%0 Journal Article %J Journal of Behavioral and Experimental Economics %D 2022 %T Depression and financial planning horizon %A Youngjoo Choung %A Swarn Chatterjee %A Tae-Young Pak %K Clinical depression %K financial planning horizon %K Intertemporal choice %K Major depressive episode %K Myopic decision %K Time preference %X Major depression is associated with biased information processing and decision making. Previous research suggests that people dealing with depression view the future negatively and exhibit a higher discounting rate than healthy people do. This study tests the hypothesis that depression is associated with financial planning horizon–the time horizon by which individuals and households formulate their saving and spending schedules. Analyses conducted using data drawn from multiple waves of the Health and Retirement Study showed an inverse association between major depressive episodes and financial planning horizon, indicating that depressed people plan their finances over a shorter horizon. We also found that major depression is associated with various health and financial outcomes representing evidence of myopic decision making. The link between depression and financial planning horizon is partially explained by depression-oriented differences in behavioral traits, such as optimism/pessimism, perceived control, perceived mastery, and self-assessed survival probability. Overall, our findings point to a significant economic cost of depression, which compounds through myopic financial planning. %B Journal of Behavioral and Experimental Economics %V 98 %P 101877 %G eng %R 10.1016/j.socec.2022.101877 %0 Journal Article %J JAMA Network Open %D 2021 %T Association of Food Insecurity With Allostatic Load Among Older Adults in the US. %A Tae-Young Pak %A GwanSeon Kim %K Allostatic load %K biomarker %K Food insecurity %K morbidity risk %X

Importance: Allostatic overload, a biomarker of wear and tear, could be the potential pathway through which food insecurity leads to increased morbidity risk.

Objective: To assess the association of food insecurity with allostatic load (AL) among US adults aged 50 years or older.

Design, Setting, and Participants: A multiwave longitudinal cohort study was conducted using data from the 2006 to 2014 waves of the Health and Retirement Study in a national cohort study setting. The data comprise 26 509 person-years observations from 14 394 noninstitutionalized individuals aged 50 years or older during the study period. Data were analyzed from September 1 to December 14, 2020.

Exposures: Moderate food insecurity (not enough money to buy the food needed) and severe food insecurity (reduced food intake due to financial constraints) measured at the household level.

Main Outcomes and Measures: The AL score (0-9, with higher scores indicating a greater risk of physiologic dysregulation) and binary indicators of dysregulated inflammatory (C-reactive protein), cardiovascular (systolic and diastolic blood pressure, pulse rate, and cystatin C), and metabolic (hemoglobin A1c, body mass index, waist-to-height ratio, total cholesterol to high-density lipoprotein cholesterol ratio) systems.

Results: Of 14 394 participants included in the analysis, the median age was 60 (IQR, 56-69) years, 8143 (56.6%) were women, 517 (3.6%) were moderately food insecure, and 804 (5.6%) were severely food insecure. In adjusted models, the incidence rate of AL was 1.05 (95% CI, 1.00-1.09) times higher for the participants with moderate food insecurity and 1.11 (95% CI, 1.07-1.15) times higher for the participants with severe food insecurity, compared with those who were food secure. The increased incidence rate of AL among participants with severe food insecurity was associated with C-reactive protein level (odds ratio [OR], 1.22; 95% CI, 1.04-1.44), cystatin C level (OR, 1.23; 95% CI, 1.01-1.51), hemoglobin A1c level (OR, 1.27; 95% CI, 1.01-1.59), body mass index (OR, 1.84; 95% CI, 1.41-2.40), waist-to-height ratio (OR, 1.54; 95% CI, 1.26-1.88), and total to high-density lipoprotein cholesterol ratio (OR, 1.32; 95% CI, 1.10-1.59) inflated to the high-risk range. The interaction between moderate food insecurity and Supplemental Nutrition Assistance Program (SNAP) enrollment (β = -0.18; P = .001) and the interaction between severe food insecurity and SNAP enrollment (β = -0.09; P = .02) were associated with a reduction in AL.

Conclusions and Relevance: In this national cohort study of US adults aged 50 years or older, food insecurity was associated with higher AL, mainly through dysregulation of the inflammatory and metabolic systems. SNAP enrollment may modify this association between food insecurity and AL.

%B JAMA Network Open %V 4 %P e2137503 %G eng %N 12 %R 10.1001/jamanetworkopen.2021.37503 %0 Journal Article %J Preventive Medicine %D 2020 %T Food stamps, food insecurity, and health outcomes among elderly Americans %A Tae-Young Pak %A GwanSeon Kim %K depression %K Food assistance %K Mental Health %K Self-esteem %K Stigma %K Supplemental Nutrition Assistance Program %X This study examined associations between very low food security and health outcomes in older adults, and tested whether participation in the Supplemental Nutrition Assistance Program (SNAP) mitigates adverse health consequences associated with very low food security. Data were drawn from the 1998–2014 waves of the Health and Retirement Study (N = 148,138 from 27,281 persons). A longitudinal analysis of the relationship between very low food security and health condition depending on SNAP participation was conducted using the individual fixed effects regression. Respondents' health status was assessed by self-rated health, grip strength, and depressive symptoms. The correlations between very low food security and physical health outcomes were negatively significant prior to SNAP enrollment (p < 0.05) but became insignificant upon participation, indicating that SNAP may have prevented poor physical health resulting from very low food security. However, results concerning mental health showed that SNAP enrollment does not modify the association between very low food security and depression; very low food security remained a significant risk factor of depressive symptoms conditional on SNAP enrollment (p < 0.001). Further analyses showed that SNAP participation is correlated with negative self-attitudes (p < 0.05), and that the correlation between SNAP and depression becomes insignificant after controlling for self-attitudes. These results suggest that a stigma effect arising from welfare use may have reduced self-esteem and resulted in depressive moods. Future research needs to delve into whether reforms to the food assistance program aimed at reducing stigma can help alleviate emotional distress among welfare recipients. %B Preventive Medicine %V 130 %G eng %U http://www.sciencedirect.com/science/article/pii/S0091743519303470 %R https://doi.org/10.1016/j.ypmed.2019.105871 %0 Journal Article %J Health Economics Review %D 2020 %T The long-term effects of cancer survivorship on household assets %A Tae-Young Pak %A Hyungsoo Kim %A Kim, Kyoung Tae %X Less is known about the impact of cancer on household assets and household financial portfolio during which cancer survivors face higher mortality risk. Economic theory predicts that cancer survivors would deplete their wealth in such a way that meets immediate financial needs for treatment and that hedges the risk of anticipated medical expenses associated with recurrence. Building upon this prediction, we examine long-term changes in household assets in response to cancer diagnosis among middle-aged and elderly Americans (age ≥ 50). %B Health Economics Review %V 10 %P 2 %8 2020/01/13 %@ 2191-1991 %G eng %U https://doi.org/10.1186/s13561-019-0253-7 %N 1 %! Health Economics Review %0 Journal Article %J JOURNAL OF AFFECTIVE DISORDERS %D 2020 %T Welfare stigma as a risk factor for major depressive disorder: Evidence from the Supplemental Nutrition Assistance Program %A Tae-Young Pak %K CIDI-SF %K Food stamp %K Longitudinal analysis %K Major depression %K Welfare stigma %X Background: Negative public attitude about welfare is known to impair feelings of self-worth and psychological well-being in welfare recipients. What is missing in the extant literature is whether the stress of being on welfare increases the risk for clinically severe depression. To fill this gap, the present study examines the association between participation in the food stamp program and major depressive disorder. Methods: Study data is drawn from the 2008-2014 waves of the Health and Retirement Study (N = 67076). Depressive symptom is assessed with the Composite International Diagnostic Interview - Short Form, and modeled by a continuous score of major depressive symptoms (0-7) and a binary indicator for three or more symptoms. A fixed effects regression is used to estimate changes in depressive symptoms explained by the food stamp participation, adjusted for confounding covariates. Results: Food stamp participation was associated with an average of 19% increases in depressive symptoms (p < 0.001) and 29% higher odds of having major depression (p < 0.01). The associations were statistically significant only for men, middle-aged adults, Whites, and those without disability - groups that are more likely to be stigmatized by the social norm for not being able to rise above poverty. Limitations: Depression outcomes are self-reported. Causality remains not established. The recession during the study periods may have dampened the stigma effects. Conclusions: Welfare participation is a risk factor for clinical depression in a low-income setting. Depressive symptoms induced by welfare stigma need to be clinically targeted through counseling and cognitive therapy programs. %B JOURNAL OF AFFECTIVE DISORDERS %V 260 %P 53-60 %8 JAN 1 %G eng %9 Article %R 10.1016/j.jad.2019.08.079 %0 Journal Article %J Journal of Consumer Affairs %D 2019 %T Asset Allocation of Two-Person Households under Different Longevity Expectations %A Tae-Young Pak %A Patryk D. Babiarz %K asset allocations %K Couples %K longevity expectations %X This study examines asset allocations of near-elderly couples when spouses have different longevity expectations. Since the risk-adjusted return on equities increases with investment horizon, a spouse who expects longer retirement period has an incentive to hold riskier portfolio. Using data from the Health and Retirement Study, we show that portfolio riskiness increases with the subjective survival probability of the decision-making spouse. As predicted by the bargaining model, portfolio outcomes are uncorrelated with the horizon of the spouse who has less bargaining power. Results also show that the extent expected horizon is incorporated into asset allocation depends on the decider's gender. The share of equities depends on the husband's expected horizon when he leads decision making but not on the wife's horizon when she has more power. These findings contradict the prediction that wife-led households may hold more equities than do husband-led households because of their longer lifespan. %B Journal of Consumer Affairs %V 53 %P 1234-1254 %@ 0022-0078 %G eng %N 3 %R https://doi.org/10.1111/joca.12225 %0 Journal Article %J Journal of Economic Psychology %D 2018 %T Does cognitive aging affect portfolio choice? %A Tae-Young Pak %A Patryk D. Babiarz %K Cognitive Ability %K Depressive symptoms %K Finances %K Portfolios %X The association between cognitive aging and portfolio reallocation towards riskless assets is well documented. Past studies have suggested several mechanisms such as rising information costs or preference changes to explain the shift away from financial risk. However, these narratives appear to be at odds with the evidence that some domains of cognitive functions improve with age, and many individuals are not cognizant of their intellectual decline. Using data from the Health and Retirement Study, this study examines whether or not cognitive decline leads to a safer portfolio choice and how much can be attributed to causal. Our empirical analysis develops an instrumental variable approach that exploits seasonal variation in cognition triggered by a seasonal affective disorder. While the fixed effects estimates show strong positive correlations between cognition and stock ownership, these estimates lose significance in the instrumental variable models. Our findings suggest that cognitive function is not a major determinant of portfolio riskiness. %B Journal of Economic Psychology %V 66 %P 1-12 %G eng %U http://linkinghub.elsevier.com/retrieve/pii/S0167487017303215http://api.elsevier.com/content/article/PII:S0167487017303215?httpAccept=text/xmlhttp://api.elsevier.com/content/article/PII:S0167487017303215?httpAccept=text/plain %! Journal of Economic Psychology %R 10.1016/j.joep.2018.03.001 %0 Journal Article %J Social Science & Medicine %D 2017 %T The impact of Medicare Part D on cognitive functioning at older ages. %A Tae-Young Pak %A GwanSeon Kim %K Cognition & Reasoning %K Medicare Part D %K Prescription Medication %X Research has shown that the establishment of Medicare prescription drug benefit in 2006 leads to improvement in medication adherence and mortality outcomes. Despite a clear connection between physical/mental health and the risk of dementia, little is known about the extent to which this reform has affected the cognitive functioning of the elderly. Using data from the Health and Retirement Study and difference-in-differences approach, this study provides the first evidence on the cognition-enhancing effects of Medicare Part D. Our estimates show that Part D implementation is associated with 1.6% increase in cognitive functioning or 1.1-year delay of cognitive aging among benefit-eligible persons. Further analyses indicate that most of the cognitive benefits accrue to the vulnerable populations who previously lacked prescription drug coverage, and that a reduction in cardiovascular mortality is the most likely pathway through which the expansion improved cognitive functioning. %B Social Science & Medicine %V 193 %P 118-126 %G eng %1 http://www.ncbi.nlm.nih.gov/pubmed/29049904?dopt=Abstract %R 10.1016/j.socscimed.2017.09.037