%0 Journal Article %J Health Services Research %D 2005 %T Do Seniors Understand Their Risk of Moving to a Nursing Home? %A Donald H. Taylor Jr. %A Ostermann, Jan %A Acuff, S. Will %A Truls Ostbye %K Health Conditions and Status %K Healthcare %X Objective: To determine whether seniors understand their risk of moving to a nursing home. Data Sources: We used longitudinal data from the Asset and Health Dynamics Among the Oldest Old (AHEAD) database. AHEAD is a nationally representative survey (n=8,203) of community dwellers aged 70 years and their spouses. Study Design: We followed respondents for 5 years from the date of the first interview fielded in 1993. Our primary dependent variable was whether respondents moved to a nursing home within 5 years of baseline; self-assessed probability of moving to a nursing home within 5 years, also assessed at baseline, was the primary explanatory variable. Principal Findings: We found that seniors who believed they were more likely to move to a nursing home within 5 years were indeed more likely to do so, and that most elders overestimated their likelihood of moving to a nursing home. Conclusions: Low rates of private long-term care insurance are not plausibly a result of seniors underestimating their personal risk of moving to a nursing home; such an assumption is inherent in many strategies to plan for the future long-term care needs of the baby boom generation. %B Health Services Research %I 40 %V 40 %P 811 %G eng %N 3 %L pubs_2005_Taylor_etal.pdf %4 Long-Term Care/Nursing Homes/Aging %$ 15250 %0 Journal Article %J American Journal of Ophthalmology %D 2005 %T Effects of Changes in Self-Reported Vision on Cognitive, Affective and Functional Status and Living Arrangements Among the Elderly %A Frank A Sloan %A Ostermann, Jan %A Derek S. Brown %A Paul P Lee %K Demographics %K Health Conditions and Status %X PURPOSE: To study effects of changes in self-reported vision on functional status, cognition, depressive symptoms, and living arrangements. DESIGN: Longitudinal analysis of household survey data. METHODS: A total of 6234 sample persons observed in the study of Assets and Health Dynamics Among the Oldest Old (AHEAD) 1995 were followed in 1998, 2000, and 2002 or until death or sample attrition. Effects of changes in self-reported vision and other factors were assessed by means of ordinary least-squares and logistic regression with panel data methods. Main outcome measures were limitations of instrumental activities of daily living (IADLs), activities of daily living (ADLs), and other, cognition, depressive symptoms, and living arrangements. RESULTS: A decline from excellent/good vision to fair/poor near and distance vision had statistically significant effects on several IADL limitations, and some ADL and other limitations. Largest effects were for driving (OR for no limitation: 0.55, P = .003), managing money (OR: 0.61, P .001), and preparing hot meals (OR: 0.61, P .001). Onset of fair-poor near vision increased the likelihood of onset of at least one IADL (OR for no limitation: 0.71, P .01) and ADL (OR: 0.74, P = .003) limitation. Onset of legal blindness resulted in a 78 increase in the likelihood of an IADL limitation (OR for no limitation: 0.22, P .001). Effects of vision declines on cognition and depressive symptoms were statistically significant but small. Decline in vision increased the probability of nursing home residence. CONCLUSIONS: Visual impairment has major impacts on functional status. Preventing vision loss is likely to appreciably improve the functioning of elderly persons. %B American Journal of Ophthalmology %I 140 %V 140 %P 618-27 %G eng %N 4 %4 Visually Impaired Persons/Cognitive Functioning/Elderly %$ 13822 %0 Journal Article %J Soc Sci Med %D 2005 %T Heavy alcohol use and marital dissolution in the USA. %A Ostermann, Jan %A Frank A Sloan %A Donald H. Taylor Jr. %K Alcohol Drinking %K Alcohol-Related Disorders %K Divorce %K Female %K Health Status %K Humans %K Male %K Middle Aged %K Social Class %K United States %X

Using the first five waves of the US Health and Retirement Study, a nationally representative survey of middle-aged persons in the USA conducted between 1992 and 2000, we assessed the association between alcohol consumption and separation and divorce (combined as divorced in the analysis) for 4589 married couples during up to four repeated 2-yr follow-up periods. We found that drinking status was positively correlated between spouses. The correlations did not increase over the follow-up period. Discrepancies in alcohol consumption between spouses were more closely related to the probability of subsequent divorce than consumption levels per se. Couples with two abstainers and couples with two heavy drinkers had the lowest rates of divorce. Couples with one heavy drinker were most likely to divorce. Controlling for current consumption levels, a history of problem drinking by either spouse was not significantly associated with an increased probability of divorce. Our findings on alcohol use and marital dissolution were highly robust in alternative specifications.

%B Soc Sci Med %I 61 %V 61 %P 2304-16 %8 2005 Dec %G eng %N 11 %L pubs_2005_Ostermann.pdf %1 http://www.ncbi.nlm.nih.gov/pubmed/16139939?dopt=Abstract %4 Alcohol Abuse/Marital Dissolution/Marriage/Divorce/Drinking Behavior %$ 15660 %R 10.1016/j.socscimed.2005.07.021 %0 Journal Article %J Milbank Q %D 2004 %T The effect of heavy drinking on social security old-age and survivors insurance contributions and benefits. %A Ostermann, Jan %A Frank A Sloan %K Accidents, Traffic %K Adolescent %K Adult %K Aged %K Aged, 80 and over %K Alcoholism %K Cost Sharing %K Female %K Health Behavior %K Humans %K Insurance Coverage %K Life Expectancy %K Male %K Middle Aged %K Old Age Assistance %K Social Security %K United States %X

This article estimates the effects of heavy alcohol consumption on Social Security Old-Age and Survivor Insurance (OASI) contributions and benefits. The analysis accounts for differential earnings and mortality experiences of individuals with different alcohol consumption patterns and controls for other characteristics, including smoking. Relative to moderate drinkers, heavy drinkers receive fewer OASI benefits relative to their contributions. Ironically, for each cohort of 25-year-olds, eliminating heavy drinking costs the program an additional $3 billion over the cohort's lifetime. Public health campaigns are designed to improve individual health-relevant behaviors and, in the long run, increase longevity. Therefore, if programs for the elderly are structured as longevity-independent defined benefit programs, their success will reward healthier behaviors but increase these programs' outlays and worsen their financial condition.

%B Milbank Q %I 82 %V 82 %P 507-46, table of contents %8 2004 %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/15330975?dopt=Abstract %4 Alcohol Drinking/Social Security %$ 12382 %R 10.1111/j.0887-378X.2004.00320.x %0 Book %D 2004 %T The Price of Smoking %A Frank A Sloan %A Ostermann, Jan %A Gabriel A. Picone %A Conover, Christopher %A Donald H. Taylor Jr. %K Consumption and Savings %K Health Conditions and Status %I MIT Press %C Cambridge, MA %G eng %4 Smoking/Costs %$ 13842 %0 Journal Article %J The Milbank Quarterly %D 2001 %T Effects of Alcohol Consumption on Disability Among the Near Elderly: A Longitudinal Analysis %A Ostermann, Jan %A Frank A Sloan %K Disabilities %K Health Conditions and Status %K Net Worth and Assets %K Social Security %X In this study the 1992, 1994, 1996, and 1998 waves of the Health and Retirement Study were used as a way to ascertain the validity of government policy changes in transfer benefits based on alcohol consumption and disability. Are heavy drinkers more likely than abstainers or moderate drinkers to be disabled and receiving transfers from SSDI or SSI? (cross-sectional analysis). How have the 1996 policy revisions changed the amount of government transfers given to the disabled who consume alcohol and the ease in receiving such receipts? (longitudinal analysis). The authors discuss many ways in which alcohol use may effect a persons body and ability to complete tasks, as well as, some ways in which preferences toward alcohol consumption can affect ones economic and financial decisions. At wave 4 in 1998 they find there is a strong correlation between rates of disability and the drinking behavior/history of drinking problems reported in Wave 1 of 1992. However, moderate drinkers were the least likely to be disabled in 1998 and the abstainers were the most likely. At the same time though, those that reported being heavy drinkers, had the most limitations on their abilities and were the most likely to be receiving SSDI or SSI transfers. The odds of death between two years (time interval between waves) was insignificant, but those who drank heavily reported more limitations at each subsequent wave. The change in policy had practically no effect on number of people collecting SSDI/SSI. Heavy and problem drinkers were less numerous among those receiving SSDI/SSI after the policy changes, but the data in this study were unable to pinpoint the specific reasons for this outcome. %B The Milbank Quarterly %I 79 %V 79 %P 487-515 %G eng %N 4 %L pubs_2001_Ostermann_JMiliQuart.pdf %4 Health Behaviors/Health Status/Economic Status/Alcohol Drinking/Supplemental Security Income/Disability/Disability %$ 8542