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Older Americans 2000: Key Indicators of Well-Being |
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Older Americans 2000: Key Indicators of Well-Being |
Activities of daily living (ADLs): Activities of daily living (ADLs) are basic activities that support survival, including eating, bathing, and toileting. In the National Long Term Care Survey, ADLs (designed to measure functional ability) include: eating, getting in and out of bed, getting around inside, dressing, bathing, and toileting. A person is considered disabled on an ADL activity if he or she is unable to perform the activity, uses active help, uses equipment, or requires standby help. See related Instrumental Activities of Daily Living (IADLs).
Asset income: Asset income includes money income reported in the Current Population Survey from interest (on savings or bonds), dividends, income from estates or trusts, and net rental income. Capital gains are not included.
Assisted-living facility: Assisted living is a model of residential care that blends many of the characteristics of the nursing home and community-based long term care. Assisted-living facilities offer older persons a choice in terms of living accommodations and service arrangements.
Cause of death: For the purpose of national mortality statistics, every death is attributed to one underlying condition, based on information reported on the death certificate and using the international rules for selecting the underlying cause of death from the reported conditions. Since 1979, the International Classification of Diseases, Ninth Revision (ICD-9) has been used for coding cause of death. Data from earlier time periods were coded using the appropriate revision of the ICD for that time period. Changes in classification of causes of death in successive revisions of the ICD may introduce discontinuities in cause-of-death statistics over time. For further information, see Technical Appendix in National Center for Health Statistics. (1994). Vital Statistics of the United States, 1990, Volume II, Mortality, Part A. DHHS Pub. No. (PHS) 95–1101, Public Health Service, Washington, DC: U.S. Government Printing Office.
Cause-of-death ranking: Cause-of-death ranking for adults is based on the “List of 72 Selected Causes of Death, HIV Infection, and Alzheimer’s Disease.” The List of 72 Selected Causes of Death was adapted from one of the special lists for mortality tabulations recommended by the World Health Organization for use with the Ninth Revision of the International Classification of Diseases. Two group titles—“Major cardiovascular diseases” and “Symptoms, signs, and ill-defined conditions”—are not ranked based on the list of 72 selected causes. In addition, category titles that begin with the words “other” and “all other” are not ranked. The remaining category titles are ranked according to number of deaths to determine the leading causes of death. When one of the titles that represent a subtotal is ranked (for example, unintentional injuries), its component parts are not ranked (in this case, motor vehicle crashes and all other unintentional injuries).
Centenarians: Persons age 100 or older.
Death rate: The death rate is calculated by dividing the number of deaths in a population in a year by the midyear resident population. For census years, rates are based on unrounded census counts of the resident population, as of April 1. For the noncensus years of 1981 to 1989 and 1991, rates are based on national estimates of the resident population, as of July 1, rounded to the nearest thousand. Starting in 1992, rates are based on unrounded national population estimates. Rates for the Hispanic and non-Hispanic white populations in each year are based on unrounded state population estimates for states in the Hispanic reporting area. Death rates are expressed as the number of deaths per 100,000 persons. The rate may be restricted to deaths in specific age, race, sex, or geographic groups or from specific causes of death (specific rate) or it may be related to the entire population (crude rate).
Disability: Disability refers to the temporary or long-term reduction of a person's capacity to function. The concept of disability encompasses many different dimensions of health and functioning, and the complex interactions with one's environment. The International Classification of Functioning and Disability (ICIDH-2) classifies functioning at the levels of body or body part, whole person, and whole person in social context. Accordingly, disablements are losses or abnormalities of bodily function and structure (impairments), limitations of activities (disabilities), or restrictions in participation (formerly called handicaps). See www.who.int/icidh for more information on the World Health Organization's definition of disability.
Domiciliary care home: Domiciliary care homes primarily provide supervisory care but also provide one or two personal services.
Earnings: Earnings is money income reported in the Current Population Survey from wages or salaries, net income from nonfarm self-employment, and net income from farm self-employment.
Educational attainment: Educational attainment refers to the highest level of school completed or highest degree received. For persons who attended school beyond high school, highest degree is recorded, rather than years in college.
Expenditures: See Health care expenditures and Housing expenditures.
Fee-for-service: This is the method of reimbursing health care providers on the basis of a fee for each health service provided to the insured person.
Head of household: As used in the Consumer Expenditure Survey, the head of household is the first person mentioned when the respondent is asked to name the person or persons who own or rent the home in which the consumer unit resides.
Health care expenditures: As defined in the Consumer Expenditure Survey, health care expenditures include out-of-pocket expenditures for health insurance, medical services, prescription drugs, and medical supplies. As defined in the Medicare Current Beneficiary Survey, health care expenditures include all expenditures for inpatient hospital, medical, nursing home, outpatient, dental, prescription drugs, home health care, and hospice services, including both out-of-pocket expenditures and expenditures covered by insurance.
Health maintenance organization (HMO): An HMO is a prepaid health plan delivering comprehensive care to members through designated providers, having a fixed monthly payment for health care services, and requiring members to be in a plan for a specified period of time (usually 1 year).
Healthy Eating Index: The Healthy Eating Index (HEI) is a summary measure of dietary quality. The HEI consists of 10 components, each representing different aspects of a healthful diet based on the U.S. Department of Agriculture’s Food Guide Pyramid and the Dietary Guidelines for Americans. Components 1 to 5 measure the degree to which a person’s diet conforms to the Pyramid serving recommendations for the five major food groups: grains, vegetables, fruits, milk, and meat/meat alternatives. Components 6 and 7 measure fat and saturated fat consumption. Components 8 and 9 measure cholesterol and sodium intake, and component 10 measures the degree of variety in a person’s diet. Scores for each component are given equal weight and added to calculate an overall HEI score with a maximum value of 100. High component scores indicate intakes close to recommended ranges or amounts; low component scores indicate less compliance with recommended ranges or amounts. An HEI score above 80 implies a good diet, an HEI score between 51 and 80 implies a diet that needs improvement, and an HEI score below 51 implies a poor diet.
Hispanic origin: Hispanic origin includes persons of Mexican, Puerto Rican, Cuban, Central and South American, and other or unknown Spanish origins. Persons of Hispanic origin may be of any race. See related Race.
Home care: Paid or unpaid assistance provided to a person with a chronic disability or illness, living in the community.
Home health care: Home health care is care provided to individuals and families in their place of residence for promoting, maintaining, or restoring health; or for minimizing the effects of disability and illness, including terminal illness. In the Medicare Current Beneficiary Survey and Medicare claims and enrollment data, home health care refers to home visits by professionals including nurses, doctors, social workers, therapists, and home health aides. Household head: See Head of household.
Housing expenditures: As defined in the Consumer Expenditure Survey, housing expenditures include: payments for mortgage principal, interest, and charges; property taxes; maintenance, repairs, insurance, and other expenses; rent; rent as pay (reduced or free rent for a unit as a form of pay); maintenance, insurance, and other expenses for renters; and utilities.
Incidence: Incidence is the number of cases of disease having their onset during a prescribed period of time. It is often expressed as a rate (for example, the incidence of measles per 1,000 children ages 5 to 15 during a specified year). Incidence is a measure of morbidity or other events that occur within a specified period of time. See related Prevalence.
Income: As defined in the Current Population Survey, income includes money income (prior to payments for personal income taxes, Social Security, union dues, Medicare deductions, etc.) from: (1) money wages or salary; (2) net income from nonfarm self-employment; (3) net income from farm self-employment; (4) Social Security or railroad retirement; (5) Supplemental Security Income; (6) public assistance or welfare payments; (7) interest (on savings or bonds); (8) dividends, income from estates or trusts, or net rental income; (9) veterans’ payment or unemployment and workmen’s compensation; (10) private pensions or government employee pensions; (11) alimony or child support, regular contributions from persons not living in the household, and other periodic income. Certain money receipts such as capital gains are not included.
Income fifths: A population can be divided into groups with equal numbers of persons based on the size of their income to show how the population differs on a characteristic at various income levels. Income fifths are five groups of equal size, ordered from lowest to highest income.
Inpatient hospital services: As defined in the Medicare Current Beneficiary Survey, inpatient hospital services refers to services provided in acute-care hospitals.
Institutional population: See Population.
Instrumental activities of daily living (IADLs): Instrumental activities of daily living (IADLs) are indicators of functional well-being that measure the ability to perform more complex tasks. In the National Long Term Care Survey, IADLs include: heavy housework; light housework; laundry; preparing meals; shopping for groceries; getting around outside; traveling; managing money; and using a telephone. A person is considered disabled on an IADL activity (with the exception of “getting around outside”) if he or she does not do the activity because of a disability or health problem. A person is considered disabled on the “getting around outside” activity if he or she requires active help, uses equipment, or cannot get around outside at all because of a health or disability problem. See Activities of daily living (ADLs).
Labor force participation rate: The proportion of a particular population group that is in the labor force—that is, either working (employed) or actively looking for work (unemployed).
Life expectancy: Life expectancy is the average number of years of life remaining to a person at a particular age and is based on a given set of age-specific death rates, generally the mortality conditions existing in the period mentioned. Life expectancy may be determined by race, sex, or other characteristics using age-specific death rates for the population with that characteristic.
Marital status: The marital status classification in the Current Population Survey identifies four major categories: single (never married), married, widowed, and divorced. The “married” category is divided into married, spouse present; married, spouse absent; and separated. In the Economics section, “married” includes only the married spouse present.
Median: A measure of central tendency. The simplest division of a set of measurements is into two parts—the lower and the upper half. The point on the scale that divides the group in this way is called the "median."
Medicaid: This nationwide health care program is operated and administered by the states, with Federal financial participation. Within certain broad Federally determined guidelines, states decide who is eligible; the amount, duration, and scope of services covered; rates of payment for providers; and methods of administering the program. Medicaid provides health care services for certain low-income persons. Medicaid does not provide health services to all low-income people in every state. The program was authorized in 1965 by Title XIX of the Social Security Act.
Medical/outpatient services: Medical/outpatient services refer to services provided by physicians, laboratories, clinics, emergency rooms, hospital outpatient departments, and providers of medical equipment and supplies.
Medicare: This is a nationwide health insurance program providing health insurance to people age 65 or older, people entitled to Social Security disability payments for 2 years or more, and people with end-stage renal disease, regardless of income. The program was enacted July 30, 1965, as Title XVIII, Health Insurance for the Aged of the Social Security Act, and became effective on July 1, 1966. It consists of two separate but coordinated programs, hospital insurance (Part A) and supplementary medical insurance (Part B). Medicare generally does not cover nursing homes or prescription drugs.
National population adjustment matrix: The national population adjustment matrix adjusts the population to account for net underenumeration. Details on this matrix can be found on the U.S. Census Bureau Web site at: www.census.gov/population/www/censusdata/ adjustment.html
Net worth: As defined in the Panel Study of Income Dynamics, net worth is the value of real estate, stocks, bonds, and other assets minus outstanding debts.
Nursing home: As defined in the National Nursing Home Survey, a nursing home is an establishment with three or more beds that provides nursing or personal care services to the older population, infirm, or chronically ill.
Nursing home care: As defined in the Medicare Current Beneficiary Survey, nursing home care refers to long-term, personal care provided in long-term care facilities.
Pensions: Pensions include money income reported in the Current Population Survey from railroad retirement, company or union pensions, including profit sharing and 401(k) payments, IRA’s, Keoghs, regular payments from annuities and paid-up life insurance policies, Federal government pensions, U.S. military pensions, and state or local government pensions.
Physician visits and consultations: As defined in Medicare claims and enrollment data, physician visits and consultations include visits and consultations with primary care physicians, specialists, and chiropractors in their offices, hospitals (inpatient and outpatient), emergency rooms, patient homes, and nursing homes.
Population: Data on populations in the United States are often collected and published according to several different definitions. Various statistical systems then use the appropriate population for calculating rates.
Resident population: The resident population of the United States includes persons resident in the 50 States and the District of Columbia. It excludes residents of the Commonwealth of Puerto Rico, and residents of the outlying areas under United States sovereignty or jurisdiction (principally American Samoa, Guam, Virgin Islands of the United States, and the Commonwealth of the Northern Mariana Islands). The definition of residence conforms to the criterion used in the 1990 census, which defines a resident of a specified area as a person …usually resident” in that area. The resident population excludes the United States Armed Forces overseas, as well as civilian United States citizens whose usual place of residence is outside the United States.
Civilian population: The civilian population is the United States resident population not in the active duty Armed Forces.
Civilian noninstitutional population: The civilian noninstitutional population is the civilian population not residing in institutions. Institutions include correctional institutions, detention homes, and training schools for juvenile delinquents; homes for the older population and dependent (for example, nursing homes and convalescent homes); homes for dependent and neglected children; homes and schools for the mentally or physically handicapped; homes for unwed mothers; psychiatric, tuberculosis, and chronic disease hospitals; and residential treatment centers.
Resident noninstitutional population: The resident noninstitutional population is the resident population not residing in institutions. Institutions include correctional institutions, detention homes, and training schools for juvenile delinquents; homes for the older population and dependent (for example, nursing homes and convalescent homes); homes for dependent and neglected children; homes and schools for the mentally or physically handicapped; homes for unwed mothers; psychiatric, tuberculosis, and chronic disease hospitals; and residential treatment centers.
Institutional population: The institutional population is the population residing in correctional institutions, detention homes, and training schools for juvenile delinquents; homes for the older population and dependent (for example, nursing homes and convalescent homes); homes for dependent and neglected children; homes and schools for the mentally or physically handicapped; homes for unwed mothers; psychiatric, tuberculosis, and chronic disease hospitals; and residential treatment centers.
Poverty level: Poverty statistics are based on definitions originally developed by the Social Security Administration. These include a set of money income thresholds that vary by family size and composition. Poverty thresholds are based on money income and do not include noncash benefits, such as food stamps. Families or individuals with income below their appropriate thresholds are classified as below the poverty level. These thresholds are updated annually by the U.S. Census Bureau to reflect changes in the Consumer Price Index for all urban consumers (CPI-U). For example, the average poverty threshold for a family of four was $13,359 in 1990, $16,036 in 1996, and $16,660 in 1998. For more information, see: Money Income of Households, Families, and Persons in the United States, 1996. U.S. Census Bureau. Current Population Reports. P-60. Washington, DC: U.S. Government Printing Office.
Prescription drugs: As defined in the Medicare Current Beneficiary Survey, prescription drugs are all prescription medications except those provided by the doctor or practitioner as samples and those provided in an inpatient setting.
Prevalence: Prevalence is the number of cases of a disease, infected persons, or persons with some other attribute present during a particular interval of time. It is often expressed as a rate (for example, the prevalence of diabetes per 1,000 persons during a year). See related Incidence.
Public assistance: Public assistance is money income reported in the Current Population Survey from Supplemental Security Income (payments made to low-income persons who are age 65 or older, blind, or disabled), and public assistance or welfare payments, such as Temporary Assistance for Needy Families and General Assistance. Quintiles: See Income fifths.. Race: Data used in this chartbook generally classified individuals into the following racial groups: American Indian and Alaska Native, Asian and Pacific Islander, black, and white. Depending on the data source, the classification by race may be based on self-classification or on observation by an interviewer or other persons filling out the questionnaire. See related Hispanic origin.
Rate: A rate is a measure of some event, disease, or condition in relation to a unit of population, along with some specification of time.
Reference population: The reference population is the base population from which a sample is drawn at the time of initial sampling. See Population.
Self-rated health status: Health status was measured in the National Health Interview Survey by asking the respondent, “Would you say ____________’s health is excellent, very good, good, fair, or poor?”
Skilled nursing facility: Skilled nursing facilities provide short-term skilled nursing care on an inpatient basis, following hospitalization. These facilities provide the most intensive care available outside of a hospital.
Social Security benefits: Social Security benefits include money income reported in the Current Population Survey from Social Security old-age, disability, and survivors’ benefits.
Standard population: A population in which the age and sex composition is known precisely, as a result of a census. A standard population is used as a comparison group in the proc edure for standardizing mortality rates.
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