much clinical research. Behavioral and social research along with health care delivery studies can facilitate clinical investigation of the response of older people to illness and of the effect of interventions to reduce disability and morbidity occurring late in life.
Of equal importance are crosscutting issues that involve gender, racial, and ethnic differences in response to illness, including how older persons experience illness, or in the metabolic disposition of drugs. It would be interesting to understand, for example, the marked difference in morbidity of blacks compared to whites with equal degrees of hypertension or of women compared to men insofar as hypertension-related morbidity is concerned. Another issue involves ethics in clinical research—a subject discussed in the previous section of this summary.
Many crosscutting issues arise in behavioral and social research, including the effects of gender, race, and ethnicity on longevity, functional status, and morbidity in old age; social role expectations and appropriateness of intervention; and population dynamics to predict longevity and morbidity. In addition, neurobiological study of cognitive defects will be enriched by combination with approaches to intellectual function and its modifiability through behavioral and social intervention. Study in these areas requires interdisciplinary research that cuts across all of the areas of study described in this report, from basic biomedical to health services delivery.
Significant differences in the utilization of health services by men and women extend beyond the distribution of chronic illnesses and morbidity in these groups. Gender differences are seen in participation in programs of prevention and in economic/social status of older persons. These variances should be investigated further. Other topics include the assessment of need for health services based on different patterns of illness and disability between men and women, gender influence on response to different modes of health care delivery, and sex differences in utility of common preventive and risk reduction interventions.