I

\

From Vital and Health Statistics of the National Center for Health Statistics Number 116. May 9, 1986

.

Aging in the Eighties,

Age 65 Years and Over and Living Alone,

Contacts With Family, Friends, and Neighbors

Preliminary Data From the Supplement on Aging to the

National Health Interview Survey: United States, January–June 1984

by M. G. Kovar, Dr.P.H., OffIce of Interview and Examination Statistics

I

1

Introduction

k

x, gave a complete interview to the SOA and 99 percent of those

answered the questions for themselves.

The National Health Interview Survey is the National The data in this report are from the interviews that were

“enter for Health Statistics’ large continuing survey of the completed during the fiist 6 months of 1984. The data are pre1

,—.

health of the civilian noninstitutionalized population of the liminary because only one-half of the year is included and

I

I

United States. Each year people in about 42,000 households

are interviewed by U.S. Bureau of the Census interviewers to

obtain information about their health and use of health care.

Demographic information that is needed to interpretthe data is

also obtained. The interviewers have special trainhg on this

survey in addition to their regular training, and response rates

are high-about 97 percent. The only item with a relatively

low response rate is family income, which is not used for this

analysis.

In 1984 a special supplement’ was added to the questionnaire to obtain information about older people who were living

in the community. This supplement, the Supplement on Aging

(SOA), was designed to collect information about physical

limitations, chronic conditions, housing, retirement status, interactions with family and organizations, use of community

services, and other health-related and social information about

middle-aged and older people. All household members age 65

years and over and a half sample of those 55-64 years of age

were asked the questions on the supplement themselves where

possible. Another household member was interviewed only

when the selected person was unable to answer either because

of physical or mental problems or was going to be away from

#

e household for a longer period than the intewiewer would be

the area. Response rates to the SOA were also high. Of the

,809 people age 65 years and over who were in the survey

because the data from the SOA have not been edited. Including

the full year will double the size of the sample and make estimates more reliable. It will also reduce any possibWy of bias

because of seasonality. Editing will change some of the estimates because information from other parta of the questionnaire

will be used to correct missing or inconsistent information. The

approach used to make the estimates in this report was to be

conservative. If the information was missing, which it rarely

: was for people living alone and answering for themselves, it

was treated as if the response was “No” or “None.” That is,

the number of living children was treated as if the person had

no children, and the number of telephone contacts with relatives

was treated as if there were none if there were no entries.

The purpose of this report is to provide information about

one segment of the older population—those people 65 years of

age and over who were living alone. They are of particular

interest (1) because there are so many of them (about 31 percent of all people age 65 years and over and living in the community, or about 8 million people who had had a 65th birthday,

lived alone), (2) because of concern that alienation and loneliness’decreases the quality of their lives, and (3) because researchl’z has suggested that they are at especially high risk of

n6ed for long-term care and of institutionalization. The preliminary data are being published because of these concerns

and because there is so little information available about older

January-June 1984 and who were living alone, 96 percent people living alone.

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service
2

There are two points to remember when interpreting the

data.

. First, this is a report about people who have, so far, sue

cessfully survived living alone in the community. Were

they badly disabled, many might already have moved in

with family or into institutions. They are, in a sense, a

select group of people.

. Second, the estimates are based on a sample and they may

differ from estimates based on a complete census using

exactly the same questions and interviewing techniques.

The reader should read the technical notes and consider

the size of the sampling error before making inferences.

Background

About 26.3 million Americans who had had their 65th

birthday were living in communities outside nursing homes or

other institutions in the fwst half of 1984. About one-third of

them, an estimated 8.0 million people, were living alone.

Before considering the special characteristics of the people

who have had a 65th birthday and live alone, it is useful to

recognize how they dfler as a group fkomtheir peers who live

with other people.

Senior people who live alone, are, on the average, older

than those over 65 years of age who live with others. Their

average age was 75.2 years in contrast with 73.4 years. Half

were age 75 years and oveq 11 percent were age 85 years or

over (table A). In contrast, only a third of those who lived with

others were age 75 years and oveq 6 percent were age 85 years

and over.

Table A. Percent distribution of people age 65 years and ovar by

age, sex, and marital stetua, according to whather they lived alone or

with others United states, January-June 1964

Living Living

‘Age, sex, and marital status Total alone with others

Sample . . . . . . . . . . . . . . . . . . . . . . .

Estimated population . . . . . . . . . . . .

Total . . . . . . . . . . . . . . . . . . . . . . . . .

Age

65–74 years . . . . . . . . . . . . . . . . . . .

75-84 years . . . . . . . . . . . . . . . . . . .

85yaars and over . . . . . . . . . . . . . . .

Sex

Male . . . . . . . . . . . . . . . . . . . . . . . . . .

Female . . . . . . . . . . . . . . . . . . . . . . . .

Marital status

Married . . . . . . . . . . . . . . . . . . . . . . .

Widowed . . . . . . . . . . . . . . . . . . . . . .

Divorced . . . . . . . . . . . . . . . . . . . . . .

Never married . . . . . . . . . . . . . . . . . .

Number

5,982 1,809 4,173

Number in thousands

26,290 8,018 18,272

Percent distribution

100.0 100.0 100.0

61.7 50.2 66.8

30.7 38.6 27.2

7.6 11.2 6.0

40.8 20.2 49.9

59.2 79.8 50.1

54.7 0.0 78.6

34.1 77.1 15.2

6.3 14.1 2.9

4.4 8.1 2.8

They were, being older, more likely to be widowed. They

were also more likely to be divorced or separated, or neve .

married. For example, 77 percent of the people living alon

but only 15 percent of those living with others, were widowem,

14 percent, in contrast with 3 percent, were divorced or sep

arate~ and 8 percent, in contrast with 3 percent, had never

married.

Eighty percent of the older people living alone were women,

in contrast with 50 percent of those living with others, Of the 8

million people age 65 years and over and living alone, about 11

percent were men and 39 percent were women ages 65-74

years; 9 percent were men and 40 percent were women age 75

years and over.

Thus, the population of people age 65 years and over and

living alone tends to be older, widowed women. Many of these

characteristics result from the higher death rates and shorter

life expectancies of men. Fewer males survive to age 65 years,

and even at age 65 years, a man’s expectation of life is less

than that of a woman the same age. In 1983, the difference at

age 65 years was 4.1 years.3 In addition, women tend to marry

men older than themselves, which increases their likelihood of

being widowed.

Despite these characteristics, many of the people who

were living alone were not at all disabled, in poor health, suffering from lack of medical care, or lacking family or companionship.

Although the potential for social isolation certainly exists,

the evidence from the SOA is that the majority of the older

*

peopl~who were living alone lived close to family with who-.

they had fkequent contact. Many of them had been living in

exactly the same place for many years; 62 percent had not

moved in the previous 10 years and 32 percent had lived in the

same place for 25 years or more. Only 24 percent had moved

into their current house, apartment, or mobile home within the

previous 5 years. About 11 percent lived in retirement communities. The long residence in the same place and the relatively

high proportion in retirement communities may account for

their social contacts.

Another reason that these people living alone were not as

isolated as they might have been is that 94 percent of them had

telephones and most apparently used them. The telephone was

a major means of contact with children and other relatives and

with ftiends and neighbors.

Given the importance of the telephone for maintaining

social contacts, it appeared that elderly men living alone were

at greater risk of isolation than elderly women. While 97 percent of the women had telephones, only 84 percent of the men

did.

Children

One reason there is a potential for isolation is that a substantial fraction of the people age 65 years and over who lived

alone had no living children (table B). Twenty-nine percent, b

the conservative estimates used for this report, had no livi

children and an additional 19 percent had only one child. *

However, most of those who did have children had ffequent

contact with them. They lived near their children, saw them

frequently, and talked with them frequently on the telephone.
aduancedata 3

,—

Table B. Percent of paople age 65 years and over living alone by

whathar they had living siblings and by number of living children:

nited States, January-June 1984

No living Living

Living children Total siblings siblings

Parcent of total

Total . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 27.7 72.3

No children . . . . . . . . . . . . . . . . . . . . . 28.8 10.7 18.2

I child . . . . . . . . . . . . . . . . . . . . . . . . . 19.1 5.4 13.7

2-4 children . . . . . . . . . . . . . . . . . . . . 42.2 9.9 32.3

5children or more . . . . . . . . . . . . . . . . 9.8 1.8 8.1

NOTE Based on an estimated 8,018 thousand (1,808 in sample) people who

lived alone.

When asked how quickly one ormoreof their children

could get there if needed, an estimated 4 million (half of all the

older people living alone) had at least one child who could get

there in a matter of minutes. An additional 1.4 million had at

least one child who could get there in a matter of hours—

mostly within 3 hours. Of the 5.6, million people living alone

who had at least one child, 72 percent said that at least one

child could be there within minutes and ahnost all the rest said

one could be there in a few hours (table C). The proportion

saying that at least one child could be there within minutes was

higher as the number of children increaaed-56 percent of those

with only one child, 75 percent of those with two through four

children, and 85 percent of those with five children or more.

e

Of the people living alone who had children, 23 percent

. aw a child daily. An additional 40 percent saw a child at least

once a week, and half of those saw a child more than once

during the week. Another 16 percent saw a child at least once a

month, and again they were about evenly split between those

who saw a child only once and those who saw one more often.

Most of the remainder saw their children several times during

the year. Only 3 percent of the people who lived alone and had

one child or more said they never saw a child or saw one less

than once a year.

As could be expected, there was a strong association between the time it took a child to get there and how often they

saw their children. Over 90 percent of the 3.5 million who saw

Table C. People age 65 years and over who lived alone and had

1 child or more by frequency of seeing children and how quickly a

child could get thare: United States, January-June 1984

How quickly

a child could get there

Frequency of seeing children Total Minutes Hours Days

Percent of total

Total . . . . . . . . . . . . . . . . . . . . . . 100.0 71.6 25.1 3.4

At least

e

Daily . . . . . . . . . . . . . . . . . . . . 23.4 22.9 0.0 0.0

Weekly . . . . . . . . . . . . . . . . . . 40.3 36.7 3.5 0,0

Monthly . . . . . . . . . . . . . . . . . 16.2 9.4 6.7 0.0

Yearly,,,,,...,, . . . . . . . . . 17.5 2.3 13.0 2.2

Never . . . . . . . . . . . . . . . . . . . . . 2.7 0.0 . 1.5 1.0

NOTE 8ased on an estimated 5.6 million (1 ,272 in sample) people with 1 child

or more.

a child daily or weekly had a child who could get there within

minutes. The majority of those who saw a child less often said

the quickest a child could get there if needed was an hour or

more. However, 13 percent of those who said it was less than

once a month but more than once a year also said a child could

be there if needed in less than an hour.

Seventy-eight percent of those with children, 4.4 million of

the 8.0 million people living alone, talked with at least one

child on the telephone every week. Thirty-six percent of those

with children talked with at least one child every day, another

21 percent did so two or more times a week, and an additional

20 percent talked with a child at least once a week. Only 9

percent of those with children talked with a child on the telephone less than once a month.

The combination of personal and telephone contacts meant

that of the 8.0 million older people living alone, 5.1 million had

contact with a child at least once a month, 4.5 million at least

once a week, and 2.4 million had contact with a child in person

or by telephone daily.

Four-ftis, 81 percent, of those with children had contact

with a child in person or by telephone at least once a week 57

percent had both personal-and telephone contact. Two-fifths,

42 percent, had daily contact with a child in person or by telephonq 16 percent had daily personal and telephone contact.

Most of the people who saw their children less frequently talked

with them on the telephone more often than they saw them.

Very few, perhaps 1–2 percent, of the older people living alone

who had children never saw or talked on the telephone with

them.

Mail is apparently not used now as the means for older .

people staying in touch wi~ children. The older people who

lived alone seldom received m&l ffom their children. Fortythree percent of those with children never received any mail

from them. Most of the rest reported mail several times during

the year but not on a routine basis.

Recent social contacts

Many of the older Americans who lived alone were living

in exactly the same home they had lived in for years. A few,

judging ffom the length of time they had lived in the same place,

appeared to have spent their entire lives in the same house or

apartment. Others, who were widowed, had apparently remained in the same household they had lived in with a spouse.

This long residence in the same place may help account for

their high rate of contact with family, Mends, and neighbors.

Although 29 percent of the older people living alone had

no living children and 28 percent had no living siblings, few

were without any immediate family. Only 11 percent of the

estimated 8 million Americans who had had a 65th btihday

and were living alone had neither a child nor a sibling (table B).

About 54 percent had at least one living sibliig and one living

child. Eighteen percent had one sibling or more but no child,

and 17 percent had one child or more but no sibling.

Most had recent contact with family (table D). Within the

2 weeks prior to the interview, 73 percent of the older people

who lived alone had gotten together with relatives; 84 percent

had talked with relatives on the telephone 69 percent had done

boti, and only 12 percent had done neither.
Those who had both children and siblings were even more

likely to have had recent contact. Eighty-four percent had gotten

together with relatives and 94 percent had talked with a relative

on the phone. Even some of those without a child or sibling had

had recent contact with relatives; 27 percent had gotten together

with relatives, and 38 percent had talked with relatives on the

phone within 2 weeks.

Seventy percent had gotten together with fi-iendsor neighbors within 2 weeks, and81 percent had talked with friends or

neighbors on the telephone.

Overall, 88 percent of the people living alone had gotten

together either with family or with friends and neighbors during

the 2 weeks prior to the interview. About 53 percent had gotten

together with relatives and with friends or neighbors 11 percent

had done neither.

Overall, 90 percent of the people living alone had talked

with either family or with friends and neighbors on the telephone

within the 2 weeks prior to the interview. About 75 percent had

talked with both relatives and others; 10 percent had talked

with neither within the 2 weeks.

In sum, 84 percent of all the people living alone had talked

with someone and gotten together with someone within the 2

weeks. Only 5 percent reported no contact with family or friends

in person or by telephone within the 2-week period.

About half of the people age 65 years and over and living

alone, 51 percent, had gone to a church or temple during that

period. Fewer, only 27 percent, had attended a movie, sports

event, or other such group event.

Health

On a five-point scale of excellent to poor, 70 percent of the

people living alone rated their health as good or better. The

perceived health status of about 18 percent was “excellent:’

21 percent “very good,” and31 percent “good.” Only 20 percent perceived their own health as “fair,” and 10 percent perceived their health as “poor.”

Sixty percent were not limited in their usual activity, 17

percent were limited in outside activities but not their usual

one, 16 percent were limited in kind or amount of usual activity,

and 8 percent were unable to perform their usual activity.

Their perceptions about their health were associated with

their use of health care. About 18 percent had not seen a phyTable D. Percant of people age 65 years and over who lived alone

by contacta with relatives, frienda, and neighbora within the previous

2 weeks and whether by person or telephone United States,

January-June 1984

Relatives Friends or neighbors

Immediate

family In person Telephone In person Telephone

Percent with contact

Total . . . . . . . . . . . 72.8 84.0 69.5 81.4

No child or

sibling . . . . . . . . 26.8 37.8 50.5 56.6

Sibling(s) only . . . 66.6 80.7 71.0 83.4

Child(ren) only. . . T2.8 85.8 69.2 81.5

Both . . . . . . . . . . . 84.0 93.5 39.4 85.6

sician during the preceding yew, 82 percent of those who had

not seen a physician within a year perceived their health

good or better and 74 percent had no activity limitation,

m

f

Sixty-two percent had not spent an entire day in bed duri

the preceding year and an additional 14 percent had spent less

than 7 days in bed. About 10 percent had spent 4 or more

weeks in bed during the year.

Most of them felt that if they needed care, there was someone to take care of them for a few days. The majority, 69percent, said that family would 17 percent had someone else,

However, 14 percent said there was no one.

They were less sanguine about there being someone to

care for them for a few weeks if needed. The majority$ 67 percent, had family, but only 10 percent had someone else.

Twenty-four percent said there was no one to care for them

that long.

Those who responded for themselves entirely, about 98

percent of the people living alone, were asked additional questions about their own health. Most thought they were doing

well.

When asked how good a job they were doing taking care of

their own health, 90 percent said good or better including 24

percent who said “excellent” and 33 percent who said “very

good”; most of the others said they were doing a fair job,

When asked how their health was compared with their

health a year ago, 71 percent said it was about the same, 13

percent re~rted it was better, and 16 percent said it was worse,

Most did not worry about their health. Forty-nine percent

.gaid they _hadnot worried at..all during the past year, an

percent said they had hardly any worry. Tw6nty-six percent -

had had some worry, and 10 percent a great deal,

Four-fifths of the people living alone felt they had some

control over their future heal~ including 37 percent who thought

they had a lot of control. About 8 percent thought they had

very little control, and 7 percent felt they had no control,

They felt they were as active as (41 percent) or more active

than (47 percent) other people their own age. Two-thirds of

those who felt they were more active thought they were a lot

more active.

Most (71 percent) said they were about as active now as

they had been a year before, but 21 percent were Iess active.

Two-thirds of those who were less active said it was only a

little less.

Discussion

The likelihood that older people will be living alone is

higher at older ages as spouses, siblings, and even children die.

There is a risk of being left without a support network. However,

if the support network is there, people can be helped to maintain

themselves in the community, and rates of institutionalization

can be decreased to the benefit of both individuals and public

programs.

The evidence from these preliminary data is that many o

the people who had had a 65th birthday and were living alo

*

did see, or at least talk with, family frequently. They were no

alienated and without social contacts. Also, they perceived

themselves as in generally good health and felt they had some

control over their health.
I

achnncedata 5

It is not news that older people living alone are generally in

aletter health than those living with others. The usual explanaon is that they are able to live alone because they are in good

ealth. Were they in poor health and unable to care for themselves, they would have moved in with family or been institutionalized.

These data do not refute that explanation however, they

do raise the possibility that other factors are also contributing

to the ability of these older people to live alone. The perception

of many of them that their health was good and the close relationships that many seemed to have with family maybe additional explanations of their ability to live alone.

There is evidence from longitudinal data that older people

who perceive themselves to be in good health have lower mortality rates than people the same age who perceive their health

as poor.4’5Although the people in this study who were living

alone were no different from those living with others in the

frequency of their use of health services or the number of days

they had spent in bed during the year despite their being older,

their perception of their health, whether measured on a scale of

excellent to poor or by limitation of activity, was better.

There is also evidence from population-based longitudinal

studies that people who have a lot of friends and relatives and

who see a lot of them are likely to live longer than those who

seldom visit with friends and relatives6 and that elderly people

who perceive a high level of social support have lower mortality

rates.7 Other studies have failed to coni%mthat relationship for

women.8 The number of living children was a significant pre

*

“ctorof mortaWy in a study of elderly urban poor regardless of

health status.g Many of these studies have been reviewed and

the results found to vary with the definitions of social support.10

None of them focused on older people who lived alone. Nevertheless, the preponderance of the evidence is that there is some

relationship between social contact and support and mortality.

The data from the SOA are cross-sectional and cannot be

used to demonstrate causality. However, the research from

these longitudinal studies does suggest that many of these older

people who were living alone may not beat unusually high risk

of death. They may not even be at unusually high risk of institutionalization. They had frequent contact with family and

neighbors. They had lived in the same place for many years.

Those who had children lived near them and saw them frequently. Ahnost all had telephones and used them to stay in

touch with family and neighbors.

Whether their closeness to family will have a protective

effect is a hypothesis that will have to be confiied. More

extensive analysis from the fill year of edited data may reveal

more about the cross-sectional relationships. But testing such a

hypothesis will not be possible until the records of the respondents to this survey have been matched with records in the National .Death Indexl 1 for several years and their progress followed over time. That match is planned.

There did appea to be a small group of people living alone

who did not have children or siblings, frequent social contact,

recent medical care, or high self-perception of their health.

There is some indication that men are more likely to be in this

group than women, although, because there are more women

living alone, the larger number of them are women. This may

be the group at great risk of either death or institutionalization.

Both the larger sample that will be available from the full year

and the match with the National Death Index will provide

more information about them.
6 advancedata

References”

IL.G.&~& ~dA.M.Jette A prospective study of long-termc~e institutionaliiation among the aged.Am 1 Public Health 72(12} 1373–

1379, Dec. 1982.

2S. Katx, L. G. Branch, M. H. Branson, et al.: Active life expectancy.

X Engl L Med 309(20] 1218-1223, 1983.

3National Center for Health Statistic Advance report, final mortality

statistics, 1983. Monthly Vital Statistics Report Vol. 34, No. 6 Supp.

DHHS Pub. No. (PHS) 85–1 120. Public Health Service. Hyatisville,

Md., Sept. 26, 1985.

4J. M. Mossey and E. Shapiro Self-rated healtix A predictor of mortality among the elderly. Am. J Public Health 72(8):800-808, Aug.

1982.

‘G. A. Kaplan and T. Camachm Perceived health and mortality A

nineyear follow-up of the Human Population Laboratory Cohort. Am.

J Epidemiology 117(3]292-304, Mar. 1983.

CL.F. Berkman and L. S. Syme Social networks, host resistance and

mortality A nine-year follow-up study of Alameda County residents.

Am. J. Epidemiology 109(2)186-204, Feb. 1979.

TD. G. B1~en Social suppofi and mortality in an elderly community

population. Am. J Epidemiology 115(5):684-694, May 1982.

sJ. S. House, C. Robbiis, and H. L. Metznec The association

m

\,i

social relationships and activities with mortality Prospective evident

from the Tecumseh Community Health Study. Am. i Epidemiology

116(1):123–140, July 1982.

‘D. M. Zuckerman, S. V. Kasl, and A. M. Osffeld Psychosocial predictors of mortality among the elderly pooc The role of religion, wellbeing, and social contacts. Am, J Epidemiology 119(3):410-423,

Mar. 1984.

IOW.E. Broadhead, B. H. Kaplan, S. A. James, et al.: The epidemi~

logical evidence for a relationship between social support and health,

Am. 1 Epidemiology 117(5}521-537, May 1983.

1IJ. E. Patterson md R Bilgrad. The National Death Index Experience, 1981-1985. Paper presented at the Workshop on Exact Matching Methodologies. Arlington, Vs., May 9–10, 1985, To be published

in the Proceedings.

lzNatio~~ Center for Health Statistics, M. G. KOV~ rind G. s, POI%

The National Health Interview Survey design, 1973-84, and procedures, 1975-83. Vital and Health Statistics, Series 1, No. 18.

DHHS Pub. No. (PHS) 85–1320. Public Health Service. Washington. U.S. Government Printing Office, Aug. 1985.
Technical notes

-

Each week a probability sample of households in the

United States is visited by U.S. Bureau of the Census interviewers to obtain a wide range of information about the health

and health care characteristics of the people living in those

households. A description of the survey design, methods used

to make the national estimates, and general qualifications of

the data are provided in The National Health Interview Survey

Designj 19 73–84, and Procedures, 1975–83. 12

During January throufl June 1984 there were about

21,000 households in the sample. The total nonintemiew rate

was about 3 percent—primarily because the interviewer was

unable to locate an eligible respondent despite repeated calls.

Response rates were also high for the Supplement on Aging

(SOA); 97 percent of the people age 65 years and over and

living alone who responded to the basic questiomaire completed

the SOA. A few refused to complete the SOA, which was an

extensive questionnaire, following what may have been, if

there were many illnesses or episodes of care to report, a long

interview. Thus, the coverage was extremely high.

The estimates in this report are based on a sample rather

than on the entire population of people age 65 years and over

living alone in the civilian noninstitutionalized population of

the United States during the first 6 months of 1984. Therefore,

the estimates are subject to sampling error. In addition, the

sample had a complex design that has the effect of making the

*

ampling errors somewhat larger than they would be from a

imple random sample of the same size using the same procedures.

Table I gives some of the sample numbers to enable the

user to make estimates of the sampling errors that incorporate

the complex sample design. To estimate the sampling errors,

convert the percent to a proportion, calculate the variance of a

proportion assuming simple random sampling, multiply that

NOTE: A list of referencesfollowsthe text.

Table 1. Population estimatas and sample sizes for peopIe age 65

years end over and who lived alone, by number of living children and

immediate family: United States, January-June 1984

Population Number

Characteristic in thousands in sample

Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8,018 1,809

Living children

No children . . . . . . . . . . . . . . . . . . . . . . . . 2,311 509

I child . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,533 354

2-4 children . . . . . . . . . . . . . . . . . . . . . . . 3,384 763

5children ormore . . . . . . . . . . . . . . . . . . . 789 183

Immediate family

#

ochild or sibling . . . . . . . . . . . . . . . . . . . 855 187

Iing(s) only . . . . . . . . . . . . . . . . . . . . . . 1,457 322

d(ren) only . . . . . . . . . . . . . . . . . . . . . . 1,367 311

tat .,, . ! . . . . . . . . . . . . . . . . . . . . . . . . . 4,340 989

variance by the design effect to allow for the complex sample,

then compute standard errors, confidence intervals, or significance tests. For example, the estimate of 8,018,000 people

age 65 years and over and living alone was based on 1,809

people in the sample. Eighty percent were wome~ therefore,

Variance (simple random sample) = ~

_—(0.80)(0.20)

1,809

= 0.000088

The design effect is 1.2.

Variance (complex sample) = (0.000088)(1.2)

= 0.000106

StandVd error= (0.000106)1/2

= 0.0103

95percent confidence interval= 80 + (1.96)(1.03)

= 80&2 percent

Perhaps more important for interpretation than sampling .

errors, however, is a thorough understanding of what data from

this, or any other, cross-sectional survey can provide. There

are two issues—one important for any cross sectional analysis

and the other of especial importance for older people.

The National Health Interview Survey is a point-in-time

study. Associations at one point in time should not be interpreted as causality. The difference among the age groups, for -

example, could be the result of aging or, alternatively, they —.

could be the result of different cohorts moving through time.

Based on external knowledge, one could interpret a difference

in educational status as the result of cohort differences, but the

data from a cross-sectional survey do not enable one to make -

that distinction.

The second factor is that this is a study of people who were

living alone in the community at the time of the interview.

Those elderly people who were in institutions were not in the

scope of the survey. In addition, people who had formerly lived

alone but because they had become badly disabled, no longer

had financial resources to live alone, or for other reasons now

lived with other people are no longer classified as living alone.

They had left this population. ‘Ilk is a report about people

who have, so far, successfully survived living alone in the

community. Were they badly disabled, many might already

have moved in with family or into an institution. They are, in

thatsense,a selectgroupofolderpeople.
8 ackinuxklkl

Recent Issues of Advance Data From Vital and Health Statistics

No. 115. Aging in the Eighties, Preliminary Data From the Supplem

No. 112. 1984 Summary: National Hospital Discharge Survey (I

ment on Aging to the National Health Interview Survey, United States, sued Sept. 27, 1985)

January-June 1984 (Issued April 1986) No. 111. An Overview of the 1982 NationaI Master Facility InvenNo. 114. Prevalence, impact, and demography of known diabetes in tory Survey of Nursing and Related Care Homes (Issued September

the United States (Issued February 1986) 1985)

No. 113. Provisional Data From the Health Promotion and Disease

Prevention Supplement to the National Health Interview Survey

United States, January-March 1985 (Issued November 1985)

Suggested citation

National Center for Health Statistics, M. G. Kovac

Aging in ;he Eighties, Age 65 Years-and Over and

Living Alona, Contacta With Family, Friends, and

Neighbors. Advance Data From Vital and Health Copyright Information

Statistics. No. 116.DHHS Pub. No. (PHS)

86-1250. Public Health Servica, Hyattsville, Md., This report may be reprinted without further

May 9, 1986. permission.

--- _.

U.S. DEPARTMENT OF HEALTH AND

.

!

HUMAN SERVICES

To

THIRD CLASS MAIL

Public Health Sewice BULK RATE

National Center for Health Statistics POSTAGE & FEES PAID

3700 East-West Highway PHSINCHS

Hyattaville, Maryland 20782 PERMIT No. G-281

I I

OFFICIAL BUSINESS

PENALTY FOR PRIVATE USE, $300

To receive this publication regularly, contact

the National Center for Health Statistics by

— calling 301 436-8500

OHHS Publication No. (PHS) 86-1250