, TESTBANK FOR Health Promotion and Aging,
Seventh Edition Haber
Notes
1- The file is chapter after chapter.
2- We have shown you few pages sample.
3- The file contains all Appendix and Excel sheet
if it exists.
4- We have all what you need, we make update
at every time. There are many new editions
waiting you.
5- If you think you purchased the wrong file You
can contact us at every time, we can replace it
with true one.
Our email:
, CHAPTER 1
Introduction
CHAPTER SUMMARY
This chapter introduces a wide range of health and aging concepts, topics, and data. It begins with a summary of the
Healthy People Initiatives, which is the first federal initiative to shift attention from a “war on disease” to an
“initiative on health promotion.” While this is an important shift, the initiative’s effectiveness would be considerably
enhanced by the funding of community and clinical health promotion interventions, rather than limited to the
monitoring of health goals.
Medicare coverage, for instance, is why we have made more progress with older adults over the past two or three
decades regarding increased mammograms, flu shots, and pneumonia immunizations than we have made with
reducing such risk factors as obesity and physical inactivity. While obesity and smoking counseling have recently
been covered by Medicare, it is too early to know about their impact.
The sociodemographic trends described in this chapter cover a combination of medical and health topics, with the
two areas being very much related. As medical costs have escalated beyond affordability for many Americans,
health promotion, disease prevention, and chronic disease management have increased in importance.
The aging of America contributes to escalating medical costs; it could also stimulate a growing investment in
health promotion, disease prevention, and chronic disease management. Boomers, by their sheer size in numbers,
have forced changes in hospital growth, medical personnel training, and the expansion of public schools and housing
stock. They can do the same with the promotion of health.
The coming of the baby boomers into the ranks of the old inspires much hope. The boomers are highly educated
and are more likely to advocate for what they believe in than previous generations, and they are entering this early
phase of old age in breathtaking numbers. This huge cohort has great potential to inspire political advocacy and
create institutional change.
Society also must grapple with the challenges of the oldest segment of older adults. There will be an ongoing
challenge to meet the needs of people age 80+ who are growing in number at the rate of 40% a decade. The oldest of
the old requires the most support from both family and government. Already, the growth of this segment of the
population has provided impetus to revolutionize institutions such as nursing homes, which have remained
remarkably resistant to progressive thinking, and to promote more desirable long-term care alternatives as well as
expansion of palliative care and hospice care (see Chapter 10).
The definition of health promotion in late life inspires a range of thinking, from a focus on the extraordinary
accomplishments of older adults, to a consideration of the many dimensions of wellness, to the credibility of fighting
the aging process itself. For many aging individuals, it appears that emotional health gains supremacy over physical
health, and as we will learn in subsequent chapters, the capacity for emotional health may develop with age (see
Chapter 8).
From a policy perspective, Medicare appears to dwarf all other legislation, including social security, in
challenging our best thinkers on how to control costs. Adjusted for inflation, older adults are spending more out-of-
pocket now than before Medicare. When the issues of Medicare are combined with the challenges of Medicaid and
long-term care, the need to expand quality medical care coverage to all Americans—all the while keeping health
care affordable—will require a major transformation in our health care system.
And, voila, along comes the Affordable Care Act (see Chapter 11), which is changing health care for all
Americans, including those on Medicare and Medicaid. This revolutionary piece of legislation will play out with
unexpected turns in the coming years, and will make this course very topical indeed.
Copyright © Springer Publishing Company, LLC. All Rights Reserved. 1
, There are several concepts in this chapter, such as compression of morbidity and health expectancy that can get
young students thinking about how their lifelong lifestyle practices will pay off handsomely with an elongated
period of vitality in later life.
CHAPTER 1—DISCUSSION QUESTIONS AND ANSWERS
The following set of questions and answers pertains to the sidebars in Chapter 1.
What do you think is the most important health objective to set for older adults for the Healthy People
2020 initiative? Why? What should the federal and state governments, health professionals, and
laypersons do to help achieve this objective?
To improve exercise or nutrition is the most likely Healthy People 2020 objective to be suggested by students,
but a wide range of responses will make for an interesting discussion. Most if not all student answers to this
question have a built-in credibility, because success with any one of these health goals can build confidence
toward achieving other health goals.
Government typically provides resources and knowledge to organizations and individuals. Grant initiatives
can stimulate creative health-promoting interventions and rigorous evaluations of their success. Government
is also able to disseminate what is known, as it has done with the online version of the Guide to Clinical
Preventive Services.
Libertarians will object to any government intervention. Instead, they (including some students, as this is a
popular philosophy among a minority of young students) will argue that individuals need to be strong,
responsible, and self-reliant, and government tends to weaken these character traits. With age and
vulnerability, though, this attractive philosophy loses some of its luster.
Health professionals need to link the clinical practice in their medical clinics to health-promoting activities in
the community, and vice versa. Disease and functional impairment raise patients’ awareness and motivate
their need to promote their health. The clinic needs to hire a health educator or be well versed on referring
older patients to the health-promoting opportunities available in the community. Conversely, community
practitioners need to be cognizant of the medical status of their participants and should encourage them to
keep their clinicians informed about their lifestyle changes.
Laypersons in the community need to be informed and involved in their health care. Chronic conditions don’t
just go away. We must be observant on a daily basis to changes in our health status, and we must be
motivated to make necessary lifestyle changes. Passive older patients place the quality of their lives—in fact,
their very lives—at risk.
What is your definition of healthy aging?
As with the preceding question, personal opinion is encouraged. This topic is where the multifaceted
definition of wellness comes into play. I believe that the primary component of healthy aging is to be
connected. This may mean a connection to another individual, an organization, a cause, a healthy lifestyle,
spiritual growth, and so forth. Connections provide meaning and purpose.
I have a sister who has built her life around dogs. I have a friend who constantly reads; he not only reads at
home, but wherever he goes he carries around a book—just in case. Whether a single connection is sufficient
or not for healthy aging makes for a good discussion. Rather than assume single-minded passions are
unhealthy obsessions, they can be viewed as vital connections. If these connections are multifaceted,
however, individuals become more versatile in promoting their health.
2 Copyright © Springer Publishing Company, LLC. All Rights Reserved.
, Why do we call medical care “health care”?
Health care is the more encompassing term, yet much of what we read in the literature refers to medical care
because it dominates the resources that we are spending. Visiting a physician in a medical clinic, taking a
medication, staying at a hospital, undergoing rehabilitation, and so forth, consumes the vast majority of what
we spend on health care. But if we are not also referring to exercise, nutrition, smoking cessation, support
groups, and other health-promoting activities, we should be using the narrower term of medical care rather
than health care.
The goal is to promote health care, but prematurely identifying the topic in this way (rather than by its actual
term, medical care), belittles the importance of health promotion, disease prevention, and chronic disease
management.
What are two of the most important changes needed to convert our medical care system into a health
care system? How can we make these changes?
Medical care dominates the economy, but health promotion is a growing enterprise in the community. How
do we integrate the two to the betterment of both? There are some ideas about this in the chapter, but think
outside of the box (or in this case, the book). Here are my three suggestions, sure to displease some (which is
good for discussion):
We should require that a health educator, whose services are partially reimbursed through insurance plans and
partially by patients, be affiliated with every medical clinic. (This will, however, raise costs to patients.)
We should require that every smoker, sedentary person, over-weight person, or insomniac (or substitute your
own risk factor that interests you) be referred by a physician to this clinic-based health educator. (The patient
can always refuse, but this does not negate the idea that an automatic referral is a good health care practice.)
We should require that every medical clinic not only have a health educator, but be a repository of community
health-promoting resources to patients. (With a warning, though, that assessing the quality of these resources
is the responsibility of the seeker of services.)
The additional discussion questions below can be used to provoke dissenting opinions and interesting class
discussions. They may also be used as test questions for examinations:
Must health promotion and disease prevention save medical dollars in order to inspire financial
support for such activities from our federal and state governments and through private insurance
reimbursement?
We are an economically focused society, and money dominates the lives of many Americans. Should it
dominate the discussion on health promotion and disease prevention? Health is, after all, an important and
objective value that may or may not be measured in terms of dollar amounts. Those who are focused on
dollars attempt to answer the question: will adding healthy years to our lives cost government additional
dollars, or will these health-promoting costs be offset by a reduction in medical costs?
Many economists and other experts profess that health promotion and disease prevention do not save money.
Nonsmokers and immunized seniors, for example, live longer and, therefore, receive more Medicare
reimbursements over time—as well as Social Security dollars.
In addition, a substantial percentage of individuals may not participate in an available health promotion
intervention, or respond unsuccessfully, and a significant portion of the costs of these tax-payer subsidized
interventions will not be cost-effective. If an intervention was successfully implemented with the entire
population, say a colonoscopy for every American who is age 50 or older, could this hugely expensive
intervention possibly be offset by a reduction in cancer care costs?
Copyright © Springer Publishing Company, LLC. All Rights Reserved. 3
, There are many idealists, though, who value health for its own sake, and believe federal and state
governments should play a leadership role regardless of whether it saves dollars. Conversely, there are also
people (such as libertarians) who want to prevent paternalistic government officials from interfering with
their individual freedoms.
From a political and practical perspective, health-promoting advocates will likely continue to focus on the
actual or potential medical savings from engaging in a healthy lifestyle. The reality is that we do not yet know
whether a healthy lifestyle is cost effective or not.
Will age 65 remain the de facto definition of old age? If yes, why? If not, what will replace it, and will
there be multiple chronological markers for old age?
We are living longer and healthier. What will this do to the longstanding tradition of defining old age as 65
and above? There are many ways to redefine old age from a chronological perspective, and they may reveal
strong attitudes about aging.
Given that the majority of 75-year-olds report that they are in good health and feel youthful, is it fair to have
age 65 remain the de facto marker for old age? Should 80 or 85 become the new 65?
An even more unique perspective is to believe that the label of old age can be positive; it need not diminish
the status of becoming 65. Instead, age 65 can be the portal to a new definition of a positive old age, a time
when individuals are still healthy, possess more discretionary time, and have the potential to contribute to
civic ventures and family life. Rather than postpone old age and its negative associations to an older
chronological age, redefine old age in a positive way at the relatively young chronological age of 65.
Many people aged 75 and over perceive themselves as middle-aged. What do you think about this
phenomenon?
Is there such a thing as a middle-aged 75-year-old? Obviously we do not live to the age of 150, which would
make age 75 the halfway point. Is this newly expressed belief about an extended middle age a reflection of
changing times or is it just age denial? There is some evidence that the times are changing. There are an
increasing number of 75-year-olds who are quite vigorous both mentally and physically, and they appear to be
as vital as the average middle-aged person of 50 years ago.
But at what point is this just a type of wishful thinking, a denial of old age, and an unwillingness to reflect on
a limited number of years left to live?
Americans value individual responsibility. Should we as individuals bear full responsibility for our
health-promoting activities? Why?
Should we as individuals bear most of the responsibility for our health? Many of my students have been
psychologically oriented and have answered this question in the affirmative. It is up to each person to
demonstrate the character and willpower to take care of himself or herself. Sociologists and those with a
penchant for advocacy, however, are more likely to believe that we place too much responsibility on the
individual in our society, and that we are too quick to blame the victim.
Stimulated by nonstop food and drink advertisements, and seated in front of computer screens at work for an
increasing number of hours, it is hard to minimize the gluttonous and slothful influences in our culture. Yet
many students are true-blue Americans and value individual responsibility above all else.
If two-thirds of Americans are now overweight, however, has there been some widespread character flaw that
has infected our country over the past four or five decades? Or have there been sociological influences at
work that appear to overwhelm individual responsibility?
4 Copyright © Springer Publishing Company, LLC. All Rights Reserved.
, EXAMINATION 1
*Correct Answer Name _______________________
Circle or insert the correct letter, number, or word.
1. Healthy People 2020 can best be described (i.e., corresponds to what exists in reality rather than what
it is purported to be) in the following way:
a. This is a state program that primarily monitors health goals.
b. This is a federal and state program that primarily funds health initiatives at the federal level and
monitors health goals at the state level.
*c. This is a federal and state program that primarily monitors health goals.
2. Thanks to the Healthy People 2020 initiative, there has been an increase in exercise, and a decline in
overweight/obese Americans over the past 10 years.
True *False
3. Which statement best reflects the age rectangle in the United States:
a. Those under age 18 roughly equaled those over age 65 in 2000.
b. In 1900, those under age 18 were slightly more numerous than those over age 65.
*c. The age rectangle will not take place until 2030.
4. Baby boomers refer to the cohort that started in the year ___________________ and ended in the
year ___________________.
*(1946 to 1964)
5. The oldest boomer is now how old? __________________
*70—if answered in 2016
6. The so-called “older old” are rapidly increasing in numbers. In terms of percentage growth, the
following is true:
a. The percentage increase gets larger every decade from 1980 to 2010.
*b. The percentage increase is roughly 40% every decade from 1980 to 2010.
c. The percentage increase is smaller every decade from 1980 to 2010.
d. The percentage increase is roughly 20% every decade from 1980 to 2010.
7. An increase in chronic conditions with age means a comparable increase in disability with age.
True *False
8. The number of centenarians in America is forecast to peak to one million in approximately which year
(hint: approximately when do the baby boomers start turning 100?):
2010 2030 *2050 2070
Copyright © Springer Publishing Company, LLC. All Rights Reserved. 5
, 9. Hospital stays have been getting longer for older adults over the past three decades.
True *False
10. Labor force participation among older persons is expected to climb higher in the coming years.
*True False
11. Match the following two columns:
___ Primary prevention (c) a. Medical screening
___ Secondary prevention (a) b. Rehabilitation
___ Tertiary prevention (b) c. Health promotion
12. Which best describes the term wellness:
a. Refers to several dimensions of health, without the emphasis on physical health
b. Tends to be identified with more alternative health activities
*c. Both a and b
13. Advocates of the idea that “compression of morbidity” will take place, also believe:
a. Biomedical research funds will decline.
b. Diseases such as Alzheimer’s will resist cures.
c. Medical advances will increase life expectancy rather than prevent the occurrence of disease.
*d. Risk factors will continue to be reduced as lifestyles improve.
14. A major component of Medicare coverage is long-term care.
True *False
15. Social security was designed to fully replace lost earnings.
True *False
16. Trailing-edge boomers were much less likely to serve in the military than leading-edge boomers.
*True False
17. Health educators agree that the three leading causes of death are the diseases: heart disease, cancer,
and stroke; rather than the underlying health behaviors.
True *False
18. Which would not be called an entitlement program that is based on prior earnings?
a. Medicare
*b. Medicaid
c. Social Security
6 Copyright © Springer Publishing Company, LLC. All Rights Reserved.
,19. The population of older adults age 65 and over in the United States grew from 3 million in 1900, to
40 million in 2010, and is projected to grow to 72 million in 2030.
*True False
20. The most common limitation among the components of the activities of daily living measurement tool
is:
a. Bathing/showering
b. Eating
c. Using toilet
*d. Walking
e. Dressing
21. The percent of widows to widowers over age 65 is about:
a. 2 to 1
*b. 3 to 1
c. 7 to 1
22. From 2009 to 2011, the labor force participation rate for men declined in the following age group:
*a. Ages 62 to 64
b. Ages 65 to 69
c. Ages 70 and over
d. It did not decline in any of the older age groups
23. Women in the labor force increased in all the older age categories.
*True False
24. In 2010, White, Non-Hispanic adults age 65 and older had a higher percentage of individuals with at
least a Bachelor’s degree than Asian, Black, or Hispanic adults age 65 and older.
True *False (not Asians)
25. Among the 10 leading causes of death among older adults, which disease is most likely not ranked high
enough _____________________________ (Alzheimer’s)
26. Compression of morbidity extends longevity.
True *False
27. As you might expect about half of older adults think their health is good or even better than good, and
about half think their health is not good.
True *False
Copyright © Springer Publishing Company, LLC. All Rights Reserved. 7
, 28. What is the problem with describing a generation, like the boomers. Give an example:
_______________________________________________________________________________________
_______________________________________________________________________________________
29. What are two important differences between Medicare and Medicaid?
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
8 Copyright © Springer Publishing Company, LLC. All Rights Reserved.
Seventh Edition Haber
Notes
1- The file is chapter after chapter.
2- We have shown you few pages sample.
3- The file contains all Appendix and Excel sheet
if it exists.
4- We have all what you need, we make update
at every time. There are many new editions
waiting you.
5- If you think you purchased the wrong file You
can contact us at every time, we can replace it
with true one.
Our email:
, CHAPTER 1
Introduction
CHAPTER SUMMARY
This chapter introduces a wide range of health and aging concepts, topics, and data. It begins with a summary of the
Healthy People Initiatives, which is the first federal initiative to shift attention from a “war on disease” to an
“initiative on health promotion.” While this is an important shift, the initiative’s effectiveness would be considerably
enhanced by the funding of community and clinical health promotion interventions, rather than limited to the
monitoring of health goals.
Medicare coverage, for instance, is why we have made more progress with older adults over the past two or three
decades regarding increased mammograms, flu shots, and pneumonia immunizations than we have made with
reducing such risk factors as obesity and physical inactivity. While obesity and smoking counseling have recently
been covered by Medicare, it is too early to know about their impact.
The sociodemographic trends described in this chapter cover a combination of medical and health topics, with the
two areas being very much related. As medical costs have escalated beyond affordability for many Americans,
health promotion, disease prevention, and chronic disease management have increased in importance.
The aging of America contributes to escalating medical costs; it could also stimulate a growing investment in
health promotion, disease prevention, and chronic disease management. Boomers, by their sheer size in numbers,
have forced changes in hospital growth, medical personnel training, and the expansion of public schools and housing
stock. They can do the same with the promotion of health.
The coming of the baby boomers into the ranks of the old inspires much hope. The boomers are highly educated
and are more likely to advocate for what they believe in than previous generations, and they are entering this early
phase of old age in breathtaking numbers. This huge cohort has great potential to inspire political advocacy and
create institutional change.
Society also must grapple with the challenges of the oldest segment of older adults. There will be an ongoing
challenge to meet the needs of people age 80+ who are growing in number at the rate of 40% a decade. The oldest of
the old requires the most support from both family and government. Already, the growth of this segment of the
population has provided impetus to revolutionize institutions such as nursing homes, which have remained
remarkably resistant to progressive thinking, and to promote more desirable long-term care alternatives as well as
expansion of palliative care and hospice care (see Chapter 10).
The definition of health promotion in late life inspires a range of thinking, from a focus on the extraordinary
accomplishments of older adults, to a consideration of the many dimensions of wellness, to the credibility of fighting
the aging process itself. For many aging individuals, it appears that emotional health gains supremacy over physical
health, and as we will learn in subsequent chapters, the capacity for emotional health may develop with age (see
Chapter 8).
From a policy perspective, Medicare appears to dwarf all other legislation, including social security, in
challenging our best thinkers on how to control costs. Adjusted for inflation, older adults are spending more out-of-
pocket now than before Medicare. When the issues of Medicare are combined with the challenges of Medicaid and
long-term care, the need to expand quality medical care coverage to all Americans—all the while keeping health
care affordable—will require a major transformation in our health care system.
And, voila, along comes the Affordable Care Act (see Chapter 11), which is changing health care for all
Americans, including those on Medicare and Medicaid. This revolutionary piece of legislation will play out with
unexpected turns in the coming years, and will make this course very topical indeed.
Copyright © Springer Publishing Company, LLC. All Rights Reserved. 1
, There are several concepts in this chapter, such as compression of morbidity and health expectancy that can get
young students thinking about how their lifelong lifestyle practices will pay off handsomely with an elongated
period of vitality in later life.
CHAPTER 1—DISCUSSION QUESTIONS AND ANSWERS
The following set of questions and answers pertains to the sidebars in Chapter 1.
What do you think is the most important health objective to set for older adults for the Healthy People
2020 initiative? Why? What should the federal and state governments, health professionals, and
laypersons do to help achieve this objective?
To improve exercise or nutrition is the most likely Healthy People 2020 objective to be suggested by students,
but a wide range of responses will make for an interesting discussion. Most if not all student answers to this
question have a built-in credibility, because success with any one of these health goals can build confidence
toward achieving other health goals.
Government typically provides resources and knowledge to organizations and individuals. Grant initiatives
can stimulate creative health-promoting interventions and rigorous evaluations of their success. Government
is also able to disseminate what is known, as it has done with the online version of the Guide to Clinical
Preventive Services.
Libertarians will object to any government intervention. Instead, they (including some students, as this is a
popular philosophy among a minority of young students) will argue that individuals need to be strong,
responsible, and self-reliant, and government tends to weaken these character traits. With age and
vulnerability, though, this attractive philosophy loses some of its luster.
Health professionals need to link the clinical practice in their medical clinics to health-promoting activities in
the community, and vice versa. Disease and functional impairment raise patients’ awareness and motivate
their need to promote their health. The clinic needs to hire a health educator or be well versed on referring
older patients to the health-promoting opportunities available in the community. Conversely, community
practitioners need to be cognizant of the medical status of their participants and should encourage them to
keep their clinicians informed about their lifestyle changes.
Laypersons in the community need to be informed and involved in their health care. Chronic conditions don’t
just go away. We must be observant on a daily basis to changes in our health status, and we must be
motivated to make necessary lifestyle changes. Passive older patients place the quality of their lives—in fact,
their very lives—at risk.
What is your definition of healthy aging?
As with the preceding question, personal opinion is encouraged. This topic is where the multifaceted
definition of wellness comes into play. I believe that the primary component of healthy aging is to be
connected. This may mean a connection to another individual, an organization, a cause, a healthy lifestyle,
spiritual growth, and so forth. Connections provide meaning and purpose.
I have a sister who has built her life around dogs. I have a friend who constantly reads; he not only reads at
home, but wherever he goes he carries around a book—just in case. Whether a single connection is sufficient
or not for healthy aging makes for a good discussion. Rather than assume single-minded passions are
unhealthy obsessions, they can be viewed as vital connections. If these connections are multifaceted,
however, individuals become more versatile in promoting their health.
2 Copyright © Springer Publishing Company, LLC. All Rights Reserved.
, Why do we call medical care “health care”?
Health care is the more encompassing term, yet much of what we read in the literature refers to medical care
because it dominates the resources that we are spending. Visiting a physician in a medical clinic, taking a
medication, staying at a hospital, undergoing rehabilitation, and so forth, consumes the vast majority of what
we spend on health care. But if we are not also referring to exercise, nutrition, smoking cessation, support
groups, and other health-promoting activities, we should be using the narrower term of medical care rather
than health care.
The goal is to promote health care, but prematurely identifying the topic in this way (rather than by its actual
term, medical care), belittles the importance of health promotion, disease prevention, and chronic disease
management.
What are two of the most important changes needed to convert our medical care system into a health
care system? How can we make these changes?
Medical care dominates the economy, but health promotion is a growing enterprise in the community. How
do we integrate the two to the betterment of both? There are some ideas about this in the chapter, but think
outside of the box (or in this case, the book). Here are my three suggestions, sure to displease some (which is
good for discussion):
We should require that a health educator, whose services are partially reimbursed through insurance plans and
partially by patients, be affiliated with every medical clinic. (This will, however, raise costs to patients.)
We should require that every smoker, sedentary person, over-weight person, or insomniac (or substitute your
own risk factor that interests you) be referred by a physician to this clinic-based health educator. (The patient
can always refuse, but this does not negate the idea that an automatic referral is a good health care practice.)
We should require that every medical clinic not only have a health educator, but be a repository of community
health-promoting resources to patients. (With a warning, though, that assessing the quality of these resources
is the responsibility of the seeker of services.)
The additional discussion questions below can be used to provoke dissenting opinions and interesting class
discussions. They may also be used as test questions for examinations:
Must health promotion and disease prevention save medical dollars in order to inspire financial
support for such activities from our federal and state governments and through private insurance
reimbursement?
We are an economically focused society, and money dominates the lives of many Americans. Should it
dominate the discussion on health promotion and disease prevention? Health is, after all, an important and
objective value that may or may not be measured in terms of dollar amounts. Those who are focused on
dollars attempt to answer the question: will adding healthy years to our lives cost government additional
dollars, or will these health-promoting costs be offset by a reduction in medical costs?
Many economists and other experts profess that health promotion and disease prevention do not save money.
Nonsmokers and immunized seniors, for example, live longer and, therefore, receive more Medicare
reimbursements over time—as well as Social Security dollars.
In addition, a substantial percentage of individuals may not participate in an available health promotion
intervention, or respond unsuccessfully, and a significant portion of the costs of these tax-payer subsidized
interventions will not be cost-effective. If an intervention was successfully implemented with the entire
population, say a colonoscopy for every American who is age 50 or older, could this hugely expensive
intervention possibly be offset by a reduction in cancer care costs?
Copyright © Springer Publishing Company, LLC. All Rights Reserved. 3
, There are many idealists, though, who value health for its own sake, and believe federal and state
governments should play a leadership role regardless of whether it saves dollars. Conversely, there are also
people (such as libertarians) who want to prevent paternalistic government officials from interfering with
their individual freedoms.
From a political and practical perspective, health-promoting advocates will likely continue to focus on the
actual or potential medical savings from engaging in a healthy lifestyle. The reality is that we do not yet know
whether a healthy lifestyle is cost effective or not.
Will age 65 remain the de facto definition of old age? If yes, why? If not, what will replace it, and will
there be multiple chronological markers for old age?
We are living longer and healthier. What will this do to the longstanding tradition of defining old age as 65
and above? There are many ways to redefine old age from a chronological perspective, and they may reveal
strong attitudes about aging.
Given that the majority of 75-year-olds report that they are in good health and feel youthful, is it fair to have
age 65 remain the de facto marker for old age? Should 80 or 85 become the new 65?
An even more unique perspective is to believe that the label of old age can be positive; it need not diminish
the status of becoming 65. Instead, age 65 can be the portal to a new definition of a positive old age, a time
when individuals are still healthy, possess more discretionary time, and have the potential to contribute to
civic ventures and family life. Rather than postpone old age and its negative associations to an older
chronological age, redefine old age in a positive way at the relatively young chronological age of 65.
Many people aged 75 and over perceive themselves as middle-aged. What do you think about this
phenomenon?
Is there such a thing as a middle-aged 75-year-old? Obviously we do not live to the age of 150, which would
make age 75 the halfway point. Is this newly expressed belief about an extended middle age a reflection of
changing times or is it just age denial? There is some evidence that the times are changing. There are an
increasing number of 75-year-olds who are quite vigorous both mentally and physically, and they appear to be
as vital as the average middle-aged person of 50 years ago.
But at what point is this just a type of wishful thinking, a denial of old age, and an unwillingness to reflect on
a limited number of years left to live?
Americans value individual responsibility. Should we as individuals bear full responsibility for our
health-promoting activities? Why?
Should we as individuals bear most of the responsibility for our health? Many of my students have been
psychologically oriented and have answered this question in the affirmative. It is up to each person to
demonstrate the character and willpower to take care of himself or herself. Sociologists and those with a
penchant for advocacy, however, are more likely to believe that we place too much responsibility on the
individual in our society, and that we are too quick to blame the victim.
Stimulated by nonstop food and drink advertisements, and seated in front of computer screens at work for an
increasing number of hours, it is hard to minimize the gluttonous and slothful influences in our culture. Yet
many students are true-blue Americans and value individual responsibility above all else.
If two-thirds of Americans are now overweight, however, has there been some widespread character flaw that
has infected our country over the past four or five decades? Or have there been sociological influences at
work that appear to overwhelm individual responsibility?
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, EXAMINATION 1
*Correct Answer Name _______________________
Circle or insert the correct letter, number, or word.
1. Healthy People 2020 can best be described (i.e., corresponds to what exists in reality rather than what
it is purported to be) in the following way:
a. This is a state program that primarily monitors health goals.
b. This is a federal and state program that primarily funds health initiatives at the federal level and
monitors health goals at the state level.
*c. This is a federal and state program that primarily monitors health goals.
2. Thanks to the Healthy People 2020 initiative, there has been an increase in exercise, and a decline in
overweight/obese Americans over the past 10 years.
True *False
3. Which statement best reflects the age rectangle in the United States:
a. Those under age 18 roughly equaled those over age 65 in 2000.
b. In 1900, those under age 18 were slightly more numerous than those over age 65.
*c. The age rectangle will not take place until 2030.
4. Baby boomers refer to the cohort that started in the year ___________________ and ended in the
year ___________________.
*(1946 to 1964)
5. The oldest boomer is now how old? __________________
*70—if answered in 2016
6. The so-called “older old” are rapidly increasing in numbers. In terms of percentage growth, the
following is true:
a. The percentage increase gets larger every decade from 1980 to 2010.
*b. The percentage increase is roughly 40% every decade from 1980 to 2010.
c. The percentage increase is smaller every decade from 1980 to 2010.
d. The percentage increase is roughly 20% every decade from 1980 to 2010.
7. An increase in chronic conditions with age means a comparable increase in disability with age.
True *False
8. The number of centenarians in America is forecast to peak to one million in approximately which year
(hint: approximately when do the baby boomers start turning 100?):
2010 2030 *2050 2070
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, 9. Hospital stays have been getting longer for older adults over the past three decades.
True *False
10. Labor force participation among older persons is expected to climb higher in the coming years.
*True False
11. Match the following two columns:
___ Primary prevention (c) a. Medical screening
___ Secondary prevention (a) b. Rehabilitation
___ Tertiary prevention (b) c. Health promotion
12. Which best describes the term wellness:
a. Refers to several dimensions of health, without the emphasis on physical health
b. Tends to be identified with more alternative health activities
*c. Both a and b
13. Advocates of the idea that “compression of morbidity” will take place, also believe:
a. Biomedical research funds will decline.
b. Diseases such as Alzheimer’s will resist cures.
c. Medical advances will increase life expectancy rather than prevent the occurrence of disease.
*d. Risk factors will continue to be reduced as lifestyles improve.
14. A major component of Medicare coverage is long-term care.
True *False
15. Social security was designed to fully replace lost earnings.
True *False
16. Trailing-edge boomers were much less likely to serve in the military than leading-edge boomers.
*True False
17. Health educators agree that the three leading causes of death are the diseases: heart disease, cancer,
and stroke; rather than the underlying health behaviors.
True *False
18. Which would not be called an entitlement program that is based on prior earnings?
a. Medicare
*b. Medicaid
c. Social Security
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,19. The population of older adults age 65 and over in the United States grew from 3 million in 1900, to
40 million in 2010, and is projected to grow to 72 million in 2030.
*True False
20. The most common limitation among the components of the activities of daily living measurement tool
is:
a. Bathing/showering
b. Eating
c. Using toilet
*d. Walking
e. Dressing
21. The percent of widows to widowers over age 65 is about:
a. 2 to 1
*b. 3 to 1
c. 7 to 1
22. From 2009 to 2011, the labor force participation rate for men declined in the following age group:
*a. Ages 62 to 64
b. Ages 65 to 69
c. Ages 70 and over
d. It did not decline in any of the older age groups
23. Women in the labor force increased in all the older age categories.
*True False
24. In 2010, White, Non-Hispanic adults age 65 and older had a higher percentage of individuals with at
least a Bachelor’s degree than Asian, Black, or Hispanic adults age 65 and older.
True *False (not Asians)
25. Among the 10 leading causes of death among older adults, which disease is most likely not ranked high
enough _____________________________ (Alzheimer’s)
26. Compression of morbidity extends longevity.
True *False
27. As you might expect about half of older adults think their health is good or even better than good, and
about half think their health is not good.
True *False
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, 28. What is the problem with describing a generation, like the boomers. Give an example:
_______________________________________________________________________________________
_______________________________________________________________________________________
29. What are two important differences between Medicare and Medicaid?
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
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