4.15 Health

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This section details the health-related data collected from respondents.  These data take three distinct forms.  First, information on the respondent’s physical health has been gathered during many of the surveys.  Second, the post-1982 surveys have collected information on the respondent and her family members’ health insurance coverage.  Third, measures of psychological well-being are available at select survey points.

Physical Health

A comprehensive set of health-related variables is available for all respondents.  In the early survey years, this data collection focused on health as related to employment and schooling, with questions in most interviews about whether the respondent’s health limited her work activity or prevented her from working and whether her health affected her schooling, housework, or other activities.  Information on whether any of the reported health problems were the result of an accidental injury and whether the most serious injury occurred on the job was collected in 1978.  Respondents were also asked at multiple survey points to identify if any specific workplace characteristics would cause them trouble because of their health (e.g., places that were hot, damp, or that had fumes or noise). 

Some surveys have also asked respondents about their current health status and perceived health changes over time.  Beginning in 1971, periodic questions have been fielded on whether the respondent considered her health to have remained about the same or to have changed for the better or worse over a set period of time (e.g., the past five years, since the last interview).  In the 1993–2001 surveys, each respondent was asked to rate her health as excellent, good, fair, or poor compared to other women her age.  Self-reported height and weight data are available for respondents interviewed during 1991; weight was also asked in 1995.

As the cohort aged, the health collection expanded.  Information on the specific diseases that limited the amount or kind of work that the respondent could do was collected during the 1991 and 1993 surveys.  Details on up to four health conditions (e.g., cancer, heart trouble, diabetes, hypertension, senility) and the length of time that the respondent has been limited by the primary health condition were coded during each year.  The 1991 survey further included an extensive list of medical conditions, ranging from heart problems to allergies to osteoporosis, and asked respondents to state whether they had ever experienced each condition.  In 1997, 1999, and 2001, a series of questions asked all respondents about high blood pressure, cancer, and heart disease, including limited information about treatment.

In 1971, 1978, 1983, 1988, and 1991, respondents who reported that health limited the amount or kind of work or housework they could do were also asked if their health problems prevented them from performing a predetermined set of other activities such as walking, using stairs, stooping or crouching, etc.  In 1995, a similar set of activity questions was addressed to all respondents.  During these same surveys, respondents were also asked whether they experienced certain health-related problems (e.g., pain, tiring easily, weakness, aches or swelling, fainting spells or dizziness, anxiety or depression, and/or shortness of breath).

In 1995–2001, an additional section on menopause expanded the health module’s focus.  First, this section determined the respondent’s current ovulation status.  If the respondent had stopped ovulating, she dated her last ovulation and stated why her period stopped.  Additional questions asked if the respondent had surgery to remove her ovaries or uterus.  This section ended by querying about hormonal supplements and birth control pill usage to control menopausal or aging symptoms.

A second new series included only in the 1995 survey informs researchers about these women’s day-to-day driving activities.  The section asked if the respondent ever drove a car and if she had driven over the last 12 months.  Those who had driven in the last 12 months were asked the number of miles driven and whether they drove after dark.  Those who had not driven in the last 12 months, but who had during their lifetime, stated when they stopped driving.

Health Insurance

During the 1988–2001 surveys, information was collected on whether the respondent and/or other family members were covered by health insurance.  This series gathered information on whether any family member was covered by medical or hospital insurance and the specific source of the coverage for each family member (e.g., a group policy through the respondent’s or spouse’s employment, a policy purchased directly from the company, Medicaid, or veterans benefits).  In 1991 and 1995–2001, respondents who had employer-provided health care also stated whether they contributed toward the cost of the policy.  Table 4.15.1 depicts respondents reporting health care coverage by provider. 

The 1993-2001 surveys asked those respondents who were covered by health insurance through their current or former employer whether they and their husbands expected to be covered by health insurance after the respondent retired.

Table 4.15.1 Medical Insurance Coverage of Respondent by Provider (Unweighted): 1988-2001

Psychological Well-being

In 1993, the full 20-item CES-D (Center for Epidemiological Studies Depression) scale was administered to the Young Women respondents (R14740.–R14759.).  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).  The 1995–99 surveys contained a reduced set of seven items from the original 20-item CES-D scale.  The CES-D items can be found in the data set by searching for the phrase “Attitude in past week.”

At five survey points, the Young Women gave responses to a measure of internal-external locus of control.  Internal control refers to the perception of events as being under personal control; external control involves events being perceived as unrelated to one’s own behavior.  In 1970, 1973, and 1978, an 11-item abbreviated version of Rotter’s (1966) Internal-External Control Scale was used.  The abbreviated scale was constructed by including only those items of the original 23-item Rotter scale which were the most general and oriented to the adult world of work (see Parnes et al. 1974, Appendix to Chapter VI).  Reducing the number of items would have required an overall reduction in the range of scores.  To avoid this situation, the response format was modified to four choices rather than two as in the original scale.  The respondent was thus asked how closely each of the 11 statements represented her own view of the issue.  The total score is obtained by summing the values of all 11 items, resulting in a range of 11 to 44 in order of increasing external control.  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 1983 and 1988, this scale was further reduced to only four items. The 2001 survey included a modified four-item scale.

Related Variables: Additional information on the respondent’s general satisfaction with life can be found in the “Attitudes & Expectations” section of this guide. Questions on job satisfaction can be found in the “Job Satisfaction” section of this guide.

Survey Instruments: Health and health insurance questions are located within the “Health” section of the questionnaires.  The CES-D scale items can be found in the “Health” section of the survey instruments in the years they are collected.  Components of the Rotter scale can be found in the “Work Attitudes” section of the appropriate survey year questionnaires.

References

Parnes, Herbert S., Adams, Arvil V.; Andrisani, Paul J.; Kohen, Andrew I.; and Nestel, Gilbert. The Pre-Retirement Years: Five Years in the Work Lives of Middle-aged Men, Vol. 4. Columbus, OH: CHRR, The Ohio State University, 1974.

Radloff, Lenore. “The CES-D Scale: A Self Report Depression Scale for Research in the General Population.” Applied Psychological Measurement 1 (1977): 385-401.

Ross, Catherine E. and Mirowsky, John. “Explaining the Social Patterns of Depression: Control and Problem Solving--or Support and Talking?” Journal of Health and Social Behavior 30 (June 1989): 206-9.

Rotter, Julian B. “Generalized Expectancies for Internal vs. External Control of Reinforcements.” Psychological Monographs 80,609 (1966): 1-28.

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