@article {8221, title = {Sequential Patterns of Health Conditions and Financial Outcomes in Late Life: Evidence From the Health and Retirement Study}, journal = {The International Journal of Aging and Human Development}, volume = {81}, year = {2015}, pages = {54-82}, publisher = {81}, abstract = {The cost and prevalence of chronic health conditions increase in late life and can negatively impact accumulated wealth. Based on the financial challenges midaged and older adults face, we sought to understand the evolution of distinctive sequences of chronic health conditions and how these sequences affect retirement savings. We used 10 waves of the Health and Retirement Study and tracked the health states and changes in wealth of 5,540 individuals. We identified five typical sequences of chronic health conditions, which are defined as follows: Multimorbidity, Comorbidity, Mild Disease, Late Event, and No Disease. Wealth accumulation differed across the five sequences. Multimorbidity and Comorbidity were the most costly sequences. Individuals with these health patterns, respectively, had 91,205 and 95,140, less net worth than respondents identified with No Disease. Our findings suggest policy makers consider sequential disease patterns when planning for the health-care needs and expenditures of older Americans.}, keywords = {Demographics, Net Worth and Assets, Public Policy}, doi = {10.1177/0091415015614948}, url = {http://ahd.sagepub.com/content/81/1-2/54.abstract}, author = {Hyungsoo Kim and Shin, Serah and Karen A. Zurlo} } @article {7765, title = {Health Shocks, Out-of-Pocket Medical Expenses and Consumer Debt Among Middle-Aged and Older Americans}, journal = {The Journal of Consumer Affairs}, volume = {46}, year = {2012}, pages = {357-380}, publisher = {46}, abstract = {We examine two important issues related to health and financial burden in middle-aged and older Americans: (1) whether or not new health events affect a consumer{\textquoteright}s unsecured debt, and (2) to what extent the associated out-of-pocket medical expenses (OOP) contribute to unsecured debt. We use six biennial waves (1998, 2000, 2002, 2004, 2006 and 2008) from the Health and Retirement Study (HRS). We estimated fixed effects models and conducted mediation analyses. We find that new health events affect the accumulation of unsecured debt. Our estimates suggest that new health events increase unsecured debt by 6.3 ( 230) to 9.3 ( 339); approximately 20 of the increase in unsecured consumer debt comes from OOP when experiencing new health events. New severe health events increase debt for the 50-64 age group, but do not increase it for the 65 group. PUBLICATION ABSTRACT}, keywords = {Consumption and Savings, Demographics, Healthcare, Net Worth and Assets}, doi = {10.1111/j.1745-6606.2012.01236.x}, author = {Hyungsoo Kim and Yoon, Wonah and Karen A. Zurlo} } @mastersthesis {6190, title = {The mediating effects of the sense of control on the financial well-being of older adults}, volume = {Ph.D.}, year = {2009}, pages = {228}, school = {University of Pennsylvania}, type = {Dissertation}, abstract = {Statement of the problem. The financial well-being of the older adult population has improved over the past few decades, but the outlook for future generations is not positive. As government and employers become less accountable for the provision of retirement income, adults are required to take greater responsibility for their financial circumstances as they age, yet they often have neither the skills nor ability to exercise this control. By not exercising adequate control over their different aspects of their lives, adults may be exposed to financial risk in retirement. Methods. A cross-sectional, quantitative analysis using survey data from two components of the Health and Retirement Study (HRS), the HRS Rand Data files and the Psychosocial Leave-Behind Participant Lifestyle Questionnaire, was conducted. These surveys were administered in 2006 to a sample of 7,549 adults over the age of 50 and merged to conduct this analysis. Statistical analyses used multi-stage statistical modeling to test the mediating effects of the general sense of control and domain-specific levels of control, also known as control beliefs, on the relationship between the general attributes of older adults and their financial well-being. Financial well-being was measured as financial satisfaction and wealth. Results. The control beliefs of older adults significantly influence the size and magnitudes of the linkages between their demographic attributes and financial outcomes. Control beliefs boosted explained variance in financial satisfaction by over 70 percent and they increased explained variance in wealth by 4.5 percent. The mediation analyses were consistent with these results. Conclusion. Control beliefs are more strongly influential over older adults{\textquoteright} sense of financial satisfaction than on their actual wealth levels. Accordingly, interventions that influence peoples{\textquoteright} sense of control may enhance their felt well-being but will be less influential on levels of wealth. This study can be considered the first of its kind to use the psychological construct of sense of control as a mediating factor on the relationship between the attributes of older adults and self-assessed financial satisfaction as well as actual wealth outcomes. In this way we contribute to the newly developing research stream evaluating the determinants of self-reported happiness.}, keywords = {Demographics, Methodology, Net Worth and Assets, Other, Retirement Planning and Satisfaction}, url = {http://proquest.umi.com.proxy.lib.umich.edu/pqdweb?did=1956000501\&sid=1\&Fmt=2\&clientId=17822\&RQT=309\&VName=PQD}, author = {Karen A. Zurlo} }