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OBJECTIVES: A well-documented paradox is that Hispanics tend to live longer than non-Hispanic Whites (NHW), despite structural disadvantages. We evaluate whether the "Hispanic paradox" extends to more comprehensive longitudinal aging classifications and examine how lifecourse factors relate to these groupings. METHODS: We used biennial data (1998-2014) on adults aged 65 years and older at baseline from the Health and Retirement Study. We use joint latent class discrete time and growth curve modeling to identify trajectories of aging, and multinomial logit models to determine whether U.S.-born (USB-H) and Foreign-born (FB-H) Hispanics experience healthier styles of aging than non-Hispanic Whites (NHW), and test how lifecycle factors influence this relationship. RESULTS: We identify four trajectory classes including, "cognitive unhealthy," "high morbidity," "nonaccelerated", and "healthy." Compared to NHWs, both USB-H and FB-H have higher relative risk ratios (RRR) of "cognitive unhealthy" and "high morbidity" classifications, relative to "nonaccelerated." These patterns persist upon controlling for lifecourse factors. Both Hispanic groups, however, also have higher RRRs for "healthy" classification (vs "nonaccelerated") upon adjusting for adult achievements and health behaviors. DISCUSSION: Controlling for lifefcourse factors USB-H and FB-H have equal or higher likelihood for "high morbidity" and "cognitive unhealthy" classifications, respectively, relative to NHWs. Yet, both groups are equally likely of being in the "healthy" group compared to NHWs. These segregations into healthy and unhealthy groups require more research and could contribute to explaining the paradoxical patterns produced when population heterogeneity is not taken into account.

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There is a dearth of comparative information about how women from diverse social locations think about, talk about, and experience the various types of reproductive aging. In this article I analyze racial-ethnic differences in attitudes toward surgically induced menopause (hysterectomy) utilizing data from an interview study of 130 menopausal women. African American women in this study were more suspect of doctors' initial offers of hysterectomies than European American women, with the former group of interviewees still fearing a legacy of racial-ethnic discrimination within medical institutions. Only after seeking a second opinion or finding a trustworthy doctor did African American women feel comfortable accepting a hysterectomy. European American interviewees were not as wary as their African American counterparts and sometimes reported wishing for a hysterectomy. I argue that attitudes toward hysterectomy must be contextualized within women's experiences of racial-ethnic oppression and privilege to be fully understood.

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BACKGROUND: Immigrants have disparate access to health care. Disabilities can amplify their health care burdens. OBJECTIVE/HYPOTHESIS: Examine how US- and foreign-born working-age adults with disabilities differ in their health care spending patterns. METHODS: Medical Expenditures Panel Survey yearly-consolidated files (2000-2010) on working-age adults (18-64 years) with disabilities. We used three operational definitions of disability: physical, cognitive, and sensory. We examined annual total, outpatient/office-based, prescription medication, inpatient, and emergency department (ED) health expenditures. We tested bivariate logistic and linear regression models to, respectively, assess unadjusted group differences in the propensity to spend and average expenditures. Second, we used multivariable two-part models to estimate and test per-capita expenditures adjusted for predisposing, enabling, health need and behavior indicators. RESULTS: Adjusted for age and sex differences, US-born respondents with physical, cognitive, sensory spent on average $2977, $3312, and $2355 more in total compared to their foreign-born counterparts (P < 0.01). US-born spending was also higher across the four types of health care expenditures considered. Adjusting for the behavioral model factors, especially predisposing and enabling indicators, substantially reduced nativity differences in overall, outpatient/office-based and medication spending but not in inpatient and ED expenditures. CONCLUSIONS: Working-age immigrants with disabilities have lower levels of health care use and expenditures compared to their US-born counterparts. Affordable Care Act provisions aimed at increasing access to insurance and primary care can potentially align the consumption patterns of US- and foreign-born disabled working-age adults. More work is needed to understand the pathways leading to differences in hospital and prescription medication care.

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BACKGROUND: African American adolescents experience higher rates of obesity and have an increased risk of obesity-related diseases than do White American adolescents. Despite culturally sensitive obesity preventive interventions, obesity rates are increasing within the African American adolescent population. Current obesity interventions do not usually address the heterogeneity (e.g., socioeconomic status [SES], gender, and residential status differences) within the African American adolescent community that can affect the efficacy of these interventions. PURPOSE: To examine the gender, SES, and residential status differences related to obesity and weight behaviors in African American adolescents. METHODS: A descriptive correlational study was conducted with 15- to 17-year-old African American adolescents (n = 145) from community clinics, youth organizations, churches, and social networks in metropolitan and inner-city Detroit. Data were collected through use of survey methods and analyzed with use of descriptive statistics, independent sample t tests, and multiple regression equations. RESULTS: Female adolescents consumed foods higher in fat and calories (t = -2.36, p = .019) and had more body fat (t = -9.37, p = .000) than did males. Adolescents of lower SES consumed food higher in fat and calories (t = -2.23, p = .027) and had higher body mass (t = -2.57, p = .011) than did adolescents of higher SES. Inner-city African American adolescents had higher levels of physical activity (t = -2.39, p = .018) and higher body mass (t = 2.24, p = .027) than did suburban African American adolescent counterparts. Gender, SES, and residential status were statistically significant predictors of eating behaviors, physical activity, body mass index, and body fat. CONCLUSIONS: The initial findings from the study will assist in better understanding the obesity epidemic that affects African American adolescents in disparate proportions. IMPLICATIONS: Further examination of the study variables is essential to serve as a basis for developmentally appropriate and culturally relevant targeted interventions with this population. Health care providers and obesity researchers who work with youth can use the initial findings from this study to advocate for healthy lifestyles while reducing the obesity disparity within the African American adolescent population.

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Early reproductive characteristics, including menarcheal age, may have significant effects on later health outcomes. While early exposure to ovarian hormones may influence the risk for certain diseases, the degree to which this exposure is mediated by other factors is not well understood. Research on secular trends in age at menarche and subsequent outcomes in women's health across the lifespan can help to clarify the importance of age at menarche. Since 1934, the TREMIN Research Program on Women's Health has collected longitudinal data on menstruation and reproductive health. Recently we examined the age at menarche across the entire population of TREMIN participants, across the two major cohorts of this research program (participants initially enrolled in the 1930s and in the 1960s), and within families where mothers and daughters participated in the study. Our results indicated that age at menarche among the 4,444 mainly European American girls in our sample decreased in the first part of the twentieth century, and then began to increase in the late 1940s. The comparison of age at menarche across the two major cohorts reinforced this analysis: age at menarche was slightly but significantly lower (P < .001) in the second cohort (12.66), most of whom were born in the 1940s, than in the first cohort (12.89), those women born before 1920. In analyzing data from 380 mother-daughter pairs, there was no significant difference between mothers' and daughters' mean age at menarche and no significant correlation between them.

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In this article I explore women's discussions of the interactions that families have about menopause and, thus, attempt to broaden feminist knowledge of women's experiences of menopause within families. Data on which this article is based were collected in 61 in-depth interviews with menopausal women in a midwest state in 2001. Findings suggest that biomedical definitions of menopause are often reaffirmed within interactions between intimate partners. Thus, women reported negative familial interactions about menopause, as they were encouraged to define symptoms as problematic and seek medical treatment. Alternatively, some interviewees reported positive interactions about menopause, as a few partners helped them soothe symptoms and follow health regimens. Women interpreted these latter interactions as support or care, rather than surveillance or monitoring. The author concludes that familial interactions bolster dominant constructions of both menopause and family because, as menopause is discussed between intimate partners, definitions of gendered familial roles and responsibilities are cemented.

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Feminist social scientists and some epidemiologists suggest that women's family lives may form a backdrop for menopause. Some family contexts for menopause have been ignored by researchers, however. In this article women's discussions of family background were explored in an attempt to broaden social science and epidemiological knowledge of family contexts. Data were collected in 61 in-depth interviews with menopausal women aged 38-60 in a midwest state in 2001. Unprompted by the interviewer, 42 women (69%) discussed mothers' menopause experiences when trying to describe their own; many also discussed other female relatives' experiences. Interview conversations often focused on whether daughters' menopause experiences matched their mothers'. Women's discussions of the importance of mother-daughter ties and their attentions to genetic inheritance suggest that the actual effects of family backgrounds on menopause as well as the importance women place on family background must be explored further, as women are defining and reacting toward menopause within this unexplored social context.

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Due to recent feminist scholarship, we know a considerable amount about women's mothering identities and activities, as well as the impact of mothering ideology on individual women. Nonetheless there are gaps in our knowledge about motherhood. For instance, we know mostly about experiences of mothers with young children, and an implicit assumption is that mothers are also fairly young themselves. Yet, what about mothers at midlife and beyond? What about menopausal mothers? This paper represents an initial attempt to explore motherhood experiences of middle-aged menopausal women. Findings presented in this article are based on 45 in-depth interviews with middle-class, heterosexual menopausal women in a midwestern state in 2001. Findings suggest that motherwork and the maintenance of "good" mothering ideology are still primary activities of women at menopause despite assumptions that menopausal women have completed mothering experiences and are now grandmothers (if caregivers at all). In analyzing menopausal mothers, I encourage broader explorations of women's experiences of both motherhood and menopause.

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According to previous research, pediatricians describe themselves as being "supportive" of breastfeeding, yet demonstrate suboptimal knowledge and skills when evaluated. Mothers also report dissatisfaction with receiving poor information and support from healthcare professionals (HCPs). To understand the depth of breastfeeding support problems within pediatric clinics, focus groups with mothers and individual interviews with HCPs were completed in 2000 to 2001 at a pediatric practice in a Midwest state. Results from interviews suggest that HCPs and mothers have different perceptions of "support." Existing literature hypothesizes that improvements in support provision could increase breastfeeding durations; this will ultimately involve reconciling mothers' and HCPs' definitions of breastfeeding "support."

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