 71, 353–375.
Minnesota Population Center and State Health Access Data Assistance Center. (2011). Integrated health interview series: Version 4.0. Minneapolis: University of Minnesota.
Oppenheimer, V. K. (1997). Women’s employment and the gain to marriage: The specialization and trading model. Annual Review of Sociology, 23, 431–453.
Parker, M. G., & Thorslund, M. (2007). Health trends in the elderly population: Getting better and getting worse. The Gerontologist, 47(2), 150–158.
Pienta, A. M., Hayward, M. D., & Jenkins, K. R. (2000). Health consequences of marriage for the retirement years. Journal of Family Issues, 21(5), 559–586.
Raley, R. K., & Bumpass, L. (2003). The topography of the plateau in divorce: Levels and trends in union stability after 1980. Demographic Research, 8, 246–258.
Schoeni, R. F., Freedman, V. A., & Martin, L. G. (2009). Socioeconomic and demographic disparities in trends in old-age disability. In D. M. Cutler & D. A. Wise (Eds.), Health at older ages: The causes and consequences of declining disability among the elderly (pp. 75–102). Chicago: University of Chicago Press.
Schoeni, R. F., Martin, L. G., Andreski, P. M., & Freedman, V. A. (2005). Persistent and growing socioeconomic disparities in disability among the elderly: 1982–2002. American Journal of Public Health, 95(11), 2065–2070.
Shirey, L., & Summer, L. (2000). Caregiving: Helping the elderly with activity limitations. Challenges for the 21st century: Chronic and disabling conditions. National Academy on an Aging Society profiles.
Sweeney, M. (2002). Two decades of family change: The shifting economic foundations of marriage. American Sociological Review, 67, 132–147.
Teachman, J. D., Tedrow, L. M., & Crowder, K. D. (2000). The changing demography of America’s families. Journal of Marriage and the Family, 62, 1234–1246.
Thornton, A., Axinn, W., & Xie, Y. (2007). Marriage and cohabitation. Chicago: University of Chicago Press.
Turner, R. J., & Marino, F. (1994). Social support and social structure: A descriptive epidemiology. Journal of Health and Social Behavior, 35(3), 193–212.
Umberson, D., & Montez, J. K. (2010). Social relationships and health. Journal of Health and Social Behavior, 51, S54–S66.
Umberson, D., Williams, K., Powers, D. P., Liu, H., & Needham, B. (2006). You make me sick: Marital quality and health over the life course. Journal of Health and Social Behavior, 47, 1–16.
van Poppel, F., & Joung, I. (2001). Long-term trends in marital status mortality differences in The Netherlands 1850–1970. Journal of Biosocial Sciences, 33(2), 279–303.
Waite, L. J., & Gallagher, M. (2000). The case for marriage: Why married people are happier, healthier, and better off financially. New York: Doubleday.
Warner, D. F., & Brownc, T. H. (2011). Understanding how race/ethnicity and gender define age-trajectories of disability: An intersectionality approach. Social Science and Medicine, 72, 1236–1248.
Williams, K. (2003). Has the future of marriage arrived? a contemporary examination of gender, marriage, and psychological well-being. Journal of Health and Social Behavior, 44(4), 470–487.
Williams, K., & Umberson, D. (2004). Marital status, marital transitions, and health: A gendered life course perspective. Journal of Health and Social Behavior, 45, 81–98.
Zhang, Z., & Hayward, M. D. (2006). Gender, the marital life course, and cardiovascular disease in late midlife. Journal of Marriage and Family, 68, 639–657.
Author information
Authors and Affiliations
Corresponding author
Additional information
An earlier version of this paper was presented at the Annual Meeting of the Gerontological Society of America, 2009. We are grateful for suggestions from the editor and the anonymous reviewers of this manuscript.
Rights and permissions
About this article
Cite this article
Liu, H., Zhang, Z. Disability Trends by Marital Status Among Older Americans, 1997–2010: An Examination by Gender and Race. Popul Res Policy Rev 32, 103–127 (2013). https://doi.org/10.1007/s11113-012-9259-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11113-012-9259-0