This research is directed toward two main questions: (1) How should life events be scored and aggregated for optimal validity across age groups? and (2) To what extent do stressful life events affect the health of chronically ill, elderly men and women over time? Data for this research are from the Medical Outcomes Study (MOS), a large national study of patients under different systems of health care. A two- step approach for studying the effects of stressful life events on health will guide analyses. First, using data for patients of all ages in the longitudinal baseline sample, several scoring schemes for aggregating items and measuring the impact of events will be compared. This comparison will help determine which events or set of events are most important in the etiology of illness and which method of measurement has the best power to detect small changes in health over time in a subset of older patients. After establishing a suitable algorithm for operationalizing stressful life events in step one, a model will be developed to determine the relationships between stress and health outcomes over time. This analysis will be performed on a subset of patients age 55 and older. The model will control for individual characteristics, severity of illness, comorbidity, health at baseline, and will examine changes in mental and physical health at varying intervals of time (e.g., 6, 12, 18, and 24 months) since the occurrence of stress. Findings will make an important contribution to the study of stress through improvements in measurement and through increasing knowledge about the circumstances under which stress affects health, ultimately reducing its impact. This information will have implications for healthcare planning, particularly those related to the allocation of resources for the increasing needs of the elderly.
