Much has been written in recent years about changes in family and household structure in the United States. Analyses based on census data or other cross sections indicate that fewer adults live in families, especially the nuclear family of husband, wife, and minor children. Analyses based on cross sections also indicate the relative rarity of extended households, especially three-generation families. In this descriptive analysis, data from the National Longitudinal Surveys of Mature Women are used to compare cross-section and 15-year estimates of the incidence of various types of extended households. Black and white women are analyzed separately and the estimates for the proportion of middle-aged women living in extended households are presented by marital status. Results show large differences between single-year and 15-year estimates of the incidence of extension. Overall, between one-fourth and one-third of white middle-aged women lived in extended households for some time over the 15-year period, and approximately two-thirds of black women experienced this household form for at least part of their middle years. We conclude that, contrary to popular and academic perceptions, extended families are a relatively common form of living arrangement for adults in this country, if only for short periods of time. This may be one indicator of the prevalence of the modified-extended family in the United States.
This study examined the relationships among gender, perceived financial barriers to health care, and selected health status indicators in a randomly selected rural Appalachian sample. The data were gathered through the Johnson County Health Survey. The survey was conducted through personal interviews with 207 females and 178 males representing 197 households. The Duke Health Profile was used to measure the perceived health of the respondents. Analysis of variance, t tests, and descriptive statistics were used to analyze the data. Analysis of the data revealed that women perceive financial barriers to health care significantly more than men (P < 0.01), even when living in the same household; women had significantly poorer health than men (P < 0.01); and both women and men with perceived financial barriers experienced poorer health (P < 0.01) than those who did not perceive such barriers. Conclusions from the study suggest that in this rural sample women were the most compromised by both gender and health status, and that they perceived that their health care needs were not being adequately met.
Study objective-The main purpose of the study was to determine whether the health or economic status of a cohort of residents in an economically troubled geographical area changed between 1990 and 1993. Design-Longitudinal, single cohort, interview survey method with the key variables of health status and economic status. Quasi-experimental pre-post design with economic rebound as the intervention. Setting-A relatively low income geographical area in a rural, mountainous region before and after an economic rebound. In 1990, the local economy and health care system collapsed because of the closure of a series of manufacturing plants; outward migration from the area peaked. Between 1990 and 1993, new industries opened, and state and private community assistance programmes intervened, resulting in an economic rebound, migration into the area, and marked growth of the health service sector. Participants-A 2% sample of residents of households, using a combination of random, stratified, and clustered sampling. Residents included in the study had lived within the area throughout the 1990-1993 period of the study. Main results-Stable, non-migrating residents had a statistically significant 7% reduction in health status between 1990 and 1993, as measured by a composite of subjective and objective measures. The non-migrating residents also had a significant decrease in average household income ($14 700 in 1990 and $12 400 in 1993 in constant 1990 dollars) during the strong economic expansion, and therefore did not participate in or receive direct economic benefit from the expansion. There was a rapid population increase during the expansion, attributable to inward migrants who were younger and healthier than existing residents. The decline in health for the non-migrating residents was tentatively attributed to either direct or indirect eVects of the decline in family income. Conclusions-Local economic development accompanied by expanded health care services availability can leave existing area residents poorer and less healthy, and this problem may be masked by an abundance of healthier, wealthier inward migrants.(J Epidemiol Community Health 1998;52:749-757)
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