The Role of Micro-level Panel Data in Policy Research - R.V. Burkhauser; Smeeding, Timothy M. (Schmollers Jahrbuch: Zeitschrift fur Wirtschafts und Sozialwissenschaften/Journal of Applied Social Science Studies, 2001)
This paper focuses on the value of longitudinal micro-level data for policy centered research on behavioral and economic well-being. It provides examples of policy questions that can best be answered using such data and shows how they have been answered using data from four ongoing longitudinal panels--the BHPS (British Household Panel Study), the GSOEP (German Socio-Economic Panel), the HRS (Health and Retirement Study) and the PSID (Panel Study of Income Dynamics). Finally, it suggests a set of policy issues that can be considered using these data or from a national or a cross-national perspective.
Keywords: Consumption and Savings; Health Conditions and Status; Healthcare; Methodology; Public Policy; Retirement Planning and Satisfaction

Study Reveals Today's Seniors Are More Apt to Be of Sound Mind - Goldsmith, Rebecca (Newhouse News Service, 2001)
Keywords: Health Conditions and Status

Two Essays Related to Labor Market Behavior: Demand for publicly provided job training programs in Illinois and Poor health, asset accumulation, and early retirement behavior - Miah, Mohammad Solaiman (Northern Illinois University, 2001)
Essay 1. This essay examines the determinants of the demand for public job training programs in Illinois. My first objective is to determine which personal characteristics influence support for an increase in spending on publicly provided job training programs for the unemployed across various income groups in Illinois. In particular, I empirically test for a u- shaped relationship between income and the demand for publicly-provided job training. My second objective is to examine the role of local economic conditions in determining the demand for job training programs. I use data from the 1995 Illinois policy survey supplemented with county- and regional-level data (including the unemployment rate, manufacturing employment, population density, and poverty rate). I do not find a u-shaped relationship between income and the demand for job training. However, I find that regional economic conditions, particularly the unemployment rate, the poverty rate, and population density, significantly influence the demand for job training programs in Illinois. In contrast, I find county-level economic conditions are not very influential. Essay 2. The purpose of this essay is to examine the impact of chronic health conditions on asset accumulation and retirement. Compared to a healthy worker, a person with a chronic health condition throughout his or her working life may have had reduced labor force participation and may have built a smaller portfolio of assets. Because this individual will have lower asset income than a healthy person, he or she will be less likely to retire, other things equal. Thus, chronic poor health may lead to opposing effects on the labor supply of the elderly. In my empirical analysis, I use data on adults aged 51-61 from the Health and Retirement Study (HRS) to study asset accumulation and retirement behavior of the chronically ill. I find that for 90% of individuals with chronic health problems, asset accumulation is sufficiently reduced to delay retirement. The needs of this group have not been addressed by researchers or policy makers discussing critical issues surrounding poor health and retirement.
Keywords: Education; Employment and Labor Force; Health Conditions and Status; Income; Net Worth and Assets; Other; Retirement Planning and Satisfaction

On The Use and Misuse of Socioeconomic Status: A Study of Mortality Among the Elderly - Donahue, Dennis (Population Association of America, 2001)
Abstract: Examined the effects of occupation on mortality among older adults, with an emphasis on how these effects relate to other measures of socioeconomic status (SES) such as income, wealth and assets, and education. Data were obtained from the Asset and Health Dynamics of the Oldest Old (AHEAD) survey on 7,441 adults aged 70 and older (mean age 77.48) in regard to 10 categories of occupations (including those who had never worked) and various measures of SES. Although the measures are crude, primary lifetime occupation was found to be as strong a predictor of mortality as traditional measures of SES. Further analysis of the effects of education found that although educational status is a significant predictor of mortality in simple hazard models, it acts fundamentally as a proxy for other SES measures. The results suggest that data availability and statistical convenience have led to the overuse of such measures as education as proxies for SES, to the detriment of more refined SES measures that are more directly proximate to individual differences in behavior, lifestyle, and financial resources.
Keywords: Demographics; Employment and Labor Force; Health Conditions and Status; Methodology

Association between Body Size and Mortality in Later Life - Christine L Himes (Aging Study Program Paper, 2000)
The rising prevalence of obesity in the United States has focused attention on the health consequences of excess weight. Obesity is linked to many of the major causes of death in the United States, including heart disease, some types of cancer, strokes, diabetes, and atherosclerosis. However, the effects of body size on mortality and health among the elderly are much less clear. This paper extends our current understanding of the relationship between body size and mortality by using two nationally representative, longitudinal datasets of individuals at older ages. These analyses indicate that obesity may not contribute greatly to increased mortality risks after age 70. In fact, obesity may be somewhat protective and lower the risk of death. At younger ages, however, the effects of obesity tend to operate in the opposite direction. Women especially appear to be at greater risk of death in their 50s and 60s if they are overweight.
Keywords: Health Conditions and Status

A Benefit of One's Own: Older Women's Entitlement to Social Security Retirement - Phillip B. Levine; Olivia S. Mitchell; John W R Phillips (Social Security Bulletin, 2000)
Using data from the Health and Retirement Study (HRS) and linked administrative records, we explore differences in old-age benefits between men and women attributable to differences in length of work life and pay. We find that most women are fully insured for Social Security purposes, but those who are not would have to work substantially more to become eligible. Among those who are eligible, additional work would translate into only slightly higher benefits.
Keywords: Consumption and Savings; Health Conditions and Status; Methodology; Retirement Planning and Satisfaction; Social Security; Women and Minorities

Black and White Differences in Health and Functional Status Dimensions: How Many and What Type Among Older Americans - Alvin E. Headen Jr.; Kenneth G. Manton; Woodbury, Max A. (North Carolina State University, 2000)
Keywords: Health Conditions and Status

The Case for Marriage: Why Married People are Happier, Healthier, and Better Off Financially - Linda J. Waite; Gallagher, Maggie (Doubleday, 2000)
The Case for Marriage is a critically important intervention in the national debate about the future of family. Based on the authoritative research of family sociologist Linda J. Waite, journalist Maggie Gallagher, and a number of other scholars, this book’s findings dramatically contradict the anti-marriage myths that have become the common sense of most Americans. Today a broad consensus holds that marriage is a bad deal for women, that divorce is better for children when parents are unhappy, and that marriage is essentially a private choice, not a public institution. Waite and Gallagher flatly contradict these assumptions, arguing instead that by a broad range of indices, marriage is actually better for you than being single or divorced– physically, materially, and spiritually. They contend that married people live longer, have better health, earn more money, accumulate more wealth, feel more fulfillment in their lives, enjoy more satisfying sexual relationships, and have happier and more successful children than those who remain single, cohabit, or get divorced.
Keywords: Adult children; Health Conditions and Status; Net Worth and Assets

Comparative Models of the Impact of Social Support on Psychological Distress in Cancer Patients - Forjaz, Maria Joao Bettencourt Pereira (University of North Texas, 2000)
This study tested the relationship between Social Support, Psychological Distress, and Illness Stress in individuals who report cancer as a health condition. This study was based on archival data obtained from the Wave 1 of the Health and Retirement Study (HRS). The HRS provides a nationally representative sample of individuals aged 51 to 61 in 1992 and their spouses. The study sample was limited to cancer patients with a spouse or partner (n = 503). A structural equation modeling analysis procedure was used to test the theoretical models. Measures of social support were limited to variables assessing the participant's satisfaction with social support. Evidence was found for the Stress Prevention and the Support Deterioration models. This is congruent with previous research using measures of social support perception. Both the Stress Prevention and the Support Deterioration models predict a negative relationship between Illness Stress and Social Support. In addition, a univariate analysis of variance was used to test the stress buffering model. Similarly to other studies measuring the individual's degree of integration, or its perception, in the social network, the present research supported the only the Main Effect model and not the Stress Buffering model.
Keywords: Adult children; Health Conditions and Status; Healthcare

Consequences of Health Events: Economics and Behavioral Outcomes in the Health and Retirement Study - Tracy Falba (Stanford University, 2000)
Keywords: Health Conditions and Status; Healthcare; Retirement Planning and Satisfaction

Documentation of Affective Functioning Measures in the Health and Retirement Study - Steffick, Diane E. (Institute for Social Research, University of Michigan, 2000)
This paper documents the HRS measures of mental health status, also called affective functioning. It is intended for a wide range of users, particularly those who would like to include mental health in their research but are not familiar with the measures available in the HRS. It also addresses topics of interest to mental health specialists who are concerned with how the abbreviated scales in the HRS correspond to the full scales used in the existing literature. This paper provides users with an overview of the measures included in the study, including their origins and pedigree. It details the specific steps used to create standard summary variables for the scales measuring depressive symptoms and major depressive episodes, and includes SAS code for this variable creation in a Technical Appendix.
Keywords: Health Conditions and Status

Does Mental Health Affect Transitions out of the Labor Force in Older Workers? - Linda A. Wray (American Sociological Association, 2000)
This paper extends earlier studies on health and work by examining how mental health affects transitions out of paid work in the years prior to the traditional Social Security retirement ages. Specifically, I investigate how mental health is linked to transitions to early retirement or other unemployed state in 1996 for middle-age adults who were currently working in 1992 and, in particular, whether deficits in mental health affect those transitions. To answer those questions, I use data from the first three waves of the Health and Retirement Study, a panel study of a nationally representative sample of Americans age 51-61 in 1992. Results of logistic regression analyses indicated that mental health had a strong and significant influence on the move from paid work to unemployment in three ways, net of other documented health, job, and socioeconomic correlates of work status: (1) Above-average self-assessed mental health predicted the transition from current worker to retiree. (2) Above -average mental health played a protective role in keeping workers in the work force rather than being laid off, on sick leave, or otherwise unemployed. (3) Increased CES-D depressive symptoms between 1992 and 1994 predicted exits from paid employment and into other unemployment by 1996. The results also indicate that mental health was an even more important predictor of transitions out of paid work among middle-age workers than were physical health and functioning.
Keywords: Demographics; Employment and Labor Force; Health Conditions and Status; Healthcare; Retirement Planning and Satisfaction

Drug Use Among the Elderly: An Assessment of California's Need for Prevention and Treatment Services - Wong, Mamie M.; Anglin, M. Douglas (State of California, Dept. of Alcohol and Drug Programs, 2000)
Keywords: Health Conditions and Status; Healthcare

Economic, Cultural, and Social Origins of Emotional Well-Being: Comparisons of Immigrants and Natives at Midlife - Hao, Lingxin; Richard W. Johnson (Research on Aging, 2000)
Linking theories of social stratification, ethnicity, and mental health with theories of human and social capital, the authors examine the impact of economic, cultural, and social factors on five different dimensions of emotional well-being for immigrants and natives at midlife. Based on data from the 1992 wave of the Health and Retirement Study, the authors found that economic factors and human capital variables are the most important determinants of emotional health for both immigrants and natives. The results indicate that cultural factors can enhance emotional well-being. Religious affiliation and participation are important for both immigrants and natives, but religious participation appears to be more beneficial for immigrants. Being part of a couple was also associated with better emotional health, especially for immigrants. The effects of several determinants of emotional health differed across immigrant groups. It was found that marriage, education, and the presence of economically stable kin are particularly important for Cubans. 6 Tables, 36 References. Adapted from the source document
Keywords: Demographics; Health Conditions and Status; Other

Elderly Asset Management and Health: An Empirical Analysis - Feinstein, Jonathan S.; Ho, Chih-Chin (NBER Working Paper, 2000)
We present models of asset management by the elderly. We focus on saving, spend-down of assets, and gift-giving, and the influence of health on these precesses. We also study the evolution of elderly health and the impact of economic variables on health outcomes. We present results from estimating our models using data from waves one and two of the AHEAD dataset. Our model of asset management links elderly decisions about saving, spend-down of assets, and gift-giving in a system of equations. We divide households for which head and partner (if present) are in poor health and those for which head and partner are in good health; our specification allows for differences in health to affect both the average level of economic outcomes and the marginal effects of income and wealth on the outcomes. We also include in our model a set of sociodemographic control variables. Our model of health outcomes links health in the preceding period to health in the current period, allowing for three outcomes good health, poor health, or death. In our models of health outcomes we include variables measuring health in the previous period, wealth, age, education, and control variables. Our main results are the following. First, results for gift-giving suggest that at least some elderly do plan their estate transfer - those that have established trust funds or for which households assets exceed the estate tax filling threshold have a significantly greater propensity to give gifts. Second, the average level of gift-giving is lower for those in poor health, but the marginal effect of increasing wealth on gift-giving is much greater. This result is important in showing the ways in which health can interact with economic variables in influencing economic decision-making. Third, income is an important determinant of saving and spend-down. Fourth, other things equal, households that save are also more likely to give gifts. Fifth, sudden changes in family structure and health are associated with changing patters of economic behavior - most especially, becoming a widow or widower is associated with a significant increase in the likelihood both of spending out of assets and of making gifts. Finally, variables related to children have less effect on propensity to give gifts than expected - the only variable that has a significant effect is the number of children for which parents cannot provide income information, suggesting that the quality of the relationship between parents and children is important for gift-giving.
Keywords: Adult children; Demographics; Health Conditions and Status; Net Worth and Assets

Fatter women end up with thinner wallets - Elias, Marilyn (USA Today, 2000)
Keywords: Health Conditions and Status; Income; Women and Minorities

Forecasting Retirement Needs and Retirement Wealth - Olivia S. Mitchell; P. Brett Hammond; Anna M. Rappaport (University of Pennsylvania Press, 2000)
Thirteen papers draw on data from the Health and Retirement Study and from other sources to explore people's preparation for and the financial challenges of retirement in the United States. Papers discuss new paths to retirement; how prepared Americans are for retirement; projected retirement wealth and saving adequacy; individual savings and investment choices associated with 401(k) plans; factors explaining retirement savings shortfalls; women's economic well -being at the end of their work lives and the factors that appear to be associated with the poorer economic status of older women relative to older men; the prospects for widow poverty; minorities facing retirement; early retirement windows; the relationship between people's expectations about their retirement, their realizations of retirement, and the role of health shocks in this process; planning for health care needs in retirement; the evaluation of pension entitlements; social security earnings and projected benefits. Mitchell is at the Wharton School, University of Pennsylvania. Hammond is with the Teachers Insurance Annuity Association-College Retirement Equities Fund (TIAA -CREF). Rappaport is at William M. Mercer, Inc. Index.
Keywords: Consumption and Savings; Health Conditions and Status; Healthcare; Pensions; Retirement Planning and Satisfaction; Women and Minorities

A Health and Demographic Profile of Noninstitutionalized Older Americans Residing in Environments with Home Modifications. - Tabbarah, M.; Merril Silverstein; Teresa Seeman (Journal of Aging and Health, 2000)
OBJECTIVES. In this analysis the authors investigate the demographic characteristics, the health conditions/events, and the disabilities of community-dwelling Americans 70 years of age and older that are associated with residing in environments with specific home modifications. METHODS. Data from a large population-based study of the elderly are used to estimate logistic regression equations that reveal profiles of older individuals who are likely to have distinct home modifications. RESULTS. Having diseases such as diabetes and stroke, having experienced a hip fracture, a fall or a joint replacement, and having greater limitations with activities of daily living raise the likelihood of having home modifications. Low income, Hispanic, and African American elderly appear underrepresented among those with modifications. DISCUSSION. The authors conclude that specialized housing alternatives will be an increasingly important issue in the future as individuals aim to achieve and maintain the delicate balance between their functional ability and their living environment.
Keywords: Demographics; Disabilities; Health Conditions and Status; Healthcare; Housing; Methodology

Health Consequences of Marriage for the Retirement Years - Pienta, Amy M.; Mark D Hayward; Kristi Rahrig Jenkins (Journal of Family Issues, 2000)
Over the last few decades there has been an increasing trend toward divorce, postponed marriage, never marrying, and cohabitation. It is also known that marriage increases ones health, mainly because of the ability to gain from the help of a spouse or other relatives that transfer finances and time to the married person. How will changes in marriage trends effect the health of people as they reach retirement ages? What aspects of health are linked to marriage? Married persons from this data were the least likely to be afflicted by any of the diseases or limitations studied. Widowed and divorced persons were found to have the worst overall health of any two groups. However, cohabiting people were not much better off then the widowed or divorced persons. The authors also break down the data further and compare genders and races. Exiting marriage, surprisingly, was worse then never having been married.
Keywords: Adult children; Demographics; Health Conditions and Status; Retirement Planning and Satisfaction

How Should We Insure Longevity Risk in Pensions and Social Security? - Brown, Jeffrey R. (Center for Retirement Research at Boston College Briefs, 2000)
Keywords: Health Conditions and Status; Pensions; Social Security

Modeling the Effect of Health on Retirement - John Bound; Michael Schoenbaum; Todd R. Stinebrickner; Timothy A Waidmann (National Bureau of Economic Research, 2000)
Keywords: Health Conditions and Status; Retirement Planning and Satisfaction

Obesity, Disease, and Functional Limitation in Later Life - Christine L Himes (Demography, 2000)
Little is known about the effects of obesity late in life. Using data from the Longitudinal Study of Aging and the Assets and Health Dynamics of the Oldest Old Survey, this study finds an increased prevalence of obesity, over time, among those 70 and older. Obesity is related most strongly to limitations in activities of daily living (ADLs) for women and to activities related to mobility. One ADL, eating, has a negative association to obesity. Obesity is associated with an increased prevalence of arthritis, diabetes, and hypertension. These results are cross-sectional and are based on self-reports of height and weight; they must be interpreted cautiously.
Keywords: Demographics; Health Conditions and Status; Methodology; Other

Older Workers Sweat Boom Times - Rosenblatt, Robert A. (Aging Today, 2000)
This article looks at the first four waves of HRS data (1992-1998) to evaluate how older workers are affected by this period of economic boom. David Weir of the University of Michigan, Associate Director of the HRS, comments throughout the article on general trends and findings that can be seen in the data. The study shows that Americans have become wealthier, are more likely to be working in their 50s and 60s, and are increasingly worried about their health.
Keywords: Employment and Labor Force; Health Conditions and Status; Net Worth and Assets

Parental Care at Midlife: Balancing Work and Family Responsibilities near Retirement - Richard W. Johnson; Anthony T. Lo Sasso (The Retirement Project Brief Series, 2000)
The costs of providing care informally at home to frail elderly persons can be substantial, especially if caregivers are forced to interrupt their careers or retire early when they provide care. This report describes findings from a recent Urban Institute study of the characteristics of persons in their fifties and early sixties who provide care to their elderly parents and the trade-offs that families face when they divide their time between the provision of informal care and paid work. Estimates were based on a sample of men and women between the ages of 53 and 65 in the 1994 and 1996 waves of the Health and Retirement Study. Only 11 percent of women and 6 percent of men at midlife devoted more than 100 hours per year to assisting their parents in 1994 with personal care, chores, or errands. However, for those who did provide informal care the costs were high. Results from simultaneous panel data models indicated that women who assisted their parents reduced their annual labor supply by 459 hours, which translated on average to about $7,800 in pre-tax lost earnings per year in 1994 dollars. The estimated effect was almost identical for men, who reduced their labor supply by 462 hours when they helped their parents. Although some proposed legislation would compensate caregivers for lost earnings and benefits with tax and Social Security credits, it is difficult to design policies that narrowly target those who reduce hours of work to help their parents.
Keywords: Adult children; Demographics; Health Conditions and Status; Healthcare

Patterns: When Obesity Comes With a Price Tag - Nagourney, Eric (The New York Times, 2000)
Keywords: Health Conditions and Status; Net Worth and Assets

Perceiving Mortality Decline - Montgomery,Mark R. (Population and Development Review, 2000)
In the demographic literature on developing countries, studies of mortality perceptions are conspicuous by their absence. Perhaps it has been assumed that when mortality declines, the decline will be quickly recognized by individuals and will then influence their demographic decisions. The possibility of substantial lags and biases in risk perception, which cause individual perceptions to diverge from the changing empirical realities, has not been much considered. Yet studies in cognitive and social psychology indicate that individual mortality perceptions are likely to be diffuse and may well be biased upward in relation to the declining empirical risks. If individuals are poorly equipped to recognize mortality decline, so too may be social groups--social learning will not necessarily correct individual misapprehensions. This note discusses the perceptual limitations that may delay recognition of mortality decline and examines the implications for demographic behavior in three areas: modern health care, fertility control, and children's schooling.
Keywords: Health Conditions and Status; Risk Taking

Planned Bequests: Decision to have a will and distributive preferences among the very old - Lee, Jieun (Purdue University, 2000)
The main purpose of this study is to investigate older people's planning for estate distribution and their distributive preferences by examining the factors associated with their will-holding status and the inclusion of specific beneficiary (i.e., children, grandchildren, and charity) in their wills. This study uses data from the 1994 Assets and Health Dynamics among the Oldest Old (AHEAD) survey, Wave One and the sample consists of 5,365 households. A conceptual model is developed based on altruistic bequest theory, life-cycle-permanent-income hypothesis, social exchange theory, and the findings of previous research to reflect complexity of estate planning and bequest behavior. Logit regression analysis is employed for the model estimation. Major findings of this study are: (1) estate planning is not actively implemented as significant aspect of financial management practices even among older people; (2) wealthier and better educated people are more likely to be will-holders, but their distributive preferences are similar to those with lower level of wealth and education. Status factors (i.e., financial resources, education) influence whether one has a will, and family or beneficiary characteristics influence whether one is selected as a beneficiary; (3) custodial grandparents have higher likelihood of making a provision for grandchildren in their wills, while they are less likely to name own children as beneficiaries; (4) Black, Hispanic, and other racial groups are less likely to be will-holders. Black are less likely to cite children as beneficiaries than are White, while Black and other racial groups tend to name grandchildren as beneficiaries than are White; (5) those who have a financial advisor are more likely to have a will and name a charity as a beneficiary, holding financial resources and other variables constant; (6) marital relationship is found to be more important than linear relationship, suggesting that current intestate statutes may not reflect people's preferences for favoring their spouses over their children; and (7) the lower likelihood of being named in a will for stepchildren indicates that biological relationships are more important in deciding beneficiaries than step relationships. Lastly, implications for financial educators and planners, policy makers, and fund-raisers in nonprofit organizations, and future research are presented based on the findings.
Keywords: Adult children; Health Conditions and Status

The Production of Functionality by the Elderly: A Household Production Function Approach - Kutty, Nandinee K. (Applied Economics, 2000)
This paper extends Becker's model of the household production function of human capital to the production of elderly functionality. In this model, elderly functionality is produced with the direct inputs of assistive devices, personal assistance, and nutritional intake. Education, endowment variables (like genetic endowment and sex) and health conditions (like stroke) determine the production function environment. Data from the Survey of Asset and Health Dynamics Among the Oldest-Old (AHEAD) are used to estimate a production function of bathing functionality, using a two-stage estimation procedure. In the first stage, input demands for the endogenous functionality inputs are estimated, recognizing health heterogeneity. The results suggest that reverses in functionality caused by age and health conditions can be partially compensated for by the use of assistive devices (like grab bars and bathing equipment), secure nutritional intake, and moderate alcohol consumption. However, non-inputs like chronic health conditions, age, sex and genetic endowment exert a strong influence on the level of functionality.
Keywords: Consumption and Savings; Demographics; Health Conditions and Status; Net Worth and Assets

Retirement Expectations and Realizations: The Role of Health Shocks and Economic Factors - Debra S. Dwyer; Hu, Jianting (Forecasting Retirement Needs and Retirement Wealth, 2000)
This chapter explores the relationship between peoples' expectations about retirement, their realizations of retirement, and the role of health shocks in this process. We look at how accurately people predict retirement and we examine the determinants of changes in retirement expectations. Expectations are made under uncertainty about future health, labor force status, household characteristics, and economic variables; therefore plans must frequently be updated with new information. While many factors influence the decision to retire, we are specifically interested in the role of health shocks in peoples' decisions to alter their plans to retire. Research to date has recognized the importance of understanding the relationship between health and retirement; however, until now, information about health, work, and economic well-being was difficult to obtain in a single survey. The Health and Retirement Study (HRS) is the first national survey to combine comprehensive data on all of these areas. Nevertheless much of the early HRS research has used only the first wave of data, at which time many in the cohort were too young to retire. In this chapter we use new information on this group of people from wave 2, enabling us to observe this cohort moving into retirement. In what follows we first offer a brief discussion of the literature, and then discuss empirical models, data used in the analysis, results and conclusions.
Keywords: Expectations; Health Conditions and Status; Retirement Planning and Satisfaction

Retirement Responses to early Social Security Benefit Reductions - Olivia S. Mitchell; John W R Phillips (National Bureau of Economic Research, 2000)
Respondents who retire early are similar initially, in terms of their health, education, and wealth, to those who subsequently elect the normal retirement path. Both groups are healthier and better educated than those who take disability retirement. Analysis of the life-cycle budget constraint shows that cutting early Social Security benefits would have an uneven effect on beneficiaries. Respondents who are black, have lower levels of education, and are in poor health would suffer relatively large losses. This study finds that a cut in early Social Security benefits would result in more workers delaying benefit acceptance as opposed to taking disability benefits.
Keywords: Disabilities; Employment and Labor Force; Event History/Life Cycle; Health Conditions and Status; Income; Insurance

Saving for Retirement: The Importance of Planning - Annamaria Lusardi (TIAA-CREF Institute Research Dialogue, 2000)
In this article, I examine saving and planning behavior of households whose head is only a few years away from retirement using data from the Health and Retirement Study (HRS), a survey of a sample of U.S. households in which the head was born between 1931 and 1941. This survey reports detailed information on wealth and the retirement process, with a focus on health, participation in labor markets, and economic and psychosocial factors. These data provide the researcher with an unusually rich set of information to analyze household behavior. I also use data from the Survey of Consumer Finances (SCF), a triennial survey of U.S. families sponsored by the Board of Governors of the Federal Reserve System. This survey is designed to provide detailed information on families' balance sheets and their use of financial services. Finally, in a few instances, data from the 1997 Retirement Confidence Survey are mentioned; this survey collected information on American workers' retirement planning and saving behavior (Yakoboski and Dickemper, 1997).
Keywords: Employment and Labor Force; Health Conditions and Status; Net Worth and Assets

The Significance of Socioeconomic Status in Explaining the Racial Gap in Chronic Health Conditions - Mark D Hayward; Eileen M. Crimmins; Toni Miles; Yang, Yu (American Sociological Review, 2000)
Using Wave 1 (1992) and Wave 2 (1994) of the Health and Retirement Study the researchers try to detect the differences in life without health problems between different races so as to understand disparities in mortality rate and quality of life. Do Blacks have a higher risk of acquiring chronic health impairments of all types? How do differences in social conditions produce differences in the prevalence of fatal chronic diseases among races? The researchers notice that Blacks have a lower chance of surviving to middle age then do Whites. Blacks have a far greater level of morbidity in middle age, as well as, chances in having multiple fatal disease conditions. The author s give possible reasons for their findings, with much of it based on social status and life events.
Keywords: Health Conditions and Status; Net Worth and Assets

The Trade-Off Between Hours of Paid Employment and Time Assistance to Elderly Parents at Midlife - Richard W. Johnson; LoSasso, Anthony T. (The Urban Institute Research Report, 2000)
Although the family has traditionally been the primary caregiver for the frail elderly, the rising labor force participation rates of married women may interfere with their historical caregiving responsibilities. This paper explores time transfers to elderly parents and their impact on labor supply for persons at midlife. We estimate simultaneous panel data models of annual hours of paid work and the provision of time assistance to parents for a sample of men and women ages 53-65 in the Health and Retirement Study. Our results indicate that time help to parents substantially reduces labor supply for both women and men.
Keywords: Adult children; Demographics; Health Conditions and Status; Healthcare

America's Elderly Population and Their Need for Supportive Services - Shafer, Robert (Cambridge, MA, Harvard University, 1999)
Abstract: Examined the characteristics of older adults and their needs for supportive services. Data were obtained from the Assets and Health Dynamics Among the Oldest-Old (AHEAD) survey on 8,222 adults aged 70 and older in 1993 and 6,047 housing units. It was found that the population aged 70 and older is largely female and increasingly so with age, rising to 79.2 percent for adults aged 90 and older. The educational achievement and occupational status of older adults reflects societywide trends, and 9 percent are currently employed. The best measures of the health of older adults and their need for assistance are measures of activities of daily living (ADLs) and instrumental ADLs (IADLs). While about 19 percent of adults aged 70-74 had difficulty with at least one ADL, 74 percent of those aged 90 and older had difficulty with at least one ADL. For IADLs, the percentage increased from 20 percent to 74 percent across the same age range. The results suggest that a variety of responses are required to meet older adults' diverse needs for supportive services.
Keywords: Health Conditions and Status; Healthcare

The Association of Influenza Vaccine Receipt with Health and Economic Expectations among Elders: The AHEAD Study - Robert B Wallace; Nichols, Sara; Michael D Hurd (Wealth, work, and health: Innovations in measurement in the social sciences: Essays in honor of F. Thomas Juster, 1999)
Keywords: Consumption and Savings; Expectations; Health Conditions and Status; Methodology

Cognitive Performance Measures in Survey Research on Older Adults - A. Regula Herzog; Willard L Rodgers (Cognition, Aging, and Self Reports, 1999)
Many researchers wonder whether cognitive ability decreases in the elderly and surveys of the elderly tend to include tests of cognitive ability that allow survey administrators to reject certain peoples responses or adjust the weight given to responses based on the respondents cognitive ability. The author s discuss cognitive tests used in the AHEAD Study, methodological issues of such tests, and the validity of cognitive measures in these tests. After a great deal of testing they conclude that the survey measures for cognition in the two studies are valid. They also present a number of methodological problems within cognitive tests and ways to resolve such problems.
Keywords: Health Conditions and Status; Methodology

Consumer Preferences for Health Care Reform Options - Gong-Soog Hong; Shelley I. White-Means (Journal of Consumer Affairs, 1999)
This study uses the 1992 Health and Retirement Study to examine consumer preferences for four health care reform options: tax-financed national health insurance, personally subsidized Medicare extensions, publicly subsidized nursing home insurance, and tax credits for health insurance purchases. Males, non-Caucasians, the self-employed, those in excellent health, and those who reside in the Northeast favor national health insurance, while those with high levels of liquid and non-liquid assets tend to disfavor it. Males and those with higher expectations of living in nursing homes tend to favor personally subsidized Medicare extensions to cover nursing homes and home health care. Those with higher expectations of living in nursing homes also favor publicly subsidized nursing home insurance. Relatively little support for subsidized nursing home insurance is found among males and those with high levels of liquid and non-liquid assets. The self-employed tend to support tax credits for health insurance premiums.
Keywords: Consumption and Savings; Health Conditions and Status; Healthcare; Net Worth and Assets; Public Policy

Demand for Home Modifications: A Household Production Function Approach - Kutty, Nandinee K. (Applied Economics, 1999)
Coping with activity limitations that occur in old age is an important issue in the context of increasing life expectancy and the, still, inevitable onset of chronic conditions in old age. Elderly households can be viewed as coping with activity limitations by producing functionality with the use of direct inputs that include home modifications. A model of the household production of functionality is developed within the general framework of household production function models of health. Hypotheses generated from this model are tested using a logit model for data from the Survey of Asset and Health Dynamics Among the Oldest Old (AHEAD). The main findings of the empirical analysis are that the demand for home modifications is fairly income-inelastic, home modifications and personal care are substitutes to some degree, the demand for home modifications increases with years of schooling, and that particular health conditions and the use of other assistive devices are important determinants of the demand for modifications.
Keywords: Consumption and Savings; Health Conditions and Status; Housing; Net Worth and Assets

Determinants of the Living Arrangements of the Elderly - Shafer, Robert (Cambridge, MA, Harvard University, 1999)
Abstract: Examined the determinants of the living arrangements of older adults. Data were obtained from the Assets and Health Dynamics Among the Oldest-Old (AHEAD) survey on 8,222 adults aged 70 and older in 1993 and 6,047 housing units. It was found that assisted living communities were favored by older households (especially those with the oldest person aged 85 or older) and when no adult children were living within 10 miles. However, preferences for assisted living communities were unaffected by the presence of difficulties with activities of daily living (ADLs) or instrumental ADLs (IADLs). Shared housing was favored by households with one or more members having difficulties with ADLs and IADLs and by households without any nonresident children. Supported housing was favored by households with one or more members having difficulties with ADLs and IADLs. Educational attainment, income, net worth, and sex had little to do with the selection of living arrangements. Blacks and Hispanics were less likely than whites to live in age-segregated housing and more likely to live in shared housing. An appendix provides information on the multinomial logit model used in the study.
Keywords: Demographics; Health Conditions and Status; Housing

Does Retirement Planning Affect the Level of Retirement Satisfaction? - Elder, Harold W.; Rudolph, Patricia M. (Financial Services Review, 1999)
This article analyzes the relationship between retirement planning and retirement satisfaction. Planning for retirement is positively related to the level of retirement satisfaction. As expected, individuals with higher incomes, larger net worths, and those who have partners are significantly more likely to be satisfied in retirement. However, even after controlling for these variables, results show that planning does indeed impact the level of retirement satisfaction. Furthermore, planning implies a higher level of satisfaction even for those who did not make the decision to retire voluntarily- - either because of health problems or an employer's decision.
Keywords: Adult children; Demographics; Employment and Labor Force; Health Conditions and Status; Net Worth and Assets

The Dynamic Effects of Health on the Labor Force Transitions of Older Workers - John Bound; Michael Schoenbaum; Todd R. Stinebrickner; Timothy A Waidmann (Labour Economics, 1999)
This article analyzes the relationship between health and alternative labor force transitions, including labor force exit, job change, and application for disability insurance. Health is a very significant determinant of labor force patterns. Controlling for lagged values of health, poor contemporaneous health is strongly related to older men and women's exit from the labor force and their decisions to apply for disability insurance. Controlling for poor contemporaneous health, poor lagged health is associated with continued participation in the work force. The earlier a health shock occurs, the less likely it is to lead to labor force exit. People who experience health setbacks earlier in life tend to switch jobs instead of stopping to work. Results suggest that both poor health and declines in health are significant variables that help to explain retirement behavior.
Keywords: Demographics; Employment and Labor Force; Health Conditions and Status

Elder Depression Linked to Disease - Unattributed (Parent Care Advisor, 1999)
This article describes the findings of a University of Michigan study (based on AHEAD data) that examined the "complex" relationship among depression, disease, and disability. Data from the first two waves of the AHEAD study was used to evaluate the link between disease and depressive symptoms. Results showed that older people who smoked or had multiple symptoms of depression were much more likely to develope a new disease within two years than those without these symptoms.
Keywords: Demographics; Disabilities; Health Conditions and Status; Net Worth and Assets

An Empirical Analysis of the Social Security Disability Application, Appeal, and Award Process - Hugo Benítez-Silva; Buchinsky, Moshe; Hiu-Man Chan; Rust, John; Sheidvasser, Sofia (Labour Economics, 1999)
This paper uses the first three waves of the HRS to provide an empirical analysis of the Social Security disability application, award, and appeal process.
Keywords: Disabilities; Employment and Labor Force; Health Conditions and Status; Net Worth and Assets; Social Security

Formal and Informal Community Care to Older Adults: Comparative Analysis of the United States and Great Britain - Adam Davey; Patsios, Demi (Journal of Family and Economic Issues, 1999)
This article examines four components of community-based care for older adults with ADL limitations from a cross-national perspective, focusing on the U.S. and Great Britian. Surveys of older adults were used to determine whether differences exist between the two countries with respect to: the type of support that is primarily provided (informal sector vs. formal sector), the overall likelihood that those with at least 1 ADL limitations receive assistance, and the extent of unmet needs. Results show that the likelihood of receiving formal and informal support was significantly greater in G.B. than in the U.S. However, while high in both, the rates of unmet need did not differ between the two countries. The data also shows that community-based formal support does not substitute family help. This finding emphasizes the importance of family caregivers and further reinforces the already existing effort made by both countries to provide support for these primary support agents.
Keywords: Adult children; Health Conditions and Status; Healthcare

Formation of Trusts and Spend Down to Medicaid - Donald H. Taylor Jr.; Frank A Sloan; Edward C Norton (The Journals of Gerontology: Social Sciences, 1999)
OBJECTIVE: To identify the proportion of community-dwelling elderly persons (70 ) who could affect their eligibility for Medicaid financing of a nursing home stay through the use of a trust and to quantify the prevalence and predictors of trusts. METHODS: State-specific Medicaid eligibility regulations were used to determine eligibility and to identify those who could affect the same through the use of trusts. Multivariate logistic regression was used to identify correlates of having a trust. Wave 1 of the Assets and Health Dynamics of the Oldest Old (AHEAD) data base was used. RESULTS: Four in 10 elderly community dwellers could potentially qualify for Medicaid by using a trust; however, less than 10 had a trust. On average, wealthier persons had trusts. Avoidance of probate and controlling assets after death appear to be stronger motivations for trust creation among the elderly than achieving Medicaid spend down. DISCUSSION: The use of trusts was not common, and motives other than spend down were more important for those with trusts. Our results suggest little need for policy efforts to limit the use of trusts to achieve spend down.
Keywords: Adult children; Demographics; Health Conditions and Status; Healthcare; Medicare/Medicaid/Health Insurance; Methodology; Net Worth and Assets

Health, Work, and Economic Well-Being of Older Workers, Aged 51-61: A Cross-National Comparison Using the United States HRS and the Netherlands CERRA Data Sets - R.V. Burkhauser; Debra S. Dwyer; Maarten Lindeboom; Theeuwes, Jules; Wottiez, Isolde (Wealth, Work and Health: Innovations in Measurement in the Social Sciences, 1999)
Keywords: Employment and Labor Force; Health Conditions and Status

Illness and Economic Status: Why are they so closely connected? - Koretz, Gene (Business Week, 1999)
Keywords: Health Conditions and Status; Net Worth and Assets

The Importance of Accommodation on the Timing of Male Disability Insurance Application - R.V. Burkhauser; Butler, J.S.; Kim, Yang-Woo; Robert R. Weathers II (Journal of Human Resources, 1999)
Using data from the 1978 Survey of Disability and Work and the 1992 Health and Retirement Study, we test the importance of accommodation and other policy variables on the timing of application for Social Security Disability Insurance benefits following the onset of a work-limiting condition. We correct for choice-based sampling in the Survey of Disability and Work by extending the Manski and Lerman (1977) correction to the likelihood function of our continuous time hazard model, we find that this correction significantly affects the results. Similar findings emerge from these two data sets. Accommodation significantly reduces the speed of application and more generous benefits increase the speed of applying for SSDI.
Keywords: Disabilities; Employment and Labor Force; Health Conditions and Status; Retirement Planning and Satisfaction

Latent Work Disability and Reporting Bias - Kreider, Brent (Journal of Human Resources, 1999)
A measure of true disability is constructed as a continuous index of unobserved work limitation using information from the Health and Retirement Study. Estimates from a simultaneous model of work participation, disability, and income flows suggest that nonworkers tend to substantially overreport limitation, with overreporting most prevalent among nonworking women, high school dropouts, nonwhites, and former blue collar workers. Former white collar workers are found unlikely to overreport limitation. Use of a biased disability measure in the model leads to an upward-biased estimate of the effect of limitation on non work and to a downward-biased estimate of the effect of income.
Keywords: Disabilities; Employment and Labor Force; Health Conditions and Status; Public Policy

Linkages with Data from Social Security Administrative Records in the Health And Retirement Study - Olson, Janice A. (Social Security Bulletin, 1999)
Keywords: Consumption and Savings; Disabilities; Health Conditions and Status; Retirement Planning and Satisfaction; Social Security

Scale Simplification of Expectations for Survival: Cognitive Ability and the Quality of Survey Responses - Robert F. Belli; A. Regula Herzog; Van Hoewyk, John (Cognitive Technology, 1999)
This paper examines how data quality (specifically data that uses response scales designed to measure event probability) is affected by the cognitive ability of respondents and whether or not respondents provide a simplification process. Cognitive ability does have an affect on how respondents answer survey questions that use a high number of response options. Evidence of satisficing and providing simplification responses does show up in respondents with lower cognitive abilities, but the bunching phenomenon (due to satisficing) appears to have only limited effects on the data quality. Regardless of this limited effect, the results suggest ways of improving the quality of survey questions that use many response options. Better data quality will result when questioning leads respondents with higher cognitive abilities to maximize the number of response options while leading lower able respondents to deal with a reduced set of response options. The unfolded bracket technique is an example of such a method.
Keywords: Expectations; Health Conditions and Status; Methodology

Study: Depression as deadly as smoking - Webster, Sarah A. (Detroit News, 1999)
Keywords: Health Conditions and Status

Theory Confronts Data: How the HRS is Shaped by the Economics of Aging and How the Economics of Aging Will be Shaped by the HRS - Robert J. Willis (Labour Economics, 1999)
This paper describes the evolution of the HRS from its origins in 1992 to its current design as a longitudinal 'steady state' sample of older Americans which is representative of the U.S. population over age 50. It discusses the conceptual framework of the survey as well as the broad theoretical concepts that lead to its content and design. The paper concludes with a description of some recent findings that use the HRS data; in particular the positive correlation between health and wealth.
Keywords: Health Conditions and Status; Methodology; Net Worth and Assets

The Transfer of Resources from Middle-Aged Children to Functionally Limited Elderly Parents: Providing Time, Giving Money, Sharing Space - Boaz, Rachel F.; Hu, Jason; Ye, Yongjia (The Gerontologist, 1999)
This article investigates the interdependence among all three major modes of trasfer (giving time, money, and sharing space), given the parents' specific needs for resources and the children's ability to provide them. While only reported in 17 of the households, the provision of caregiving time is the primary mode of resource transfer from children to their parents. When the other modes of transfers are added, money and space, the percentage of households transfering resources to their parents rose to 29 . It is significant to consider all modes of transfer in order to understand how families accomodate the needs of elderly/disabeled parents. These transfer modes appear to be dependent upon the needs and situations of the parents as well as the types of resources available to the household that is giving.
Keywords: Adult children; Employment and Labor Force; Health Conditions and Status; Net Worth and Assets

Wealth, Work, and Health: Innovations in Measurement in the Social Sciences: Essays in honor of F. Thomas Juster - James P Smith; Robert J. Willis (University of Michigan Press, 1999)
Twelve papers, presented at a December 1996 conference at the Institute for Social Research (ISR), celebrating the career of F. Thomas Juster and his retirement from the University of Michigan and the ISR, focus on survey measurement and analysis of survey data in the social sciences. Papers discuss the several cultures of research on subjective expectations; measuring investment in young children with time diaries; the unfolding bracket method in the measurement of expenditures and wealth; lifetime earnings, saving choices, and wealth at retirement; inheritances and bequests; pension and social security wealth in the Health and Retirement Study; the size distribution of wealth in the United States as measured by recent household surveys; a cross -national comparison of health, work, and economic well-being of older workers aged fifty-one to sixty-one using the U.S. and Dutch data sets; labor market transitions and whether subjective probabilities of working have predictive power for actual retirement; the impact of education and heart attack on smoking cessation among middle-aged adults; the association of influenza vaccine receipt with health and economic expectations among elders; and co -residence between married adult children and their elderly unmarried mothers. Contributors include economists. Smith is at the RAND Corporation. Willis is at the University of Michigan and the Institute for Social Research. No index.
Keywords: Consumption and Savings; Health Conditions and Status; Income; Methodology; Retirement Planning and Satisfaction

Anchoring Effects in the HRS: Experimental and Nonexperimental Evidence - Michael D Hurd (The National Bureau of Economic Research, 1998)
The Health and Retirement Study (HRS) and a number of other major household surveys use unfolding brackets to reduce item nonresponse. However, the initial entry point into a bracketing sequence is likely to act as an anchor or point of reference to the respondent. For example, when the initial entry point is high the distribution will be shifted to the right, leading one to believe that holdings of the particular asset are greater than they truly are. This paper analyzes some experimental data on housing value from HRS wave 3 for anchoring effects. The paper also compares the distributions of assets in HRS waves 1 and 2 for evidence about any anchoring effects that may have been caused by changes in the entry points between the waves. Both the experimental data on housing values and the nonexperimental data from HRS waves 1 and 2 on assets show anchoring effects.
Keywords: Health Conditions and Status; Healthcare; Methodology; Retirement Planning and Satisfaction

Assessing Older Worker Perceived Climate of Occupational Health and Safety: A descriptive study - Stalnaker, Charles Keith (The University of Tennessee, 1998)
Items from the Health and Retirement Study survey questionnaire were used to construct two scales: the Occupational Health and Safety Climate Scale and the Willingness to Accommodate Scale. The first scale used nine survey questions that elicited workers' assessments of the frequency they experienced job characteristics associated with a negative occupational health and safety climate (OHSC). The second scale contained six survey questions that elicited workers' perceptions of employer willingness to accommodate the needs of aging workers. Using descriptive statistics, it was concluded that older skilled craft workers assessed their jobs as having characteristics (e.g., lifting heavy loads and working inawkward positions) associated with a negative health and safety climate significantly more often than workers in other job classifications. Within the skilled craft group, it was concluded there was no significant difference between younger old (aged 51-55 years)and older old (aged 57-61 years) worker assessments of OHSC; there was a significant difference between male and females, with females assessing their jobs as having a significantly higher frequency of characteristics (including less freedom to decide how do their work and ahigh degree of repetitiveness) associated with a negative OHSC; there was no significant difference in the assessments of OHSC between Blacks and Caucasians or between Blacks and Latinos, but there was a significant difference between Caucasians and Latinos, with Latinos assessing their jobs as having a higher frequency of characteristics associated with a negative OHSC; and there was no significant difference in assessment of OHSC between union and non-union members. It was concluded that there was no significant difference in how skilled craft and other workers perceived the willingness oftheir employers to accommodate the needs of older employees.
Keywords: Demographics; Employment and Labor Force; Health Conditions and Status

The Availability and Utilization of Assistance by Childless Elderly and Elderly Parents: A Comparative Study - Hayes, Melanie (Gerontology, 1998)
Using data from the Survey of Asset and Health Dynamics Among the Oldest-Old, Wave 1, 1993, the differences between elderly parents and childless elderly in the sources of assistance that are available to them and utilized by them are examined. Parental status is examined for its effect on sources of assistance with activities of daily living (ADLs), instrumental activities of daily living (LADLs), expected sources of future support with ADLs/LADLs, residence in a building or community which provides personal care services and with financial management. The effect is controlled for covariates of marital status, age, sex, and household income using regression models. The examination found that the lack of or presence of children does affect who assists an elderly person. Overall, the childless respondents used more non-family sources of assistance with a broad spectrum of care needs. Implications of the findings are discussed and recommendations for future research are detailed.
Keywords: Health Conditions and Status; Healthcare

Childhood Conditions and Adult Health: Evidence from the Health and Retirement Study - Irma Elo (Population Aging Research Center Working Paper Series, 1998)
Poor health and premature death are direct manifestations of biological processes influenced by genetic, environmental, and life style factors. These factors operate throughout the life course and interact in complex ways to produce observed differentials in adult health and mortality. To explain these differentials, authors of most studies have typically examined the role of adult environment, employing such explanatory factors as socioeconomic status (e.g., education, income and wealth), health-related behaviors (e.g., smoking and exercise), and social support (kin and social networks and marriage).
Keywords: Adult children; Health Conditions and Status

Comparison of Health Outcomes Among Older Construction and Blue-Collar Employees in the United States - Petersen, Jeffrey S.; Zwerling, Craig (American Journal of Industrial Medicine, 1998)
This article examines health outcomes of older male construction workers (age 51-61), as compared with older male blue-collar workers of the same age range. Results show that older construction workers are significantly more susceptible to musculoskeletal problems, emotional disorders, and chronic lung disease (CLD). This high rate of CLD, non-smoking construction workers are three times more likely to have CLD than are non-smoking blue-collar workers, is most likely due to on-the-job dust exposure. These findings suggest the need for further research on these topics and on possible solutions to these problems.
Keywords: Employment and Labor Force; Health Conditions and Status; Net Worth and Assets

Education's Role in Explaining Diabetic Health Investment Differentials - Kahn, Matthew E. (Economics of Education Review, 1998)
This paper studies the relationship between education and diabetic health investment. It examines how education affects diabetic health investment proxies such as smoking propensity, BMI, blood sugar control, and diet. Results indicate that increased education raises diabetic health investments. However, this increase in health investments is less for diabetics than for non-diabetics.
Keywords: Education; Health Conditions and Status

Functional Limitation, Disability and Perceived Health of the Oldest Old: An examination of health status in AHEAD - Lee A. Lillard; Farmer, Melissa M. (1998)
This research focuses on the effects of functional limitation and disability on perceived health status in those age 70 and older. It uses the first wave of the Asset and Health Dynamics Among the Oldest Old (AHEAD) and provides a new methodology for the solving methodological issues of threshold response indicators of limitations and disability and conditional wording of questions. The study provides support for the disability process model outlined by Verbrugge and Jette (1994) and also provided insight into the dynamics that operate between demographics, pathology, functional limitation, disability and perceived health status. For functional limitation, the two domains were confirmed: immobility and cognition. Disability also had two domains confirmed: personal care, and household management. Pathologies were found to have a substantial impact on all four domains as well as perceived health status. Controlling for immobility, personal care and household management were not significant predictors of perceived health status.
Keywords: Disabilities; Health Conditions and Status

The Health and Financial Decisions of the Elderly - Davis, Morris A. (University of Pennsylvania, 1998)
Keywords: Consumption and Savings; Health Conditions and Status

Health and Labor Market Performance: The Case of Diabetes - Kahn, Matthew E. (Journal of Labor Economics, 1998)
This article documents improvements in diabetic labor market performance. Three cross-sectional data sets, from 1976, 1989, and 1992, are used to study trends in diabetic employment and earnings prospects. Results show that the labor force participation of diabetic women has significantly increased between 1976 and 1992, relative to diabetic men and nondiabetics. Results also indicate that relative to nondiabetic family heads of households, the income of the diabetic family has increased. These findings suggest that medical advance and technological change have helped to reduce the probability and effects of diabetic complications.
Keywords: Employment and Labor Force; Health Conditions and Status; Net Worth and Assets

Health and Socioeconomic Mobility: The Economic Consequences of Changes in Health for Pre-Retirement Workers - Reynolds, John R.; Quadagno, Jill (1998)
The theory of cumulative advantage/disadvantage provides a life-course framework for analyzing stratification systems among the aged. Although income inequality has been the primary focus of this theory, recent studies have examined processes of cumulative disadvantage in terms of health. One consistent finding has been that socioeconomic status has a significant effect on health. Focus here, however, is extended to analyze the opposite - the effect of health on socioeconomic mobility. The first two waves of the Health and Retirement Study are used to estimate the reciprocal effects that exist between health and economic status of the US preretirement working population, specifically, to examine the reciprocal relationships between changes in physical and emotional health, on the one hand, and changes in workforce attachment, earnings, and assets, on the other. Preliminary analyses indicate that, while health and wealth are reciprocally related, among older workers, the association is primarily from health to changes in wealth, and not vice versa. These findings support the cumulative advantage perspective on inequality in old age, and challenge the commonly held view that socioeconomic status is more determinative of health than vice versa.
Keywords: Demographics; Health Conditions and Status

Health Events, Health Insurance and Labor Supply: Evidence from the Health and Retirement Survey - Mark McClellan (Frontiers in the Economics of Aging, 1998)
The economic consequences of health problems are reported to be enormous. For example, many investigators have concluded that the cost to society of common health problems such as heart disease, diabetes, and cancer is many billions of dollars per year in terms of lost work productivity, intensive medical treatments, and additional supportive care. However, these estimates have several important limitations. Few data sets have incorporated detailed information on health problems and economic circumstances such as retirement, medical and personal care expenditures, income, and wealth. Consequently, most existing studies have had to combine data from different sources, possibly missing important correlations between variables such as insurance availability and the occurrence of health problems. Many of these studies have been based on cross-sectional, descriptive comparisons of individuals with and without health problems. As a result, it is difficult to account for other differences besides health problems that might also have affected these outcomes. For example, individuals with health problems may have had chronically worse health status, or have lower-income backgrounds, or have other differences in preferences that might have led to differences in economic outcomes anyway.
Keywords: Employment and Labor Force; Health Conditions and Status; Medicare/Medicaid/Health Insurance

How America Saves - Korczyk, Sophie (Washington, DC, American Association of Retired Persons, 1998)
Certain groups with lower savings througout their work lives reach retirement with significantly fewer assets than their peers. Single people, African American and Hispanic households, those with a high school education or less, people with health problems, and lower income households are all vulnerable to lower savings. Even though people save more as they age, age does not make up for low saving patterns. In nearly all economic and demographic groups, there are some people who do not save at all, some who save a little, and some who save a great deal. Taking into consideration the experiences, attitudes, and personal expectations of people nearing or in the early stages of retirement age is important to understanding their saving capacities, patterns, and decisions.
Keywords: Adult children; Employment and Labor Force; Expectations; Health Conditions and Status; Net Worth and Assets; Risk Taking

The Impact of Education and Heart Attack on Smoking Cessation Among Middle-aged Adults - Linda A. Wray; A. Regula Herzog; Robert J. Willis; Robert B Wallace (Journal of Health and Social Behavior, 1998)
Considerable evidence supports the premise that higher levels of education lead to enhanced health, including protective health behaviors. This paper focuses on how education affects one health behavior known to lead to enhanced health: the cessation of smoking. In particular, the authors examine the extent to which education influences the decision by middle-aged adults to quit smoking following a heart attack, a potentially life-threatening health event. We first hypothesize that middle-aged adults with more formal education will stop smoking more readily than people with less formal education following the experience of a heart attack. Second, we ask what other factors might underlie and explain that hypothesized effect. Using longitudinal data, the authors track changes in individual smoking behaviors after a heart attack among preretirement-age Americans. We control for documented correlates of smoking and heart attack plus other factors associated with education, heart attack, and smoking that may also influence whether a person quits smoking. In addition to confirming evidence on the education-health association as well as the documented connection between heart attack and smoking cessation, this study provides a surprising twist on those links: Our results show that the move to quit smoking following the experience of a heart attack among middle-aged adults is significantly and dramatically moderated by their level of educational attainment.
Keywords: Demographics; Health Conditions and Status; Methodology

The Impact of Multiple Caregiving Roles on Well-being: A longitudinal study of middle-aged adults - Perez-Cahill, Danae (University of Massachusetts, Amherst, 1998)
This longitudinal study examined the experience of caregiving among a nationally-representative sample of 10,537 middle-aged adults participating in Wave 1 and Wave 2 of the Health and Retirement Study. Individuals were classified as parent caregivers, child caregivers, and multiple (parent and child) caregivers. The low incidence of multiple caregiving found among these middle-aged adults questions the validity of the phenomenon described as the 'sandwich generation.' Females comprised the majority of the parent, child, and multiple caregiving groups. Contrary to expectations, black and latina caregivers were not more likely than whites to hold parent and multiple caregiving roles. A high frequency of caregiving role losses and a low frequency of caregiving role assumptions occurred between Wave 1 and Wave 2. Most notable was the finding that 41% of multiple caregivers and 70% of parent caregivers in Wave 1 became noncaregivers in Wave 2. In addition, only.4% And 6.5% Of women assumed multiple care and parent care, respectively. These findings suggest that the experience of caregiving during the middle-generation years is of short duration and likely to decrease over time. No support was found for the 'caregiving pile up effect' (Doress-Worters, 1994) among those holding multiple caregiving roles. Rather, female caregivers experienced a decrease in well-being regardless of their caregiving role transitions, while caregivers who gained or maintained caregiving reported better physical health than those who lost caregiving. In addition, caregivers' well-being did not differ from that of noncaregivers, with the exception of ADLs (better for caregivers). Ethnicity was found to play an important and complex role in predicting transitions in caregiving and well-being. As hypothesized, being a black or latina caregiver who lost parent care predicted worse well-being. With regards to the maintenance or assumption of child care, however, being a minority woman accounted for worse well-being. The negative consequences of child caregiving for latinas is especially intriguing given their greater likelihood to maintain child care. There was some support for the notion that minorities' traditional family values in support of caregiving predict better well-being for women maintaining child care or for multiple caregivers.
Keywords: Adult children; Demographics; Health Conditions and Status; Healthcare; Women and Minorities

The Influence of Push and Pull Factors on Voluntary and Involuntary Early Retirees' Retirement Decision and Adjustment - Kenneth S. Shultz; Morton, Kelly R.; Weckerle, Joelle R. (Journal of Vocational Behavior, 1998)
This paper examines early retirees' decisions to retire, as well as their postretirement adjustment, in terms of both push (negative considerations: e.g., poor health) and pull (positive considerations: e.g., leisure interests) factors. Results confirm the hypothesis that both negative push and positive pull factors differentially influenced those retirees who voluntarily retired and those forced to retire. After retirement, the negative push factors became the more salient differentiators; those forced to retire appeared to have generally lower self ratings of physical and emotional health and lower satisfaction rates. In addition, the findings suggest that the way an individual views their retirement decision is related to their postretirement experience: those who viewed their retirement decision as voluntary reported higher satisfaction and health levels during retirement than those who viewed their retirement as involuntary.
Keywords: Adult children; Health Conditions and Status; Net Worth and Assets; Retirement Planning and Satisfaction

Late Life Job Displacement - Kenneth A. Couch (The Gerontologist, 1998)
Data from the 1992 wave of the Health and Retirement Study are used to examine the incidence of job displacement among workers ages 51 through 60. The average displaced worker experiences a loss in earnings of 39 . Households which contain a displaced worker have incomes 24 lower than the household of an average worker. Little of these lost earnings are replaced through pension income. The rate of health insurance coverage is 16 lower among displaced workers. As with other labor market outcomes, non-Whites on average are the most economically vulnerable following displacement.
Keywords: Demographics; Employment and Labor Force; Health Conditions and Status; Income; Medicare/Medicaid/Health Insurance; Methodology; Other; Pensions

Moving the Nest: A Look at the Effects of Family and Work Status Change in Later Mid-Life - Regina M. Bures (University of Chicago - Population Research Center, 1998)
Using data from the first two Waves of the Health and Retirement Survey (HRS), this research examines the relationship between migration, family change, and work status change in later mid-life. The results suggest that both family and work status change have significant effects on mobility in later mid-life. The findings for work status change appear consistent with theories of labor force migration: Individuals who worked full-time at both waves were significantly less likely to move long distances than nearly every other group. Departure from the labor force increased the likelihood that an individual experienced a move, either locally and interstate. Changes in the number of adult children resident in a household are found to have strong and significant effects on mobility in later mid-life. Adult children returning home are positively associated with both local and interstate moves. Children leaving home have an even greater impact on mobility. A previously unreported finding is that adult children leaving home have a significant positive effect on long-distance mobility. These findings extend the migration literature by seeking to explain mobility and migration in the context of family and work change over the life course.
Keywords: Adult children; Demographics; Employment and Labor Force; Health Conditions and Status; Retirement Planning and Satisfaction

Older Parents' Expectations of Moving Closer to Their Children. - Merril Silverstein; Angelelli, J.J. (The Journals of Gerontology: Social Sciences, 1998)
Research shows that older parents engage in return migration in older to live closer to children from whom they receive care. However, less is known about how characteristics of adult children influence this process. Data for this analysis are from 5,382 older parents participating in the 1993/4 AHEAD national survey of adults aged 70 years old and older. Findings demonstrate that elderly parents who expect to move closer to adult children tend to be older, female, and have at least one child who is better-off financially than they are. Living alone magnifies the effect of poor self-rated health on expecting to move closer to a child. Random effects modeling of children's characteristics reveals that parents are more likely to expect to move closer to a daughter than to a son. Greater parental functional impairment was found to further depress the selection of sons. Overall, the findings suggest that older parents expect to move closer to adult children out of need and tend to select a target child with greater potential to provide support.
Keywords: Adult children; Demographics; Health Conditions and Status; Housing; Income; Methodology

Predictors of Mobility and Basic ADL Difficulty Among Adults Aged 70 Years and Older - Daniel O. Clark; Timothy E. Stump; Hui, S.L.; Frederic D Wolinsky (Journal of Aging and Health, 1998)
We use data from the 1993-1995 Assets and Health Dynamics of the Oldest-Old survey to estimate predictors of onset of mobility difficulty, onset of basic activity of daily living (ADL) difficulty, and improvement to no mobility difficulty. Onset of mobility difficulty occurred among 20 of those with no difficulty at baseline (n = 2,857) and was most likely among those 85 years of age or over, women, those with a body-mass index of 30 or over, and those who reported lung disease, arthritis, frequent pain, and poor memory. For those with mobility difficulty at baseline (n = 1,871), improvement occurred among 24 and onset of basic ADL difficulty occurred among 25 . Improvement was more likely among those with difficulty in just one mobility item at baseline, and onset of ADL difficulty was most common among those with difficulty in three or more mobility items at baseline.
Keywords: Health Conditions and Status

Predictors of Onset Of and Recovery From Mobility Difficulty Among Adults Aged 51-61 Years - Daniel O. Clark; Timothy E. Stump; Frederic D Wolinsky (American Journal of Epidemiology, 1998)
Relative to information on activities of daily living, information regarding the onset of and recovery from mobility difficulty has been limited. Drawing upon data gathered from 6,376 self-respondents aged 51-61 years at baseline (1992) who were successfully reinterviewed in 1994 as part of the Health and Retirement Survey, the authors were able to build upon and add to knowledge gained from previous studies of the onset of and recovery from mobility difficulty. Hierarchical logistic regression was used to separate the direct and indirect effects of predictors of mobility difficulty onset and recovery at 2-year follow-up. To separate direct and indirect effects, the authors categorized various predictors as being related to sociodemographic factors, economic factors, health behavior, chronic disease, or physical impairment, and the categories were sequentially incorporated into a series of equations. The order in which the predictors were incorporated into the equations followed from a theoretical model of the disability process. In this study of mobility difficulty, the strongest direct predictors of recovery were having little baseline difficulty and the absence of diabetes mellitus, lung disease, and frequent pain. The strongest direct predictors of onset were female sex, less education, low net worth, lack of private health insurance, obesity, and frequent pain. Few indirect predictors for either onset or recovery were identified. Predictors of recovery were few and differed from predictors of onset. Further efforts are needed to identify modifiable predictors among females, persons with few economic resources, and those with frequent pain.
Keywords: Demographics; Disabilities; Health Conditions and Status; Methodology; Other; Risk Taking

Social Security Reform: Raising Retirement Ages Improves Program Solvency but May Cause Hardship for Some - Bovbjerg, Barbara D. (GAO Testimony before the Special Committee on Aging, U.S. Senate, 1998)
This report examines how raising the retirement age could affect Social Security (SS) and the economy and how the labor market might respond to these changes. It then looks at the possible impacts this raising of the age would have on the Disability Insurance (DI) and Supplemental Security Income (SSI) programs. The analysis shows that due to high life expectancies and the overall good health condition of the elderly, raising the retirement age could improve SS program's long-term solvency and could increase economic output. However, potential negative effects arise from the fact that older workers who have been laid off or have been retired may experience difficulties finding jobs. While the elderly may be willing to continue working, it is questionable whether employers will be willing to retain and hire them. Another possible drawback to raising the retirement age is explained by using the Health and Retirement Study. HRS data demonstrated that blue-collar workers in particular would be disproportionately affected by this age increase because due to the nature of their jobs which puts them at an increased risk of incurring health problems, they may be unable to remain in the workforce in later ages. These poor health, predominately blue-collar workers who will not receive SS retirement benefits because they cannot continue working up until the new age set by the increase, may apply for DI or be eligible for SSI, which would increase the costs of those programs.
Keywords: Demographics; Disabilities; Employment and Labor Force; Health Conditions and Status; Net Worth and Assets; Social Security

Socioeconomic Status and Health - James P Smith (American Economic Review, 1998)
Keywords: Consumption and Savings; Demographics; Health Conditions and Status

Subjective Survival Curves and Life Cycle Behavior - Michael D Hurd; Daniel McFadden; Gan, Li (Inquiries in the Economics of Aging, 1998)
Keywords: Consumption and Savings; Event History/Life Cycle; Health Conditions and Status

Adverse Selection, Bequests, Crowding Out, and Private Demand for Insurance: Evidence from the Long-Term Care Insurance Market - Frank A Sloan; Edward C Norton (Journal of Risk and Uncertainty, 1997)
Adverse selection, moral hazard and crowding out by public insurance have all been proposed as theoretical reasons for why the market for private long -term care insurance has been slow to evolve in the U.S. Using national samples of the elderly and near elderly, this study investigates which is most important. The data contain direct measures of risk aversion, expectations of future nursing home use and living to old age, and the bequest motive. For both groups, we find evidence of adverse selection, and, for the elderly, crowding out of private long-term care insurance by Medicaid. However, we do not find that demand for such insurance is motivated either by bequest or exchange motives.
Keywords: Consumption and Savings; Demographics; Health Conditions and Status; Healthcare; Insurance; Methodology

Alcohol Consumption and Mortality among Middle-Aged and Elderly U.S. Adults - Michael J Thun; Peto, Richard; Lopez, Alan D.; Monaco, Jane H.; Henley, S. Jane; Heath, Clark W.; Doll, Richard (New England Journal of Medicine, 1997)
BACKGROUND Alcohol consumption has both adverse and beneficial effects on survival. We examined the balance of these in a large prospective study of mortality among U.S. adults. METHODS Of 490,000 men and women (mean age, 56 years; range, 30 to 104) who reported their alcohol and tobacco use in 1982, 46,000 died during nine years of follow-up. We compared cause-specific death rates and rates of death from all causes across categories of base-line alcohol consumption, adjusting for other risk factors, and related drinking and smoking habits to the cumulative probability of dying between the ages of 35 and 69 years. RESULTS Causes of death associated with drinking were cirrhosis and alcoholism; cancers of the mouth, esophagus, pharynx, larynx, and liver combined; breast cancer in women; and injuries and other external causes in men. The mortality from breast cancer was 30 percent higher among women reporting at least one drink daily than among nondrinkers (relative risk, 1.3; 95 percent confidence interval, 1.1 to 1.6). The rates of death from all cardiovascular diseases were 30 to 40 percent lower among men (relative risk, 0.7; 95 percent confidence interval, 0.7 to 0.8) and women (relative risk, 0.6; 95 percent confidence interval, 0.6 to 0.7) reporting at least one drink daily than among nondrinkers, with little relation to the level of consumption. The overall death rates were lowest among men and women reporting about one drink daily. Mortality from all causes increased with heavier drinking, particularly among adults under age 60 with lower risk of cardiovascular disease. Alcohol consumption was associated with a small reduction in the overall risk of death in middle age (ages 35 to 69), whereas smoking approximately doubled this risk. CONCLUSIONS In this middle-aged and elderly population, moderate alcohol consumption slightly reduced overall mortality. The benefit depended in part on age and background cardiovascular risk and was far smaller than the large increase in risk produced by tobacco.
Keywords: Alcohol Consumption; Health Conditions and Status; Mortality; Older Adults; Smoking

Asset and Health Dynamics Among the Oldest Old: An overview of the AHEAD Study - Beth J Soldo; Michael D Hurd; Willard L Rodgers; Robert B Wallace (The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 1997)
This article contains background information on the study of Asset and Health Dynamics Among the Oldest Old (AHEAD), a prospective panel survey of persons born in 1923 or earlier who were residing in the community at the time of the 1993 baseline. Interviews were sought with both spouses in married households, and an overall total of 8,222 were completed. We review the interdisciplinary scientific issues that motivated the study, describe the fundamental design decisions that structured AHEAD, and summarize the content in the core and experimental modules. The study provides unusually detailed data on cognition, family structure and transfers, and assets. Data are presented on sample selections, response rates, and oversamples of minority groups. Basic descriptive data on the demographic, health, and socioeconomic attributes of respondents also are presented. Plans for future waves of AHEAD are described, including a next-of-kin interview for decreased respondents.
Keywords: Adult children; Demographics; Health Conditions and Status; Healthcare; Income; Methodology; Net Worth and Assets

The Changing Economic Circumstances of the Elderly: Income, Wealth and Social Security - James P Smith (Syracuse University, 1997)
This Policy Brief looks at how the economic status of the elderly is changing and discusses their prospects for the future. While the economic status of the elderly has dramatically improved over the decades and there is evidence of modest wealth holdings by the typical older household, there still exists the reality of economic disparities. Many older Americans remain economically vulnerable and there are large inequalities in wealth. Wide disparities exist across racial and ethnic groups and across age groups, with the oldest households always faring worst, largely due to deaths of spouses. Evidence suggests that while income explains a significant part of the existing wealth disparities, it is not the sole factor. The other contributing factors are the significantly lower savings rates for low- and middle-income households, socioeconomic status and health, bequests motives, and Social Security. The brief ends with a discussion about the power of Social Security as a highly successful redistributive system and the reasons behind its need for reform.
Keywords: Health Conditions and Status; Income; Net Worth and Assets; Social Security

Distribution and Association of Chronic Disease and Mobility Difficulty Across Four Body Mass Index Categories of African-American Women - Daniel O. Clark; Mungai, S.M. (American Journal of Epidemiology, 1997)
A majority of African-American women over the age of 50 are obese, have at least one chronic disease, and experience mobility difficulty. Using self-reported data from the 1992 Health and Retirement Study of 1,150 African-American women aged 30-70 years, this report first compares chronic disease prevalence and severity, pain, sensory deficits, and mobility difficulty across four categories of body mass index and, second, investigates whether body mass index affects the association of chronic disease with mobility difficulty. Body mass index was categorized as low, medium, high, and severe, being equal to 19-24 (20 ), 25-29 (38 ), 30-34 (24 ), and 35 or over (18 ), respectively. There were few differences when comparing the medium category with either the low or high category. Those in the severe body mass index category, however, reported significantly more frequent and severe hypertension, diabetes, cancer, heart disease, arthritis, pain, sensory deficits, and mobility difficulty than did those in the medium body mass index category. Obesity did not appear to affect the association between chronic disease and mobility difficulty. The relatively high rates of mobility difficulty observed among the severe body mass index group appear to be more likely a result of relatively high chronic disease prevalence and severity than to a disproportionate impact of these on mobility.
Keywords: Demographics; Health Conditions and Status; Methodology; Other

The Effect of Health on Employment Transitions of Older Men - David M. Blau; Gilleskie, Donna B.; Slusher, Chuck (Chapel Hill, NC, UNC-Chapel Hill, Department of Economics, 1997)
Keywords: Employment and Labor Force; Health Conditions and Status; Retirement Planning and Satisfaction

Heart Disease Risk Factors and Onset of Heart Problems among the Elderly - Ueda, Hiroshi; Shirakawa, Taku; Goko, Hideki (Bulletin of Allied Medical Sciences, Kobe, 1997)
This study looks at the incidence of heart problems among the elderly in order to examine possible risk factors of heart disease. The six heart disease risk factors- - hypertension, diabetes, alcohol consumption, smoking status, body mass index (BMI), and physical performance- - were examined in both bivariate and multivariate logistic regression analyses. In bivariate analyses, hypertension, diabetes, alcohol consumption, and physical performance all related to the incidence of heart problems among the elderly. However, hypertension and alcohol consumption do not show significance in multivariate analyses and therefore their effects as a risk factor on the incidence of heart disease are low. BMI only significantly indicated the risk of the incidence of heart problems in the multiple logistic regression analyses. Both diabetes and physical performance proved to be statistically significant indicators of heart disease in both types of analyses, yet they show different direction of effects when demographic factors are added.
Keywords: Health Conditions and Status; Risk Taking

Older Couples: An Examination of Health and Retirement within the Context of the Family - Pienta, Amy M. (Penn State University Population Research Institute, 1997)
This paper illustrates the ways in which health experiences of one's spouse effects retirement choices of other persons in the family. To understand the consequences of health problems on one's spouse the researchers devise a theoretical model and use data from the first (1992) and second (1994) waves of the Health and Retirement Study. A longitudinal study was necessary in order to see changes across time and develop multilevel hazard models reflecting the labor force transitions due to changes in a spouses health. Poor health of ones spouse reduces the chance of a persons retiring at the time that one had initially anticipated. They also find that a person whose spouse is disabled is no more likely to become disabled themselves then one whose spouse is not disabled. The researchers were surprised to find that labor force reentry was not changed when a family member became ill or disabled.
Keywords: Adult children; Disabilities; Employment and Labor Force; Health Conditions and Status; Healthcare; Methodology

Preference Parameters and Behavioral Heterogeneity: An Experimental Approach in the HRS - Barsky, Robert; Miles S Kimball; Juster, F. Thomas; Matthew D. Shapiro (Quarterly Journal of Economics, 1997)
This paper reports measures of preference parameters relating to risk tolerance, time preference, and intertemporal substitution. These measures are based on survey responses to hypothetical situations constructed using an economic theorist's concept of the underlying parameters. The individual measures of preference parameters display heterogeneity. Estimated risk tolerance and the elasticity of intertemporal substitution are essentially uncorrelated across individuals. Measured risk tolerance is positively related to risky behaviors, including smoking, drinking, failing to have insurance, and holding stocks rather than Treasury bills. These relationships are both statistically and quantitatively significant, although measured risk tolerance explains only a small fraction of the variation of the studied behaviors.
Keywords: End of life decisions; Health Conditions and Status; Retirement Planning and Satisfaction

Projected Retirement Wealth and Savings Adequacy in the Health and Retirement Study - James Moore; Olivia S. Mitchell (National Bureau of Economic Research, 1997)
Low saving rates raise questions about Americans' ability to maintain consumption levels in old age. Using the Health and Retirement Study, this paper explores asset holdings among a nationally representative sample of people on the verge of retirement. The authors assess how much more people would need to save in order to preserve consumption levels after retirement. They find that the median older household has current wealth of approximately 325,000 including pensions, social security, housing, and other financial wealth, an amount projected to grow to about 380,000 by retirement at age 62. Nevertheless, their model suggests that this median household will still need to save 16 of annual earnings to preserve pre-retirement consumption. For retirement at age 65, assets are expected to be 420,000 and required additional saving totals 7 of earnings per year. These summary statistics conceal extraordinary heterogeneity in both assets and saving needs in the older population.
Keywords: Consumption and Savings; Health Conditions and Status; Net Worth and Assets; Pensions; Retirement Planning and Satisfaction; Social Security

Protecting Persons With Severe Cognitive and Mental Disorders: An Analysis of Public Conservatorship in Los Angeles County, California - Sandra L Reynolds; Kathleen H. Wilber (Aging and Mental Health, 1997)
This article begins to identify the factors that place older adults at risk for conservatorship. Comaprisons are drawn between the characteristics of adult public conservatees in the civil commitment and Probate programs in Los Angeles, between young and old conservatees, and then between old conservatees and adults nationwide who are part of the AHEAD sample. Findings show obvious differences between the two types of conservatees. Individuals in the Probate program have the characteristics of young conservatees while adults in the civil commitment program have the characteristics of older conservatees and have less available family memebers, implying social isolation as a risk factor for older adults for public conservatorship. Compared to older adults nationwide, older public conservatees (70 and older) are much older, more likely to suffer from dementia, to be physically impaired, and are far less affluent. This comparison suggests that older adults in public conservatorship in Los Angeles appear to reflect the correct target population for such a service, socially isolated and highly impaired adults.
Keywords: Health Conditions and Status; Net Worth and Assets; Public Policy

Question Difficulty and Respondents' Cognitive Ability: The Impact on Data Quality - Barbel Knauper; Robert F. Belli; Daniel H. Hill; A. Regula Herzog (Journal of Official Statistics, 1997)
Older respondents lower in cognitive ability are more affected by question difficulty than older respondents higher in cognitive ability. Respondents lower in cognitive ability gave more DK responses to difficult than to easy questions, while the differences between the difficult and easy questions were not as apparent for respondents with higher cognitive abilities. This effect may result in biased survey findings because responses to difficult questions from respondents with lower cognitive ability would be underrepresented.
Keywords: Health Conditions and Status; Medicare/Medicaid/Health Insurance; Methodology

Race, Socioeconomic Status, and Health: Accounting for race differences in health - Michael Schoenbaum; Timothy A Waidmann (The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 1997)
This article uses the Asset and Health Dynamics Among the Oldest Old (AHEAD) study to examine the extent to which observed differences in the prevalence of chronic conditions and functional limitations between Black and White adults (aged 70 ) in the United States can be attributed to differences in various aspects of socioeconomic status (SES) between these groups. We use linear and logistic regression techniques to model the relationships between health outcomes and SES. Our findings indicate that race differences in measurable socioeconomic characteristics indeed explain a substantial fraction, but in general not all, of Black/White differences in health status. While our findings do not suggest that low SES directly causes poor health, any more than being Black does so, they do suggest that research and policy intended to address the deficit in health status among Blacks (when compared to Whites) in the U.S. would be well-served to begin with the deficit in wealth, education, and other SES measures.
Keywords: Demographics; Health Conditions and Status; Public Policy

Race, Socioeconomic Status, and Health in Late Life - James P Smith; Raynard Kington (Racial and Ethnic Differences in the Health of Older Americans, 1997)
Keywords: Demographics; Health Conditions and Status

Review of: Aging and Old Age - Olivia S. Mitchell (Journal of Economic Literature, 1997)
Keywords: Consumption and Savings; Demographics; Health Conditions and Status

Selection of Children to Provide Care: The effect of earlier parental transfers - John C Henretta; Martha S. Hill; Li, Wei; Beth J Soldo; Douglas A. Wolf (The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 1997)
We use the first wave of data from the Asset and Health Dynamics Among the Oldest Old (AHEAD) study to examine the effects of past parent-to-child financial transfers on selection of a child to provide assistance with basic personal care for unmarried parents. We estimate a fixed-effects conditional logit model and find a positive and significant association between past financial transfers and a child's current helping behavior. The coefficient of past financial transfers is in the direction hypothesized, and its magnitude is 80 as large as that of gender, a well-documented powerful predictor of parental caregiving. There appears to be substantial evidence that earlier parent-to-child financial gifts play a role in determining which child in the family will provide assistance.
Keywords: Adult children; Demographics; Health Conditions and Status; Healthcare; Income; Methodology; Other

Socioeconomic Status and Racial and Ethnic Differences in Functional Status Associated with Chronic Diseases - Raynard Kington; James P Smith (American Journal of Public Health, 1997)
OBJECTIVES: This study examined the relationships between wealth and income and selected racial and ethnic differences in health. METHODS: Cross-sectional data on a national sample of 9744 men and women aged 51 through 61 from the 1992 Health and Retirement Survey were analyzed to examine the association between socioeconomic status and racial and ethnic differences in functional status among those with hypertension, diabetes, a heart condition, and arthritis. RESULTS: Compared with Whites, African Americans report higher rates of hypertension, diabetes, and arthritis, while Hispanics report higher rates of hypertension and diabetes and a lower rate of heart conditions. Accounting for differences in education, income, and wealth had little effect on these prevalence differences. In general, among those with chronic diseases, African Americans and Hispanics reported worse function than Whites. This disadvantage was eliminated in every case by controlling for socioeconomic status. CONCLUSIONS: While socioeconomic status, including wealth, accounts for much of the difference in functional status associated with these chronic diseases. It plays a relatively small role in explaining differences in the prevalence of chronic disease, possibly reflecting different causal pathways.
Keywords: Demographics; Health Conditions and Status; Income; Methodology; Other; Retirement Planning and Satisfaction; Women and Minorities

The Structure of Health Status among Hispanic, African American, and White Older Adults - Timothy E. Stump; Daniel O. Clark; Johnson, R.J.; Frederic D Wolinsky (The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 1997)
Activities of daily living (ADLs), instrumental ADLs, and disability markers have traditionally been the most common indicators of functional status. The study on Asset and Health Dynamics Among the Oldest Old (AHEAD) is used to replicate a five-dimensional measurement model composed of these observable indicators among the older adult self-respondents. The items available to measure upper body disability were found wanting, but the lower body disability, and the basic, household, and advanced ADL constructs were confirmed. Analyses of the measurement model separately among subgroups of women, men, Hispanics, Mexican Americans, African Americans, and Whites found no meaningful differences. Two structural models linking the lower body disability, and the basic, household, and advanced ADL constructs to perceived health and depression were also replicated among the older adult self-respondents, as well as separately among African Americans and among Whites. These models reaffirmed the dominant role of lower body disability on the everyday activities of older adults, and on their perceived health and depression.
Keywords: Demographics; Disabilities; Health Conditions and Status; Methodology; Women and Minorities

Wealth Inequality Among Older Americans - James P Smith (The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 1997)
This article uses the AHEAD study to examine the distribution of wealth among American households with a member at least 70 years old. As in other age groups, wealth is unevenly distributed among Americans aged 70 years and older. The households in the top 10th percentile of wealth distribution have 2,500 times as much wealth as those in the lowest 10th percentile. This wealth inequality is reflected in large racial and ethnic wealth deficits. Such wealth disparities, largely due to income, are the primary reason why older minority households have accumulated so little wealth compared to older White households. The findings confirm that current health status remains a powerful correlate of household wealth and that bequests motives for the elderly are congruent with the extreme wealth disparities.
Keywords: Health Conditions and Status; Income; Net Worth and Assets

Alcohol and Occupational Injuries among Older Workers - Zwerling, Craig; Nancy L. Sprince; Robert B Wallace; Charles S. Davis; Paul S. Whitten; Steven G Heeringa (Accident Analysis and Prevention, 1996)
Keywords: Demographics; Employment and Labor Force; Health Conditions and Status; Methodology; Risk Taking

Differential Rates of Cardiovascular Disease Among the Immigrant Elderly - Karen C. Swallen (American Journal of Epidemiology, 1996)
This paper examines the difference in morbidity among foreign-born and native-born elderly populations in the United States. Findings suggest that other differences between immigrant and native populations contribute to differential disease rates.
Keywords: Demographics; Health Conditions and Status; Net Worth and Assets

Living Arrangements: Health and Wealth Effects - Daniel McFadden; Axel Borsch-Supan; Schnabel, R. (Advances in the Economics of Aging, 1996)
Keywords: Health Conditions and Status; Housing; Net Worth and Assets

Profiling Plans for Retirement - David J Ekerdt; Stanley DeViney; Karl Kosloski (The Journals of Gerontology: Series B, 1996)
Actual decision making for retirement is largely inaccessible to investigation, yet research can focus on plans as a window into the preretirement process. This article proposes a construct that profiles five generic types of retirement plans, including plans to retire completely, change jobs, never retire, and uncertainty about retirement. The heuristic value of the construct lies in its recognition of the heterogeneity of retirement intentions. The five plan types were operationalized among workers aged 51-61 in the 1992 Health and Retirement Study. Convergent validity was demonstrated by comparisons to analogous survey questions. Construct validity was shown by predictable relationships between intentions and elements of workers' opportunity structure. The retirement-plans construct can serve as the foundation for a taxonomy of specific retirement plans (e.g., about timing, employment), to organize research on stability and change in retirement intentions, and characterize the path dependence of eventual retirement behavior.
Keywords: Adult children; Demographics; Employment and Labor Force; End of life decisions; Health Conditions and Status; Methodology; Other; Retirement Planning and Satisfaction

Race Differences in Labor Force Attachment and Disability Status - John Bound; Michael Schoenbaum; Timothy A Waidmann (The Gerontologist, 1996)
We used the first wave of the Health and Retirement Survey to study the effect of health on the labor force activity of black and white men and women in their 50s. The evidence we present confirms the notion that health is an extremely important determinant of early labor force exit. Our estimates suggest that health differences between blacks and whites can account for most of the racial gap in labor force attachment for men. For women, when participation rates are comparable, our estimates imply that black women would be substantially more likely to work than white women were it not for the marked health differences. We also found for both men and women that poor health has a substantially larger effect on labor force behavior for blacks. The evidence suggests that these differences result from black/white differences in access to the resources necessary to retire.
Keywords: Demographics; Disabilities; Employment and Labor Force; Health Conditions and Status; Methodology; Other; Women and Minorities

Race Differences in the Multiple Social Roles of Midlife Women: Implications for Mental Well-Being - Brown, Diane R.; Cochran, Donna; McGregor, Karl C. (1996)
An examination of the relationship between multiple role participation and the level of distress experienced by midlife African-American and white women. Data from the Health and Retirement Study regarding 2,699 women ages 55-64 show that more whites were married than African Americans. Further, African Americans were more likely to: be separated, unemployed, sick, and disabled; provide care to one of their own children, a parent, or a husband's parent; and provide at least 100 hours of care to a grandchild. White women were more likely to occupy more roles and to be homemakers. When other factors are controlled (eg, age, education), the results show no difference for either race. Higher levels of depression for African Americans appear attributable to their lower likelihood of being married and having fewer social roles than white women.
Keywords: Demographics; Health Conditions and Status; Women and Minorities

Racial Differences in Home Ownership and Home Equity Among Preretirement-Aged Households - Myers, Samuel L., Jr.; Chung, Chanjin (The Gerontologist, 1996)
The article seeks to determine the extent of unexplained racial residual in home ownership and home equity that could possibly be explained by discrimination on the part of lenders or other institutions. While many factors differ substantially between black and white households- besides family income, none of these factors can explain much of the overall inequality in home equity. Although there are sizable income disparities that lead to lower home ownership rates among blacks, these alone are only sufficient in explaining about a quarter of the gap in expected home equity between blacks and whites. This means that the remaining portion of unexplained racial gaps is large and appears to support the hypothesis that the underlying cause of racial differences in expected home equity rests with the behavior of lenders and creditors.
Keywords: Health Conditions and Status; Housing; Net Worth and Assets; Risk Taking

The Role of Bridge Jobs in the Retirement Transition: Gender, Race and Ethnicity - Joseph F. Quinn; Kozy, M. (The Gerontologist, 1996)
This paper uses the first wave of HRS data to describe the retirement patterns of the 1990s and to investigate whether these patterns differ by race and ethnicity. Results demonstrate that retirement patterns are varied, even within narrowly defined age groups. Many Americans, probably more in the future, are choosing to retire gradually and are turning to bridge jobs as a transitional stage between a career job and complete labor force withdrawal. There are in fact differences in how people leave the labor force by race and ethnicity, although they do not fall into an obvious pattern. This wave of data shows that Hispanic men are more likely than both white and black men to be on or have last worked on a bridge job. Among women, blacks are least likely to have last worked on a bridge job. Further research on these results is planned for when the future waves of HRS data become available.
Keywords: Employment and Labor Force; Health Conditions and Status; Net Worth and Assets; Retirement Planning and Satisfaction; Women and Minorities

Worker Adaptation and Employer Accommodations Following the Onset of a Health Impairment - Mary C. Daly; John Bound (The Journals of Gerontology: Social Sciences, 1996)
This paper examines the extent to which workers, through their own actions or those of their employer, adjust to their health limitations and continue working in the labor market. Results show that age and education are important determinants of the employment outcomes for workers following the onset of health impairments. Older workers are more likely to stay with their original employer if they continue to work, but are overall more likely to exit the labor force. Education seems to have little effect on the decisions to stay or leave an employer, but plays a large role in determining whether a worker stays in or leaves the work force. Workers with at least a high school education are less likely to stop working after the onset of health impairments. Many of the respondents who stayed with their original employer after the onset of health problems reported specific ways in which their employer had accomodated them. This data provides further support for anecdotal evidence that claims that employers often accomodate their workers who suffer from health impairments and that workers who are not accomodated for adjust to their limitations by changing jobs/employers and changing their job demands. The responses of workers and their employers to the onset of work-limiting health impairments were investigated using data from the new Health and Retirement Study. The results indicate that many workers who suffer from health limitations are directly accommodated by their employers, and that those those who do not receive direct accommodation frequently adapt to their limitations by altering their job demands or by changing jobs. These findings point to the potential for adjustments on both sides of the market: by employers, in the form of job accommodation, and by employees, in the form of job change.
Keywords: Disabilities; Employment and Labor Force; Health Conditions and Status

Emotional Health Status and Quality of Life Measures in the Health and Retirement Study - Glicksman, Allen; Lawton, M. Powell; Kleban, Morton H.; Brown-Glaude, Winnifred (1995)
Keywords: Health Conditions and Status

Evaluation of the Subjective Probabilities of Survival in the Health and Retirement Study - Michael D Hurd; Kathleen McGarry (Journal of Human Resources, 1995)
In the Health and Retirement Study respondents were asked about the chances they would live to 75 or to 85. We analyze these responses to determine if they behave like probabilities of survival, if their averages are close to average probabilities in the population, and if they have correlations with other variables that are similar to correlations with actual mortality outcomes. We find that generally they do behave like probabilities and that they do aggregate to population probabilities. most remarkable, however, is that they covary with other variables in the same way actual outcomes vary with the variables. For example, respondents with higher socioeconomic status give higher probabilities of survival, whereas respondents who smoke give lower probabilities. We conclude that these measures of subjective probabilities have great potential use in models of intertemporal decision-making under uncertainty.
Keywords: Consumption and Savings; Disabilities; Health Conditions and Status

Gender, Disabilities, and Employment in the Health and Retirement Study - Loprest, Pamela; Rupp, Kalman; Sandell, Steven H. (Journal of Human Resources, 1995)
This paper examines disabilities of older women and men and analyzes gender differences in the effect of disabilities on labor force participation using information on men and women aged 51-61 from the early release of the first wave of the Health and Retirement Survey. Our results demonstrate the importance of using multiple measures of disabilities (we use work limitations, functional limitations, and specific health impairments) to document gender differences and understand the connections between disabilities and work. We find that men and women have different rates of disability, and that both men and women working in occupations with greater physical requirements exhibit higher rates of disabilities than other workers. We also find that measures of functional limitations and health impairments both have significant negative effects on labor force participation. The effects of disabilities on labor force participation are larger for men and single women than for married women.
Keywords: Consumption and Savings; Demographics; Employment and Labor Force; Health Conditions and Status; Methodology; Women and Minorities

Musculoskeletal Conditions and Employment - Yelin, Edward (Arthritis Care and Research, 1995)
OBJECTIVE: To describe the prevalence, incidence, and correlates of work disability among persons with musculoskeletal conditions. METHODS: Literature review and analysis of the Health and Retirement Survey, a national, probability sample of community-based adults ages 51-61. RESULTS: Clinical samples of persons with RA report work disability rates of 51 to 60 . Community-based studies of persons with a broad range of musculoskeletal conditions find work disability rates of 38 to 71 , depending on the mix of symptoms and particular sampling strategy. Persons with musculoskeletal conditions and comorbidity are particularly prone to work loss, with three-quarters leaving work prior to the normal age of retirement. In multivariate models, after adjusting for demographic and functional characteristics, persons with musculoskeletal conditions actually are more likely to work than those without. CONCLUSIONS: Persons with musculoskeletal conditions have high rates of work disability, but given their level of impairment, are more likely to work than persons without musculoskeletal conditions.
Keywords: Demographics; Disabilities; Employment and Labor Force; Health Conditions and Status; Methodology

Occupational Injuries Among Agricultural Workers 51 to 61 Years Old: A National Study - Zwerling, Craig; Nancy L. Sprince; Robert B Wallace; Charles S. Davis; Paul S. Whitten; Steven G Heeringa (Journal of Agricultural Safety and Health, 1995)
This paper examines risk factors for occupational injuries among agricultural workers and compares them with the risk factors for injury among other older workers. The findings suggest that the risks for occupational injuries among agricultural workers differ from those that affect workers in all other occupations. While heavy lifting and poor eye sight were risk factors for both agricultural and other workers, self-employment- - which acted as a protective factor for other workers- - proved to be a risk factor for agricultural workers. Other variables - depressive symptoms and dissatisfaction with marriage, job, family life, the way problems are handled, and life overall - tended to be more strongly associated with occupational injuries in agricultural workers than among other workers.
Keywords: Demographics; Employment and Labor Force; Health Conditions and Status; Net Worth and Assets

Overview of the Health Measures in the Health and Retirement Survey - Robert B Wallace; A. Regula Herzog (The Journal of Human Resources, 1995)
This report discusses the conceptual and logistical issues that lead to the items and instruments used to measure health and function status in Wave 1 of the Health and Retirement Study (HRS). Health status was conceptualized as multidimensional, and included selected major symptoms, diseases and conditions, global self-assessment of health, physical and cognitive functional status, the utilization of health services and selected elements of emotional health. In addition, two physiologic measures were obtained on a sample basis: grip strength and pulmonary maximum expiratory flow rate. Prevalence rates for major conditions and functional states are presented. Correlational analyses generally demonstrated a high rate of convergent, discriminant and construct validity. These findings should assist those intending to analyze HRS data in terms of the focus and utility of the measures employed.
Keywords: Consumption and Savings; Health Conditions and Status; Healthcare; Methodology

Prevalence and Incidence of Health Problems in the First Two Waves of the Health and Retirement Study - Eileen M. Crimmins; Mark D Hayward; Linda A. Wray; Lu, Ranyan (1995)
Keywords: Health Conditions and Status

Race and Education Differences in Disability Status and Labor Force Attachment in the Health and Retirement Study - John Bound; Michael Schoenbaum; Timothy A Waidmann (The Journal of Human Resources, 1995)
This article examines the various effects of health problems, functional limitations, socioeconomic characteristics, and job characteristics on the disability and labor market status of black and white men. Results show that measures of current health status are significant predictors of both labor force participation and self-reported disability status of men aged 50-61. Differences in health status and functional ability between this cohort of black and white men does account for some of the differences in labor force attachment. Health differences between men with different education levels seem to account for all of the gap in labor force attachment between the two groups. Results also suggest that job characteristics affect the manner in which adults adapt to the onset of health limitations and their ability to continue working.
Keywords: Demographics; Employment and Labor Force; Health Conditions and Status

The 20-item word list as a measure of cognitive functioning in the HRS: Norms and validity for white, African-American, and Hispanic respondents - Fillenbaum, Gerda G.; Burchett, Bruce M.; Welsh, Kathleen A. (University of Michigan, 1993)
The Health and Retirement Survey includes among its measures of cognitive functioning a 20-item Word List Learning task from which measures of immediate recall, delayed recall and savings (delayed recall/immediate recall) can be derived. Those with preferred demographic condition (white, increased education, younger) and better physical and mental health have better recall scores, so suggesting that this task is a valid measure of cognitive functioning. Norms have been developed for subcategories of race, gender, education and age. Recall performance may help to identify those experiencing difficulty the job, those may be prone to retire, those less likely to obtain or retain new employment, and those with incipient dementia.
Keywords: Health Conditions and Status

Evaluation of Subjective Probability Distributions in the HRS - Michael D Hurd; Kathleen McGarry (National Bureau of Economic Research, 1993)
In the Health and Retirement Survey respondents were asked about the chances they would live to 75 or to 85, and the chances they would work after age 62 or 65. We analyze the responses to determine if they behave like probabilities, if their averages are close to average probabilities in the population, and if they have correlations with other variables that are similar to correlations with actual outcomes. We find that generally they do behave like probabilities and they do aggregate. Most remarkable, however, is that they covary with other variables in the same way actual outcomes vary with the variables. For example, smokers give lower probabilities of living to 75 than nonsmokers. We conclude that these measures of subjective probabilities have great potential use in models of intertemporal decision making under uncertainty.
Keywords: Consumption and Savings; Health Conditions and Status; Methodology

Longer Life Means Expanding Families - Snider, Mike (USA Today, 1993)
Keywords: Adult children; Health Conditions and Status

The Relationship Between Occupational Characteristics and Cognitive Performance in Adulthood - Brent J. Small; Hultsch, David (University of Michigan, 1993)
The predictive relationships among individual in occupational characteristics and cognitive performance were examined. A sample of 4,039 men and women aged 25 to 78 years completed immediate and delayed word recall tasks and a reasoning measure. Hierarchical regression was used to predict performance on these tasks from occupational characteristic measures. Results indicated that occupational characteristics related to physical demands, cognitive demands, stressfulness, and repetitiousness predicted significant portions of variance in immediate recall, delayed recall, and reasoning, independent of the potentially confounding variables of age, education, gender, race, length of tenure, and health status.
Keywords: Employment and Labor Force; Health Conditions and Status