In September 2002, a technical working group met to resolve previously published inconsistencies across national surveys in trends in activity limitations among the older population. The 12-person panel prepared estimates from five national data sets and investigated methodological sources of the inconsistencies among the population aged 70 and older from the early 1980s to 2001. Although the evidence was mixed for the 1980s and it is difficult to pinpoint when in the 1990s the decline began, during the mid- and late 1990s, the panel found consistent declines on the order of 1%-2.5% per year for two commonly used measures in the disability literature: difficulty with daily activities and help with daily activities. Mixed evidence was found for a third measure: the use of help or equipment with daily activities. The panel also found agreement across surveys that the proportion of older persons who receive help with bathing has declined at the same time as the proportion who use only equipment (but not personal care) to bathe has increased. In comparing findings across surveys, the panel found that the period, definition of disability, treatment of the institutionalized population, and age standardizing of results were important to consider. The implications of the findings for policy, national survey efforts, and further research are discussed.

OBJECTIVES: This study evaluated the relative gross and net predictive value of multiple socioeconomic status indicators for the likelihood of undergoing hysterectomy. METHODS: Data from a sample of Wisconsin Longitudinal Study women respondents (n = 3326) followed for 35 years were analyzed by means of multivariate logistic regression. RESULTS: Women's own higher occupational status and greater family net worth were significant net predictors of a lower likelihood of hysterectomy. Women's own education was a significant bivariate predictor. Mental ability did not account for the education effect. CONCLUSIONS: Higher education's association with a lower rate of hysterectomy is not due to ability, but to the opportunities that more-educated women have for higher-status employment and its health-related benefits. Measures of women's own occupational status should be included in future health surveys.

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The relative benefits and hazards of noncontraceptive hormone therapy (HT) for aging women remain a controversial medical and social issue. This study examined the lifetime incidence of HT use, how usage varied by surgery status, and the bivariate and net associations between a large array of SES indicators and the likelihood of midlife women ever using HT by age 53-54 among N=3,612 non-Hispanic white women participants in the Wisconsin Longitudinal Study . About half the sample of women had ever used HT; 79% who had ever used HT were currently using HT (38.5%). In multivariate logistic regression analyses, the most robust SES predictor of HT use was a woman's husband's occupational status (higher status associated with higher rates of use). This association withstood adjusting for all other measured sociological and biomedical factors (e.g., other health behaviors, menopausal symptoms, age at menopause, health insurance). The association of HT use and education differed for women who underwent hysterectomy and/or oophorectomy (where the odds of using HT were higher for less educated women) and for women with intact reproductive organs (where the odds of using HT were lower for less educated women). Only among women who had surgery was the association of education with use of HT persistent adjusting for all other measured factors. Additionally, a woman's own earnings and household net worth showed positive net associations with HT use. Two competing explanations for the observed relationship between husband's occupational status and women's HT use are discussed: HT as a preventive health behavior and HT as a socially influenced behavior to help maximize femininity. Prevalence estimates of HT use have ranged widely depending upon the sampling frame of the study (Derby et al. 1993; Johannes et al. 1994;Thompson 1995). Rates of prescribing HT in the U.S. have been found to be highest in the West and lowest in the East (Hemminki et al. 1988). The use of HT is not random. While the most significant sociodemographic correlate of HT use other than age and gender is socioeconomic status (SES), SES has not been examined systematically in most studies of HT. SES is generally found to be positively associated with health-promoting behaviors and good health outcomes for both women and men (Adler et al. 1993;House et al. 1990House et al. , 1994Feinstein 1993; Longino, Warheit, and Green 1989; Marmot, Kogevinas, and Elston 1987;Syme and Berkman 1976;Waldron 1991). Yet considerable public health debate continues regarding the mechanisms and processes whereby SES influences differences in health behaviors and health status (Adler et al. 1993;Andersen 1995; Link and Phelan 1995). SES is measured in different ways -e.g., years of education, occupational status, and income. Different measures of SES tend to be only moderately correlated, and each captures different attributes of social status. One research approach to help elucidate the possible processes underlying any given relationship between a health outcome and S...

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