TY - JOUR T1 - The difference-in-difference method: assessing the selection bias in the effects of neighborhood environment on health. JF - Economics and Human Biology Y1 - 2014 A1 - Irina B Grafova A1 - Vicki A Freedman A1 - Lurie, Nicole A1 - Kumar, Rizie A1 - Jeannette Rogowski KW - Neighborhoods AB - This paper uses the difference-in-difference estimation approach to explore the self-selection bias in estimating the effect of neighborhood economic environment on self-assessed health among older adults. The results indicate that there is evidence of downward bias in the conventional estimates of the effect of neighborhood economic disadvantage on self-reported health, representing a lower bound of the true effect. VL - 13 U1 - http://www.ncbi.nlm.nih.gov/pubmed/23623818?dopt=Abstract ER - TY - JOUR T1 - How does health insurance affect the retirement behavior of women? JF - Inquiry Y1 - 2011 A1 - Kanika Kapur A1 - Jeannette Rogowski KW - Decision making KW - Female KW - Health Benefit Plans, Employee KW - Humans KW - Male KW - Models, Econometric KW - Multivariate Analysis KW - Pensions KW - Retirement KW - Spouses KW - United States KW - Women, Working AB -

The availability of health insurance is a crucial factor in the retirement decision. Women are substantially less likely to have health insurance from their own employment. Using the Health and Retirement Study, we examine the role of employer-provided retiree health insurance in the retirement decisions of single women, and women in single-earner and dual-earner couples. We compare the effect of health insurance on female and male retirement. Our results show that retiree health insurance increases retirement for all groups except single men. We find suggestive evidence that the role of health insurance for women hinges on their husbands' labor force status.

PB - 48 VL - 48 IS - 1 U1 - http://www.ncbi.nlm.nih.gov/pubmed/21634262?dopt=Abstract U3 - 21634262 U4 - Health insurance/Retirement planning/Employee benefits/Impact analysis/Female employees/Life insurance/health insurance/Investment analysis/personal finance/benefits/compensation/Experiment/theoretical treatment ER - TY - JOUR T1 - Neighborhoods and chronic disease onset in later life. JF - Am J Public Health Y1 - 2011 A1 - Vicki A Freedman A1 - Irina B Grafova A1 - Jeannette Rogowski KW - Aged KW - Chronic disease KW - Environment Design KW - Factor Analysis, Statistical KW - Female KW - Health Resources KW - Health Status Disparities KW - Humans KW - Logistic Models KW - Male KW - Middle Aged KW - Poverty Areas KW - Residence Characteristics KW - Risk Factors KW - Small-Area Analysis KW - Social Environment KW - Social Problems KW - Socioeconomic factors KW - United States AB -

OBJECTIVES: To strengthen existing evidence on the role of neighborhoods in chronic disease onset in later life, we investigated associations between multiple neighborhood features and 2-year onset of 6 common conditions using a national sample of older adults.

METHODS: Neighborhood features for adults aged 55 years or older in the 2002 Health and Retirement Study were measured by use of previously validated scales reflecting the built, social, and economic environment. Two-level random-intercept logistic models predicting the onset of heart problems, hypertension, stroke, diabetes, cancer, and arthritis by 2004 were estimated.

RESULTS: In adjusted models, living in more economically disadvantaged areas predicted the onset of heart problems for women (odds ratio [OR] = 1.20; P < .05). Living in more highly segregated, higher-crime areas was associated with greater chances of developing cancer for men (OR = 1.31; P < .05) and women (OR = 1.25; P < .05).

CONCLUSIONS: The neighborhood economic environment is associated with heart disease onset for women, and neighborhood-level social stressors are associated with cancer onset for men and women. The social and biological mechanisms that underlie these associations require further investigation.

PB - 101 VL - 101 IS - 1 U1 - http://www.ncbi.nlm.nih.gov/pubmed/20299643?dopt=Abstract U2 - PMC2912970 U4 - Chronic Disease/neighborhood Characteristics/Safety/crime/Heart disease/CANCER ER - TY - JOUR T1 - The health effects of Medicare for the near-elderly uninsured. JF - Health Serv Res Y1 - 2009 A1 - Daniel Polsky A1 - Jalpa A Doshi A1 - José J Escarce A1 - Manning, Willard A1 - Susan M Paddock A1 - Cen, Liyi A1 - Jeannette Rogowski KW - Aged KW - Attitude to Health KW - Female KW - Follow-Up Studies KW - Health Services Accessibility KW - Health Services Research KW - Health Status KW - Health Surveys KW - Humans KW - Insurance Coverage KW - Logistic Models KW - Male KW - Medically Uninsured KW - Medicare KW - Mortality KW - Multivariate Analysis KW - Program Evaluation KW - Retirement KW - Socioeconomic factors KW - Statistics, Nonparametric KW - United States AB -

OBJECTIVE: To determine whether Medicare enrollment at age 65 has an effect on the health trajectory of the near-elderly uninsured.

DATA SOURCES: Eight biennial waves (1992-2006) of the Health and Retirement Study, a nationally representative panel survey of noninstitutionalized 51-61 year olds and their spouses.

STUDY DESIGN: We use a quasi-experimental approach to compare the health effects of insurance for the near-elderly uninsured with previously insured contemporaneous controls. The primary outcome measure is overall self-reported health status combined with mortality (i.e., excellent to very good, good, fair to poor, dead).

RESULTS: The change in the trajectory of overall health status for the previously uninsured that can be attributed to Medicare is small and not statistically significant. For every 100 persons in the previously uninsured group, joining Medicare is associated with 0.6 fewer in excellent or very good health (95 percent CI: -4.8, 3.3), 0.3 more in good health (95 percent CI: -3.8, 4.1), 2.5 fewer in fair or poor health (95 percent CI: -7.4, 2.3), and 2.8 more dead (-4.0, 10.0) by age 73. The health trajectory patterns from physician objective health measures are similarly small and not statistically significant.

CONCLUSIONS: Medicare coverage at age 65 for the previously uninsured is not linked to improvements in overall health status.

PB - 44 VL - 44 IS - 3 U1 - http://www.ncbi.nlm.nih.gov/pubmed/19674430?dopt=Abstract U2 - PMC2699915 U4 - Medicare/health status/Health Insurance/Health Benefits ER - TY - JOUR T1 - Neighborhoods and disability in later life. JF - Soc Sci Med Y1 - 2008 A1 - Vicki A Freedman A1 - Irina B Grafova A1 - Robert F. Schoeni A1 - Jeannette Rogowski KW - Aging KW - Disabled Persons KW - Factor Analysis, Statistical KW - Female KW - Health Status Disparities KW - Humans KW - Male KW - Middle Aged KW - Residence Characteristics KW - Social Conditions KW - Socioeconomic factors KW - United States AB -

This paper uses the US Health and Retirement Study to explore linkages between neighborhood conditions and stages of the disablement process among adults aged 55 years and older in the United States. We consider multiple dimensions of the neighborhood including the built environment as well as social and economic conditions. In doing so, we use factor analysis to reduce indicators into eight neighborhood scales, which we incorporate into two-level logistic regression models along with controls for individual-level factors. We find evidence that economic conditions and the built environment, but not social conditions, matter. Neighborhood economic advantage is associated with a reduced risk of lower body limitations for both men and women. We also find for men that neighborhood economic disadvantage is linked to increased chances of reporting personal care limitations, particularly for those aged 55-64 years, and that high connectivity of the built environment is associated with reduced risk of limitations in instrumental activities. Our findings highlight the distinctive benefits of neighborhood economic advantage early in the disablement process. In addition, findings underscore the need for attention in the design and evaluation of disability-prevention efforts to the benefits that accrue from more physically connected communities and to the potential harm that may arise in later life from living in economically disadvantaged areas.

PB - 66 VL - 66 IS - 11 U1 - http://www.ncbi.nlm.nih.gov/pubmed/18329148?dopt=Abstract U2 - PMC2478756 U4 - Neighborhood Change/DISABILITY/DISABILITY/Social conditions ER - TY - JOUR T1 - Neighborhoods and obesity in later life. JF - Am J Public Health Y1 - 2008 A1 - Irina B Grafova A1 - Vicki A Freedman A1 - Kumar, Rizie A1 - Jeannette Rogowski KW - Aged KW - Air Pollution KW - Crime KW - Emigrants and Immigrants KW - Environment Design KW - Female KW - Health Status Indicators KW - Humans KW - Income KW - Logistic Models KW - Male KW - Middle Aged KW - Obesity KW - Odds Ratio KW - Overweight KW - Population Density KW - Residence Characteristics KW - Retirement KW - Social Class KW - Social Conditions KW - Social Environment KW - Socioeconomic factors KW - United States AB -

OBJECTIVES: We examined the influence of neighborhood environment on the weight status of adults 55 years and older.

METHODS: We conducted a 2-level logistic regression analysis of data from the 2002 wave of the Health and Retirement Study. We included 8 neighborhood scales: economic advantage, economic disadvantage, air pollution, crime and segregation, street connectivity, density, immigrant concentration, and residential stability.

RESULTS: When we controlled for individual- and family-level confounders, living in a neighborhood with a high level of economic advantage was associated with a lower likelihood of being obese for both men (odds ratio [OR] = 0.86; 95% confidence interval [CI] = 0.80, 0.94) and women (OR = 0.83; 95% CI = 0.77, 0.89). Men living in areas with a high concentration of immigrants and women living in areas of high residential stability were more likely to be obese. Women living in areas of high street connectivity were less likely to be overweight or obese.

CONCLUSIONS: The mechanisms by which neighborhood environment and weight status are linked in later life differ by gender, with economic and social environment aspects being important for men and built environment aspects being salient for women.

PB - 98 VL - 98 IS - 11 U1 - http://www.ncbi.nlm.nih.gov/pubmed/18799770?dopt=Abstract U2 - PMC2636421 U4 - Obesity/Weight/Neighborhood Characteristics ER - TY - JOUR T1 - The Role of Health Insurance in Joint Retirement among Married Couples JF - Industrial & Labor Relations Review Y1 - 2007 A1 - Kanika Kapur A1 - Jeannette Rogowski KW - Health Insurance KW - Joint Retirement AB - Because the near-elderly have high expected medical expenditures, availability of health insurance is an important factor in their retirement decisions. Using Health and Retirement Study data collected in 1992-2002, the authors of this study investigate whether access to employer-provided retiree health insurance enabled dual working couples to time their retirement together–a behavior called “joint retirement.” They find that when wives had employer-provided retiree health insurance, the likelihood of joint retirement more than doubled. The effect of retiree health insurance on overall employment patterns, in contrast, was modest: estimates indicate that a hypothetical change from universal availability of such insurance to its universal unavailability would have increased employment levels by only two percentage points. VL - 60 UR - http://hdl.handle.net/10197/257 IS - 3 ER - TY - JOUR T1 - Health insurance and retirement behavior: evidence from the health and retirement survey. JF - J Health Econ Y1 - 2000 A1 - Jeannette Rogowski A1 - Lynn A Karoly KW - Aged KW - Career Mobility KW - Data collection KW - Decision making KW - Employment KW - Health Services Accessibility KW - Humans KW - Insurance, Health KW - Male KW - Retirement KW - Social Class KW - United States AB -

This paper studies the role of health insurance in the retirement decisions of older workers. As policymakers consider mechanisms for how to increase access to affordable health insurance for the near elderly, considerations of the potential labor force implications of such policies will be important to consider--potentially inducing retirements just at a time when the labor force is shrinking. Using data from the 1992 and 1996 waves of the Health and Retirement Survey, this study demonstrates that access to post-retirement health insurance has a large effect on retirement. Among older male workers, those with retiree health benefit offers are 68% more likely to retire (and those with non-employment based insurance are 44% more likely to retire) than their counterparts who would lose employment-based health insurance upon retirement. In addition, the study demonstrated that in retirement models, when retiree health benefits are controlled for, the effects of pension coverage are reduced, suggesting that these effects may have been overestimated in the prior literature.

PB - 19 VL - 19 IS - 4 U1 - http://www.ncbi.nlm.nih.gov/pubmed/11010239?dopt=Abstract U4 - Retirement/Retirement Policies/Analysis of Health Care Markets/Insurance/Insurance Companies/Elderly/Health Insurance/Health/Insurance/Older Workers/Retirement ER - TY - RPRT T1 - Health Insurance and Labor Market Transitions of Older Workers Y1 - 1998 A1 - Lynn A Karoly A1 - Jeannette Rogowski KW - Employment and Labor Force KW - Insurance AB - This report describes the labor market transitions associated with the availability and cost of post-retirement health insurance among the population that is not yet eligible for Medicare. The study uses data from the Health and Retirement Survey, a nationally representative survey of Americans who are near elderly, to study transitions from full-time to part-time employment or retirement, and from wage and salary employment to self employment or retirement. The study should be useful to policymakers interested in understanding how public policies aimed at expanding access to health insurance among the near elderly may affect labor market transitions. These include such policy initiatives as continuation and portability mandates, as well as buy-ins to Medicare. In addition, it provides insights on how increases in the age of full Medicare eligibility as well as the trend towards decreased generosity of retiree health insurance among employers might affect the labor force behavior of older workers. JF - RAND Unrestricted Draft PB - RAND UR - https://www.rand.org/pubs/drafts/DRU1797.html U4 - Labor Market/Older Workers ER - TY - RPRT T1 - Retiree Health Benefits and Retirement Behavior: Implications for Health Policy Y1 - 1998 A1 - Lynn A Karoly A1 - Jeannette Rogowski KW - Healthcare KW - Medicare/Medicaid/Health Insurance KW - Retirement Planning and Satisfaction PB - Washington, DC, U.S. Dept. of Labor U4 - Health Policy/Retirement Behavior/Health Benefits ER - TY - RPRT T1 - Health Insurance and Retirement Behavior: Evidence from the Health and Retirement Study Y1 - 1997 A1 - Lynn A Karoly A1 - Jeannette Rogowski KW - Medicare/Medicaid/Health Insurance KW - Retirement Planning and Satisfaction PB - RAND U4 - Retirement Behavior/Health Insurance ER -