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1 Introduction and Overview
Pages 1-10

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From page 1...
... Demographic and social trends -- such as changes in marriage and fertility preferences, the increasing fragility of unions, the decline of the intact nuclear family, the increasing amount of time for some young people to transition to adulthood and the continuing improvements in health and disability at older ages -- all influence the amount and types of support available to older persons and their need for support. To deal effectively with the challenges created by population aging, it is vital to first understand these demographic, economic, and social changes and, to the extent possible, their causes, consequences and implications.
From page 2...
... Both these last two themes underline the importance of adopting fruitful theoretical approaches. The choice of inputs, outputs, mechanisms, and theoretical constructs is crucial to the success of any effort, whether it is the development of a model, the collection of data, or the design of an intervention trial.
From page 3...
... The choices are complicated by the uncertainties related to the growing fiscal stresses facing the Social Security and Medicare systems as an increasingly large percentage of the population becomes eligible to claim retirement benefits.
From page 4...
... (1977) identified 16 different theoretical approaches used in the sociology of aging including, for example, disengagement theory, which views aging as encompassing an inevitable process of withdrawing or disengaging from various social roles, activities, and relationships (Cumming and Henry, 1961)
From page 5...
... In Chapter 5, Moen offers a different theoretical approach, institutional theory, for analyzing the issues surrounding aging. In this context "institutions" are not places where organized social activities take place, as described by Cagney and colleagues in the previous chapter, but instead are "taken-for-granted schemas about ‘appropriate' 1-5
From page 6...
... Over the years social epidemiologists have accumulated a great deal of data indicating that various social factors -- socioeconomic status (SES) , education, social isolation, a lack of social support, social networks and the social environment -- affect rates of morbidity and mortality.
From page 7...
... This has led to the development of the accumulation of risk model, which predicts that various adverse social factors, such as low SES, have negative biological effects that accumulate over the life course, so that an older adult's health prospects are shaped by social experiences from throughout his or her life. As Gruenewald notes, however, many questions about this phenomenon remain to be answered, such as exactly when and how the effects of socioeconomic status leave their biological mark.
From page 8...
... Furthermore, because the effects of social factors on individuals can start accumulating before the age of five and because diseases develop over many decades, the most effective studies will follow individuals for much of their lives, gathering social and biological data at many different points along the life course. Finally, improving our understanding of social genomics will require both the creation of better measures of social context and the development of diverse research designs that can strengthen evidence of causality and also tease out how various contexts -- policy settings, political economies, demographic compositions, and so forth -- shape the effects of socioeconomic status on gene expression.
From page 9...
... There have been a number of advances in the methodology of randomized controlled trials, for example; some of these advances have increased the real-world relevance of such trials, while others have focused on the best ways to induce multiple behavioral changes to take into account the fact that most diseases are influenced by multiple risk factors. Another advance has been the use of "stealth interventions" that use subjects' interests in areas other than their own health -- such as the environment or their faith -- to induce them to change health-related behaviors.
From page 10...
... Social Forces, 73(4)


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