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BOOK REVIEW |
Professor Emeritus of Medical Sociology Center for Aging and Human Development Duke University Medical Center Durham, NC 27710
Aging in Context: Socio-Physical Environments, Annual Review of Gerontology and Geriatrics Volume 23, edited by Hans-Werner Wahl, Rick J. Scheidt, and Paul G. Windley. Springer Publishing Company, New York, 2004, 400 pp., $58 (cloth).
Aging Independently: Living Arrangements and Mobility, edited by K. Warner Schaie, Hans-Werner Wahl, Heidrum Mollenkopf, and Frank Oswald. Springer Publishing Company, New York, 2003, 376 pp., $69.95 (cloth).
Although intellectual appetites are easily and often jaded by edited volumes that lack a clear sense of purpose guided by theory, the two books reviewed in this essay—Aging in Context: Socio-Physical Environments, edited by Hans-Werner Wahl, Rick J. Scheidt, and Paul Windley, and Aging Independently: Living Arrangements and Mobility, edited by K. Warner Schaie, Hans-Werner Wahl, Heidrum Mollenkopf, and Frank Oswald—are likely to interest most scholars and investigators in gerontology. I have rarely been so engaged as by the breadth of these complementary volumes that explore and build on the work of M. Powell Lawton and the large number of scholars he attracted.
The debt of contemporary ecological psychology to Lawton is acknowledged, but his work is clearly a point of departure for these books, not a final statement. For the most part, the repetition of Lawton's contributions provides useful reinforcement of key points. The only surprise, a minor one, is the discovery that in the Schaie volume, mobility refers primarily to transportation and its related technology rather than to personal capacity to manage one's proximate physical environment.
This unexpected focus appears to have resulted from the coincidence of two conferences that took place in Germany under Schaie's leadership, one of which focused on older drivers and the design of automobiles and roadways. The equating of mobility and transportation, although unexpected, is interesting enough—just unanticipated.
The substantive issues discussed in these works are very much what one might expect from scholars largely identified with ecological psychology—housing, the changing conceptualization of urbanity and rurality, neighborhoods as promising venues for research on adaptation in later life, and the potential beneficial uses of technology by older adults. The bibliographies are extensive and appropriately current.
Lawton and Beyond
While both books celebrate and affirm their indebtedness to Powell Lawton, the authors do not hesitate to critique his contributions and document the evolution of his thinking over a long and productive career. Laura Gitlin's essay on the evolution of his thought (in the Schaie volume) provides a particularly useful overview and commentary. She notes, for example, that although Lawton's earlier work stressed behavioral reactivity to environment, his later work recognized proactivity to environmental stressors. Additionally, others have noted that personal resources, goals, and strategies of Self Optimization with Compensation (Baltes & Baltes, 1990) are relevant variables in person/context interactions that are better described as transactions than reactions. And the various authors in these two anthologies illustrate, if not acknowledge explicitly, how inadequately environment/context/milieu are specified and measured in most gerontological research. Self-efficacy, one of the most often discussed explanatory variables in health research currently, is also surprisingly referenced only once in either text. Self-efficacy and its companion concept, collective efficacy, are particularly useful in research on assisted living housing environments, warranting more attention than they receive (Schulz, Maddox, & Lawton, 2000).
Specifying Contexts
Gerontologists of a certain age will remember the excitement in gerontology created by Warner Schaie's formulation of age/period/cohort in the analysis of longitudinal data. This proposal so obviously made sense that it became the newest of new methodological strategies in the 1960s. There was a problem, however, because empirically these variables were confounded. And worse than that, as Jim Wiley and I (Maddox & Wiley, 1976) noted in the opening chapter on methodology in aging research in the first edition of The Handbook of Aging and the Social Sciences, the demands of specifying period as a very broad construct denoting both socio-cultural content and historic events as well as the length and degree of exposure of individuals to context, were extraordinarily daunting. So daunting in fact that good illustrations of a proper specification and measurement of the dynamics and outcomes of person/period interaction remain rare.
Researchers who use qualitative strategies to study delimited milieus, such as living spaces, are among the investigators most likely to describe physical places and their meaning. And notably, Moos (1976) has been a pioneer in the conceptualization and measurement of a variety of specialized services and educational institutional settings, including long-term-care facilities (see Maddox, 2001), in terms of physical and organizational factors he summarizes as climates.
In sum, the measurement of environment/context/milieu remains elusive even in ecological psychology. And, one must add, in sociology and social gerontology. Part of the explanation for this omission lies in the preference in the recent past within these disciplines for survey research based on areal probability samples that make the explicit measurement of environment/context/milieu—physically, socially, or historically—very difficult, if not impossible. I asked Paul Baltes a long time ago why even ecological psychologists are often so casual about the explicit measurement of environments/context/milieu. He answered wryly, "I thought that was the responsibility of sociologists." Correcting this persistent deficit in our theoretical specification of context remains an important task for the future. The authors writing in these volumes largely miss the opportunity to advance our thinking on this issue.
A Comparative Perspective
In the Schaie volume there are references to differing German and American perspectives, and anthropologist Chris Fry comments on cultural aspects of family organizations and expectations. But these presentations are descriptive, not analytical, in explaining systematically why one would expect culture as context to make a difference in terms of expectations, behavior, or outcomes. Those interested in the use of culture as an explanatory variable in comparative research may benefit from exploring the perspective of Urie Bronfenbrenner on the importance of behavioral settings for defining expectations (see Maddox, 2001). Bronfenbrenner's interest in resilience reflected his optimism about the mobilization of unrealized potential for health and well-being in children, an optimism increasingly shared about the unrealized potential of older adults.
We have no reason to expect grand solutions to how best to conceptualize and measure environment/context/milieu in gerontology. A modest but useful step forward is found in Neal Krause's chapter on neighborhoods, health, and well-being in later life in the Wahl volume. Exploring neighborhoods as a proximate context of social behavior and social action was a favorite strategy of the Chicago school of sociology early in the last century. More recently the usefulness of neighborhoods has been perceived by those who forecast the potential explanatory power of social capital (e.g., trust and mutual expectations of support) differentially distributed in defined neighborhoods to account for better and worse behavioral outcomes (e.g., delinquency or care in response to community crises). What makes this development potentially exciting is that survey social research can increasingly identify neighborhoods and introduce measures of social capital and collective efficacy as explanatory contextual variables.
Interdisciplinarity as a Style of Thought and Practice
An interdisciplinary style of thought and practice that promises appropriate conceptualization and measurement of environment/context/milieu is easier to wish for than to achieve. But the routine inclusion of ecological perspective in theory and research on behavior in later life will be achieved only when there is a common commitment to this objective across gerontological disciplines, not just in ecological psychology.
The usefulness of interdisciplinarity in practice, not just as aspiration, was brought to my personal attention almost forty years ago while I was on sabbatical at the London School of Hygiene. My objective then was to study health policy formulation and implementation in the British National Health Service. All my mentors—at St. Thomas' Hospital, the London School of Economics, and The Maudsley Hospital—were grounded in the intellectual tradition of epidemiology. The classical version of epidemiology assumed that its practitioners would be physicians capable of diagnosing causal agents involved in sickness, disability, and death. But this exquisitely interdisciplinary style of thought required that investigators, regardless of discipline, be trained to understand the great triumvirate of person/context/noxious agent. By the time of my visit, the London School of Hygiene had received a new dean who believed that epidemiologists needed to understand the perspective of medicine but not necessarily be trained as physicians. Further, epidemiologists also needed to understand, in order to use them, the then-emerging large population social survey techniques. And the concept of noxious agents required the inclusion of social factors of the physical and social environment, factors such as the presence or absence of social support, resource deprivation, and poor housing. An epidemiological investigation, in sum, required the inclusion of all three components, an achievement that would benefit all gerontological investigators. The emphasis in ecological psychology on person/context is commendable, but its reach continues to exceed its grasp.
In the years following my early training in epidemiology, social epidemiology became popular among medical sociologists in the United States. But as one might expect, social scientists in gerontology and other disciplines substituted self-reports of disease and functioning for the expensive alternative of clinical evaluation. A broadened view of noxious agents prevailed. And, not surprisingly, social survey techniques tended to settle for inadequate measurements of contexts because areal probability sampling could measure individual perceptions of context but not shared perceptions of the same context.
Intellectual ferment, however, continues in social epidemiology, particularly in the work of Lisa Berkman (see, e.g., Berkman & Kawachi, 2000). Berkman is of particular interest in gerontology because she emphasizes exploring better ways to bring clinical medical perspectives more effectively into social gerontology. And multilevel strategies of data collection and analysis increasingly permit collecting and analyzing data in areas that can be characterized in terms of socioeconomic characteristics such as social capital, economic resources, and ethnic diversity.
Knowledge for What?
Although academics are fond of saying "There is nothing so practical as a good theory," serious, sustained application of theory to the solution of human problems in our aging society is most often left to clinicians and architects, not to social policy analysts, designers of intervention research, and program developers. The irrelevance for practice of much research is an old, well-known complaint. A case in point is the citation in Chapter 13 of the Wahl volume of Kurt Lewin's plea, dating from the 1940s, for more research relevant for social action. The author missed the opportunity to also cite the classic, often-referenced book by Robert Lynd (1939) on the same topic, Knowledge for What? A recent volume edited by Schulz, Maddox, & Lawton (2000) illustrates current interest in research on purposive social interventions intended to promote health and well-being among older adults but does not explore the question of the responsibility for promotion and training for such research in higher education.
I am not surprised by the interest in applied research among those attracted to Lawton, who was a clinician and an interventionist by both training and inclination. He naturally gravitated toward planners and architects with an inclination for practical translation of ideas into action. The fact that centers of graduate education remain so indifferent, if not resistant, to applied research is not addressed in the Wahl volume, nor is how to fix this omission if one perceives its needs fixing. In my own career, summarized briefly in my Kleemeier Lecture in 1985 (Maddox, 1987), my interest in explaining observed diversity in older populations and the increasing evidence that some negative aspects of aging are modifiable, were powerful incentives for my involvement with social policy and social action. These interests, however, were in spite of my academic training, not because of it. The call for more interest in applied research in the volumes under review is commendable. What is missing is how to build into contemporary higher education both the appropriate training and career incentives.
An inclination to translate ideas into action is notable in several of the chapters. A discussion by Rowles and colleagues of interior living environments in which "spaces become places" (in the Wahl volume) illustrates a theoretical understanding of how physical space becomes related to a positive self-concept and how comfort with one's milieu not only occurs but also how favorable outcomes can be facilitated. Also worth noting again, in the same volume, is Krause's review of the practical implications of documenting and understanding how neighborhood contexts can promote health and well-being.
The Role of Publishing in the Development of Gerontology and Geriatrics
In recent decades, the study of late life has increasingly attracted productive scholars and investigators and, in turn, publishing houses, such as Haworth Publishers, Johns Hopkins University Press, Oxford University Press, Sage Publications, and Springer Publishing Company, which are essential in the dissemination of ideas and their applications. It is worth noting that the two volumes reviewed here were published by Springer Publishing Company. Dr. Ursula Springer has for some decades now been not only a leading publisher of books in gerontology and geriatrics but also a leading proponent of scholars and scholarship in these areas. Of particular note is the continuation for nearly a quarter of a century of the Annual Review of Gerontology and Geriatrics Series of which the Wahl volume in this review is a part. Dr. Springer will be retiring shortly from her role as publisher. This is a fitting occasion for gerontologists to thank her for her vision and leadership in promoting the ideas and applications of scholarship and research that will continue to contribute so much to the well-being of older adults.
References
This article has been cited by other articles:
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  R. A. Settersten Jr Linking the Two Ends of Life: What Gerontology Can Learn From Childhood Studies J. Gerontol. B. Psychol. Sci. Soc. Sci., July 1, 2005; 60(4): S173 - S180. [Abstract] [Full Text] [PDF]
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