Older Men Health Variables

Work-related variables. Each survey except 1968 asked respondents whether their health limited the kind or amount of work they could do. A supplemental series of questions, fielded during 1966, 1969, 1976, 1981, and 1990, gathered information on the duration of the respondent's limitation and on whether his health prevented him from working altogether. The 1976 survey determined whether any of the respondent's reported health problems were the result of an accidental injury and whether the most serious injury occurred on the job. Finally, in 1976 and 1981, retrospective questions asked whether the respondent had ever been prevented from working for 6 or more months due to a health problem and the duration of this limitation.

A series of questions, shown in Figure OM1 below, asked respondents to describe the types of physical activities which their job regularly involved. In several surveys, respondents were also asked to identify specific workplace characteristics that would cause them trouble because of their health.

User Notes

Researchers should be aware that the work limitation questions were not asked in exactly the same format in every survey. In general, more complete information is available in personal interview years.

General physical health. A comprehensive set of health-related variables is available for all respondents. This data collection includes information on the respondent's health status, perceived health changes over time, and the types of health-related problems and specific health conditions experienced. To provide a general overview of his health, each respondent was asked during the 1966, 1969, and 1978-90 surveys to rate his health as excellent, good, fair, or poor compared to other men his age. Questions were fielded in 1967, 1971, and 1976-83 on whether the respondent considered his health to have remained about the same, improved, or worsened over a set period of time (e.g., the past five years). Self-reported height and weight data are available for respondents interviewed during 1973 or 1990.

Several interviews included question series assessing the respondent's overall physical condition. These series, and the years when they were included, are described in Figure OM1.

Figure OM1. Older Men Health Question Series

 Topic  Questions  Years
Activities that are difficult
  • walking?
  • using stairs or inclines?
  • standing for long periods
  • stooping/kneeling/crouching?
  • lifting/carrying weights < 10 lbs?
  • lifting/carrying weights > 10 lbs?
  • reaching?
  • handling and fingering?
  • seeing (even with glasses)?
  • hearing?
  • dealing with people?
1971 (universe limited to respondents reporting that their health limited the kind/amount of work they could do), 1976, 1981, 1990
 Physical problems
  • pain?
  • tiring easily/no energy?
  •  weakness/lack of strength?
  • aches/swelling/sick feeling?
  • fainting spells/dizziness?
  • nervousness/tension/anxiety/depression?
  • shortness of breath/trouble breathing?
1971 (universe limited to respondents reporting that their health limited the kind/amount of work they could do), 1976, 1981, 1990
Working conditions that respondent would have trouble with due to health
  • fumes/dust/smoke?
  • hot places?
  • cold places?
  • damp places?
  • noise or vibrations?
  • confusion or disorder?
  • indoors?
  • outdoors?
1971 (universe limited to respondents reporting that their health limited the kind/amount of work they could do), 1976, 1981
Activities respondent does regularly at work
  • walking?
  • using stairs or inclines?
  • standing for long periods?
  • stooping/kneeling/crouching?
  • lifting/carrying weights < 10 lbs.?
  • lifting/carrying weights > 10 lbs.?
  • reaching?
  • handling and fingering?
  • reading printed documents?
  • hearing special sounds (signals, directions, etc.)?
  • dealing with people?
Assistance with daily life
  • can R go outdoors without help?
  • can R use public transportation without help?
  • can R perform personal care without help (bathing, eating, etc.)?
  • frequency R needs help
1971 (universe limited to respondents reporting that their health limited the kind/amount of work they could do), 1976, 1981, 1990

Because the respondents were in their 70s and early 80s at that time, the 1990 survey collected significantly more health information than previous years' questionnaires. In addition to the questions described elsewhere in this section, the sample person questionnaire asked Older Men who were still living about the topics outlined in Figure OM2.

Figure OM2. Special Health Topics in 1990 Older Men Questionnaire

Topic Questions
Specific health problems in last 12 months
  • arthritis or rheumatism? 
  • lung disease (asthma, bronchitis, emphysema)? 
  • hypertension? 
  • heart attack or other heart problem?
  • diabetes or high blood sugar? 
  • cancer or malignant tumor?
  • foot problems?
  • stroke? 
  • broken bones? 
  • kidney stones/chronic kidney problems?
  • back/spine problems?
  • paralysis? 
  • mental illness? 
  • Alzheimer's disease?
Special equipment needed in last 12 months
  • glasses/contacts? 
  • hearing aids?
  • cane(s)? 
  • crutch(es)? 
  • wheelchair?
  • walker? 
  • leg brace?
  • support stockings? 
  • artificial limb?
  • catheter?
  • commode/portable toilet? 
  • pacemaker? 
  • knee brace? 
  • colostomy bag?
Use of medical services in last 12 months
  • number of times in a hospital overnight?
  • total number of nights hospitalized?
  • number of times in a nursing home?
  • total number of days spent in a nursing home?
  • number of days kept in bed for more than half the day?
  • number of times seen a doctor (other than as part of overnight hospital stay)
Use of community services in last 12 months
  • special transportation for the elderly?
  • meals delivered to home?
  • meals at a senior center or program? 
  • a senior center for any other purpose?
  • a homemaker service for the elderly (cooking, cleaning, etc.)?
  • a service that makes regular phone calls to check on the elderly? 
  • visiting nurse?
  • home health aide? 
  • adult day care?
  • has R driven in past 12 months? 
  • miles driven in past 12 months? 
  • whether R drives after dark?
  • if no longer driving, when last drove and why stopped driving
Information about institutionalized respondents
  • when admitted for current stay?
  • length of time R will remain in institution? 
  • where R lived before admission? 
  • number of times admitted to nursing home in past two years?
  • when admitted for previous stay
  • who paid for current stay at time of admission? 
  • who was paying for current stay at interview date? 
  • relationship of R's emergency contact person

If the respondent was deceased at the time of the 1990 interview, the widow questionnaire gathered information about the last year of the respondent's life. The widow reported whether and how long the respondent had been ill before his death, the amount of nursing care she provided for the respondent, and the main cause of death. Widows also answered questions, somewhat less detailed than those in the sample person questionnaire, about use of medical services in the year before the respondent's death. Finally, the widow estimated the total cost of her husband's medical care in the year before his death, reported the amount paid by the sample person and widow, and described sources of payment for remaining bills (Medicare, private insurance, employer/union, veteran's benefits, relatives, etc.).

In conjunction with this survey, up to four causes of death of deceased respondents were recorded from death certificates on file at state vital records departments. These administrative data supplement the cause of death information collected on 2,166 deceased respondents directly from the widows or next-of-kin. Table OM1 compares the causes of death as reported by widows or next-of-kin and as listed on the death certificate.

Table OM1. Cause of Death of Older Men Respondents (1990)

Cause of death Main cause of death
reported by widow/proxy
First cause of death
listed on death certificate
Heart disease (rheumatic heart disease, heart attack) 893 1037
Cancer (neoplasm, malignancy, leukemia) 561 357
Stroke 164 145
Accident, industrial 6 --
Accident, other 56 51
Diabetes 55 5
Emphysema, chronic bronchitis, asthma 83 183
Homicide 10 11
Suicide 24 24
Other 314 254
Total 2166 2067
Note: This table is based on R07185. and R07185.10.

Health insurance. Two surveys collected information on the respondent's medical insurance. In 1981, the respondent reported whether he was covered by part A of Medicare, part B of Medicare, Medicaid, or any other medical or hospital insurance. The survey also asked if the respondent was a member of a health maintenance organization (HMO) and whether he was eligible for free hospital or medical care due to veteran status. As part of this series, respondents stated whether they had received any hospital or medical care in the past year that was paid for by Medicare, other health insurance, or Medicaid.

The 1990 interview asked sample persons whether they were eligible for Medicare part A and part B, as well as whether they had received any care paid for by Medicaid in past 12 months. If the respondent was covered by a plan other than Medicare, he reported whether it paid hospital expenses and doctor's bills, whether it was obtained through an employer or union, and whether the employer or union paid all or part of the premium. If the respondent was not covered by any insurance (other than Medicare), the interview asked him to state the reason. Finally, respondents were asked how they paid for medical expenses not covered by insurance in the past 12 months (savings, current income, debt).

Psychological well-being. A collection of variables related to mental health is available for this cohort. Table OM2 provides reference numbers for the psychological well-being scales and questions described in this section.

Table OM2. Reference Numbers for Older Men Psychological Well-Being Questions

Survey year Rotter Locus of Control Scale Bradburn Affect Balance Scale Pfeiffer Short Portable Mental Status CES-D Depression Scale Attitudes about life
1969 R01280.-R01290., R01601.-R01603. -- -- -- --
1971 R02004.-R02014., R02523.00-R02523.02 -- -- -- --
1976 R03103.-R03121., R03707.-R03709. -- -- -- R03123.-R03128.
1978 -- -- -- -- R03866.-R03870., R03901., R03902.
1980 -- -- -- -- R04255.-R04261.
1981 R05008.-R05020. R04865.-R04874. -- -- R05029.-R05050.
1983 -- R05700.-R05709. -- -- R05693.-R05699.
1990 -- R06377.-R06386. R07022.-R07031., R07803.-R07812. R06387.-R06396. R06371.-R06376.

In four surveys, the Older Men gave responses to an abbreviated version of Rotter's Internal-External Control Scale (1966). This scale measures locus of control, with internal control referring to the perception of events as being under personal control and external control meaning that events are perceived as unrelated to one's own behavior. The abbreviated scale used in the first three administrations included the 11 items from the original 23-item Rotter scale that were the most general and oriented to the adult world of work. The modified scale has been shown to be highly correlated with the original 23-item scale (see Parnes et al. 1974, Appendix to Chapter VI). In 1981, this scale was further reduced to only four items.

Reducing the number of items from 23 to 11 would have resulted in an overall reduction in the range of scores. To avoid this situation, the response format was modified to four choices rather than the two in the original scale. The respondent was first read a pair of statements representing opposite views and asked which statement was closer to his own opinion. He then stated whether the chosen statement was much closer to his own view or only slightly closer. These answers were combined into one score along a 4-point scale in the data set. The total score was obtained by summing the values of all 11 items, resulting in a range of 11 to 44 (4 to 16 in 1981) in order of increasing external control.

A second scale used in multiple surveys is the Bradburn Affect Balance Scale (Bradburn, 1969). This measure of positive and negative feelings in the weeks before the interview provides an indication of the respondent's general psychological well-being. The 10 statements used in the Older Men questionnaires asked, for example, whether the respondent felt particularly excited or interested in something in the past few weeks, whether he was so restless he could not sit long in a chair, and whether he felt that things were going his way.

Two scales were used only in the 1990 survey. Addressed only to sample persons (Older Men respondents still living at the time of the interview), the first series used 10 items from the Center for Epidemiological Studies Depression (CES-D) Scale. This scale measures symptoms of depression and discriminates between clinically depressed individuals and others; it is highly correlated with other depression rating scales (see Radloff 1977; Ross and Mirowsky 1989). To provide researchers with an assessment of their cognitive functioning, both sample persons and widows responded to the Short Portable Mental Status Questionnaire (Pfeiffer, 1975). This scale is scored by awarding respondents one point for each correct answer. A score of 2 or less signifies severe cognitive impairment, scores of 3-5 indicate moderate cognitive impairment, and scores of 6 or more indicate mild or no impairment. Pfeiffer cautions that some adjustments need to be made for race and educational level.

Finally, in 1976-90, respondents answered questions about their satisfaction with various aspects of their lives and with life in general. On a 4-point scale, respondents reported their happiness with their housing, the local area in which they lived, their health, their standard of living, and their leisure time activities.

Family member health. Limited information was collected about the health of the respondent's family members. In most personal interviews, the respondent reported whether his wife was limited in the amount or kind or work or housework she could do and the duration of this limitation. In personal interviews beginning in 1971, the respondent also stated whether his wife's health problem limited his own work or activities. In 1971, 1976, 1981, and 1990, respondents answered the series of questions about assistance with daily life (see Figure OM1) with respect to their wives. In 1990, interviewed sample persons reported whether their wife was in a long-term care institution; interviewed widows who lived in long-term care institutions (or their proxies) answered the same series of questions as sample persons about the length of and payment for their current stay (see Figure OM2). Finally, the 1981 survey and 1990 sample person questionnaire asked the respondent about his wife's Medicare coverage and health insurance.

In the 1971 survey only, respondents were asked whether any family members were unable to work or go to school due to a health condition. If so, the respondent then stated whether the family member's health affected his own employment.

Related Variables: Questions on job satisfaction and other attitudes related to employment can be found in the "Job Satisfaction & Work Attitudes" section of this guide. Attitudes about retirement are discussed in the Pensions, Social Security & Retirement section.

Survey Instruments: Health and health insurance questions are located within the "Health" sections of the questionnaires. The CES-D scale items can be found in the "Health" section of the 1990 sample person questionnaire. Components of the Rotter scale can be found in the "Work Attitudes" section of the appropriate instruments. Questions asked of widows are found in the "Information on Deceased Sample Persons" and "Medical Care Prior to Death" sections of the 1990 questionnaire.