A model aimed for use by various institutions that provide asylum to orphaned children and struggling mothers, including temporary receiving homes into which mothers who might otherwise abandon their children are received with them. The model is designed to exhibited the chief sanitary features which the medical profession recognize as essential to success in saving the lives and improving the vitality of the babies who must have institutional care temporarily.

Including a directory of institutions dealing with tuberculosis in the United States and Canada. Compiled under the direction of the National Association for the Study and Prevention of Tuberculosis by Philip P. Jacobs.

From the Introduction: “The development of the anti-tuberculosis activity in the United States during the last ten years has been so rapid and the extension of its field so varied that the need of a comprehensive survey of the work is obvious. A similar situation was met in 1904 by the appearance of the ‘Directory of Institutions Dealing with Tuberculosis’ compiled by Miss Lilian Brandt and published by the New York Charity Organization Society in cooperation with the National Association for the Study and Prevention of Tuberculosis. The present volume includes a revision of that directory as an important section of its contents.”

A report on conditions and care of mental health patients in the United States, with details on attempts to alleviate the dilemmas faced by large public mental hospitals in different parts of the country.

Otto von Mering, School of Medicine, University of Pittsburgh

Stanley H. King, Graduate School of Public Health, University of Pittsburgh

A Volume in the American Sociological Association’s Rose Series in Sociology

Winner of the 2020 Gerontological Society of America’s Richard Kalish Innovation Publication Award

“Comprehensive, cogent, and carefully researched, Golden Years? provides a window onto the realities, risks, and disparities confronting the burgeoning numbers moving to and through life after age sixty-five. But Deborah Carr also showcases possibilities—ways governments, communities, and families can rewrite the scripts of later adulthood in ways that promote greater equality and life quality. This book is must reading for understanding both aging and our aging society—for individuals, family members, students, scholars, and policy makers. An instant classic!”
—PHYLLIS MOEN, director, Life Course Center and McKnight Endowed Presidential Chair in Sociology, University of Minnesota

“Deborah Carr provides an engaging and clearly written analysis of the key questions and controversies driving social science aging research. Golden Years? is essential reading for everyone from those engaged in this research to students who are being exposed to the topic for the first time.”
—PAMELA HERD, professor, McCourt School of Public Policy, Georgetown University

Thanks to advances in technology, medicine, Social Security, and Medicare, old age for many Americans is characterized by comfortable retirement, good health, and fulfilling relationships. But there are also millions of people over 65 who struggle with poverty, chronic illness, unsafe housing, social isolation, and mistreatment by their caretakers. What accounts for these disparities among older adults? Sociologist Deborah Carr’s Golden Years? draws insights from multiple disciplines to illuminate the complex ways that socioeconomic status, race, and gender shape nearly every aspect of older adults’ lives. By focusing on an often-invisible group of vulnerable elders, Golden Years? reveals that disadvantages accumulate across the life course and can diminish the well-being of many.

Carr connects research in sociology, psychology, epidemiology, gerontology, and other fields to explore the well-being of older adults. On many indicators of physical health, such as propensity for heart disease or cancer, black seniors fare worse than whites due to lifetimes of exposure to stressors such as economic hardships and racial discrimination and diminished access to health care. In terms of mental health, Carr finds that older women are at higher risk of depression and anxiety than men, yet older men are especially vulnerable to suicide, a result of complex factors including the rigid masculinity expectations placed on this generation of men. Carr finds that older adults’ physical and mental health are also closely associated with their social networks and the neighborhoods in which they live. Even though strong relationships with spouses, families, and friends can moderate some of the health declines associated with aging, women—and especially women of color—are more likely than men to live alone and often cannot afford home health care services, a combination that can be isolating and even fatal. Finally, social inequalities affect the process of dying itself, with white and affluent seniors in a better position to convey their end-of-life preferences and use hospice or palliative care than their disadvantaged peers.

Carr cautions that rising economic inequality, the lingering impact of the Great Recession, and escalating rates of obesity and opioid addiction, among other factors, may contribute to even greater disparities between the haves and the have-nots in future cohorts of older adults. She concludes that policies such as income supplements for the poorest older adults, expanded paid family leave, and universal health care could ameliorate or even reverse some disparities.

A comprehensive analysis of the causes and consequences of later-life inequalities, Golden Years? demonstrates the importance of increased awareness, strong public initiatives, and creative community- based programs in ensuring that all Americans have an opportunity to age well.

DEBORAH CARR is professor and chair of sociology at Boston University

This report explores the complex ethical, political, psychological, and economic questions that arise from developments in medical genetics. It reviews research in applied genetics at the interface of the social and bio-medical fields, including the counseling and study of birth control, as well as the active treatment and selection of individual genetic attributes.

James R. Sorenson was chair of the Gillings School of Global Public Health’s Department of Human Behavior at the University of North Carolina.

A report advising against a "hands off" mindset of caring for children, pubished by the Playground Association of America in 1910.

LUTHER HALSEY GULICK was president of the Playground Association of America.

Published by the Department of Child-Helping of the Russell Sage Foundation in 1911, this paper analyzes research on height and weight in children.

MILTON A. GERSHEL was attending physician of the Hebrew Sheltering Orphan Asylum of New York City.

“Who Will Care for Us? is a comprehensive and probing work on the challenges and opportunities of building a labor force to do some of the most consequential and sensitive work in our society: providing long-term care for others. Paul Osterman analyzes this complicated landscape with clarity and offers new, creative, and tractable approaches to policy.”

—David Weil, dean, Heller School for Social Policy and Management, Brandeis University, and former Wage and Hour Administrator, U.S. Department of Labor

“In Who Will Care for Us?, Paul Osterman provides important insights into the chall- enges and opportunities for the most important members of the long-term care workforce—the certified nursing assistants and home care aides who provide the lion’s share of services to very vulnerable populations. He combines the best of storytelling and robust scholarship to highlight the systemic factors that explain why this profession is so undervalued. As important, he offers a thoughtful range of policy and practice solutions to elevate this workforce and ultimately deliver better services to a diverse and growing long-term care population.”

—Robyn I. Stone, executive director and senior vice president for research, LeadingAge Center for Applied Research

“With the aging baby boom generation, long-term care will be one of the great policy challenges in the coming decades. In Who Will Care for Us?, Paul Osterman identifies one of the key barriers to achieving high-value long-term care: our underinvestment in how we pay and train the direct care workforce. He makes the compelling case that continuing with the status quo is not the answer. He argues for transforming the direct caregiver job to encompass a much wider set of roles. In order for this to occur, we need to not only retrain our workforce, but also reform many of the policies that have led us to neglect our caregivers.”

—David Grabowski, professor of health care policy, Harvard Medical School

The number of elderly and disabled adults who require assistance with day-to-day activities is expected to double over the next twenty-five years. As a result, direct care workers such as home care aides and certified nursing assistants (CNAs) will become essential to many more families. Yet these workers tend to be low-paid, poorly trained, and receive little respect. Is such a workforce capable of addressing the needs of our aging population? In Who Will Care for Us? economist Paul Osterman assesses the challenges facing the long-term care industry. He presents an innovative policy agenda that reconceives direct care workers’ work roles and would improve both the quality of their jobs and the quality of elder care.

Using national surveys, administrative data, and nearly 120 original interviews with workers, employers, advocates, and policymakers, Osterman finds that direct care workers are marginalized and often invisible in the health care system. While doctors and families alike agree that good home care aides and CNAs are crucial to the wellbeing of their patients, the workers report poverty-level wages, erratic schedules, exclusion from care teams, and frequent incidences of physical injury on the job. Direct care workers are also highly constrained by policies that specify what they are allowed to do on the job, and in some states are even prevented from simple tasks such as administering eye drops.

Osterman concludes that broadening the scope of care workers’ duties will simultaneously boost the quality of care for patients and lead to better jobs and higher wages. He proposes integrating home care aides and CNAs into larger medical teams and training them as “health coaches” who educate patients on concerns such as managing chronic conditions and transitioning out of hospitals. Osterman shows that restructuring direct care workers’ jobs, and providing the appropriate training, could lower health spending in the long term by reducing unnecessary emergency room and hospital visits, limiting the use of nursing homes, and lowering the rate of turnover among care workers.

As the Baby Boom generation ages, Who Will Care for Us? demonstrates the importance of restructuring the long-term care industry and establishing a new relationship between direct care workers, patients, and the medical system.

PAUL OSTERMAN is Nanyang Technological University (NTU) Professor of Human Resources and Management at the M.I.T. Sloan School of Management.