Although these data are observational, and rigorous research on the best methods for recruiting and retaining older minorities is still necessary, the results suggest that a consumer-centered model of research yields greater overall recruitment and retention rates than do traditional research methods.

Medicine, with its focus on individual organic pathology and interventions, has become a powerful and pervasive force in the definition and treatment of aging. The resulting "biomedicalization of aging" socially constructs old age as a process of decremental physical decline and places aging under the domain and control of biomedicine. This paper examines the effects of medicalization on the scientific enterprise and development of the knowledge base in aging, the status and work of the professions, policy, and public perception.

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While providing services in primary care results in better access to and use of these services, accessing these services is not enough for assuring adequate clinical outcomes.

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Sufficient resources, sufficient organizational autonomy, and a supportive political and social environment are key elements in achieving varying types of perceived effectiveness in the state LTCOPs. Research is needed to extend this work to local ombudsman programs and to compare self-rated effectiveness with other outcome measures.

The origins and influence of social science perspectives have conditioned theoretical and empirical developments in the field of gerontology. Yet little systematic examination has been afforded to the role of social science in the production of gerontological knowledge in providing the underlying rationale for American social policy for the aged. This paper examines the dominant U.S. social science perspectives or paradigms and discusses the reasons for their centrality in American gerontological thought. The paper concludes with a proposal for an alternative line of inquiry — a political economy of ageing — which takes as problematic the effects of social history, the world economy, capitalism and social class on the ageing process and the aged and the policy interventions designed for them.

A new political economy is shaping the lives of present and future generations of older people. The key change has been the move from the mass institutions that defined growing old in the period from 1945 through the late 1970s to the more individualized structures--privatized pensions, privatized health and social care--that increasingly inform the current period. The authors examine the role of international governmental organizations in promoting this trend, with examples drawn from the work of the World Bank, World Trade Organization, and Organization for Economic Cooperation and Development, and the relationship between international governmental organizations and the state. The article concludes with an assessment of the changes to citizenship that accompany globalization and the implications for political organization among older people themselves.