Patterns of work and retirement among pediatricians aged >or=50 years.

OBJECTIVE: This study examined patterns of work and retirement among older pediatricians, including the determinants of part-time work and retirement, as well as extended participation in the pediatrician workforce. METHODS: A mail survey regarding recent and expected workforce participation was distributed to American Academy of Pediatrics members who were aged >or=50 years. A total of 1158 (72%) responded, 1114 (70%) of whom were included in these analyses. Analyses examined levels of engagement in medicine, retirement plans, and differences between men and women and primary care pediatricians and pediatric subspecialists. RESULTS: Providing or planning to provide patient care past age 65 was reported by 45% of the respondents. Engaging in part-time work was increasingly more common with age and may represent a step toward retirement for many. In this sample, women were more likely to work part-time (32% vs 18% of men) and less likely to work past age 65 (26% vs 57% of men). When compared with primary care pediatricians, pediatric subspecialists worked more hours per week (59 vs 53) but spent a smaller percentage of their time on patient care (63% vs 82%). CONCLUSIONS: Part-time work and reduced work hours in anticipation of retirement are options that are used and desired by older pediatricians. Results of this study suggest that making provisions for gradual reduction in work hours or other forms of phasing out of the workforce could benefit the practice of pediatrics by extending the career length of the most experienced pediatricians.

Substance use in marital dyads: premarital assortment and change over time.

OBJECTIVE: The purpose of this study was to examine change in substance use with marriage, premarriage similarity in substance use between spouses, and the role of spouse use in predicting changes in use with marriage. METHOD: Nationally representative samples of high school seniors were followed longitudinally through age 35. The sample consisted of 2,169 adults from eight senior-year cohorts (1977-1984) from the Monitoring the Future study who completed a questionnaire at least once before their first marriage and at 2-year intervals at four consecutive points in time after marriage. RESULTS: Results indicate significant reductions in use with marriage for cigarette smoking, heavy drinking, and marijuana use. Both men and women reported reductions in all three substances following marriage. Changes in women's use followed a linear pattern. Although men's decreases in cigarette smoking and heavy drinking were initially rapid and then decelerated, their decrease in marijuana use accelerated over time. Declines in use for both genders were associated with getting married to individuals who also decreased their use. Those with higher premarriage levels of substance use experienced greater reductions in use. A significant association between respondent and spouse premarital use suggests assortative mating takes place for all three substances. CONCLUSIONS: This study affirms and further qualifies the presence of a marriage effect on substance use using multiwave and multicohort national data. Results suggest that the effects of marriage on smoking, heavy drinking, and marijuana use are related to one's own initial levels of use and the direction of change in the spouse's use. These findings have important implications for life span theoretical advances as well as interventions aimed at the marital dyad.

Trajectories of Marijuana Use During the Transition to Adulthood: The Big Picture Based on National Panel Data.

The purposes of this study were to: a) identify trajectory groups of frequent marijuana use during emerging adulthood, b) distinguish among trajectory groups according to demographic and lifestyle characteristics, and c) examine how the trajectory groups relate to behavioral, attitudinal, and social-emotional correlates over time. National panel data from the Monitoring the Future study were used: 18 cohorts of high school seniors (classes of 1977-94) were followed biennially through age 24. Frequent marijuana use was defined as 3+ occasions of use in past month and/or 20 to 40+ occasions in past year. Based on four waves of complete longitudinal data (N=19,952), six frequent marijuana use trajectory groups were identified: chronic, decreased, increased, fling, rare, and abstain. Categorical analyses revealed trajectory group differences in demographic and lifestyle characteristics at senior year and age 24. The trajectory groups varied significantly in longitudinal patterns of other substance use, problem behaviors, and well-being.

Substance use among adults 35 years of age: prevalence, adulthood predictors, and impact of adolescent substance use.

OBJECTIVES: We examined the prevalence of substance use among American adults aged 35 years, and we considered adulthood predictors and the impact of adolescent substance use. METHODS: National panel data were drawn from the Monitoring the Future study. Logistic regressions were conducted to assess the impact of demographics, life experiences, and adolescent substance use on smoking, heavy drinking, prescription drug misuse, marijuana use, and cocaine use at 35 years of age. RESULTS: Factors related to increased likelihood of substance use include high school use, unemployment, and noncustodial parenthood. Lower use was associated with being female, a college graduate, a professional, married, or a custodial parent. CONCLUSIONS: Among those aged 35 years, substance use was still rather prevalent and was a function of adulthood roles, experiences, and previous use.