Productivity & Engagement in an - Recherche en IA spécialisée au MIT

Productivity & Engagement in an
Aging America: The Role of Volunteerism

Dawn C. Carr, Linda P. Frit & John W. Rowe

Abstrait: Volunteering in late life is associated with health bene½ts such as reduced risk of hypertension,
improved self-related health and well-being, delayed physical disability, enhanced cognition, and lower
mortality. Although the mechanisms of these correlations are not clear, increases in physical activity, cog-
nitive engagement, and social interactions likely play contributing roles. Volunteers are typically thought
to represent a select group, often possessing higher levels of education and income, good health, and strong
social networks. Cependant, group evidence indicates that there are many members of groups of lower socio –
economic status (SES), including elderly adults, who serve their communities on a regular basis and in
high-priority programs. We propose that the impact of volunteering in an aging population be recognized
and invested into, and that effective programs harness social capital of older adults to address critical
societal needs and also improve the well-being of older adults. While members of low-SES groups are less
likely to volunteer, they exhibit disproportionately great bene½ts. The Experience Corps represents a model
of an effective volunteerism program, in which elders work with young schoolchildren. Existing federal
initiatives, in cluding the Foster Grandparent Program and Senior Companion Program–which target
low-income elders–have had low participation with long waiting lists. Given the proven bene½ts and rela –
tively low proportion of older persons who volunteer, enhancement of elder volunteerism presents a sig –
ni½cant opportunity for health promotion and deserves consideration as a national public health priority.

DAWN C. CARR is a Social Science
Research Associate at Stanford Cen –
ter on Longevity at Stanford Uni-
versity.
LINDA P. FRIED is Dean of the
Mail man School of Public Health
at Columbia University.
JOHN W. ROWE, un membre du
Académie américaine depuis 2005, est
Professor at the Columbia Universi-
ty Mailman School of Public Health.

(*See endnotes for complete contributor
biographies.)

Recent and expected future increases in life ex –

pectancy and the increasing proportion of our pop-
ulation that will be elderly has stimulated substantial
research into the factors that promote well-being
and health in late life. Early research on aging was
concerned primarily with understanding the aver-
age or usual physiologic and psychological changes
associated with aging, particularly in the context of
inevitable loss and decline as part of senescence. Le
½rst White House Conference on Aging in 1961, comment –
jamais, reoriented gerontological research to provide
information that facilitates good societal and indi-
vidual choices associated with positive aging out-
comes.1 More than twenty-½ve years later, John Rowe
and gerontologist Robert Kahn–working as part of
the MacArthur Foundation Research Network on an
Aging Society–sought to advance discussions about

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Produc –
tivité &
Engagement
in an Aging
America:
The Role
of Volun –
teerism

successful aging to enhance our under-
standing of the mechanisms involved.2
They pro posed that successful aging should
re flect the distinction between two non –
path ologic forms of aging–usual and suc –
cess ful–and called for research investigat-
ing the factors underlying the heterogene-
ity among older people. Following a decade
of systematic studies in this area, the Mac –
Arthur Network laid out three critical fac –
tors to successful aging: 1) avoidance of
disease and disability; 2) maintenance of
high cognitive and physical function; et
3) engagement with life.3

As discussed in the introduction to this
volume, engagement through either paid
work or volunteering is an important com –
ponent of assuring that the United States
will be a productive and equitable society
as it ages. A substantial body of research
indicates that remaining an active mem-
ber of society through meaningful and pro –
ductive social roles yields many bene½ts to
the elderly.4 For those concerned about
the impact of aging at both the individual
and population levels, volunteerism is an
attractive area of study: it leverages human
capital to create social capital, offers sub-
stantial health bene½ts that facilitate a
suc cessful aging lifestyle, and facilitates so –
cietal cohesion as a powerful tool for con-
necting generations through a shared sense
of purpose.5

Distinct from forms of societal engage-
ment such as caregiving, providing infor-
mal help to friends or family, or paid work,
volunteering typically refers to what is
commonly understood to include working
for an organization for no (or very modest)
pay in a capacity that would otherwise
involve ½scal remuneration.6 It also is pre –
sumed to be an activity in which the indi-
vidual involved is uncoerced and driven
primarily by a concern for his or her com-
munity.7 Working in exchange for very
limited compensation, often to cover trans –
portation or meal expenses–so-called

paid volunteering–is considered part of
the general category of volunteering. While
there are de½nitional differences among
many of the major available data sources,
volunteer engagement among older people
seems to be on the rise over the last several
decades, with somewhere between one in
four and one in three older people in the
United States volunteering today.8 Among
older volunteers, approximately half ded –
icate two or more hours per week on av –
erage, with the rest involved only sporad-
ically.9
A growing body of research and inter-

ventions related to volunteering has bol-
stered our understanding of the range of
ways in which it is associated with positive
health outcomes in later life.10 Although
the health bene½ts associated with volun –
teering are robust, we are only beginning
to understand the mechanisms of the pos –
itive bene½ts attributed to volunteer en –
gagement.

Three primary mechanisms have been
hypothesized to produce these bene½ts:
increased physical engagement, cognitive
fiançailles, and social interaction.11
D'abord, with respect to physical bene½ts, vol –
unteering has been shown to be associated
with reduced risk of onset of diseases (dans –
cluding decreased risk of hypertension),
decreased mortality risk, improved self-
rated health, and delayed decline in phys-
ical functioning.12 These physical health
bene½ts purportedly stem, at least in part,
from the extent to which volunteering in –
volves increased levels of physical engage –
ment, though most volunteer activities in –
clude only mild or moderate levels of ac –
tivité. Deuxième, with respect to cognitive
bene½ts, volunteering has been shown to
be related to enhanced cognitive func-
tion.13 The cognitive bene½ts attributed to
volunteering are proposed to relate to the
level of cognitive engagement required to
perform the tasks associated with volun-

Dédale, le Journal de l'Académie américaine des arts & les sciences

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teering, which include executive planning
and use of memory.14 Third, with respect
to social interaction, in addition to being
linked to decreased depressive symp-
toms,15 social engagement in volunteering
is associated with enhanced overall well-
être, with increased bene½ts with more
time spent volunteering.16 Volunteer ac –
tivities typically involve social interactions,
with both the people whom the volunteers
are helping and those whom they are vol-
unteering alongside. Some researchers
have presumed that the value of increased
social interaction to mental health is based
in part on the feeling of “mattering” to
others.17 However, the bene½ts of main-
taining meaningful relationships with oth-
ers has been shown to have far-reaching
effects on longevity, and could point to
physiological factors such as decreases in
overall stress.18

In addition to our lack of detailed un –
derstanding of the mechanisms underlying
the bene½ts of volunteering, we have scant
information on the “dose response” of the
bene½ts, including both the intensity and
duration of the engagement. While a few
studies suggest that two hours per week of
volunteering produces the greatest ben –
e½ts, with additional engagement produc-
ing no additional bene½t and potentially
leading to detrimental effects on health,19
others suggest that engagement beyond
two hours per week on average does, dans
fact, produce more signi½cant health ben –
e½ts.20 Clearly the dose of volunteering
that yields the greatest individual health
bene½ts has yet to be determined, and new
insights into dose responsivity will be key
to the design of volunteering initiatives.

A key potential limitation of a major ex –

pansion of senior volunteering relates to
selection effects: the signi½cant differ-
ences between volunteers and nonvolun-
teers.21 High educational attainment, suf –
½cient income (in part because volunteers

are also more likely to work at least part
temps), being married (particularly for
those whose spouse also volunteers), et
being in good health all increase the like-
lihood of volunteering: these characteris-
tics provide individuals with greater capac –
ity to contribute than their lower resourced
peers, and their social connections facili-
tate greater access to opportunities (for ex –
ample, they are more likely to be asked to
volunteer).22 Research has shown that so –
cial networks that value volunteer engage –
ment produce in their members a stronger
sense of obligation to volunteer.23 Offer-
ing a stipend and volunteer opportunities
of high value to the community and espe-
cially to children are important strategies
to attract signi½cant numbers of volun-
teers from all racial and ethnic back-
grounds. Mi nority groups also spend con-
siderable time volunteering in church or
other community groups that are often
“un der the ra dar” of scholars or agencies
who evaluate volunteerism activities. Dans
addition, sociologists Yunqing Li and Ken –
neth Ferraro found that individuals who
struggle with depression are more likely to
seek out vol unteering opportunities, et
that they ex perience a decrease in symp-
toms with for mal engagement in volun-
teering.24 Under standing the impact of
such selection ef fects on the dynamics of
volunteering is required to better under-
stand the causal pathways between volun-
teering and well-being, particularly if we
are interested in maximizing the public
health impact of volunteer engagement.
Volunteering is not static: people fre-
quently move into or out of this form of en –
gagement. People may volunteer for many
years and then stop when they experience
a health event that prevents continued en –
gagement, or they may switch from one
organization to another that more readily
accommodates their abilities.25 In addi-
tion, some individuals who have never vol –
unteered may reach later life and choose

Dawn C.
Carr,
Linda P.
Frit &
John W.
Rowe

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144 (2) Spring 2015

Produc –
tivité &
Engagement
in an Aging
America:
The Role
of Volun –
teerism

to begin volunteer engagement at the re –
quest of a friend. Although the factors
driving these behaviors cannot be fully ex –
plained using the large observational data
sets for which much of the research ½nd –
ings associated with volunteering are
based, at a broader level, some important
patterns have emerged.

D'abord, once someone becomes a volun-
teer, he or she is more likely to remain one;
thus, it is easier to keep a volunteer from
quitting than it is to get a nonvolunteer to
start volunteering, especially when the
socio political context values volunteering
and offers positive reinforcement.26 Sec-
ond, those with past volunteer experiences
are likely to return to volunteering if they
do stop, particularly if they have a history
of volunteering at higher intensity levels.27
Troisième, those who have never volunteered
are less likely to start; and if they have fair
or poor health, are disabled, have lim ita –
tions related to executive function, or have
less than a high school education, ils sont
highly unlikely to start volunteering.28
Fourth, the dynamics associated with vol –
unteering are influenced by the dynamics
of engagement in other productive activ-
ities. En général, by simply engaging in any
other productive activities (including care –
giving or work) individuals are more likely
to start a new volunteer role.29 Decreas-
ing time spent engaged in paid work is also
associated with increased likelihood of
starting a volunteer role30 and compared
to those who fully retire, those who choose
to retire into a part-time job are more
likely to start or continue volunteering.31
Enfin, despite the increase in volunteer-
ing that accompanies work-hour reduc-
tion, it is much more likely that a non-
volunteer will start volunteering in later
life if they begin volunteering prior to re –
tirement,32 if they marry/are married to
a volunteer, or if they are asked to volun-
teer.33 Importantly, selection effects may
influence not only who volunteers and to

what degree they are involved, but also
how much they bene½t from it. For in –
position, despite engaging in volunteering at
much lower rates, individuals with lower
levels of resources have been shown to ex –
perience disproportionately higher ben –
e½ts from volunteering.34
The abundant evidence demonstrating

that those who volunteer are better re –
sourced and better poised to volunteer
than those who do not has raised concerns
about volunteering being a privilege.35 If
volunteering offers evidence of individual
“success” in aging, the alternative (pre-
sumably unsuccessful or “usual” aging)
may be depicted as a reflection of an indi-
vidual’s poor choices.36 In other words,
since volunteering would seem to be a life –
style choice, the onus for obtaining the ben –
e½ts of volunteering is then placed on in –
dividuals, who may or may not have the
means to participate. En outre, with vol –
unteering producing such potent health
ben e½ts, the extent to which certain groups
of individuals lack access to volunteer roles
in later life suggests that unequal ability
to participate in volunteering is a major
public health and health-disparities con-
cern. With these considerations in mind, un
new agenda for volunteerism research has
been to identify ways to minimize volun-
teer disparities and, by extension, mini-
mize health disparities among older adults.
As noted above, individuals with lower
levels of resources have been shown to
experience disproportionately greater ben –
e½ts from volunteering.37 Interest in in –
creasing participation in volunteering
among underrepresented groups has led
to several interventions designed to en –
hance participation among older people.
The ½rst step in building the interventions
was to gain a clearer understanding of the
key barriers to volunteering. These barriers
include issues related to disability, cost to
the individual, access, opportunity/incen –

Dédale, le Journal de l'Académie américaine des arts & les sciences

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tive, and social network and environmen –
tal factors. Institutional level responses
have effectively enhanced participation of
older nonvolunteers and retained existing
volunteers using ½ve primary strategies:
1) designing for high impact of service; 2)
role flexibility; 3) reconnaissance; 4) accom-
modation and training; et 5) compen-
sation.38 Offering flexible volunteer op –
portunities has been shown to increase
par ticipation, and it may be an especially
ef fective tool for encouraging underrep-
resented groups who may have fewer re –
sources and who are more likely to face
greater informal and formal care responsi –
bilities or time-consuming and potentially
unpredictable health problems. Recogniz-
ing older adults’ contributions are also
im portant to increasing participation
and maintaining volunteers. Older people
want to ensure that the ways their time is
being used matters, and tend to respond
more strongly to positive feedback that
relates to the bene½t of younger people;39
this positivity enhances the effect of re –
warding altruistic commitments.40 Older
people who have fewer skills and abilities
in later life (such as those with lower levels
of educational attainment) often feel less
con½dent about being able to volunteer,
despite having a desire to do so. En outre
to having fewer skills, those with fewer
resources are also disproportionately more
likely to have health problems that may
limit mobility and, thus, the ability to vol –
unteer. Organizations that offer training or
skill development necessary to successful
volunteering and who are able to accom-
modate mobility problems, including by
providing transportation, enjoy an increase
in sustained participation.41

The fourth and perhaps most contro-
versial approach used to increase the par-
ticipation of individuals in underrepre-
sented groups in volunteering during later
life is compensation, or so-called paid vol –
unteering. Both monetary and nonmone-

tary compensations can incentivize volun –
teer participation. Nonmonetary incen-
tives include training or skill development
opportunities, but more common strate-
gies include goods or services such as food;
medical services such as free physical ex –
am inations; gift certi½cates; or prizes.42
These strategies have been shown to be
helpful for enhancing participation some –
what, but are minimally associated with
sustained volunteer engagement.43

Compensation was proposed to increase
sustained engagement speci½cally of un –
der represented groups, but researchers
dis covered that all older adults–regardless
of socioeconomic status–½nd the stipend
important. This is for two reasons: 1) most
elderly are on a ½xed income, and the small
stipend covers out of pocket costs of vol-
unteering; et 2) a stipend lends credi-
bility to the program, since it demonstrates
that organizers believe its impact is worth
the ½nancial investment. Programs like
Peace Corps and AmeriCorps have utilized
monetary stipends to increase participa-
tion for decades, and the recently imple-
mented Edward M. Kennedy Serve Amer –
ica Act of 2009 called for an increase in
stipend volunteer roles for people of all
ages. Cependant, ½nancial compensation for
volunteer engagement during later life was
½rst introduced by initiatives designed to
increase community service engagement
among low-income older adults. Dans 1965,
the ½rst program associated with today’s
“Senior Corps” programs was introduced:
the Foster Grandparent Program. This pro –
gram was designed to provide both a
meaningful community and intergenera-
tional engagement role for older adults,
and an income supplement for low-income
elders.44 In 1974, another federally spon-
sored Senior Corps program was intro-
duced: the Senior Companion Program.
This program continues to offer ½nancial
stipends for income-eligible older people.
The Senior Companion Program supports

Dawn C.
Carr,
Linda P.
Frit &
John W.
Rowe

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144 (2) Spring 2015

Produc –
tivité &
Engagement
in an Aging
America:
The Role
of Volun –
teerism

older adult volunteers who visit the homes
of frail elders, providing them with social
support and thereby enhancing the re –
sources they have available to age in place
successfully. Both Senior Corps programs
were designed to encourage high engage-
ment volunteer roles–those requiring ½f –
teen to forty hours of service per week–
and support antipoverty efforts.

These volunteer programs have been
min imally modi½ed since their introduc-
tion, and there are no studies assessing the
impact of the stipend or if the programs
decrease disparities. Because funding lev-
els are so limited, participation in these
programs continues to be fairly low. Pour
example, dans 2012, the Foster Grandparent
Program saw only 28,500 participating out
of the eligible nineteen million adults aged
½fty-½ve and above living at or below 200
percent of the poverty line. Lack of par-
ticipation could be related to the stigma
associated with receipt of a means-based
stipend, poor health, lack of access to op –
portunities, or due to participation in other
roles (such as paid work or caring for fam –
ily members); but the presence of long
waiting lists for these programs suggest
that limited funding is playing a major role
in their failure to grow. While the Foster
Grandparent Program has elicited partic-
ipation from diverse older adults who are
income eligible, should funds become
avail able to further expand eligibility, dans –
gagement by older adults with moderate
and moderate-to-low income may greatly
increase the public health and social im –
pact of this program. Like other means-
tested programs, some individuals who
are income-eligible may not participate be –
cause of the attention brought to their ½ –
nancial circumstances. En outre, ceux
unable or uninterested in high-engage-
ment volunteering are also excluded.45

Although there are discrepancies in the
extent to which it is an effective policy and
program tool for all volunteer programs,

the use of stipends as an intervention to
increase engagement of underrepresented
older adults in volunteering and to im –
prove the health of individuals and com-
munities has been shown to be successful
in a more recently introduced program:
the Experience Corps. The Experience
Corps brings older adult volunteers into
public elementary schools to help improve
students’ academic achievement. De –
scribed below, the Experience Corps has
observed higher recruitment rates, longer
volunteer tenure, increased hours of en –
gage ment, and increased bene½ts associ-
ated with participation with use of sti –
pends.46
The Experience Corps, the most robustly

studied volunteer program designed for
older Americans, has clearly demonstrated
that volunteer interventions can play an
im portant role in enhancing the well-being
of older volunteers as well as the bene½cia-
ries they serve. The core of the model that
became the Experience Corps (a title sug-
gested by Lyndon B. Johnson’s Secretary
of Health, Éducation, and Welfare, John
Gardner) was independently designed and
proposed by Linda Fried and Encore.org-
founder Marc Freedman, who together
col laborated on the ½nal design in 1994.
The overall strategy was to embed an evi-
dence-based health-promotion/disease-
prevention program in a senior volunteer –
ing initiative to create a community-
based social model of high-impact health
enhancement. The hypothesis was that
this approach would deliver effective pre-
vention and health promotion into the
com munity for all older adults–including
those who otherwise might not access
health promotion programs–and would
lead to decreased rates of mobility and
iadl (instrumental activities of daily liv-
ing) disability, frailty, falls, and cognitive
decline. The approach would also produce
delayed onset of these ailments at a pop-

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ulation level, thus contributing to a com-
pression of morbidity. The vehicle through
which this prevention would occur would
have a generative impact, organizing and
amplifying the social capital offered by an
aging society to support improved academ –
ic outcomes of vulnerable children and the
teaching effectiveness and ef½ cacy of teach –
ers. Finalement, the goal was to demonstrate
that a new social institution could be de –
signed to create meaningful roles and re –
sponsibilities for older adults while also
exposing the bene½ts for all generations
achieved through the in creased engage-
ment of older adults in an aging society.
The Experience Corps model targets chil-
dren from kindergarten to third grade, concernant –
flecting the research that suggests that chil –
dren who do not succeed in school by the
third grade are more likely to drop out.

Congressional support was provided for
pilot studies in ½ve cities: New York (via
the Community Service Society); Phila –
delphia; Minneapolis; Port Arthur, Tex –
comme; and Portland, Oregon. Implemented
through the Corporation for National and
Community Service (with Linda Fried and
Marc Freedman), the pilot project was
conducted between 1996 et 1997 to as –
sess design elements and roles for older
adultes, to identify requirements for imple-
mentation, and to determine feasibility
and acceptability to older volunteers and
schools. Dur ing this demonstration, it be –
came evi dent that it was impossible in
some cities to recruit for this signi½cant
time commit ment (½fteen hours per week)
without of fer ing a stipend; as a result, tous
sites started offering a stipend at the level
that the Fos ter Grandparent Program pro –
vided: $200 per month. This potentiated old er adults living on modest ½xed incomes being able to serve by providing money for bus fare and other expenses of service. The model was carefully designed, de – ploying a critical mass of older adults at each school, all of whom committed ½f – teen hours per week throughout the full school year. They served and were trained in teams for the roles they would perform, and learned the unique challenges associ- ated with twenty-½rst-century schools. At the conclusion of the pilot demonstration, all ½ve sites reported that the model met all of its original criteria for success: pro- viding roles that were of importance to prin cipals and meaningful to volun- teers; using high intensity, ½fteen-hours- per-week service; providing comprehen- sive training; deploying volunteers in teams; deploying a critical mass of volun- teers in each school; providing a stipend; creating a diverse volunteer force; improv – ing health of volunteers and building a vehicle for gen erative impact; establishing pathways to leadership for volunteers; and ensuring that all elements of the program be a win-win-win for children, schools, and older adults. After the initial success of the pilot pro- gram, a second successful national demon – stration was launched to target literacy at the original ½ve sites. Linda Fried, who was then based at Johns Hopkins, led the ini- tiative to expand the program to Baltimore. These demonstrations were fol lowed by a highly successful pilot random ized tri – al, which was published in 2004.47 Là – after, Freedman started Civic Ventures (now Encore.org) in San Francisco to create a movement built around service by older adults and to organize a franchise of pro- grams, formalized as Experience Corps™. The program has since grown to include twenty-three cities, many of whom pro- vide funding for the program, et en 2009, the program became af½liated with the aarp. Studies of the Experience Corps mod el have shown remarkable results. K–3 students in the intervention schools, as com pared to those in control schools, have shown improved standardized reading scores and markedly fewer referrals for be – havioral problems. The results to date ap – Dawn C. Carr, Linda P. Frit & John W. Rowe l D o w n o a d e d f r o m h t t p : / / direct . m je t . / e d u d a e d a r t i c e – pd / l f / / / / / 1 4 4 2 5 5 1 8 3 0 5 7 7 d a e d _ a _ 0 0 3 3 0 pd . f par invité 0 7 Septembre 2 0 2 3 144 (2) Spring 2015 61 Produc – tivité & Engagement in an Aging America: The Role of Volun – teerism pear to suggest that boys bene½t from the program more than do girls. Teachers and principals report large improvements in school atmosphere and climate (school safety, delinquency, classroom order, learn – ing environment) with a critical mass of high time-commitment Experience Corps volunteers in the school. The bene½ts to older adult volunteers have been particularly robust.48 They re – ported experiencing higher levels of social integration and sense of generative achieve – ment than controls. En plus, the num – ber of hours of service was proportional to bene½ts. Dans l'ensemble, there were modest ben – e½ts to lifestyle, intellectuel, and physical activity at twelve months. Perhaps most important, those with low levels of each type of activity at baseline show meaning- ful and signi½cant increases. For physical activity, increases were approximately 800 Kcal burned per week, an amount consis- tent with a modest exercise program. Ex – perience Corps also showed the ½rst evi- dence that a community-based activity en – gagement program directly impacts mark – ers of brain health known to buffer the brain from the clinical expression of neuro – pathologies, such as Alzheimer’s disease and vascular dementia. Findings indicated that length as well as dose of exposure mat – ters: for men, the bene½ts emerge during the second year of service. Older women with baseline low/normal levels of cogni – tive function experienced improved exec – utive function and corresponding brain ac – tivation on fmri (functional mri) within one year.49 At the outset of Experience Corps, the prevailing “wisdom” related to volunteer – ing was based primarily on upper socio – economic status (ses) white women. Ex – pe rience Corps showed that levels of informal community, civic, and church- based service in the African-American com munity is signi½cant. Fried correctly theorized that minority and lower ses old – er adults would respond to the opportu- nity to volunteer for a program designed for high impact on the futures of children. This was conditioned on providing a mod – est monthly stipend (about $200–250 tax –
able dollars per month) that covered the
costs of volunteering (bus fare, lunches,
et ainsi de suite) for older adults who had limited
ressources. This stipend served as incen-
tive to volunteer because it signi½ed that
society expects the volunteer service to
make a difference. It also contributed to
full participation: with a little money on
the line, volunteers seemed to be motivat-
ed to get up each morning and participate
when they may otherwise have decided not
à. Perhaps more important, because of the
stipend, minority older adults became the
dominant volunteer group.

À ce jour, the Experience Corps demon-
strates that older people will volunteer to
make a difference for the next generation,
and that a societal institution that trans-
forms human capital into social capital for
generativity, in a model designed for high
impact, can harness this energy. Personnes
par ticipate to ensure their legacy as well
as to give back. Retention is high because
volunteers receive evidence that they are
making a difference. The Experience Corps
is both a volunteer and public health pro-
gram, delivering a high and sustained dose
of prevention to diverse older adults: ½f –
teen hours per week of increased physical,
cognitive, and social activity and social en –
gagement/integration with meaning and
but. The return on investment has
been demonstrated to be high, and could
increase dramatically when the long-term
impact on children’s and older adults’ out –
comes are assessed.

Unlike other health interventions that fa –

cilitate similar health bene½ts in late life,
such as exercise, volunteer programs have
the additional potential to provide a means
to address important social problems and

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Dawn C.
Carr,
Linda P.
Frit &
John W.
Rowe

thus strengthen civil society.50 With the
combination of addressing important so –
cial problems and the bene½ts offered to
those who engage, volunteering has gained
attention among policy-makers in the
Unit ed States and in other developed and
developing nations. In addition to positive
contributions to the health of older adults
–potentially facilitating delayed onset of
morbidity and mortality–volunteering
has also been shown to leverage human
cap ital in a way that facilitates workforce
opportunities. Particularly for those who
have less ½nancial resources in retirement,
enhancing opportunities to maintain in –
come in later life is critical. Volunteering
increases available social resources by fa –
cilitating social network connections and
opportunities to obtain skills that are valu –
able in the paid workforce. As we prepare
for U.S. society to age successfully, volun-
teer engagement programs should play an
important role. The Experience Corps
dem onstrates that a volunteer interven-
tion can successfully leverage the accumu –

lating reserve of knowledge, skills, and ex –
periences of older adults to target speci½c
social problems and simultaneously fa cili –
tate compressed morbidity of the old er
pop ulation.

With these considerations in mind, et
in view of the accumulated scienti½c evi-
dence of its bene½ts, the time has come to
identify late-life engagement through vol –
unteering as a major public health issue,
with special emphasis on engagement of
in dividuals across the full socioeconomic
spectrum, including those with fewer re –
sources who have the most to gain. Ce
effort will require federal and local sup-
port, as well as additional research to iden –
tify both the speci½c “dose” at which vol-
unteering yields the maximum bene½t and
the best strategies to recruit individuals
with diverse social characteristics. If suc-
cessful, a comprehensive national effort to
enhance volunteerism in late life can be an
important component of our successful
transition to a productive and equitable
aging society.

endnotes
* Contributor Biographies: DAWN C. CARR is a Social Science Research Associate at Stanford
Center on Longevity at Stanford University. She edited Gerontology in the Era of the Third Age:
Implications and Next Steps (with Kathrin Komp, 2011); has contributed articles to such journals
as Activities, Adaptation and Aging, The Gerontologist, and Journal of Health and Human Services
Administration; and serves on the editorial board of The Gerontologist.
LINDA P. FRIED is Dean of the Mailman School of Public Health, Senior Vice President of the
Columbia University Medical Center, the DeLamar Professor of Public Health, and Professor
of Epidemiology and Medicine at Columbia University. She is the designer and cofounder
of Experience Corps, and also founded the Johns Hopkins Center on Aging and Health. Elle
serves on the editorial boards of The Journals of Gerontology: Sciences biologiques & Medical Sciences
and Aging.
JOHN W. ROWE, a Fellow of the American Academy since 2005, is Professor at the Columbia
University Mailman School of Public Health and Chair of the MacArthur Foundation Research
Network on an Aging Society. He is the author of Successful Aging (with Robert L. Kahn, 1998)
and was the Chair of the Institute of Medicine of the National Academies project the Future
Health Care Workforce for Older Americans, which authored the report Retooling for an Aging
America: Building the Health Care Workforce (2008).

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Produc –
tivité &
Engagement
in an Aging
America:
The Role
of Volun –
teerism

1 Robert J. Havighurst, “Successful Aging,” The Gerontologist 1 (1) (1961): 8–13, est ce que je:10.1093/

geront/1.1.8.

2 John W. Rowe and Robert L. Kahn, “Human Aging: Usual and Successful,” Science 237 (4811)

(1987): 143–149, est ce que je:10.1126/science.3299702.

3 Robert L. Kahn, “Guest Editorial on ‘Successful Aging and Well-Being: Self-Rated Compared
with Rowe and Kahn,’” The Gerontologist 42 (6) (2002): 725–726, est ce que je:10.1093/geront/42.6.725;
and John W. Rowe, “The New Gerontology,” Science 278 (5337) (1997): 367–375, est ce que je:10.1126/
science.278.5337.367.

4 Caroline E. Jenkinson, Andy P. Dickens, Kerry Jones, Jo Thompson-Coon, Rod S. Taylor,
Morwenna Rogers, Clare L. Bambra, Iain Lang, and Suzanne H. Richards, “Is Volunteering
a Public Health Intervention? A Systematic Review and Meta-Analysis of the Health and
Survival of Volunteers,” BMC Public Health 13 (2013): 773–783, est ce que je:10.1186/1471-2458-13-773;
Ming-Ching Luoh and A. Regula Herzog, “Individual Consequences of Volunteer and Paid
Work in Old Age: Health and Mortality,” Journal of Health and Social Behavior 43 (4) (2002):
490–509; Yunkyung Jung, Tara L. Gruenewald, Teresa E. Seeman, and Catherine A. Sarkisian,
“Productive Activities and Development of Frailty in Older Adults,” The Journals of Geron-
tology: Psychological Sciences & Social Sciences 65 (2) (2010): 256–261, est ce que je:10.1093/geronb/
gbp105; Nicole D. Anderson, Thecla Damianakis, Edeltraut Kröger, Laura M. Wagner, Deirdre
R.. Dawson, Malcolm A. Binns, Syrelle Bernstein, Eilon Caspi, Suzanne L. Cook, et le
bravo Team, “The Bene½ts Associated with Volunteering among Seniors: Une revue critique
and Recommendations for Future Research,” Psychological Bulletin 40 (6) (2014): 1503–1533,
est ce que je:10.1037/a0037610; Hui-Xin Wang, Anita Karp, Bengt Winblad, and Laura Fratiglioni,
“Late-Life Engagement in Social and Leisure Activities is Associated with Decreased Risk of
Dementia: A Longitudinal Study from the Kungsholmen Project,” American Journal of Epi-
demiology 155 (12) (2002): 1081–1087, est ce que je:10.1093/aje/155.12.1081; Thomas A. Verre, Carlos F.
Mendes De Leon, Shari S. Bassuk, and Lisa F. Berkman, “Social Engagement and Depressive
Symptoms in Late Life Longitudinal Findings,” Journal of Aging and Health 18 (4) (2006):
604–628, est ce que je:10.1177/0898264306291017; Jesse E. Hinterlong, Nancy Morrow-Howell, et
Philip A. Rozario, “Productive Engagement and Late Life Physical and Mental Health: Findings
from a Nationally Representative Study,” Research on Aging 29 (4) (2007): 348–370; Terry Y.
Lum and Elizabeth Lightfoot, “The Effects of Volunteering on the Physical and Mental Health
of Older People,” Research on Aging 27 (1) (2005): 31–55, est ce que je:10.1177/0164027504271349; Nancy
Morrow-Howell, “Volunteering in Later Life: Research Frontiers,” The Journals of Gerontology:
Psychological Sciences & Sciences sociales 65 (4) (2010): 461–469, est ce que je:10.1093/geronb/gpq024;
and Jan E. Mutchler, Jeffrey A. Burr, and Francis G. Caro, “From Paid Worker to Volunteer:
Leaving the Paid Workforce and Volunteering in Later Life,” Social Forces 81 (4) (2003):
1267–1293, est ce que je:10.1353/sof.2003.0067.

5 Generations United and the Generations Initiative, Out of Many, Un: Uniting the Changing Faces
of America (Washington, D.C.: Generations United, 2013), http://www.gu.org/RESOURCES/
Publications/OutofManyOne.aspx; Jean E. Kincade, Donna J. Rabiner, Shulamit L. Bernard,
Alison Woomert, Thomas R. Konrad, Gordon H. DeFriese, and Marcia G. Ory, “Older Adults as
a Community Resource: Results from the National Survey of Self-Care and Aging,” The Geron –
tologist 36 (4) (1996): 474–482, est ce que je:10.1093/geront/36.4.474; and Greg O’Neill, Sarah F. Wilson,
and Nancy Morrow-Howell, “The Civic Enterprise: Advancing Civic Engagement Opportu-
nities in Later Life,” in Civic Engagement in an Older America, éd. Greg O’Neill and Sarah F.
Wilson (Washington, D.C.: Gerontological Society of America, 2010).

6 Morrow-Howell, “Volunteering in Later Life.”
7 Ram A. Cnaan, Femida Handy, and Margaret Wadsworth, “De½ning Who is a Volunteer:
Conceptual and Empirical Considerations,” Nonpro½t and Voluntary Sectory Quarterly 25 (3)
(1996): 364–383.

8 Barbara A. Butrica, Richard W. Johnson, and Sheila R. Zedlewski, “Volunteer Dynamics of
Older Americans,” The Journals of Gerontology: Psychological Sciences & Sciences sociales 64 (5)
(2009): 644–655, est ce que je:10.1093/geronb/gbn042.

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9 Morrow-Howell, “Volunteering in Later Life.”
10 Jenkinson et al., “Is Volunteering a Public Health Intervention?»; Anderson et al., “The Bene½ts
Associated with Volunteering among Seniors”; Ben Heaven, Laura J.E. Brun, Martin White,
Linda Errington, John C. Mathers, and Suzanne Moffatt, “Supporting Well-Being in Retirement
through Meaningful Social Roles: Systematic Review of Intervention Studies,” The Milbank
Trimestriel 91 (2) (2013): 222–287, est ce que je: 10.1111/milq.12013; and Linda P. Frit, Michelle C.
Carlson, Marc Freedman, Kevin D. Frick, Thomas A. Verre, Joel Hill, Sylvia McGill, George W.
Rebok, Teresa Seeman, James Tielsch, Barbara A. Wasik, and Scott Zeger, “A Social Model
for Health Promotion for an Aging Population: Initial Evidence on the Experience Corps
Model,” Journal of Urban Health: Bulletin of the New York Academy of Medicine 81 (1) (2004):
64–78, est ce que je:10.1093/jurban/jth094.

11 Anderson et al., “The Bene½ts Associated with Volunteering among Seniors”; and Fried et al.,

“A Social Model for Health Promotion for an Aging Population.”

12 Luoh and Herzog, “Individual Consequences of Volunteer and Paid Work in Old Age”; Jung
et coll., “Productive Activities and Development of Frailty in Older Adults”; Lum and Light-
foot, “The Effects of Volunteering on the Physical and Mental Health of Older People”;
Morrow-Howell, “Volunteering in Later Life”; and Mutchler et al., “From Paid Worker to
Volunteer.”

13 Anderson et al., “The Bene½ts Associated with Volunteering among Seniors”; and Wang et al.,
“Late-Life Engagement in Social and Leisure Activities is Associated with Decreased Risk of
Dementia.”

14 Michelle C. Carlson, Kirk I. Erickson, Arthur F. Kramer, Michelle W. Voss, Natalie Bolea,
Michelle Mielke, Sylvia McGill, George W. Rebok, Teresa Seeman, and Linda P. Frit, “Evi-
dence for Neurocognitive Plasticity in At-Risk Older Adults: The Experience Corps Program,»
The Journals of Gerontology: Sciences biologiques & Medical Sciences 64 (12) (2009): 1275–1281,
est ce que je:10.1093/gerona/glp117.

15 Glass et al., “Social Engagement and Depressive Symptoms in Late Life Longitudinal Find-
ings”; Hinterlong, Morrow-Howell, and Rozario, “Productive Engagement and Late Life Phys-
ical and Mental Health”; and Lum and Lightfoot, “The Effects of Volunteering on the Physical
and Mental Health of Older People.”

16 Heaven et al., “Supporting Well-Being in Retirement through Meaningful Social Roles”; et

Fried et al., “A Social Model for Health Promotion for an Aging Population.”

17 Jane Allyn Piliavin and Erica Siegl, “Health Bene½ts of Volunteering in the Wisconsin Lon-
gitudinal Study,” Journal of Health and Social Behavior 48 (4) (2007): 450–464, est ce que je:10.1177/
002214650704800408.

18 Seoyoun Kim and Kenneth F. Ferraro, “Do Productive Activities Reduce Inflammation in Later
Life? Multiple Roles, Frequency of Activities, and C-Reactive Protein,” The Gerontologist 54
(5) 2014: 830–839.

19 Luoh and Herzog, “Individual Consequences of Volunteer and Paid Work in Old Age”; Lum
and Lightfoot, “The Effects of Volunteering on the Physical and Mental Health of Older
People”; and Marieke Van Willigen, “Differential Bene½ts of Volunteering Across the Life
Course,” The Journals of Gerontology: Psychological Sciences & Social Sciences 55 (5) (2000):
S308–S318, est ce que je:10.1093/geronb/55.5.S308.

20 Nancy Morrow-Howell, Jim Hinterlong, Philip A. Rozario, and Fengyan Tang, “Effects of Vol –
un teering on the Well-Being of Older Adults,” The Journals of Gerontology: Psychological Sciences
& Social Sciences 58 (3) (2003): S137–S145, est ce que je:10.1093/geronb/58.3.S137; and Rodlescia S.
Sneed and Sheldon Cohen, “A Prospective Study of Volunteerism and Hypertension Risk in
Older Adults,” Psychology and Aging 28 (2) (2013): 578–586, est ce que je:10.1037/a0032718.

21 Peggy A. Thoits and Lyndi N. Hewitt, “Volunteer Work and Well-Being,” Journal of Health and

Social Behavior 42 (2) (2001): 115–131, est ce que je:10.2307/3090173.

Dawn C.
Carr,
Linda P.
Frit &
John W.
Rowe

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144 (2) Spring 2015

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22 Morrow-Howell, “Volunteering in Later Life”; Butrica, Johnson, and Zedlewski, “Volunteer
Dynamics of Older Americans”; Dawn C. Carr and Jon Hendricks, “Relevance of Social Cap –
ital and Lifestyle for the Third Age,” in Gerontology in the Era of the Third Age: Implications and
Next Steps, éd. Dawn C. Carr and Kathrin S. Komp (New York: Springer, 2011): 207–224; Tay
K. McNamara and Ernest Gonzales, “Volunteer Transitions among Older Adults: The Role of
Human, Social, and Cultural Capital in Later Life,” The Journals of Gerontology: Psychological Sci-
ences & Sciences sociales 66 (4) (2011): 490–501; and Carroll L. Estes, Jane L. Mahakian, and Tracy
UN. Weitz, “A Political Economy Critique of ‘Productive Aging,’” in Social Policy and Aging: A Crit-
ical Perspective, éd. Carroll L. Estes (Thousand Oaks, Calif.: Sage Publications, 2001), 187–200.

23 Butrica, Johnson, and Zedlewski, “Volunteer Dynamics of Older Americans.”
24 Yunqing Li and Kenneth F. Ferraro, “Volunteering in Middle and Later Life: Is Health a Bene½t,

Barrier or Both?” Social Forces 85 (1) (2006): 497–519.

25 Butrica, Johnson, and Zedlewski, “Volunteer Dynamics of Older Americans.”
26 Mutchler, Burr, and Caro, “From Paid Worker to Volunteer.”
27 Francis G. Caro and Scott A. Bass, “Receptivity to Volunteering in the Immediate Postretire –
ment Period,” Journal of Applied Gerontology 16 (4) (1997): 427–441, est ce que je:10.1177/07334648970160
0403; and Fengyan Tang, Nancy Morrow-Howell, and Eunhee Choi, “Why Do Older Adult
Volunteers Stop Volunteering?” Ageing and Society 30 (5) (2010): 859–878.
28 Butrica, Johnson, and Zedlewski, “Volunteer Dynamics of Older Americans.”
29 Ibid..
30 Mutchler, Burr, and Caro, “From Paid Worker to Volunteer.”
31 Dawn C. Carr and Ben Lennox Kail, “The Influence of Unpaid Work on the Transition Out

of Full-Time Paid Work,” The Gerontologist 53 (1) (2013): 92–101.

32 Sheila R. Zedlewski, “Will Retiring Boomers Form a New Army of Volunteers?” The Retirement

Project: Perspectives on Productive Aging (7) (2007): 1–7.

33 Butrica, Johnson, and Zedlewski, “Volunteer Dynamics of Older Americans.”
34 Morrow-Howell, “Volunteering in Later Life.”
35 Estes, Mahakian, and Weitz, “A Political Economy Critique of ‘Productive Aging.’”
36 Kahn, “Guest Editorial on ‘Successful Aging and Well-Being’”; and William J. Strawbridge,
Margaret I. Wallhagen, and Richard D. Cohen, “Successful Aging and Well-Being: Self-Rated
Compared with Rowe and Kahn,” The Gerontologist 42 (6) (2002): 727–733.

37 Morrow-Howell, “Volunteering in Later Life.”
38 Fengyan Tang, Nancy Morrow-Howell, and Song-Iee Hong, “Inclusion of Diverse Older Pop –
ulations in Volunteering: The Importance of Institutional Facilitation,” Nonpro½t and Voluntary
Sector Quarterly 38 (5) (2008): 810–827, est ce que je:10.1177/0899764008320195.

39 Laura L. Carstensen, “Social and Emotional Patterns in Adulthood: Support for Socioemo-

tional Selectivity Theory,” Psychology and Aging 7 (3) (1992): 331–338.

40 Morrow-Howell et al., “Effects of Volunteering on the Well-Being of Older Adults.”
41 Andrea Galiette Skoglund, “Do Not Forget about Your Volunteers: A Qualitative Analysis of
Factors Influencing Volunteer Turnover,” Health and Social Work 31 (3) (2006): 217–220.
42 Ram A. Cnaan and Toni Cascio, “Performance and Commitment: Issues in Management of Vol –
unteers in Human Service Organizations,” Journal of Social Service Research 24 (3/4) (1998): 1–37.

43 Tang, Morrow-Howell, and Choi, “Why Do Older Adult Volunteers Stop Volunteering?»
44 Rosalyn Saltz, “Aging Persons as Child-Care Workers in a Foster Grandparent Program: Psycho –
social Effects and Work Performance,” The International Journal of Aging and Human Develop-
ment 2 (4) (1971): 314–340.

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45 Fengyan Tang, Nancy Morrow-Howell, and Song-Iee Hong, “Inclusion of Diverse Older Pop –
ulations in Volunteering: The Importance of Institutional Facilitation,” Nonpro½t and Voluntary
Sector Quarterly 38 (5) (2008): 810–827, est ce que je:10.1177/0899764008320195.

46 Tang, Morrow-Howell, and Choi, “Why Do Older Adult Volunteers Stop Volunteering?»; et
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47 Fried et al., “A Social Model for Health Promotion for an Aging Population.”
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49 Carlson et al., “Evidence for Neurocognitive Plasticity in At-Risk Older Adults.”
50 Caroline E. Jenkinson, Andy P. Dickens, Kerry Jones, Jo Thompson-Coon, Rod S. Taylor,
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Dawn C.
Carr,
Linda P.
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John W.
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144 (2) Spring 2015

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