Abstract
In this longitudinal study, we applied structural equation modeling (SEM) to examine the historical, predisposing, enabling/barrier, and need factors as related to the underuse of medical services during early midlife. We gathered longitudinal data on a prospective cohort of community-dwelling men and women (N = 548) followed from adolescence to early midlife. The findings supported a mediational model: A mutually affectionate parent–child relationship in early adolescence was inversely related to underuse of medical services in early midlife via the mediational roles played by later predisposing factors (i.e., depressive mood and cigarette smoking), need factor (i.e., physical health problems), barriers (i.e., financial difficulty), and enabling factors (i.e., social support for health services in early midlife). In addition, satisfaction with medical services in the neighborhood had an association with less underuse of medical services in early midlife. Family therapy focused on an increase in the affectionate relationship between the adolescents and his/her parents and cognitive-behavioral treatment of depressive mood may lead to a decrease in the underuse of medical services.
| Original language | English |
|---|---|
| Pages (from-to) | 652-665 |
| Number of pages | 14 |
| Journal | Journal of Urban Health |
| Volume | 93 |
| Issue number | 4 |
| DOIs | |
| State | Published - Aug 1 2016 |
Bibliographical note
Publisher Copyright:© 2016, The New York Academy of Medicine.
Funding
This research was supported by NIH grants DA032603 and DA003188 from the National Institute on Drug Abuse awarded to Dr. Judith S. Brook. The authors wish to thank Dr. Stephen J. Finch for his critical review of this manuscript.
| Funders | Funder number |
|---|---|
| National Institutes of Health (NIH) | DA032603 |
| Author National Institute on Drug Abuse DA031791 Mark J Ferris National Institute on Drug Abuse DA006634 Mark J Ferris National Institute on Alcohol Abuse and Alcoholism AA026117 Mark J Ferris National Institute on Alcohol Abuse and Alcoholism AA028162 Elizabeth G Pitts National Institute of General Medical Sciences GM102773 Elizabeth G Pitts Peter McManus Charitable Trust Mark J Ferris National Institute on Drug Abuse | R01DA003188 |
Keywords
- Cigarette smoking
- Depressive mood
- Financial difficulty
- Longitudinal study
- Neighborhood medical services
- Parent–child relationship
- Physical health problems
- Social support
- Underuse of medical services
ASJC Scopus subject areas
- Health(social science)
- Urban Studies
- Public Health, Environmental and Occupational Health
