@article {knapp_lee_2021, title = {Introduction to special issue on institutional influences on retirement, health and well-being}, journal = {Journal of Pension Economics and Finance}, year = {Forthcoming}, abstract = {Countries make differing policy choices. They can serve as a scientific laboratory for drawing lessons on the policy paths to follow or to avoid and the consequences of those institutional choices on individuals at older ages. In this special issue we bring together six articles that evaluate the influence of institutions on retirement decisions, health and well-being of older adults using common data that have emerged with the international network of health and retirement studies to study key life outcomes such as health, work, and lifecycle transitions at older ages.}, keywords = {health, Retirement, Social Security, Well Being}, doi = {10.1017/S1474747221000408}, author = {Knapp, David and Lee, Jinkook} } @article { WOS:001085701200001, title = {Keeping us young? Grandchild caregiving and older adults\' cognitive functioning}, journal = {JOURNAL OF MARRIAGE AND FAMILY}, year = {Forthcoming}, abstract = {Objective; This study investigates longitudinal associations between providing care to grandchildren and cognitive functioning. It also examines heterogeneity in these relationships. Background: Grandchild caregiving may support older adults{\textquoteright} cognitive functioning by providing social engagement and emotional meaning. However, studies caution that time-intensive or custodial grandchild caregiving can take a toll on grandparents. The cognitive health implications of grandchild caregiving may thus depend on contexts including time spent providing care and living arrangements. They may also vary across sociodemographic groups and have greater effects on older adults who are more vulnerable to cognitive decline. Method: Data came from the 1998-2016 waves of the Health and Retirement Study (HRS) and represented over 11,000 US adults aged 50+. Using linear growth curve and dynamic panel models, the analysis explored relationships between level of grandchild care and cognitive functioning over time and across sociodemographic, family, work, and health characteristics. Results: Those providing 100-199, 200-499, or 500+ h of care to grandchildren had better cognitive functioning than non-caregivers regardless of whether they lived with grandchildren. Positive links between grandchild caregiving and cognition were stronger for lower income, non-working, and unpartnered adults and grew with age and functional limitations. Conclusion: These findings suggest that providing care to minor grandchildren may help support cognitive functioning as adults age. They also support the hypothesis that more vulnerable or isolated groups of older adults may benefit the most from grandchild caregiving.}, keywords = {Caregiving, Dementia, grandchildren, health, intergenerational relationships, Longitudinal research}, issn = {0022-2445}, doi = {10.1111/jomf.12945}, author = {Caputo, Jennifer and Cagney, Kathleen A. and Waite, Linda} } @mastersthesis {13842, title = {Education, Occupation, and Healthcare Accessibility as Predictors of Self-Reporting Memory Rating }, volume = {Doctor of Philosophy}, year = {2024}, pages = {137}, school = {Walden University}, address = {Minneapolis, MN}, abstract = {The increasing number of dementia cases in the United States, particularly among women, is a significant concern. This progressively deteriorating cognitive disease may profoundly affect talking, decision-making, and problem-solving abilities, interfere with their daily lives, and decrease their life expectancy. Although education, occupation, and healthcare access are individually associated with positive health outcomes, it was essential to explore whether their combination impacts self-reporting memory loss, an indicator of dementia. The purpose of this study was to determine the role of education, occupation, and access to health care as predictors of dementia among women in the United States. This study used Krieger{\textquoteright}s ecosocial theory of disease distribution, which branches off the social-ecological model and presents the many factors affecting health. This cross-sectional, quantitative study used secondary data from females participating in the 2018 Health and Retirement Study data set. Pearson{\textquoteright}s chi square tests of independence, crosstabulations and a multiple linear regression analysis were used to identify relationships between education, occupation, access to health care, as predictors of self-reported memory rating as a measure of dementia symptoms. Results of the multiple linear regression analysis show that age, Hispanic/Latino origin, non-Hispanic Black ethnicity, job status, affordability, and education predict self-reported memory ratings; type of place of care was not associated with memory ratings. Implications for positive social change include raising awareness of the impact of these variables on dementia and promote policy changes to improve women{\textquoteright}s lives through equal access to education, occupation, and health care.}, keywords = {Dementia, Education, health, Occupation}, url = {https://scholarworks.waldenu.edu/cgi/viewcontent.cgi?article=16728\&context=dissertations}, author = {Ana Maria Gonzales} } @article {13753, title = {{\textquoteleft}Forgotten middle{\textquoteright} near-retirees worse off than prior generations, will need stronger supports in aging, researchers say}, year = {2024}, publisher = {McKnights }, keywords = {Finances, health, near-retiree}, url = {https://www.mcknightsseniorliving.com/home/news/forgotten-middle-worse-off-than-prior-generations-will-need-stronger-supports-in-aging-researchers-say/}, author = {Bonvissuto, Kimberly} } @article {CHEN2024100513, title = {The impact of retirement on health: Empirical evidence from the change in public pensionable age in Japan}, journal = {The Journal of the Economics of Ageing}, volume = {28}, year = {2024}, pages = {100513}, abstract = {The balance between maintaining and enhancing the health, quality of life, and healthy life expectancy of the elderly and their corresponding social costs, including medical and long-term care expenses, is an important policy issue in the context of Japan{\textquoteright}s super-aging society. In this paper, we employ individual panel data from the four waves of the Japanese Study of Aging and Retirement to examine how retirement from the labor market affects the health of elderly males. Numerous empirical studies have shown mixed results concerning the causal effect of retirement on health through diverse and complex mechanisms. However, we present several new insights by focusing on the policy change in 2000 of raising the pensionable age for the earnings-related public pension system which completely eliminates pension income after the statutory retirement age for particular cohorts. Our fixed-effects instrumental variable estimation shows that retirement significantly improves oral function and mental health, but it also makes male retirees more susceptible to lifestyle-related diseases. Supplemental results further suggest that a significant increase in dental care utilization would help improve post-retirement oral function.}, keywords = {Fixed-effects instrumental variable estimation, health, Japan, Oral Health, Pensionable age, Retirement}, issn = {2212-828X}, doi = {https://doi.org/10.1016/j.jeoa.2024.100513}, author = {Fengming Chen and Midori Wakabayashi and Michio Yuda} } @article {13754, title = {Research Spotlight: Modeling Study Shows that Policies to Reduce Wealth Inequality Could Improve Health and Life Expectancy of Americans}, year = {2024}, publisher = {Massachusetts General Hospital}, keywords = {health, Life Expectancy, Wealth Inequality}, url = {https://www.massgeneral.org/news/research-spotlight/study-shows-policies-to-reduce-wealth-inequality-could-improve-life-expectancy}, author = {Himmelstein, Kathryn} } @article {13752, title = {Wealth, Health, And Longevity: Exploring The Connection}, year = {2024}, publisher = {American Council on Science and Health}, keywords = {health, race and ethnicity, Wealth, Wealth Inequality}, url = {https://www.acsh.org/news/2024/02/02/wealth-health-and-longevity-exploring-connection-17616}, author = {Dinerstein, Chuck} } @article {12537, title = {Aging with Incarceration Histories: An Intersectional Examination of Incarceration and Health Outcomes among Older Adults.}, journal = {The Journals of Gerontology, Series B}, year = {2023}, abstract = {

OBJECTIVES: Experiences with incarceration are linked to poor mental and physical health across the life course. The purpose of this research is to examine whether incarceration histories are associated with worse physical and mental health among older adults. We apply an intersectionality framework and consider how the intersection of sexism and racism leads to unequal health outcomes following incarceration among women and people of color.

METHODS: We employ two measures of health (i.e., number of depressive symptoms and physical limitations) to broadly capture mental and physical health. Using data from Waves 11 and 12 of the Health and Retirement Study (HRS), we estimated a series of general linear models (GLM) to analyze differences in health by incarceration history, gender/sex, and race/ethnicity.

RESULTS: Findings suggest that experiences with incarceration are associated with a greater number of physical limitations and more depressive symptoms among older men and women, net of sociodemographic characteristics, early-life conditions, and lifetime stressful events. Formerly incarcerated women, particularly women of color, had more physical limitations and depressive symptoms, relative to other groups.

DISCUSSION: These findings suggest that incarceration histories have far-reaching health implications. Older women of color with incarceration histories experience markedly high levels of physical limitations and depressive symptoms in later life.

}, keywords = {health, incarceration, Intersectionality, life course}, issn = {1758-5368}, doi = {10.1093/geronb/gbac088}, author = {Latham-Mintus, Kenzie and Deck, Monica M and Nelson, Elizabeth} } @article {13415, title = {Are loneliness and social isolation equal threats to health and well-being? An outcome-wide longitudinal approach.}, journal = {SSM Popul Health}, volume = {23}, year = {2023}, pages = {101459}, abstract = {

The detrimental effects of loneliness and social isolation on health and well-being outcomes are well documented. In response, governments, corporations, and community-based organizations have begun leveraging tools to create interventions and policies aimed at reducing loneliness and social isolation at scale. However, these efforts are frequently hampered by a key knowledge gap: when attempting to improve specific health and well-being outcomes, decision-makers are often unsure whether to target loneliness, social isolation, or both. Filling this knowledge gap will inform the development and refinement of effective interventions. Using data from the Health and Retirement Study (13,752 participants (59\% women and 41\% men, mean [SD] age~=~67 [10] years)), we examined how changes in loneliness and social isolation over a 4-year follow-up period (from t0:2008/2010 to t1:2012/2014) were associated with 32 indicators of physical-, behavioral-, and psychosocial-health outcomes 4-years later (t2:2016/2018). We used multiple logistic-, linear-, and generalized-linear regression models, and adjusted for sociodemographic, personality traits, pre-baseline levels of both exposures (loneliness and social isolation), and all outcomes (t0:2008/2010). We incorporated data from all participants into the overall estimate, regardless of whether their levels of loneliness and social isolation changed from the pre-baseline to baseline waves. After adjusting for a wide range of covariates, we observed that both loneliness and social isolation were associated with several physical health outcomes and health behaviors. However, social isolation was more predictive of mortality risk and loneliness was a stronger predictor of psychological outcomes. Loneliness and social isolation have independent effects on various health and well-being outcomes and thus constitute distinct targets for interventions aimed at improving population health and well-being.

}, keywords = {health, Loneliness, social isolation, Well-being}, issn = {2352-8273}, doi = {10.1016/j.ssmph.2023.101459}, author = {Hong, Joanna H and Nakamura, Julia S and Berkman, Lisa F and Chen, Frances S and Shiba, Koichiro and Chen, Ying and Kim, Eric S and VanderWeele, Tyler J} } @mastersthesis {13413, title = {Arthritis Diagnosis, Self-Rated Health, and the Period Pattern in Arthritis Prevalence}, volume = {Doctor of Philosophy}, year = {2023}, month = {6/1/2023}, school = {University of Buffalo}, type = {Dissertation}, address = {Buffalo, New York}, abstract = {Arthritis is one of the most common chronic conditions with a prevalence that increases with age, particularly among adults with comorbid conditions. Diagnosis as a medical process connects patients with medical care, whereas health insurance status may influence how long a person has illness symptoms before they receive a diagnosis. Progressing arthritis can change one{\textquoteright}s health status significantly. The distribution of healthcare resources also varies by health insurance status, which may impact individuals{\textquoteright} access arthritis care. Cohort and period effects may affect the prevalence of arthritis over time due to changes in wealth, education attainment, health insurance status and increasing BMI. This study investigates the relationship between health insurance status and the time one reports arthritis diagnosis, the relationship between arthritis diagnosis and self-rated health, and cohort and period effects in arthritis prevalence. I address these research questions using data from Midlife in the United States (MIDUS) and Health and Retirement Study (HRS) where I test hypotheses using a variety of statistical models. In the first empirical chapter, I examine the relationship between health insurance status (coverage and type) and the time at which a person self-reports an arthritis diagnosis using data from three waves of MIDUS and panel-data survival analysis. Results indicate that respondents who reported arthritis symptoms who were covered by public health insurance took longer to report arthritis diagnosis than their privately insured counterparts. In the second chapter, I investigate the relationship between arthritis diagnosis and selfrated health (physical and mental) using data from three waves of MIDUS and growth curve models. Results demonstrate that having baseline private health insurance coverage moderates the relationship between arthritis diagnosis and self-rated physical health. Symptomatic individuals with arthritis diagnosis benefitted from baseline private health insurance coverage vii and reported better self-rated physical health than their counterparts who were not covered by private health insurance. In the final empirical chapter, I use fourteen waves of the Health and Retirement Study (HRS, 1992-2018) along with hierarchical age-period-cohort (HAPC) models to study cohort and period effects on the prevalence of self-reported doctor-diagnosed arthritis over time. Factors that predicted significantly higher risk of arthritis, independent of period, include age and high BMI. Wealth explained away cohort effects for pre-War Baby Cohorts and period effects from survey year 2006 to 2018. Overall, under the guidance of fundamental cause theory and sociology of diagnosis theory, my dissertation provides empirical evidence on the role of health insurance status as a form of flexible resource in predicting the timeliness of an arthritis diagnosis, and as a moderator in the arthritis diagnosis{\textemdash}self-rated health relationship. Private health insurance also lowered one{\textquoteright}s likelihood of reporting arthritis over time. My findings contribute to systematic examination of the role of health insurance status in the persistent of health inequality in the field of medical sociology.}, keywords = {Arthritis, health, period pattern, Self-rated health}, url = {https://www.proquest.com/docview/2829371108?pq-origsite=gscholar\&fromopenview=true}, author = {Siqi Wang} } @article {12611, title = {Early-Life Socioeconomic Disadvantage and Health in Late Middle-Age: Importance of Heterogeneous Income Trajectories.}, journal = {Research on Aging}, year = {2023}, abstract = {

This paper aims to investigate heterogeneous income changes and whether the income trajectories moderate effects of early socioeconomic disadvantage on health in late middle age. The sample was restricted to 9,056 middle-aged adults from the Health and Retirement Study (1998-2010). Through a latent class growth analysis, six patterns of income changes were identified: constantly low, constantly moderate, constantly high \& increasing, high to low, moderate to high, and high to moderate. The Constantly low group more frequently displayed depressive symptoms if exposed to early socioeconomic disadvantage and Constantly low income mobility. Individuals who experienced early socioeconomic disadvantage and a downward income mobility in middle age tended to have multiple chronic conditions while there was no moderating effect of income changes for mobility functional limitations. These findings suggest that not all health outcomes are programmed in early life: Disadvantage can be somewhat alleviated through stable and better later-life economic status.

}, keywords = {health, income trajectory, late middle-age, life course}, issn = {1552-7573}, doi = {10.1177/01640275221117304}, author = {Kwon, Eunsun and Park, Sojung and Lee, Hyunjoo} } @article {13480, title = {The Forgotten Middle: Worsening Health And Economic Trends Extend To Americans With Modest Resources Nearing Retirement.}, journal = {Health Affairs}, volume = {42}, year = {2023}, pages = {1230-1240}, abstract = {

In an aging US society, anticipating the challenges that future seniors will face is essential. This study analyzed the health and economic well-being of five cohorts of Americans in their mid-fifties between 1994 and 2018 using the Future Elderly Model, a dynamic microsimulation based on the Health and Retirement Study. We projected mortality, quality-adjusted life years, health expenditures, and income and benefits. We classified individuals by economic status and focused on the lower middle and upper middle of the economic distribution. Outcome disparities between people in these two groups widened substantially between the 1994 and 2018 cohorts. Quality-adjusted life expectancy increased (5~percent) for the upper-middle economic status group but stagnated for their lower-middle peers. We found that the combined value of the current stock (financial and housing wealth) and the present value of the expected flow of resources (income, health expenditures, and quality-adjusted life-years) after age sixty grew 13~percent for the upper-middle group between cohorts, whereas people in the lower-middle group in 2018 were left scarcely better off (3~percent growth) than their peers two decades earlier. The relatively neglected "forgotten middle" group of near-retirees in the lower-middle group may require stronger supports than are currently available to them.

}, keywords = {Future Elderly Model, health, middle class, Retirement}, issn = {1544-5208}, doi = {10.1377/hlthaff.2023.00134}, author = {Chapel, Jack M and Tysinger, Bryan and Goldman, Dana P and Rowe, John W} } @article {12486, title = {Gender Disparities in Healthy Aging: A Cross-National Comparative Study in the United States and South Korea from 2006 to 2016.}, journal = {The International Journal of Aging and Human Development}, year = {2023}, abstract = {

Using the 2006-2016 wave of Health and Retirement Study and Korean Longitudinal Study of Aging, this study explores the gender disparities in the health of older adults in the United States and South Korea. A logit model is adopted to explore the differences in the likelihood of aging healthily by gender in two countries. Results indicate that older females in the United States have a significantly higher probability of healthy aging than their male counterparts. However, the opposite finding is demonstrated among the older population in South Korea. These results are verified using various robustness check methods. The heterogeneities in the gender disparities in healthy aging across age groups and income levels are further explored. The gender effect in each healthy aging domain is investigated to understand the underlying causes of gender disparities. These findings can provide cross-national insights for policymakers to establish targeted aging policies with a gender perspective.

}, keywords = {cross-national studies, Disparities, gender, health, KLoSA, Policy}, issn = {1541-3535}, doi = {10.1177/00914150221106643}, author = {Chu, Lanlan and Lor, Anjelynt and Moisan, Mary-Genevieve and Phi, Kieu My} } @article {13759, title = {How Staying Active Could Make You Richer}, year = {2023}, publisher = {Money Talks News}, keywords = {health, Income, mobility, Work}, url = {https://www.moneytalksnews.com/how-staying-active-could-make-you-richer/}, author = {Kissell, Chris} } @article {13439, title = {In sickness and in health: Loneliness, depression, and the role of marital quality among spouses of persons with dementia.}, journal = {J Am Geriatr Soc}, year = {2023}, abstract = {

BACKGROUND: Older adults married to persons living with dementia (PLwD) may be at risk for loneliness and depression. We assessed the prevalence of loneliness and depressive symptoms among spouses of PLwD or cognitive impairment not dementia (CIND), and the role of marital quality in mediating these outcomes.

METHODS: We used a US population-based sample of 4071 couples enrolled in the Health and Retirement Study (2014 and 2016). We included older adults married to PLwD (N = 227), married to persons with CIND (N = 885), or married to persons with no cognitive impairment (NCI) (N = 2959). We determined the prevalence of loneliness (UCLA 3-item scale), depressive symptoms (CESD-8 scale), and both, using multivariable logistic regression adjusting for sociodemographic and health-related characteristics. We then tested for interaction terms between marital quality (4-item scale) and degree of spousal cognitive impairment for each outcome of loneliness and depressive symptoms.

RESULTS: The sample was 55\% women and on average 67-years-old (range: 50-97). After adjustment, spouses of persons with cognitive impairment were more likely to be lonely (NCI: 20\%, CIND: 23\%, PLwD: 29\%; p = 0.04), depressed (NCI: 8\%, CIND: 15\%, PLwD: 14\%; p < 0.01), and both (NCI: 4\%, CIND: 9\%, PLwD: 7\%; p < 0.01). The association between cognition and loneliness, but not depression, differed by marital quality (interaction p-value = 0.03). Among couples with high marital quality, spousal cognitive impairment was associated with higher likelihood of loneliness (p < 0.05). In contrast, no association existed between spousal cognition and loneliness among couples with lower marital quality (p = 0.37).

CONCLUSIONS: One in six spouses of persons with CIND or more advanced disease (PLwD) experienced depressive symptoms, and loneliness among spouses of PLwD was experienced at a twofold rate. By identifying and managing both, and facilitating interventions that promote high-quality social connection, clinical teams might improve the lives of older couples facing dementia.

}, keywords = {Dementia, depression, health, Loneliness, Marital quality, sickness, Spouses}, issn = {1532-5415}, doi = {10.1111/jgs.18520}, author = {Hsu, Kristie Y and Cenzer, Irena and Harrison, Krista L and Ritchie, Christine S and Waite, Linda and Kotwal, Ashwin} } @article {12876, title = {Life After 50: If You Have Questions, These Researchers Have Answers}, year = {2023}, publisher = {Medscape}, keywords = {Baby Boomers, Dementia, health}, url = {https://www.medscape.com/viewarticle/987486?reg=1$\#$vp_1}, author = {Dillon, John} } @article {13443, title = {Life, Longevity, and the Pursuit of Happiness: The Role of Disability in Shaping Racial and Sex Disparities in Living a Long and Happy Life}, journal = {Population Research and Policy Review}, volume = {42}, year = {2023}, pages = {72}, abstract = {Disability-free life expectancy is a common measure used by demographers to gauge quantity and quality of life. Yet, the extent to which positive dimensions of quality of life differ by disability status remains unexplored. Using data from the Health and Retirement Study (N = 16,614), we estimated happy life expectancy by age, race, sex, and severe Activities of Daily Living (ADL) limitations. First, results show that happy life expectancy differed substantially by disability status, as older adults with severe ADL limitations experienced 50{\textendash}60\% fewer remaining years of their life happy compared to their more able-bodied peers. Second, healthy Black women and men at age fifty can expect to live five fewer years of their remaining life happy compared to their White peers, but there were no significant race or sex differences among individuals with severe ADL limitations. Finally, the racial gap in Happy Life Expectancy between Black and White women was largely accounted for by group differences in marital status, education, and wealth, but Black men continued to be disadvantaged compared to their White peers. Implications of this study point to a need to critically examine the intersections of race and sex to develop a clearer portrait of the pattern and underlying factors associated with social disparities in longevity and quality of life. Findings highlight the importance of considering positive dimensions of quality of life alongside measures of illness, disability, or disease when determining whether we are adding life to years or just years to life.}, keywords = {Activities of Daily Living, Black People, Black white differences, Black women, Business And Economics{\textendash}Economic Situation And Conditions, Data quality, Demographers, Demography, Disability, Disadvantaged, Gender Differences, Happiness, health, Inequality, Intersectionality, Life Expectancy, Life span, limitations, Longevity, Marital Status, Men, Older people, Peers, Quality of Life, race, Racial differences, Racial inequality, Retirement, Severity, Sex differences, Subjective well-being, Wealth, women}, isbn = {01675923}, url = {https://proxy.lib.umich.edu/login?url=https://www.proquest.com/scholarly-journals/life-longevity-pursuit-happiness-role-disability/docview/2849184861/se-2}, author = {Bardo,Anthony R. and Cummings,Jason L.} } @article {10.1093/sf/soad027, title = {Parental Death Across the Life Course, Social Isolation, and Health in Later Life: Racial/Ethnic Disadvantage in the U.S.}, journal = {Social Forces}, year = {2023}, abstract = {Bereavement is a risk factor for poor health, yet prior research has not considered how exposure to parental death across the life course may contribute to lasting social isolation and, in turn, poor health among older adults. Moreover, prior research often fails to consider the racial context of bereavement in the United States wherein Black and Hispanic Americans are much more likely than White Americans to experience parental death earlier in life. The present study uses longitudinal data from the Health and Retirement Study (HRS; 1998{\textendash}2016) to consider linkages of parental death, social isolation, and health (self-rated health, functional limitations) for Black, Hispanic, and White older adults. Findings suggest that exposure to parental death is associated with higher levels of isolation, greater odds of fair/poor self-rated health, and greater odds of functional limitations in later life. Moreover, social isolation partially explains associations between parental bereavement and later-life health. These patterns persist net of psychological distress{\textemdash}an additional psychosocial response to bereavement. Racial inequities in bereavement are central to disadvantage: Black and Hispanic adults are more likely to experience a parent{\textquoteright}s death earlier in the life course, and this differential exposure to parental death in childhood or young adulthood has implications for racial and ethnic inequities in social isolation and health throughout life.}, keywords = {health, later life, parental death, racial disadvantage, social isolation, United States}, issn = {0037-7732}, doi = {10.1093/sf/soad027}, author = {Donnelly, Rachel and Lin, Zhiyong and Umberson, Debra} } @article {13108, title = {Social Determinants of Health Contribute to Racial and Ethnic Disparities in Depression, Cognition}, year = {2023}, publisher = {Psychiatry Advisor}, keywords = {Cognition, depression, Disparities, health, Race/ethnicity, social determinants}, url = {https://www.psychiatryadvisor.com/home/topics/general-psychiatry/sdoh-contribute-racial-ethnic-disparities-depression-cognition/}, author = {Nye, Jessica} } @mastersthesis {13286, title = {SUCCESSFUL AGING AMONG MIDLIFE BLACK WOMEN: A LATENT CLASS ANALYSIS}, volume = {Master of Arts}, year = {2023}, school = {University of Alabama at Birmingham}, abstract = {Successful aging (SA), as outlined by Rowe and Khan, with its objective focus on disease and disability avoidance, maintaining high physical and cognitive function, and sustaining engagement in social and productive activities, was meant to be a benchmark for assessing health and aging. However, given its rigid criteria virtually no one {\textquotedblleft}ages successfully{\textquotedblright} despite being in otherwise relatively good health. The assumption of unsuccessful aging in populations who experience a higher prevalence of chronic disease, illness, disability, and other health disparities, is implicit in the SA framework outlined by Rowe and Khan and would preclude many Black women from being considered to age well. Building on recent theoretical advancements and critiques of the successful aging framework I investigate how Black women successfully age intersectionally and examine how interpersonal experiences of discrimination affect these successful aging patterns. Using an uncorrected three-step process, I first conduct a latent class analysis (LCA) on data from the Health and Retirement Study to identify successful aging classes among Non-Hispanic Black women between the ages of 50 and 72 (N = 1098) along sociocultural, physical, and psychological indicators. Secondly, I assign class membership to the women of my sample. Thirdly and lastly, I estimate how perceived everyday discrimination and discrimination attributions affect membership into SA classes across social status using multinomial logistic regressions. I identified 5 unique successful aging classes among Black women indicated by differences in self-rated health, chronic conditions, resilience, life satisfaction, psychological well-being, religiosity/spirituality, social engagement, and social support. Everyday interpersonal experiences of discrimination were associated with increased odds of poorer SA among Black women and increased probabilities into poorer SA classes. My findings improve our understanding of successful aging among Black women by incorporating intersectionality and life course considerations into the successful aging framework modeled by Rowe and Khan.}, keywords = {African American Women, Discrimniation, health, Successful aging, Well-being}, url = {https://www.proquest.com/docview/2811445137?pq-origsite=gscholar\&fromopenview=true}, author = {JOSHUA CHRISTIAN JULIAN LEWIS} } @article {12717, title = {11 Meaningful Ways Older Adults Can Volunteer Right Now}, year = {2022}, publisher = {Forbes}, keywords = {health, Volunteerism, Well-being}, url = {https://www.forbes.com/health/healthy-aging/volunteer-opportunities-for-older-adults/}, author = {Lagemann, Jennifer} } @article {13001, title = {ARE CAREGIVERS HEALTHIER?: ASSESSING CAREGIVERS{\textquoteright} EPISODIC MEMORY IN A MATCHED AND UNMATCHED SAMPLE}, journal = {Innovation in Aging}, volume = {6}, year = {2022}, pages = {548}, abstract = {Recent findings using an advanced methodological technique of propensity matching have found that caregivers may have better cognitive health compared to non-caregivers. However, there are limited studies assessing how personality and other psychosocial variables may affect the relationship between caregiver status and cognition. Utilizing the healthy caregiver hypothesis (HCH), the current study examined the association between caregiving and episodic memory in a matched (N= 1,246) and unmatched (N=3,112) sample of caregivers from the 2016 wave of the Health and Retirement Study. The interaction between caregiving status and personality was also examined. Unadjusted models showed no difference between caregiver status and episodic memory in the samples; however, depression was significantly (p=<.0001) related to cognition in the unmatched sample. In adjusted models for the unmatched sample, conscientiousness (p=0.043), pessimism (p=0.006), and feeling constrained (p=0.028) were found to be significantly associated with episodic memory. In the matched adjusted models, conscientiousness was no longer a significant predictor, but number of chronic conditions was significantly related to episodic memory (p=0.001). The interaction between caregiving and extraversion also approached significance (p=0.076). Findings suggest extraverted caregivers may have better episodic memory performance. These findings highlight the importance of implementing propensity matching in caregiving research. Future research is needed to examine the relationship between coping style and personality specific domains in relation to the HCH.}, keywords = {Caregivers, Cognitive health, health}, doi = {10.1093/geroni/igac059.2077}, author = {Veal, Britney and Yauk, Jessica Ann and Meng, Hongdao} } @article {12624, title = {Are We Worrying About the {\textquoteleft}Right{\textquoteright} Retirement Risks?}, year = {2022}, publisher = {American Society of Pension Professionals \& Actuaries }, keywords = {health, Longevity, market, retirement risks}, url = {https://www.asppa-net.org/news/are-we-worrying-about-\%E2\%80\%98right\%E2\%80\%99-retirement-risks}, author = {Adams, Nevin E} } @article {11714, title = {Beyond Hours Worked and Dollars Earned: Multidimensional EQ, Retirement Trajectories and Health in Later Life}, journal = {Work Aging and Retirement}, volume = {8}, year = {2022}, pages = {51-73}, abstract = {The working lives of Americans have become less stable over the past several decades and older adults may be particularly vulnerable to these changes in employment quality (EQ). We aimed to develop a multidimensional indicator of EQ among older adults and identify EQ and retirement trajectories in the United States. Using longitudinal data on employment stability, material rewards, workers{\textquoteright} rights, working-time arrangements, unionization, and interpersonal power relations from the Health and Retirement Study (HRS), we used principal component analysis to construct an EQ score. Then, we used sequence analysis to identify late-career EQ trajectories (age 50{\textendash}70 years; N = 11,958 respondents), overall and by sociodemographics (race, gender, educational attainment, marital status). We subsequently examined the sociodemographic, employment, and health profiles of these trajectories. We identified 10 EQ trajectories; the most prevalent trajectories were Minimally Attached and Wealthy (13.9\%) and Good EQ to Well-off Retirement (13.7\%), however, 42\% of respondents were classified into suboptimal trajectories. Those in suboptimal trajectories were disproportionately women, people of color, and less-educated. Individuals in the Poor EQ to Delayed and Poor Retirement and Unattached and Poor clusters self-reported the greatest prevalence of poor health and depression, while individuals in the Wealthy Business Owners and Great EQ to Well-off Retirement clusters self-reported the lowest prevalence of poor health and depression at baseline. Trajectories were substantially constrained for women of color. Although our study demonstrates EQ is inequitably distributed in later life, labor organizing and policy change may afford opportunities to improve EQ and retirement among marginalized populations.}, keywords = {employment quality, health, Retirement}, isbn = {2054-4650}, doi = {10.1093/workar/waab012}, author = {Sarah B. Andrea and Eisenberg-Guyot, Jerzy and Vanessa M Oddo and Peckham, Trevor and Jacoby, Daniel and Hajat, Anjum} } @article {12511, title = {Beyond Income: Health, Wealth, and Racial Welfare Gaps Among Older Americans}, year = {2022}, abstract = {We estimate racial disparities in well-being among the older U.S. population using an expected utility framework that incorporates differences in consumption, leisure, health, mortality, and wealth. We find large racial disparities in expected welfare later in life. Moreover, disparity measures based on cross-sectional consumption substantially underestimate racial welfare gaps by ignoring disparities in expected elderly health, wealth, and mortality. Our decomposition exercises show that a majority of the estimated welfare gaps are determined by age sixty initial conditions as opposed to racial differences in dynamic processes after age sixty. This suggests that policies aimed at closing racial gaps in late-life may be more successful and efficient if targeted earlier in the life-cycle. In other words, outside of direct wealth transfers, it may largely be too late to target such interventions directly at older populations.}, keywords = {consumption, health, Inequality, Mortality, race, Wealth}, url = {https://schinlfc.github.io/files/pdf/research/Racial_Welfare_Chin_Miller_2022.pdf}, author = {Chin, Sayorn and Miller, Ray} } @article {12219, title = {Demographic and Health Characteristics of Older Latino Birth Cohorts in the Health and Retirement Study.}, journal = {The Journals of Gerontology, Series B }, volume = {77}, year = {2022}, pages = {2060-2071}, abstract = {

BACKGROUND AND OBJECTIVES: Latinos are the fastest aging racial/ethnic minority group in the United States One limitation to understanding the diverse experiences of older Latinos is the lack of nationally representative data necessary to examine factors contributing to changes in population-level health over time. This is needed to provide a more comprehensive picture of the demographic characteristics that influence the health and well-being of older Latinos.

METHODS: We utilized the steady-state design of the Health and Retirement Study (HRS) from 1992 to 2016 to examine the demographic and health characteristics of the five entry birth cohorts of older Latinos aged 51-56 (n=2,882). Adjusted Wald tests were used to assess statistically significant differences in demographic and health characteristics across the five HRS birth cohorts.

RESULTS: Cross-cohort comparisons of demographic and health characteristics of older Latinos indicate significant change over time, with later-born HRS birth cohorts less likely to identify as Mexican-origin, more likely to identify as a racial "other," and more likely to be foreign-born. In addition, we find that later-born cohorts are more educated and exhibit a higher prevalence of hypertension, diabetes, and obesity.

DISCUSSION: Increasing growth and diversity among the older U.S. Latino population make it imperative that researchers document changes in the demographic composition and health characteristics of this population as it will have implications for researchers, policymakers, health care professionals, and others seeking to anticipate the needs of this rapidly aging population.

}, keywords = {Demographics, health, Latinos/Hispanics, Well-being}, issn = {1758-5368}, doi = {10.1093/geronb/gbac017}, author = {Garc{\'\i}a, Catherine and Garcia, Marc A and Jennifer A Ailshire} } @mastersthesis {12574, title = {Does a Purposeful Life Mean a Healthy Life? Evaluating Longitudinal Associations between Sense of Purpose, Cognition, and Health}, volume = {Ph.D.}, year = {2022}, school = {University of Victoria}, keywords = {Cognition, health, life purpose}, url = {https://www.uvic.ca/socialsciences/psychology/assets/docs/oral/lewis-abstract.pdf}, author = {Nathan Alexander Lewis} } @article {12514, title = {Does Aging at Home Make Older Adults Healthy: Evidence from Medicaid Home and Community-Based Services}, year = {2022}, institution = {ZBW {\textendash} Leibniz Information Centre for Economics}, address = {Kiel, Germany}, abstract = {The Medicaid Home and Community-Based Services (HCBS) subsidizes long-term care to satisfy the increasing desire to age at home among older adults. The HCBS program may improve health outcomes of this population by allowing them to age-inplace, but less quality and quantity of home-based care comparing to nursing home care could offset some of the potential benefits. We use plausibly exogenous policy expenditure across states over time linked with detailed health information from the restricted Health and Retirement Study (HRS) to identify the causal effects of HCBS on general health, physical health, and mental health of older adults. Overall, our findings suggest that HCBS is beneficial to health: a $1,000 increase in HCBS per older person improves health status by 6 percent, mitigates functional mobility limitations by 5 percent, and reduces negative psychological feelings by 10 percent. The positive effect on physical health is concentrated among people with limited financial resources, while the reducing impact on mental health is significant among the richer group. The HCBS program improves health outcomes mainly through three mechanisms: decreasing risk behavior on drinking, increasing healthcare use, and spending more time accompanying with family. }, keywords = {health, Long-term Care, Medicaid HCBS}, url = {https://www.econstor.eu/bitstream/10419/260523/1/chapter3.pdf}, author = {Liu, Yinan and Zai, Xianhua} } @inbook {12306, title = {Does working longer enhance old age?}, booktitle = {New Models for Managing Longevity Risk: Public-Private Partnerships}, year = {2022}, publisher = {Oxford University Press}, organization = {Oxford University Press}, chapter = {4}, keywords = {health, Retirement, working}, isbn = {978{\textendash}0{\textendash}19{\textendash}285980{\textendash}8}, doi = {10.1093/oso/9780192859808.001.0001}, author = {Maria D Fitzpatrick and Olivia S. Mitchell} } @article {10.1525/collabra.37611, title = {Dyadic Associations Between Conscientiousness Facets, Health, and Health Behavior Over Time}, journal = {Collabra: Psychology}, volume = {8}, year = {2022}, pages = {37611}, abstract = {Previous studies show consistent associations between conscientiousness and health outcomes. However, less is known about how various facets of conscientiousness, of both individuals and their partners, are associated with changes in health in older adults over time. Applying the actor{\textendash}partner interdependence model, we examined dyadic associations of broader conscientiousness and its six facets and changes in health, health behavior, and well-being in middle-aged and older couples. With a sample of 3,271 couples (N=6,542) from the Health and Retirement Study, we found that actor conscientiousness, orderliness, and industriousness were most reliably associated with better health outcomes over time. Partner orderliness was associated with better health and more positive health behavior. The remaining associations were near-zero in their effect sizes. Many of these associations persisted over the 10-year period of the study, and there was little evidence for gender differences or multiplicative interactions.}, keywords = {actor-partner interdependence model, Conscientiousness, depression, health, personality facets}, issn = {2474-7394}, doi = {10.1525/collabra.37611}, author = {Chopik, William and Lee, Ji Hyun} } @article {13200, title = {The Dynamic Effects of Health on the Employment of Older Workers: Impacts by Gender, Country, and Race}, year = {2022}, institution = {University of Michigan}, address = {Ann Arbor, Michigan}, abstract = {Using data from the Health and Retirement Study (HRS) and the English Longitudinal Study of Ageing (ELSA), we estimate the impact of health on employment. Estimating the model separately by race and gender, we find that racial differences in employment can be partly explained by the worse health of minorities and the larger impact of health on employment for these groups. }, keywords = {country, gender, health, Older workers, race}, url = {https://mrdrc.isr.umich.edu/publications/papers/pdf/wp451.pdf}, author = {Richard Blundell and Jack Britton and Monica Costa Dias and Eric French and Weijian Zou} } @article {12239, title = {The Effect of Medicaid Home and Community- Based Services on Health Outcomes}, year = {2022}, institution = {Leibniz Information Centre for Economics}, address = {Kiel, Germany}, abstract = {The Medicaid Home and Community- Based Services (HCBS) program in the United States subsidizes the long-term care provided at home or in community-based settings for older adults. Little is known about how HCBS affects the well-being of the aging population. Using detailed information about health from the Health and Retirement Study (HRS) linked with state-level HCBS policy expenditures, we show that HCBS indeed helps older people avoid institutionalization and stay at home longer. Furthermore, the program is positively associated with the probability of older individuals reporting better mental health, especially among people with limited resources. }, keywords = {health, Long-term Care, Medicaid HCBS}, url = {http://hdl.handle.net/10419/249565}, author = {Liu, Yinan and Zai, Xianhua} } @article {13046, title = {EXAMINING PHYSICAL HEALTH AMONG COHORTS OF CENTENARIAN SURVIVORS IN THE HEALTH AND RETIREMENT STUDY}, journal = {Innovation in Aging}, volume = {6}, year = {2022}, month = {12/2022}, type = {Journal Article}, chapter = {304}, abstract = {This research highlights cohort differences in physical health among centenarians/near-centenarians in the Health and Retirement Study. Across 14 waves, participants aged 98 or older (n=494) were compared by three cohorts (i.e., 1890-1900, 1901-1910, and 1911-1920). Cohorts were examined at respective waves where participants were 96, 98, and 100 years of age. One-way ANOVA results presented significant differences in functional health at age 96 (F[2,324]=5.01, p<.01), subjective health at age 98 (F[2,212]=7.94, p<.001), and health conditions at ages 98 (F[2,213]=12.52, p<.001) and 100 (F[2,115]=3.45, p<.05). The oldest cohort had significantly better functional health than the youngest cohort (age 96), better subjective health than the two younger cohorts (age 98), and fewer health conditions than the youngest cohort (ages 98 and 100). Consistently, the oldest cohort performed better on subjective and objective health markers, providing implications for health care, disease prevention, and policy related to the shrinking {\textquotedblleft}healthspan{\textquotedblright} among exceptional agers.}, keywords = {health}, doi = {https://doi.org/10.1093/geroni/igac059.1205}, author = {Rotem Arieli} } @article {STEPHAN2022110961, title = {Five-factor model personality traits and grip strength: Meta-analysis of seven studies}, journal = {Journal of Psychosomatic Research}, volume = {160}, year = {2022}, pages = {110961}, abstract = {Objective To examine the association between Five-Factor Model personality traits and grip strength. Method Adults aged 16 to 104 years old (N > 40,000) were from the Health and Retirement Study, the Midlife in the United States Study, The English Longitudinal Study of Aging, the National Health and Aging Trends Survey, the United Kingdom Household Longitudinal Study, and the Wisconsin Longitudinal Study graduate and sibling samples. Participants had data on personality traits, demographic factors, grip strength, and mediators such as depressive symptoms, physical activity, body mass index (BMI), and c-reactive protein (CRP). Results Across all samples and a meta-analysis, higher neuroticism was related to lower grip strength (meta-analytic estimate: -0.07, 95\%CI: -0.075; -0.056). Higher extraversion (0.04, 95\%CI: 0.022; 0.060), openness (0.05, 95\%CI: 0.032; 0.062), and conscientiousness (0.05, 95\%CI: 0.04; 0.065) were associated with higher grip strength across most samples and the meta-analysis. Depressive symptoms were the most consistent mediators between neuroticism and grip strength. Depressive symptoms and physical activity partly mediated the associations with extraversion, openness, and conscientiousness. Lower CRP partly mediated the association with conscientiousness. Sex moderated the associations for extraversion, openness, and conscientiousness, with stronger associations among males. Age moderated the neuroticism association, with stronger associations among younger individuals. Conclusion This study provides replicable evidence that personality is related to grip strength and identifies potential moderators and mediators of these associations. Overall, higher neuroticism is a risk factor for low grip strength, whereas high extraversion, openness, and conscientiousness may be protective.}, keywords = {five-factor model, Grip strength, health, Neuroticism, Personality}, issn = {0022-3999}, doi = {https://doi.org/10.1016/j.jpsychores.2022.110961}, author = {Yannick Stephan and Angelina R. Sutin and Brice Canada and Maxime Deshayes and Tiia Kek{\"a}l{\"a}inen and Antonio Terracciano} } @article {12649, title = {Formerly incarcerated women of color face worse health in later life}, journal = {OUPBlog}, year = {2022}, publisher = {Oxford University Press}, keywords = {health, incarcerated, Race/ethnicity, women}, url = {https://blog.oup.com/2022/09/formerly-incarcerated-women-of-color-face-worse-health-in-later-life/}, author = {Latham-Mintus, Kenzie and Deck, Monica M and Nelson, Elizabeth} } @article {13189, title = {Helping others: A path to social connectedness, health, and well-being for older Canadians}, journal = {Genwell Project}, year = {2022}, keywords = {health, older Canadians, Well-being}, url = {https://genwellproject.org/helping-others-a-path-to-social-connectedness-health-and-well-being-for-older-canadians/}, author = {Julia Nakamura and Marisa Nelson and Michelle Lin and Frances S. Chen} } @mastersthesis {13061, title = {Home Away From Home: Education, Health, and Nursing Home Care}, volume = {Master of Arts}, year = {2022}, school = {The Pennsylvania State University}, address = {State College, PA}, abstract = {Nursing homes are dominant late-life health care institutions slated to grow in importance as the United States experiences a dramatic demographic shift characterized by a significant segment of the population entering older age groups. Though a substantial portion of the U.S. population is about to enter the period of life in which they are at highest risk of entering a nursing home, we know little about how their demographic identities and accumulated resources influence their decisions about using nursing homes. This study contributes a more thorough examination of the relationship between education, health, and use of nursing homes. Education is hypothesized to affect nursing home usage through two pathways: access (e.g., institutional familiarity) and need (e.g., development of health conditions). Two different models are run using data from Wave 13 of the Health and Retirement Study to explore these questions. The results show that the link between education and nursing home usage primarily operates through the access pathway, as high school and college-educated respondents had significantly higher odds of reporting any nursing home usage compared to their non-degree-holding peers but did not show a significant difference in the expected time spent in nursing homes. These findings have important implications for the influence of education over the life course into older ages and highlight a potential source of health inequity.}, keywords = {Education, health, nursing home care}, url = {https://etda.libraries.psu.edu/catalog/29085cer5700}, author = {Ryan, Cayley} } @article {11423, title = {Housing status, mortgage debt and financial burden as barriers to health among older adults in the U.S}, journal = {Housing and Society}, volume = {49}, year = {2022}, pages = {58-72.}, abstract = {ABSTRACT We examine relations between housing status, mortgage, financial burden, and healthy aging among older U.S. adults. We combine cross-sectional data from 2012 to 2014 Health and Retirement Study cohorts. Using regression models, we examined associations between owners and renters, mortgage and non-mortgage holders, financial strain, and difficulty paying bills, and poor self-rated health (SRH), heart condition (HC) and hospitalization (past two years). We find that compared to owners, renters had greater likelihood of poor SRH and hospitalization. Regardless of tenure, financial strain was associated with greater likelihood of poor SRH, HC and hospitalization, while difficulty paying bills was associated with poor SRH and HC. Mortgage holders had lower likelihood of poor SRH. Accounting for mortgage status, financial strain was associated with greater likelihood of poor SRH, HC and hospitalization, while difficulty paying bills was associated with poor SRH and HC. Associations between tenure or mortgage status and health were not modified by either financial burden factors. We conclude that there need to be more robust and inclusive programs that assist older populations with housing could improve self-rated health, with particular attention to renters, mortgage holders and those experiencing financial burden.}, keywords = {health, Housing, housing tenure, mortgage, Older adult}, isbn = {0888-2746}, doi = {https://doi.org/10.1080/08882746.2021.1881373}, author = {Mehdipanah, Roshanak and Martin, Jaclyn and Eisenberg, Alexa K. and Amy J Schulz and Lewis B Morgenstern and Kenneth M. Langa} } @article {12081, title = {How Much Less You{\textquoteright}ll Spend Throughout Retirement Depends on These 2 Factors}, journal = {yahoo!finance}, year = {2022}, publisher = {Yahoo.com}, keywords = {health, Retirement, Spending, Wealth}, url = {https://uk.finance.yahoo.com/news/much-less-ll-spend-throughout-222057678.html}, author = {Villanova, Patrick} } @article {12445, title = {In Older Americans, Rising Debt May Adversely Affect Health}, number = {June 5, 2022}, year = {2022}, publisher = {The New York Times}, abstract = {Research shows that debt has risen among older people, and those who owe are more likely to have multiple diagnosed illnesses.}, keywords = {Debt, health, multimorbidity}, url = {https://www.nytimes.com/2022/06/05/health/elderly-medical-health-debt.html}, author = {Paula Span} } @mastersthesis {Nakamura_2022, title = {Informal helping and subsequent health and well-being in older U.S. adults}, volume = {M.A.}, year = {2022}, school = {University of British Columbia}, abstract = {While there is a large and growing body of evidence around the health and well-being benefits of formal volunteering, less is known about the downstream benefits of informal helping behaviors. A small literature has evaluated associations between informal helping and health and well-being outcomes. However, epidemiological studies have not evaluated if changes in informal helping are associated with subsequent health and well-being. Using data from 12,998 participants in the Health and Retirement Study, a national cohort of US adults aged >50, we evaluated if changes in informal helping (between t0;2006/2008 and t1;2010/2012) were associated with 35 indicators of physical, behavioral, and psychosocial health and well-being (at t2;2014/2016). Over the four-year follow-up period, informal helping >=100 (versus 0) hours/year was associated with a 32\% lower mortality risk (95\% CI [0.54, 0.86]), and improved physical health (e.g., 21\% reduced risk of stroke (95\% CI [0.64, 0.96])), health behaviors (e.g., 11\% increased physical activity (95\% CI [1.04, 1.19])), and psychosocial outcomes (e.g., higher purpose in life (β=0.13, 95\% CI [0.08, 0.18])). However, there was also evidence that informal helping was associated with higher negative affect (β=0.06, 95\% CI [0.003, 0.12]) and little evidence of associations with various other outcomes. In secondary analyses, we adjusted for formal volunteering and caregiving and results were largely unchanged. Encouraging informal helping may improve various aspects of health and well-being and also promote societal well-being.}, keywords = {health, informal helping, Well-being}, doi = {http://dx.doi.org/10.14288/1.0417297}, author = {Nakamura, Julia Sharon} } @article {12156, title = {Let{\textquoteright}s commit infrastructure funding to help older Americans lead healthier lives}, journal = {Opinion}, year = {2022}, publisher = {The Hill}, keywords = {health, infrastructure funding}, url = {https://thehill.com/opinion/healthcare/590425-lets-commit-infrastructure-funding-to-help-older-americans-lead-healthier}, author = {Kirk-Sanchez, Neva} } @article {12395, title = {Loneliness at Older Ages in the United States: Lonely Life Expectancy and the Role of Loneliness in Health Disparities.}, journal = {Demography}, volume = {59}, year = {2022}, pages = {921-947}, abstract = {

We provide an empirical foundation for research on the demography of loneliness at older ages. First, we use published life tables and data from the U.S.-based Health and Retirement Study for the period 2008-2016 to calculate lonely life expectancy for Americans aged 55 or older. Using Sullivan{\textquoteright}s method, we demonstrate pronounced differences in lonely life expectancy by sex, race/ethnicity, and educational attainment that correspond to well-established patterns of stratification in other dimensions of well-being. Next, we estimate models that decompose observed sex, racial/ethnic, and educational differences in three key health outcomes into the part explained (in a statistical accounting sense) by loneliness and the part accounted for by other factors. We find little evidence of an important role for loneliness in understanding disparities in mortality and the onset of physical disability and cognitive impairment among Americans aged 55 or older, net of several established correlates of health disparities. These descriptive findings provide an empirical foundation for continued development of a demography of loneliness at older ages in response to the anticipated growth in scientific and policy emphasis on loneliness and the fundamental life changes that have accompanied the COVID-19 pandemic.

}, keywords = {health, Health Disparities, Life Expectancy, Loneliness}, issn = {1533-7790}, doi = {10.1215/00703370-9937606}, author = {Raymo, James M and Wang, Jia} } @article {12005, title = {Precarious Work in Midlife: Long-Term Implications for the Health and Mortality of Women and Men.}, journal = {Journal of Health and Social Behavior}, volume = {63}, year = {2022}, pages = {142-158}, abstract = {

Although prior research documents adverse health consequences of precarious work, we know less about how chronic exposure to precarious work in midlife shapes health trajectories among aging adults. The present study uses longitudinal data from the Health and Retirement Study to consider how histories of precarious work in later midlife (ages 50-65) shape trajectories of health and mortality risk after age 65. Results show that greater exposure to unemployment, job insecurity, and insufficient work hours in midlife predicts more chronic conditions and functional limitations after age 65. Characteristics of precarious work also predict increased mortality risk in later life. Findings indicate few gender differences in linkages between precarious work and health; however, women are more likely than men to experience job insecurity throughout midlife. Because precarious work is unlikely to abate, results suggest the need to reduce the health consequences of working in precarious jobs.

}, keywords = {gender, health, life course, Mortality, precarious work}, issn = {2150-6000}, doi = {10.1177/00221465211055090}, author = {Rachel Donnelly} } @article {12670, title = {Regional variation in healthcare usage for Medicare beneficiaries: a cross-sectional study based on the health and retirement study.}, journal = {BMJ Open}, volume = {12}, year = {2022}, pages = {e061375}, abstract = {

OBJECTIVES: To investigate whether regional variation changes with different beneficiary health insurance coverage types.

DESIGN: A cross-sectional study of the Health and Retirement Study (HRS) in 2018 was used.

SETTING: Medicare beneficiaries only covered by Medicare (group 1) are compared with those covered by Medicare and other health insurance (group 2). Outcomes included healthcare usage measures: (1) whether beneficiaries have a hospital stay and (2) the number for those with at least one stay; (3) whether beneficiaries have a doctor{\textquoteright}s visit and (4) the number for those with at least one visit. We compared healthcare usage in both groups across the five regions: (1) New England and Mid-Atlantic; (2) East North Central and West North Central; (3) South Atlantic; (4) East South Central and West South Central; (5) Mountain and Pacific. We used logistic regression for binary outcomes and negative binomial regression for count outcomes in each group.

PARTICIPANTS: We identified 8749 Medicare beneficiaries, of which 4098 in group 1 and 4651 in group 2.

RESULTS: Residents in all non-reference regions had a significantly lower probability of seeking a doctor{\textquoteright}s visit in group 1 (OR with 95\% CI 0.606 (0.374 to 0.982), 0.619 (0.392 to 0.977), 0.472 (0.299 to 0.746) and 0.618 (0.386 to 0.990) in the order of above regions, respectively), which is not significant in group 2. Residents in most non-reference regions (except South Atlantic) had a significantly fewer number of seeking a hospital stay in group 2 (incident rate ratio (IRR) with 95\% CI 0.797 (0.691 to 0.919), 0.740 (0.643 to 0.865), 0.726 (0.613 to 0.859) in the order of above regions, respectively), which is not significant in group 1.

CONCLUSION: Regional variation in the likelihood of having a doctor{\textquoteright}s visit was reduced in Medicare beneficiaries covered by supplemental health insurance. Regional variation in hospital stays was accentuated among Medicare beneficiaries covered by supplemental health insurance.

}, keywords = {health, Health Expenditures, Insurance, Medicare, Retirement}, issn = {2044-6055}, doi = {10.1136/bmjopen-2022-061375}, author = {Luo, Dian} } @article {RePEc:fip:fedgfe:2022-07, title = {Revisiting the Effect of Education on Later Life Health}, number = {2022-007}, year = {2022}, institution = {Board of Governors of the Federal Reserve System}, abstract = {We provide new evidence on the effect of education on later life health. Using variation in state compulsory schooling laws, we examine education{\textquoteright}s effect on a range of outcomes encompassing physical health, decision-making, and life expectancy. We employ under-utilized Health and Retirement Study data linked to restricted geographic identifiers, allowing us to match individuals more accurately to compulsory schooling laws. While positively related to educational attainment, compulsory schooling laws have no significant effect on later life health outcomes. Our results suggest that increased educational attainment has no significant causal effect on health.}, keywords = {Compulsory school attendance laws, Education policy, health, Human capital, Returns to education}, doi = {10.17016/FEDS.2022.007}, author = {Theodore F. Figinski and Alicia Lloro and Avinash Moorthy} } @article {11764, title = {The Roles of General and Domain-Specific Perceived Stress in Healthy Aging.}, journal = {The Journals of Gerontology: Series B }, volume = {77}, year = {2022}, pages = {536-549}, abstract = {

OBJECTIVES: Theoretical and empirical evidence suggests the existence of a general perceived stress factor overarching different life domains. The present study investigated the general perceived stress relative to domain-specific perceived stress as predictors of 26 diverse health outcomes, including mental and physical health, health behaviors, cognitive functioning, and physiological indicators of health.

METHOD: A bifactor exploratory structural equational modelling (BiESEM) approach was adopted in two aging samples from the Health and Retirement Study (HRS; N = 8325 in Sample 1, N = 7408 in Sample 2).

RESULTS: Across the two samples, perceived stress was well-represented by a bifactor structure where there was a robust general perceived stress factor representing a general propensity towards stress perception. Meanwhile, after controlling for the general perceived stress factor, specific factors that represent perceived stress in different life domains were still clearly present. Results also suggested age, sex, race, education, personality traits, and past and recent stressor exposure as possible factors underlying individual differences in the general perceived stress factor. The general perceived stress factor was the most robust predictor of the majority of health outcomes, as well as changes in mental health outcomes. The specific factor of perceived neighborhood stress demonstrated incremental predictive effects across different types of health outcomes.

DISCUSSION: The current study provides strong evidence for the existence of a general perceived stress factor that captures variance shared among stress across life domains, and the general perceived stress factor demonstrated substantial prospective predictive effects on diverse health outcomes in older adulthood.

}, keywords = {Aging, Bifactor model, health, Perceived stress}, issn = {1758-5368}, doi = {10.1093/geronb/gbab134}, author = {Luo, Jing and Zhang, Bo and Willroth, Emily C and Daniel K. Mroczek and Brent W Roberts} } @article {12158, title = {Sick And Tired Of Being Excluded: Structural Racism In Disenfranchisement As A Threat To Population Health Equity.}, journal = {Health Affairs}, volume = {41}, year = {2022}, pages = {219-227}, abstract = {

Theoretical research suggests that racialized felony disenfranchisement-a form of structural racism-is likely to undermine the health of Black people, yet empirical studies on the topic are scant. We used administrative data on disproportionate felony disenfranchisement of Black residents across US states, linked to geocoded individual-level health data from the 2016 Health and Retirement Study, to estimate race-specific regression models describing the relationship between racialized disenfranchisement and health among middle-aged and older adults, adjusting for other individual- and state-level factors. Results show that living in states with higher levels of racialized disenfranchisement is associated with more depressive symptoms, more functional limitations, more difficulty performing instrumental activities of daily living, and more difficulty performing activities of daily living among Black people. However, there are no statistically significant relationships between racialized disenfranchisement and health among White people. These findings suggest that policies aiming to mitigate disproportionate Black felony disenfranchisement not only are essential for political inclusion but also may be valuable tools for improving population health equity.

}, keywords = {administrative data, disenfranchisement, health, race}, issn = {1544-5208}, doi = {10.1377/hlthaff.2021.01414}, author = {Patricia Homan and Brown, Tyson H} } @article {12528, title = {Using the Health and Retirement Study for Research on the Impact of the Working Conditions on the Individual Life Course.}, journal = {Forum for Health Economics \& Policy}, year = {2022}, abstract = {

The aim of this paper is to evaluate the utility of the Health and Retirement Study (HRS) for studying the impact of working conditions on individuals{\textquoteright} health, well-being and labor supply decisions at older ages. I provide a brief overview of the information on working conditions that is currently available in the HRS and discuss implications for studies on the effects of working conditions on the individual life course. I conclude with a discussion of how recent and projected trends in the U.S. workforce are reflected in the current HRS survey content.

}, keywords = {health, Labor Supply, Well-being, Working conditions}, issn = {1558-9544}, doi = {10.1515/fhep-2021-0059}, author = {Mullen, Kathleen J} } @article {12161, title = {When people{\textquoteright}s attitudes about aging improve, better health may follow}, journal = {Art \& Humanities}, year = {2022}, publisher = {The University of British Columbia}, keywords = {Aging, aging satisfaction, health, Wellbeing}, url = {https://news.ubc.ca/2022/02/09/when-peoples-attitudes-about-aging-improve-better-health-may-follow/}, author = {Rolfsen, Erik} } @article {12257, title = {Would It Kill You to Retire? Testing Short/Long Term/Recurrent Effects of Retirement on All-Cause Mortality Risk.}, journal = {Research on Aging}, volume = {44}, year = {2022}, pages = {619-638}, abstract = {

This study traced all-cause mortality risk over the course of retirement and tested whether re-retirement impacts mortality risk differently than the first time. The study differentiated retirement on whether prompted by health (health retirement) or not (non-health retirement). Based on data from 1992 to 2016 Health and Retirement Study (HRS), the sample consists of 7747 women and 7958 men who were working at the baseline. Adjusting for physical health before/after retirement, the discrete-time logit model found increased mortality risk within the first year of non-health retirement only for men, regardless of physical health changes. Re-retirement did not raise mortality risk further. Furthermore, health retirement increased mortality for men and women but substantially less after their surviving the first year. The findings urge future study to explore non-physical pathways of an immediate mortality increase for men in retirement, as well as the monitoring of population trends in health retirement and its antecedents.

}, keywords = {health, mortality risk, Retirement}, issn = {1552-7573}, doi = {10.1177/01640275211068151}, author = {Oi, Katsuya} } @article {11792, title = {The age profile of life satisfaction after age 65 in the U.S.}, journal = {Journal of Economic Behavior \& Organization}, volume = {189}, year = {2021}, pages = {431-442}, abstract = {Although income and wealth are frequently used as indicators of well-being, they are increasingly augmented with subjective measures such as life satisfaction to capture broader dimensions of the well-being of individuals. Based on large surveys of individuals, life satisfaction in cross-section often is found to increase with age beyond retirement into advanced old age. It may seem puzzling that average life satisfaction does not decline at older ages because older individuals are more likely to experience chronic or acute health conditions, or the loss of a spouse. Accordingly, this empirical pattern has been called the {\textquotedblleft}paradox of well-being.{\textquotedblright} We examine the age profile of life satisfaction of the U.S. population age 65 or older in the Health and Retirement Study (HRS), and find that in cross-section it increases between age 65 and 71 and is flat thereafter; but based on the longitudinal dimension of the HRS, life satisfaction significantly declines with age and the rate of decline accelerates with age. We reconcile the cross-section and longitudinal measurements by showing that both differential mortality and differential non-response bias the cross-sectional age profile upward: individuals with higher life satisfaction and in better health tend to live longer, and, among survivors, individuals with higher life satisfaction are more likely to remain in the survey, masking the decline in life satisfaction experienced by individuals as they age. We conclude that the optimistic view about increasing life satisfaction at older ages based on cross-sectional data is not warranted.}, keywords = {Differential mortality, Differential non-response, health, Subjective well-being, Widowing}, isbn = {0167-2681}, doi = {10.1016/j.jebo.2021.07.002}, author = {P{\'e}ter Hudomiet and Michael D Hurd and Susann Rohwedder} } @article {https://doi.org/10.1002/alz.050784, title = {Analysis of pleiotropic genetic effects on cognitive decline and systemic inflammation in the Women{\textquoteright}s Health Initiative Memory Study}, journal = {Alzheimer{\textquoteright}s \& Dementia}, volume = {17}, year = {2021}, pages = {e050784}, abstract = {Background SNPs associated with C-reactive protein (CRP) and plasma lipids have been investigated for polygenic overlap with Alzheimer{\textquoteright}s disease (AD) risk SNPs. Previously, we reported pleiotropic effects between SNPs associated with cognitive impairment (CI) and SNPs associated with systemic inflammation as measured by CRP and plasma lipids in the Health and Retirement Study (HRS). We sought to replicate our results in the Women{\textquoteright}s Health Initiative Memory Study (WHIMS). Method Analysis of SNP pleiotropic effects was completed using data from 6,078 non-Hispanic White women (aged 71.4 [SD 7.4] at baseline) for whom genetic, cognitive, and/or biomarker data were available. We identified CI using WHIMS adjudicated case status (normal vs. mild cognitive impairment or probable dementia). Secondary phenotypes included baseline CRP and plasma lipid levels (HDL, LDL, and total cholesterol [TC]). Genome-wide association analyses were conducted for all phenotypes. A conditional false discovery rate framework defined genetic pleiotropy. Genetic pleiotropy was identified if SNPs were associated with CI conditional on association with secondary phenotypes (CRP, HDL, LDL, TC) at an FDR < 0.05. Functional genomic bioinformatics analysis and comparison with prior findings were conducted. Result Genetic pleiotropy was observed for CI conditional on association with the secondary phenotypes of plasma CRP, HDL, LDL, and TC. These results replicate associations for SNPs in the APOE, APOC1, PVRL2/NECTIN2 loci reported in the prior HRS study for CRP, LDL, TC. The odds ratios for the association of these SNPs with CI ranged from 0.5 to 4.0, consistent with moderate effect sizes for the APOE ε2 or ε4 alleles. For WHIMS, FDR significant results were observed in both directions for several of the traits (CRP, lipids), further supporting evidence of genetic pleiotropy. Moreover, we observed associations for SNPs in the APOE, APOC1, PVRL2/NECTIN2 loci for CI conditional on HDL. Conclusion We identified polygenic overlap between CI and CRP, LDL, HDL, and TC phenotypes in WHIMS, largely replicating prior results in the HRS. The variants and associated genes identified are involved in pathological processes including metabolic, cardiovascular, and immune response and are potentially important for AD risk prediction and development of therapeutic approaches based on anti-inflammatory mechanisms.}, keywords = {Cognitive decline, health, systemic inflammation, women}, doi = {10.1002/alz.050784}, author = {Michael W Lutz and Brown, Mark M. and Kucgibhatla, Maragatha and Brenda L Plassman and Saldana, Santiago and Snively, Beverly M and Chen, Jiu-Chiuan and Henderson, Victor and JoAnn E Manson and Pal, Lubna and Shadyab, Aladdin H. and Rapp, Stephen R. and Kathleen M Hayden} } @article {12059, title = {Are Loneliness and Social Isolation Equal Threats to Health and Well-being? An Outcome Wide Longitudinal Approach}, journal = {Innovation in Aging}, volume = {5}, year = {2021}, pages = {935{\textendash}936}, abstract = {The detrimental effects of loneliness and social isolation on health and well-being outcomes are well documented. In response, governments, corporations, and community-based organizations have begun leveraging emerging tools to create interventions and policies aimed at reducing loneliness and social isolation at-scale. However, these efforts are frequently hampered by a key knowledge gap: when attempting to alleviate specific health and well-being outcomes, decision-makers are unsure whether to target loneliness, social isolation, or both. Participants (N=13,752) were from the Health and Retirement Study- a diverse nationally representative, and longitudinal sample of U.S. adults aged > 50 years. We examined how changes in loneliness and social isolation over a 4-year follow-up period (from t0:2008/2010 to t1:2012/2014) were associated with 32 indicators of physical-, behavioral-, and psychosocial-health outcomes 4-years later (t2:2016/2018). We used, multiple logistic-, linear-, and generalized-linear regression models, and adjusted for sociodemographics, personality traits, pre-baseline levels of both exposures (loneliness and social isolation), and all outcomes (t0:2008/2010). After adjusting for a wide range of covariates, we observed that both loneliness and social isolation have similar effects on physical health outcomes and health behaviors, whereas loneliness is a stronger predictor of psychological outcomes. In particular, behavioral dimensions of the social isolation measure (i.e., participation in social/religious activities, social interaction frequency) were most strongly associated with the largest number of health and well-being outcomes, including all-cause mortality. Loneliness and social isolation have independent effects on various health and well-being outcomes, thus, should be distinct targets for interventions aimed at improving the health and well-being.}, keywords = {health, Loneliness, social isolation, Well-being}, doi = {https://doi.org/10.1093/geroni/igab046.3354}, author = {Henriksson, Tatiana and Julia S Nakamura and Kim, Eric} } @article {11811, title = {Assessing the relationship between health and household portfolio allocation}, journal = {Financial Planning Review}, volume = {4}, year = {2021}, pages = {e1128}, abstract = {This paper surveys the literature on the relationship between health and household portfolio allocation and provides updated empirical analysis based on recent data. Prior research finds robust evidence for cross-sectional correlations between measures of health status and portfolio decisions, but establishing the causal pathways and underlying mechanisms has proven more difficult and complex. Analysis from the most recently available 2016 and 2018 waves of the Health and Retirement Study yields results that are consistent with existing literature. Households with worse self-reported health have a lower probability of holding various types of financial assets and invest a higher share of their portfolios in safe assets, relative to other asset categories. However, there is only weak evidence that new health shocks to a household change portfolio holdings. The paper concludes with a discussion of the implications of this research and directions for future work.}, keywords = {health, household finance, Portfolio choice}, doi = {10.1002/cfp2.1128}, author = {Wu, Stephen} } @article {11566, title = {Booms and Busts in Housing Market and Health Outcomes for Older Americans}, journal = {Innovation in Aging}, volume = {5}, year = {2021}, pages = {igab012}, abstract = {The U.S. housing market has experienced considerable fluctuations over the last decades. This study aimed to investigate the impacts of housing price dynamics on physical health, mental health, and health-related behaviors for older American outright owners, mortgaged owners, and renters.We drew longitudinal data from the 1992-2016 Health and Retirement Study and merged it to the five-digit ZIP-code level Housing Price Index. The analytic sample comprised 34,182 persons and 174,759 person-year observations. We used a fixed-effects model to identify the health impacts of housing price dynamics separately for outright owners, mortgaged owners, and renters. A 100\% increase in Housing Price Index was associated with a 2.81 and 3.50 percentage points (pp) increase in the probability of reporting excellent/very good/good health status for mortgage owners and renters, respectively. It was also related to a lower likelihood of obesity (1.82 pp) for outright owners, and a less chance of obesity (2.85 pp) and smoking (3.03 pp) for renters. All of these relationships were statistically significant (p\<0.05). Renters also experienced significantly decreased depression scores (-0.24), measured by the Center for Epidemiologic Studies Depression Scale, associated with the same housing price changes.Housing price dynamics have significant health impacts, and renters are more sensitive to fluctuations in the housing market. Our study rules out the wealth effect as the mechanism through which changes in housing prices affect older adults{\textquoteright} health. Our findings may inform policies to promote older adults{\textquoteright} health by investing in local area amenities and improving socioeconomic conditions.}, keywords = {health, Housing price dynamics, Mortgaged owners, Outright owners, Renters}, isbn = {2399-5300}, doi = {10.1093/geroni/igab012}, author = {Dahai Yue and Ninez Ponce} } @mastersthesis {12015, title = {Care Work in the Woodwork: Medicaid Home Care and Family Caregivers{\textquoteright} Health}, volume = {Ph.D.}, year = {2021}, school = {Harvard University }, address = {Cambridge, MA}, abstract = {Family caregivers provide the majority of eldercare in the United States, yet little is known about how eldercare policy affects their health. For several decades, research has shown that family caregivers experience emotional, physical, and financial strain that is associated with worse mental and physical health. These harms are particularly severe for women, who are overrepresented among family caregivers, provide more hours of more intensive care, and experience worse associated declines in health. Simultaneously, U.S. eldercare policy has undergone enormous change since the 1980s, as states have shifted Medicaid long-term care spending from nursing homes to home care services. These policy changes have restructured the social, political, and economic systems that shape the realities of family caregiving. However, this dissertation is the first work to investigate how Medicaid home care affects family caregivers{\textquoteright} health.}, keywords = {caregiver, health, home care, Medicaid}, url = {https://nrs.harvard.edu/URN-3:HUL.INSTREPOS:37370225}, author = {Unger, Emily} } @article {11381, title = {Changes in married older adults{\textquoteright} self-perceptions of aging: The role of gender.}, journal = {Psychology and Aging}, volume = {36}, year = {2021}, pages = {383-393}, abstract = {

To what extent self-perceptions of aging and their correlates in later life may be gendered remains relatively unexplored. In particular, little is known about how changes in the health and spousal relationship quality over time contribute to self-perceptions of aging among married men and women. To clarify these links, we analyzed panel data from the (2008-2016) on married individuals aged 65 years and older ( = 2,623) using within-between random effects models. Findings showed no gender difference in self-perceptions of aging at baseline and in the rate of change, and poorer health and spousal relationship quality were generally associated with less positive self-perceptions of aging. However, men and women differed in how within-person changes in health and spousal relationship quality were associated with their self-perceptions of aging. Increases in spousal strain and chronic conditions were associated with less positive self-perceptions of aging on that wave for men, whereas increases in functional limitations were associated with less positive self-perceptions of aging on that wave for women. Finally, a person-mean of spousal strain had a moderating effect for men, such that men with more overall spousal strain reported less positive self-perceptions of aging across a range of chronic conditions, compared to the men with less overall spousal strain. Findings highlight the intersection of social resources, health, and self-perceptions of aging, suggesting that gender differences in older adults{\textquoteright} self-perceptions of aging are contextualized by different behaviors and social experiences among married men and women. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

}, keywords = {health, Self-perceived age, Spouses}, issn = {1939-1498}, doi = {10.1037/pag0000507}, author = {Kim, Yijung K and Kim, Kyungmin and Shevaun Neupert and Boerner, Kathrin} } @mastersthesis {11964, title = {CHANGES IN RACIAL/ETHNIC DIFFERENCES IN HEALTH AND MORTALITY AMONG U.S. ADULTS IN LATE MIDLIFE}, volume = {Ph.D.}, year = {2021}, school = {Wayne State University}, address = {Detroit, MI}, keywords = {health, Mortality, Racial/ethnic differences}, url = {https://www.proquest.com/docview/2585959199?pq-origsite=gscholar\&fromopenview=true}, author = {Doza, Adit} } @article {11178, title = {Chronic Pain and Friendship among Middle-Aged and Older U.S. Adults.}, journal = {The Journals of Gerontology, Series B }, volume = {76}, year = {2021}, pages = {2131-2142}, abstract = {

OBJECTIVES: This study examines how chronic pain affects friendship in later life. We test whether onset of pain leads to social network activation, as suggested by research on other health conditions (Latham- Mintus, Forth.), or whether pain-an unverifiable and often stigmatizing condition-functions as a "threat to the social self" (Karos et al., 2018).

METHODS: Using longitudinal data from the Health and Retirement Study (HRS; N=4,598; 2006/2008 as Time 1 and 2010/2012 as Time 2), we conducted OLS regressions with the lagged dependent variable approach to assess how new-onset chronic pain predicted (a) respondents{\textquoteright} number of close friends and (b) their frequency of in-person meetings with friends, controlling for sociodemographic variables and health conditions.

RESULTS: New-onset severe pain predicted a decrease in number of friends. New-onset moderate pain, in contrast, predicted more friends and more frequent in-person meetings. (Findings were significant or marginally significant depending on model specifications.) Mild pain showed no significant association with either outcome. Pain had a greater effect on men{\textquoteright}s friendship outcomes than women{\textquoteright}s.

DISCUSSION: The effects of chronic pain on later-life friendships appear to depend on pain severity, and to differ between men and women. Onset of severe pain serves as a "threat to the social self," while onset of moderate pain contributes to social network activation; both associations are significantly more pronounced among men. These findings highlight the complex associations between health and social outcomes.

}, keywords = {Disability, health, number of friends, pain severity, Social networks}, issn = {1758-5368}, doi = {10.1093/geronb/gbaa185}, author = {Yang, Yulin and Grol-Prokopczyk, Hanna} } @article {11761, title = {The Consolidation of Education and Health in Families}, journal = {American Sociological Review}, volume = {86}, year = {2021}, pages = {670-699}, abstract = {For a given person, many socioeconomic resources are correlated, but resources also accumulate in families, depending on how people sort in relationships based on their individual characteristics. This study proposes that people match on multiple resources in long-term relationships as a strategy for creating families with systematically advantaged portfolios?a strategy we call ?consolidation.? Analyzing Health and Retirement Study data and using smoking as a measure of health, we show that couples match on both educational and health statuses at the start of marriage, and this systematic pattern of matching intensifies over time. We find that matching on smoking is not simply a byproduct of educational homogamy, and that matching on smoking/non-smoking status has increased over time. Moreover, couples increasingly sort on education and health jointly, such that highly educated couples are even more likely to be nonsmoking than would be expected by matching on education or smoking status alone. Increasing educational inequalities in quitting smoking between marriage and first birth reinforce this consolidation process. Using Current Population Surveys, we find these patterns are stronger in marriages than in cohabitations. The consolidation of education and health in couples is an important mechanism that amplifies inequality in families and, potentially, across generations.}, keywords = {consolidation, Education, health, Marriage, multidimensional inequality, sorting}, isbn = {0003-1224}, doi = {10.1177/00031224211028592}, author = {Maralani, Vida and Portier, Camille} } @article {11609, title = {Difference in predictors and barriers to arts and cultural engagement with age in the United States: A cross-sectional analysis using the Health and Retirement Study}, journal = {PLoS One}, volume = {16}, year = {2021}, pages = {e0261532}, abstract = {Introduction: Arts and cultural engagement are associated with a range of mental and physical health benefits, including promoting heathy aging and lower incidence of age-related disabilities such as slower cognitive decline and slower progression of frailty. This suggests arts engagement constitutes health-promoting behaviour in older age. However, there are no large-scale studies examining how the predictors of arts engagement vary with age. Methods: Data from the Health and Retirement Study (2014) were used to identify sociodemographic, life satisfaction, social, and arts appreciation predictors of (1) frequency of arts engagement, (2) cultural attendance, (3) difficulty participating in the arts, and (4) being an interested non-attendee of cultural events. Logistic regression models were stratified by age groups [50-59, 60-69, 70] for the frequency of arts participation outcome and [50-69 vs 70] all other outcomes. Results: Findings indicated a number of age-related predictors of frequent arts engagement, including gender, educational attainment, wealth, dissatisfaction with ageing, and instrumental activities of daily living (iADL). For cultural event attendance, lower interest in the arts predicted lack of engagement across age groups, whereas higher educational attainment and more frequent religious service attendance became predictors in older age groups (> 70). Adults in both age groups were less likely to report difficulties engaging in the arts if they had lower neighbourhood safety, whilst poor self-rated health and low arts appreciation also predicted reduced likelihood of this outcome, but only in the younger (50-69) age group. Adults in the older (> 70) age group were more likely to be interested non-attendees of cultural events if they had higher educational attainment and less likely if they lived in neighbourhoods with low levels of safety. Conclusions: Our results suggest that certain factors become stronger predictors of arts and cultural engagement and barriers to engagement as people age. Further, there appear to be socioeconomic inequalities in engagement that may increase in older ages, with arts activities overall more accessible as individuals age compared to cultural engagement due to additional financial barriers and transportation barriers. Ensuring that these activities are accessible to people of all ages will allow older adults to benefit from the range of health outcomes gained from arts and cultural engagement.}, keywords = {Arts, cross-sectional, Culture, health, Well-being}, doi = {10.1371/journal.pone.0261532}, author = {Meg Fluharty and Paul, Elise and Jessica K Bone and Feifei Bu and Fancourt, Daisy} } @article {11555, title = {Education, wealth, and duration of life expected in various degrees of frailty}, journal = {European Journal of Ageing}, volume = {18}, year = {2021}, pages = {393-404}, abstract = {Multistate life tables are used to estimate life expected in three frailty states: frailty free, mild/moderate frailty, severe frailty. Estimates are provided for the combination of education and wealth by age, stratified by sex. Data consider 17,115 cases from the Health and Retirement Study, 2000{\textendash}2014. Frailty is measured using a 59 item frailty index based on deficit accumulation. Estimates are derived using stochastic population analysis for complex events. Population-based and status-based results are reported. Findings confirm a hypothesis that the combination of higher education and wealth results in longer lives in more favorable degrees of frailty. Also, as hypothesized, wealth generally affords a greater advantage than does education among those with severe frailty at baseline. For instance, high wealth provides a 70-year-old woman with severe frailty at baseline 0.70 more total years and 0.81 more frailty free years then her counterpart with low wealth, compared to gains of 0.39 and 0.54, respectively, for those with high education. Unexpectedly, wealth also has a greater role among those frailty free at baseline. A 70-year-old woman frailty free at baseline with high wealth lives 3.19 more net years and 4.13 more years frailty free than her counterpart with low wealth, while the same comparison for high versus low education indicates advantages of 2.00 total and 1.96 frailty free years. Relative change ratios also indicate more robust results for wealth versus education. In sum, there is evidence that inequality in duration of life in degrees of frailty is socially patterned.}, keywords = {Aging, Frailty, health, Multistate life tables, socioeconomic status, Transition probability}, isbn = {1613-9380}, doi = {10.1007/s10433-020-00587-2}, author = {Zachary Zimmer and Saito, Yasuhiko and Theou, Olga and Haviva, Clove and Rockwood, Kenneth} } @article {11759, title = {The Elderly and the COVID Pandemic: Early Findings on the Impact on Health, Mental Well-Being, and Financial Situation}, year = {2021}, institution = {Employee Benefit Research Institute}, address = {Washington, D.C.}, abstract = {Using early releases of data from the Health and Retirement Study (HRS) COVID-19 Project survey, the Employee Benefit Research Institute (EBRI) examines the various impacts of the pandemic on older Americans{\textquoteright} health, mental well-being, and financial situation. The bottom line is that the responses within the HRS depict an older population that was clearly impacted by the pandemic but that was {\textemdash} overall {\textemdash} remarkably resilient. However, the data also identify key areas of concern as well, including lower wealth and those near or early in retireme}, keywords = {COVID-19, Finances, health, Well-being}, url = {https://www.ebri.org/content/the-elderly-and-the-covid-pandemic-early-findings-on-the-impact-on-health-mental-well-being-and-financial-situation}, author = {Zahra Ebrahimi} } @article {11772, title = {Housing and cardiometabolic risk among older renters and homeowners}, journal = {Housing Studies}, year = {2021}, abstract = {Scholars consistently find that renters have poorer health outcomes when compared with homeowners. Health disparities between renters and homeowners likely widen over the life course, yet few studies have examined this link among older adults, and the connection is not fully understood. Homeowners{\textquoteright} relative socio-economic advantage may explain their better health; renters also more commonly experience adverse housing conditions and financial challenges, both of which can harm health. In this paper, we analyse the extent to which socio-economic advantage, housing conditions, and financial strain explain the relationship between homeownership and health among adults over age 50, using Health and Retirement Study 2010/2012 data to assess cardiometabolic risk (CMR) levels using biomarkers for inflammation, cardiovascular health, and metabolic function. We find that people living with poor housing conditions and financial strain have higher CMR levels, even taking socio-economic advantage into account. This analysis sheds light on the housing-related health challenges of older adults, especially older renters.}, keywords = {cardiometabolic risk, health, Homeownership, housing affordability, housing conditions}, isbn = {0267-3037}, doi = {10.1080/02673037.2021.1941792}, author = {Mawhorter, Sarah and Eileen M. Crimmins and Jennifer A Ailshire} } @article {11226, title = {Midlife Marital Dissolution and the Onset of Cognitive Impairment.}, journal = {Gerontologist}, volume = {61}, year = {2021}, pages = {1085-1094}, abstract = {

BACKGROUND AND OBJECTIVES: Marital dissolution has become more common in midlife with the doubling of the divorce rate among middle-aged adults. Guided by the stress model that stipulates losing economic, social, and psychological resources lowers well-being, we posited that midlife adults who experienced divorce or widowhood were at greater risk of cognitive impairment than the continuously married. Subsequent repartnering was expected to negate the increased risk.

RESEARCH DESIGN AND METHODS: We used data from the 1998-2016 Health and Retirement Study to estimate discrete-time event history models using logistic regression to predict cognitive impairment onset for men and women.

RESULTS: Roughly 27\% of men who experienced spousal death in midlife went on to experience mild cognitive impairment by age 65. For women, experiencing divorce or widowhood was associated with higher odds of cognitive impairment onset although these differentials were accounted for by economic, social, and psychological resources. Men and women who repartnered after marital dissolution did not appreciably differ from their continuously married counterparts in terms of their likelihoods of cognitive impairment onset.

DISCUSSION AND IMPLICATIONS: A stressful life event, midlife marital dissolution can be detrimental to cognitive well-being, placing individuals at increased risk of developing dementia in later life. The growing diversity of partnership experiences during the second half of life points to the continued importance of examining how union dissolution and formation shape health and well-being.

}, keywords = {Divorce, health, Marriage, Social Support, Widowhood}, issn = {1758-5341}, doi = {10.1093/geront/gnaa193}, author = {Susan L. Brown and Lin, I-Fen and Vielee, Alyssa and Kagan A Mellencamp} } @article {11417, title = {Occupational differences in advance care planning: Are medical professionals more likely to plan?}, journal = {Social Science \& Medicine}, volume = {272}, year = {2021}, pages = {113730}, abstract = {Advance care planning (ACP) helps ensure that treatment preferences are met at the end of life. Medical professionals typically are responsible for facilitating patients{\textquoteright} ACP, and may be especially effective in doing so if they have first-hand insights from their own planning. However, no large-scale U.S. studies examine whether persons working on the front lines of health care are more likely than other workers to have done ACP. We contrast the use of three ACP components (living wills, durable power of attorney for health care, and informal discussions) among persons working in medical, legal, social/health support services, other professional, and other non-professional occupations. Data are from the Health and Retirement Study (n = 7668) and Wisconsin Longitudinal Study (n = 5464). Multivariable logistic regression analyses are adjusted for socioeconomic, demographic, health, and psychosocial factors that may confound associations between occupational group and ACP. Medical professionals in both samples are more likely than other professional workers to discuss their own treatment preferences, net of all controls. Medical professionals in the WLS are more likely to execute living wills and DPAHC designations, whereas legal professionals in the HRS are more likely to name a DPAHC. Non-professional workers are significantly less likely to do all three types of planning, although these differences are accounted for by socioeconomic factors. Social and health services professionals are no more likely than other professionals to do ACP. The on-the-job experiences and expertise of medical professionals may motivate them to discuss their own end-of-life preferences, which may render them more trustworthy sources of information for patients and clients. The Affordable Care Act provides reimbursement for medical professionals{\textquoteright} end-of-life consultations with Medicare beneficiary patients, yet practitioners uncomfortable with such conversations may fail to initiate them. Programs to increase medical professionals{\textquoteright} own ACP may have the secondary benefit of increasing ACP among their patients.}, keywords = {Advance care planning, Employment, end-of-life, health, Occupations, Social stratification}, isbn = {0277-9536}, doi = {https://doi.org/10.1016/j.socscimed.2021.113730}, author = {Deborah Carr and Lucie Kalousova and Lin, Katherine and Sarah A. Burgard} } @article {ABELIANSKY2021100924, title = {Social vulnerability and aging of elderly people in the United States}, journal = {SSM - Population Health}, volume = {16}, year = {2021}, pages = {100924}, abstract = {We use 7 waves of the Health and Retirement Study and construct a social vulnerability index (SVI) for elderly U.S. Americans (born 1913{\textendash}1966). We show that the SVI is mildly larger for men than for women and increases in age from above age 60 onwards for both genders. Social vulnerability of men (but not of women) is lower in the West and Midwest than in other regions and higher income mildly reduces the SVI for men (but not for women). In cohort analysis we find an increase of the SVI for individuals born in the late 1940s or later, which is, however, statistically significant only for women. In order to investigate the nexus between social vulnerability and aging, we construct a frailty index from the same data. We find that socially vulnerable persons display more health deficits at any age. Using the initial SVI (at first interview) we find that social vulnerability exerts a significant impact on subsequent accumulation of health deficits, which is of about the same size for men and women. A one standard deviation increase in the initial SVI leads to a 20 percent increase of the frailty index at any age.}, keywords = {frailty index, health, Social capital, Social vulnerability}, issn = {2352-8273}, doi = {10.1016/j.ssmph.2021.100924}, author = {Ana Lucia Abeliansky and Devin Erel and Holger Strulik} } @article {RR-A708-1, title = {Societal Impact of Research Funding for Women{\textquoteright}s Health in Alzheimer{\textquoteright}s Disease and Alzheimer{\textquoteright}s Disease - Related Dementias}, number = {RR-A708-1}, year = {2021}, institution = {RAND Corporation}, address = {Santa Monica, CA}, abstract = {Women{\textquoteright}s health has suffered from insufficient research addressing women. The research community has not widely embraced the value of this research, and the impact of limited knowledge about women{\textquoteright}s health relative to men{\textquoteright}s is far-reaching. Without information on the potential return on investment for women{\textquoteright}s health research, research funders, policymakers, and business leaders lack a basis for altering research investments to improve knowledge of women{\textquoteright}s health. As part of an initiative of the Women{\textquoteright}s Health Access Matters (WHAM) nonprofit foundation, RAND Corporation researchers examined the impact of increasing funding for women{\textquoteright}s health, beginning with a focus on Alzheimer{\textquoteright}s disease and Alzheimer{\textquoteright}s disease{\textendash}related dementias (AD/ADRD), which result in substantial illness burden, health care costs, caregiving burden, and mortality. In this report, the authors present the results of microsimulation models used to explore the potential for enhanced investment in women{\textquoteright}s health research, in terms of the economic well-being of women and for the U.S. population.}, keywords = {Alzheimer{\textquoteright}s disease, Dementia, health, women}, doi = {10.7249/RR-A708-1}, author = {Baird, Matthew D. and Melanie A. Zaber and Andrew W. Dick and Chloe E. Bird and Annie Chen and Molly Waymouth and Grace Gahlon and Denise D. Quigley and Hamad Al Ibrahim and Lori Frank} } @article {12203, title = {Using the Health and Retirement Study for Research on the Impact of the Working Conditions on the Individual Life Course}, year = {2021}, publisher = {National Institute on Aging}, address = {Bethesda, MD}, abstract = {The aim of this paper is to evaluate the utility of the Health and Retirement Study (HRS) for studying the impact of working conditions on individuals{\textquoteright} health, well-being and labor supply decisions at older ages. I provide a brief overview of the information on working conditions that is currently available in the HRS and discuss implications for studies on the effects of working conditions on the individual life course. I conclude with a discussion of how recent and projected trends in the U.S. workforce are reflected in the current HRS survey content.}, keywords = {health, Labor Supply, Well-being, Working conditions}, author = {Kathleen J Mullen} } @article {11771, title = {Volunteering as an Equalizer: A Quasi-Experimental Study Using Propensity Score Analysis}, journal = {American Journal of Preventive Medicine}, volume = {61}, year = {2021}, pages = {628-635}, abstract = {Formal volunteering in later life is beneficial for both physical and psychological well-being. However, research points to potential selection bias because older adults with key advantages, such as wealth, are more likely to volunteer and reap its benefits. Accordingly, this study addresses this selection bias by considering the characteristics of volunteers and nonvolunteers using the inverse probability of treatment weighting. It also examines whether volunteering has differential impacts between the highest and lowest wealth quintiles using inverse probability of treatment weighting. Methods Data were analyzed from the 2004{\textendash}2016 waves of the Health and Retirement Study (N=90,881). The weights, created using a machine learning method, were incorporated in the analysis to estimate the treatment effects along with relevant covariates. Analyses were conducted in 2020. Results Volunteering enhanced self-reported health and reduced depressive symptoms in the full sample. Furthermore, those in the lowest wealth quintile experienced significantly better self-reported health from volunteering than their wealthy counterparts. Volunteering was associated with fewer depressive symptoms regardless of wealth status. Conclusions The study enhances the understanding of formal volunteering and health while suggesting that volunteers with low wealth may benefit more from volunteering in terms of their health. Hindrances to volunteering among the least wealthy, such as financial distress, discrimination, or lack of organizational support, may attenuate the benefits of voluntary activity. }, keywords = {health, Volunteering, Wealth}, doi = {10.1016/j.amepre.2021.05.004}, author = {Kim, Seoyoun and Cal J. Halvorsen} } @article {12043, title = {Wealthier, Healthier Households Keep Spending In Retirement, Study Says}, journal = {FA Online}, year = {2021}, publisher = {Financial Advisor}, keywords = {health, Retirement, Spending, Wealth}, url = {https://www.fa-mag.com/news/wealthier-and-healthier-households-keep-spending-in-retirement-65306.html}, author = {Rasmussen, Eric} } @article {11276, title = {The Association Between Depressive Symptoms and Accumulation of Stress Among Black Men in the Health and Retirement Study.}, journal = {Innovation in Aging}, volume = {4}, year = {2020}, pages = {igaa047}, abstract = {

Background and Objectives: Among the multiple factors posited to drive the health inequities that black men experience, the fundamental role of stress in the production of poor health is a key component. Allostatic load (AL) is considered to be a byproduct of stressors related to cumulative disadvantage. Exposure to chronic stress is associated with poorer mental health including depressive symptoms. Few studies have investigated how AL contributes to depressive symptoms among black men. The purpose of the cross-sectional study was to examine the association between AL and depressive symptoms among middle- to old age black men.

Research Design and Methods: This project used the 2010 and 2012 wave of the Health and Retirement Study enhanced face-to-face interview that included a biomarker assessment and psychosocial questionnaire. Depressive symptoms, assessed by the endorsement of 3 or more symptoms on the Center for Epidemiological Studies-Depression 8-item scale, was the outcome variable. The main independent variable, AL, score was calculated by summing the number values that were in the high range for that particular biomarker value scores ranging from 0 to 7. black men whose AL score was 3 or greater were considered to be in the high AL group. Modified Poisson regression was used to estimate prevalence ratios (PRs) and corresponding 95\% confidence intervals (CIs).

Results: There was a larger proportion of black men in the high AL group who reported depressive symptoms (30.0\% vs. 20.0\%) compared with black men in the low AL group. After adjusting for age, education, income, drinking, and smoking status, the prevalence of reporting 3 or more depressive symptoms was statistically significant among black men in the high AL group (PR = 1.61 [95\% CI: 1.20-2.17]) than black men in the low AL group.

Discussion and Implications: Exposure to chronic stress is related to reporting 3 or more depressive symptoms among black men after controlling for potential confounders. Improving the social and economic conditions for which black men work, play, and pray is key to reducing stress, thereby potentially leading to the reporting of fewer depressive symptoms.

}, keywords = {Allostatic load, Black men, Depressive symptoms, health, Inequities, Men, Stress}, issn = {2399-5300}, doi = {10.1093/geroni/igaa047}, author = {Roland J. Thorpe Jr. and Ryon J. Cobb and King, Keyonna and Bruce, Marino A and Archibald, Paul and Jones, Harlan P and Norris, Keith C and Keith E Whitfield and Hudson, Darrell} } @article {Cobian2020e200731, title = {Changes in Health Insurance Coverage Over Time by Immigration Status Among US Older Adults, 1992-2016}, journal = {JAMA network open}, volume = {3}, year = {2020}, note = {cited By 0}, type = {Journal}, chapter = {e200731}, abstract = {Importance: Disparities in health insurance coverage by immigration status are well documented; however, there are few data comparing long-term changes in insurance coverage between immigrant and nonimmigrant adults as they age into older adulthood. Objective: To compare longitudinal changes in insurance coverage over 24 years of follow-up between recent immigrant, early immigrant, and nonimmigrant adults in the US. Design, Setting, and Participants: This population-based cohort study used data from the nationally representative Health and Retirement Study. Data were collected biennially from 1992 to 2016. The population included community-dwelling US adults born between 1931 and 1941 and aged 51 to 61 years at baseline. Statistical analysis was performed from February 3, 2017, to January 10, 2020. Exposures: Participants were categorized as nonimmigrants (born in the US), early immigrants (immigrated to the US before the age of 18 years), and recent immigrants (immigrated to the US from the age of 18 years onward). Main Outcomes and Measures: Self-reported data on public, employer, long-term care, and other private insurance were used to define any insurance coverage. Longitudinal changes in insurance coverage were examined over time by immigration status using generalized estimating equations accounting for inverse probability of attrition weights. The association between immigration status and continuous insurance coverage was also evaluated. Results: A total of 9691 participants were included (mean [SD] age, 56.0 [3.2] years; 5111 [52.6\%] female). Nonimmigrants composed 90\% (n = 8649) of the cohort; early immigrants, 2\% (n = 201); and recent immigrants, 8\% (n = 841). Insurance coverage increased from 68\%, 83\%, and 86\% of recent immigrant, early immigrant, and nonimmigrant older adults, respectively, in 1992 to 97\%, 100\%, and 99\% in 2016. After accounting for selective attrition, recent immigrants were 15\% less likely than nonimmigrants to have any insurance at baseline (risk ratio, 0.85; 95\% CI, 0.82-0.88), driven by lower rates of private insurance. However, disparities in insurance decreased incrementally over time and were eliminated, such that insurance coverage rates were similar between groups as participants attained Medicare age eligibility. Furthermore, recent immigrants were less likely than nonimmigrants to be continuously insured (risk ratio, 0.89; 95\% CI, 0.85-0.94). Conclusions and Relevance: Among community-dwelling adults who were not age eligible for Medicare, recent immigrants had lower rates of health insurance, but this disparity was eliminated over the 24-year follow-up period because of uptake of public insurance among all participants. Future studies should evaluate policies and health care reforms aimed at reducing disparities among vulnerable populations such as recent immigrants who are not age eligible for Medicare.}, keywords = {Emigrants and Immigrants, health, Immigrant population}, issn = {25743805}, doi = {10.1001/jamanetworkopen.2020.0731}, url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85081691720\&doi=10.1001\%2fjamanetworkopen.2020.0731\&partnerID=40\&md5=9a3c12cf98521d4455f3c49d64c60fc8}, author = {Cobian, J. and Maynor G Gonz{\'a}lez and Ying Jessica Cao and Xu, Huiwen and Li, R. and Mendis, M. and Noyes, K. and Becerra, A.Z.} } @mastersthesis {11182, title = {Changes in Views of Aging in Older Adulthood: The Importance of Activity Engagement}, volume = {Doctor of Philosophy}, year = {2020}, school = {North Carolina State University}, address = {Raleigh, NC}, abstract = {A growing body of literature has shown the importance of views of aging in older adulthood. Views of aging are broadly defined as beliefs a person has about old age, the aging process, or their own aging (Wurm et al., 2017). This project explored how changes in health influences changes in views of aging across older adulthood. Additionally, in two studies, this project explored different categories of activities as potential mediators explaining the association between changes in health and views of aging. In Study 1, a nationally-representative sample of adults over the age of 50 (n =1923) was used to assess how changes in physical, mental, and cognitive health were associated with changes in views of aging, mediated by different categories of activities. In Study 2, a smaller longitudinal sample of older adults over age 65 (n =150) was also used to explore the domainspecific nature of these constructs. Domain-specificity was assessed by analyzing how changes in three types of health (physical, mental, cognitive) were associated with changes in views of aging within those same domains (physical health, mental health, and cognitive health) and if activities associated with those domains were the strongest mediators. In Study 1, results found that changes in all types of health were associated with changes in views of aging. More specifically, experiencing declines in all types of health was associated with progressively more negative views of aging. Additionally, aligned with hypotheses, changes in activity engagement was a small but significant mediator for these associations. In contrast, Study 2 only found an association between changes in physical and mental health and views of aging within those domains. There were limited mediation effects found in Study 2 and support was not found for the domain-specific expectations of the mediation strengths. In conclusion, this study found support for a linkage between changes in physical, mental, and cognitive health and views of aging. Some support was also found in the larger, nationally-representative sample that changes in activity engagement were a partial mediating mechanism between changes in health and views of aging. There was mixed evidence as to the strength of the mediation and the domain-specificity. These findings suggest changes in activity engagement may be one important mechanism fueling the association between changes in health and views of aging, but future research is needed to address limitations of this project and to better understand the longitudinal within-person trajectory of views of aging. }, keywords = {Aging, health}, url = {https://repository.lib.ncsu.edu/bitstream/handle/1840.20/38303/etd.pdf?sequence=1}, author = {Allura Lothary} } @article {11306, title = {Does the Sharing of Resources Impact Health Among Married Couples? New Findings From Dyadic Models}, journal = {Innovation in Aging}, volume = {4}, year = {2020}, pages = {582}, abstract = {As married couples aging together, their health behaviors and outcomes could be shaped by both one{\textquoteright}s own and the spouse{\textquoteright}s characteristics. Using dyadic datasets, speakers in this symposium explored the interdependence nature of marital relations by identifying the mechanisms of how shared resources or strains affect spouses{\textquoteright} physical and mental health outcomes among married couples. Wang, Kim, and Burr identified distinct types of personality configurations among older couples using the Health and Retirement Study, and examined how personality compatibilities could buffer negative effects of adverse life events on older couples{\textquoteright} mental health. Using data from the National Social Life, Health, and Aging Project, Proulx, Skoblow, and Han further investigated the associations between marital quality and mental health among caregiving dyads, with a special focus on a comparison of different caregiving groups (spouse, child, others). From a physical health perspective, Wilson and Novak presented the dynamic behind relationship quality, joint health behaviors, health problems, health satisfaction, and health similarity between spouses. Finally, Kim, Jang, Park, and Chiriboga focused on couple contexts for acculturation among older Korean immigrants in the U.S., and examined how each spousal acculturation level affects healthcare utilization and difficulties in health service use. Focusing on married couples, this symposium showcases the interplay of family experiences, health behaviors, and relational dynamics of both spouses in shaping their health, and highlights the benefits of dyadic approaches. Speakers and our discussant, Dr. Karen Lyons, will discuss implications for social program design and future research.}, keywords = {dyadic models, health, Married Individuals}, isbn = {2399-5300}, doi = {10.1093/geroni/igaa057.1941}, author = {Wang, Shuangshuang and Kim, Kyungmin and Lyons, Karen} } @article {10992, title = {Does Working Longer Enhance Old Age? }, number = {WP2020-20}, year = {2020}, institution = {The Wharton School, University of Pennsylvania}, address = {Philadelphia, PA}, abstract = {Understanding the link between retirement and health is crucial for both improving people{\textquoteright}s wellbeing and for designing optimal public policy around retirement. Yet, to date, the economics literature has been inconclusive about whether retirement causes improvements or deterioration in health. The lack of consensus is likely driven by differences in study design, population, and the age of workers and set of health outcomes studied. In this paper, I explain and distill the literature, highlight patterns in the highestquality studies, and discuss the implications of the findings for longevity risk management and worker and retiree health going forward. }, keywords = {health, Retirement, Social Security, Working Longer}, url = {https://repository.upenn.edu/cgi/viewcontent.cgi?article=1691\&context=prc_papers}, author = {Maria D Fitzpatrick} } @article {doi:10.1002/hec.3962, title = {Effect of early-stage Alzheimer{\textquoteright}s disease on household financial outcomes}, journal = {Health Economics}, volume = {29}, year = {2020}, pages = {18-29}, abstract = {Abstract Significant limitations and rapid declines in financial capacity are a hallmark of patients with early-stage Alzheimer{\textquoteright}s disease (AD). We use linked Health and Retirement Study and Medicare claims data spanning 1992{\textendash}2014 to examine the effect of early-stage AD, from the start of first symptoms to diagnosis, on household financial outcomes. We estimate household fixed-effects models and examine continuous measures of liquid assets and net wealth, as well as dichotomous indicators for a large change in either outcome. We find robust evidence that early-stage AD places households at significant risk for large adverse changes in liquid assets. Further, we find some, but more limited, evidence that early-stage AD reduces net wealth. Our findings are consequential because financial vulnerability during the disease{\textquoteright}s early-stage impacts the ability of afflicted individuals and their families to pay for care in the disease{\textquoteright}s later stage. Additionally, the findings speak to the value that earlier diagnosis may provide by helping avert adverse financial outcomes that occur before the disease is currently diagnosable with available tools. These results also point to a potentially important role for financial institutions in helping reduce exposure of vulnerable elderly to poor outcomes.}, keywords = {consumer protection, health, household behavior and family economics, household saving, Personal finance}, doi = {10.1002/hec.3962}, url = {https://onlinelibrary.wiley.com/doi/abs/10.1002/hec.3962}, author = {Carole R Gresenz and Jean M Mitchell and Marrone, James and Federoff, Howard J.} } @mastersthesis {11071, title = {Essays on the Complexities of Social Inequalities and Health Disparities}, volume = {Doctor of Philosophy}, year = {2020}, school = {Duke University}, address = {Durham, NC}, abstract = {In this dissertation, I conduct three studies focusing on differences in social groups and their health outcomes or opinions related to medical practices. In Chapter 1, I outline each study and its findings. Chapter 2 focuses on the Great Recession in the United States (2007{\textendash}2009) and how this crisis is associated with health disparities. In this chapter, I use nine waves spanning 16 years (1998-2014) of the RAND version of the Health and Retirement Study (HRS) to examine disparities in cardiovascular disease, stroke, or related death (e.g., circulatory disease) among Americans ages 50 and older to determine whether these health disparities among different educational groups narrowed, widened, or remained constant during and after the Great Recession. In general, findings from discrete-time hazard analyses suggest that the disparities remained relatively constant with some (nonsignificant) evidence of some narrowing between the most educated and least educated groups. Chapter 3 examines whether there is symmetry in the effects of certain health behaviors{\textemdash}smoking, drinking, weight management{\textemdash}on cardiovascular disease, stroke, or related death between socioeconomic groups. This chapter also uses nine waves (1998{\textendash}2014) of the RAND HRS. Discrete-time hazard regression analyses indicate that while those with more education maintain better health outcomes regardless of health behaviors, the effects of health behaviors are not equally distributed. Poor weight management and higher numbers of daily cigarettes are associated with a greater increased risk for those with more education than for those with less. The effects of heavy drinking, however, are less severe for the those with the most education compared to those with the least education. Chapter 4 studies the role of social change by investigating trends in approval for euthanasia among cohorts in the United States and how those trends are influenced by cohort replacement and religious attitudes. This chapter uses 16 waves of the General Social Survey (1985{\textendash}2014) and estimates differences in approval ratings between cohorts using logistic regression models. Results show that baby boomers are significantly more likely to approve of euthanasia than either their predecessors or successors, suggesting a cohort effect. Individuals belonging to more conservative religious groups and displaying higher levels of religiosity are less likely to approve. With the meaningful effect of cohorts on approval for euthanasia, findings suggest that as baby boomers age and as the population becomes less religious, approval for euthanasia might increase again. }, keywords = {health, RAND, social inequalities}, url = {https://dukespace.lib.duke.edu/dspace/bitstream/handle/10161/21529/Marsala_duke_0066D_15888.pdf?sequence=1}, author = {Marsala, Mark} } @article {11090, title = {Family embeddedness and older adult mortality in the United States}, journal = {Population Studies}, volume = {74}, year = {2020}, pages = {415-435}, abstract = {Do different operationalizations of family structure offer different understandings of the links between family structure and older adult mortality? Using the American Health and Retirement Study (N?=?29,665), we examine mortality risks by three measures of family structure: whether respondents have different family statuses (e.g. married vs. unmarried), volume of family members available (e.g. having one vs. two living immediate family members), and family embeddedness (e.g. having neither spouse nor child vs. having spouse but no child). We focus on three kin types: partner/spouse, children, and siblings. We find that differences in empirical estimates across measures of family structure are not dramatic, but that family embeddedness can show some additional heterogeneity in mortality patterns over family status variables or the volume of ties. This paper tests different ways of operationalizing family structure to study mortality outcomes and advances our understanding of how family functions as a key social determinant of health.}, keywords = {Family, health, kinless, kinship, Mortality, Social networks}, isbn = {0032-4728}, doi = {10.1080/00324728.2020.1817529}, author = {Patterson, Sarah E. and Rachel Margolis and Ashton M. Verdery} } @article {11176, title = {For elderly couples, negative thoughts about aging can be detrimental to their spouses}, journal = {Michigan News}, year = {2020}, address = {Ann Arbor, MI}, abstract = {Elderly husbands and wives can expect their health to decline{\textemdash}as well as that of their spouse{\textemdash}when their self-perceptions about aging become negative, a new study suggests. Led by researchers at the University of Michigan and Zhejiang University, the study found that health effects differ by gender among elderly couples. The husband{\textquoteright}s self-perceptions about aging are associated with his wife{\textquoteright}s depressive symptoms, whereas the wife{\textquoteright}s views correlate with her husband{\textquoteright}s physical disability, functional limitations and chronic diseases, the findings indicated. }, keywords = {elderly couples, health, Self-perception}, url = {https://news.umich.edu/for-elderly-couples-negative-thoughts-about-aging-can-be-detrimental-to-their-spouses/}, author = {Wadley, Jared} } @article {11021, title = {Genetic Fortune: Winning or Losing Education, Income, and Health}, number = {TI 2020-053/V}, year = {2020}, institution = {Tinbergen Institute}, address = {Amsterdam}, abstract = {We study the effects of genetic endowments on inequalities in education, income, and health. Specifically, we conduct the first genome-wide association study (GWAS) of individual income, using data from individuals of European ancestries. We find that ≈10\% of the variance in occupational wages can be attributed to genetic similarities between individuals who are only very distantly related to each other. Our GWAS (N = 282,963) identifies 45 approximately independent genetic loci for occupational wages, each with a tiny effect size (R 2<0.04\%). An aggregated genetic score constructed from these GWAS results accounts for ≈1\% of the variance in self-reported income in two independent samples (N = 29,440) and improves upon the variance captured by a genetic score obtained from previous GWAS results for educational attainment. A one-standard-deviation increase in our genetic score for occupational wages is associated with a 6{\textendash}8\% increase in self-reported hourly wages. We exploit random genetic differences between ~35,000 biological siblings to show that (i) roughly half of the covariance between our genetic score and socioeconomic outcomes is causal, (ii) genetic luck for higher income is linked with better health outcomes in late adulthood, and (iii) having a college degree partly mediates this relationship. We also demonstrate that the returns to schooling remain substantial even after controlling for genetic confounds, with an average of 8{\textendash}11\% higher hourly wages for each additional year of education obtained in a US sample. Thus, the implications of genetic endowments are malleable, for example, via policies targeting education.}, keywords = {Education, Genetics, health, heritability, Income, Inequality, polygenic score}, url = {https://papers.tinbergen.nl/20053.pdf}, author = {Kweon, Hyeokmoon and Burik, Casper and Richard Karlsson Linn{\'e}r and de Vlaming, Ronald and Okbay, Aysu and Martschenko, Daphne and Harden, Kathryn and DiPrete, Thomas and Philipp D Koellinger} } @mastersthesis {10750, title = {Health Effects of Spousal Caregiving Among Elderly Americans}, volume = {Bachelor of Arts}, year = {2020}, school = {Willam and Mary }, address = {Williamsburg}, abstract = {I examine the mental health and general health effects of providing informal care for one{\textquoteright}s spouse using data from the Health and Retirement Study in the United States. Prior research has focused on children providing care for parents. In this paper, I provide the first analysis of these health effects among U.S. adults who provide care for their spouses. Using propensity score matching, I find that caregiving leads to an increase in depressive symptoms. Results are particularly strong and significant for female caregivers. I find that symptoms of depression increase with the intensity of caregiving. I find no evidence that caregiving leads to worse self-assessed health. This research is relevant to understanding the net benefit of informal caregiving in the context of the U.S. healthcare system.}, keywords = {depression, health, Informal care, Long-term Care}, url = {https://scholarworks.wm.edu/cgi/viewcontent.cgi?article=2498\&context=honorstheses}, author = {Renee Garrow} } @article {Gillen2019, title = {Health Literacy and Difference in Current Wealth Among Middle-Aged and Older Adults}, journal = {Journal of Family and Economic Issues}, volume = {41}, year = {2020}, pages = {281{\textendash}299}, abstract = {Numerous studies suggest that health literacy improves health outcomes at older ages. But how, and to what extent, health literacy contributes to improving financial outcomes has not been examined. This study proposed a conceptual framework to explain the mechanisms between health literacy and current wealth. Data from the Health and Retirement Study (HRS) are used to estimate proposed direct and indirect effects between health literacy and current wealth. We found that, for the most part, health literacy is directly associated with wealth rather than indirectly through mediating variables. Alternatively, out of all indirect effects investigated in the model, health literacy affects wealth mainly through the path of chronic condition, work limitation, and income.}, keywords = {health, Health Literacy, Wealth, Wealth Inequality}, issn = {10580476}, doi = {10.1007/s10834-019-09648-w}, author = {Gillen, Martie and Yang, Hongwei and Hyungsoo Kim} } @article {11275, title = {Hope for the Next Year, and Beyond}, year = {2020}, publisher = {Psychology Today}, address = {New York, NY}, abstract = {This past year has been difficult for our country, and for the world. We have been struggling through a deadly pandemic. We have faced tensions across racial and political lines. Many have faced tremendous economic hardship. Some are doubtless wondering if there is any reason for hope. Dare we hope for the future? And what is hope? Is it realistic? Does it help at all? Over the past couple of years, we have been trying to better understand and assess hope at the Human Flourishing Program at Harvard, to attempt to shed light on some of these critical questions of our day.}, keywords = {Aging, health, Hope, Well-being}, url = {https://www.psychologytoday.com/ca/blog/human-flourishing/202012/hope-the-next-year-and-beyond}, author = {Tyler J VanderWeele} } @article {11373, title = {The Impact of Growing Health and Mortality Inequalities on Lifetime Social Security Payouts}, number = {MRDRC WP 2020-412}, year = {2020}, institution = {Michigan Retirement and Disability Research Center, University of Michigan}, address = {Ann Arbor, MI}, abstract = {The prevalence of obesity, diabetes, and other health problems has increased in recent decades in the United States, and there is a growing gap between the health and longevity of individuals with high socioeconomic status (SES) and low SES. These trends likely have implications for Social Security{\textquoteright}s financial position in the coming decades. Because high-SES individuals tend to receive higher annual benefits and live longer, increases in health and mortality inequalities may result in increases in aggregate Social Security payouts. This paper uses data from the Health and Retirement Study, and a microsimulation model of health, mortality, and Social Security benefits, to forecast lifetime Social Security benefits of the 1934 to 1959 birth cohorts in the U.S. We compare alternative assumptions about the future course of mortality. We find that accounting for health and mortality inequalities is important. In a baseline model that ignores trends in mortality inequalities, we estimate that lifetime Social Security benefits would grow by 26\% in real terms between the 1934 and 1959 birth cohorts due to increasing benefit levels and improvements in average mortality. When we account for mortality inequalities, we find an increase of 28\% to 38\% in average lifetime benefits, depending on the assumptions of the model. We also forecast lifetime benefits using the alternative assumption that improvements in population mortality will slow for younger birth cohorts.}, keywords = {health, mortality inequalities, Social Security}, url = {https://mrdrc.isr.umich.edu/publications/papers/pdf/wp412.pdf}, author = {P{\'e}ter Hudomiet and Michael D Hurd and Susann Rohwedder} } @article {11346, title = {The Impact of Health on Wealth: Empirical Evidence}, number = {2020-19}, year = {2020}, institution = {University of Connecticut}, address = {Storrs, CT}, abstract = {This paper empirically evaluates the impact of health on wealth. Using the frailty index as a measure of health and carefully accounting for the dynamic relationship between frailty and wealth, I find that suffering one more health deficit leads, on average, to a 2.45 percent decline in the household net worth of individuals between age 50 and 100. The household net worth of individuals with no college degree, poor health, and over the age of 70 is significantly negatively affected by poor health. The results pass the tests of instrument validity and are consistent across several alternative definitions of wealth. Using financial net worth as a definition of wealth, I find that the average impact of frailty on wealth is the largest, while it is the smallest when wealth is defined to include only housing net worth.}, keywords = {health, Wealth}, url = {https://media.economics.uconn.edu/working/2020-19.pdf}, author = {Ghimire, Umesh} } @article {Kang:2020:1087-3244:159, title = {The Influence of Cognitive Impairment on Health Behaviors among Older Adults}, journal = {American Journal of Health Behavior}, volume = {44}, year = {2020}, pages = {159-168}, abstract = {Objectives: Previous research on cognitive impairment and health behaviors has focused largely on how health behaviors affect cognition; rarely has it examined whether cognitive impairment affects health behaviors. The purpose of this study was to examine the impact of cognitive impairment on engagement in health behaviors among older adults. Methods: The study sample included 19,644 adults aged 50 or older from the Health and Retirement Study 1995-2012 surveys. We used mixed-effects logistic regression to analyze the influence of cognitive impairment, measured using the Telephone Interview for Cognitive Status, on the engagement of health behaviors including physical activity, smoking, and drinking. Results: Cognitive impairment without dementia [CIND] (OR = .84, 95\% CI = .80-.89) and dementia (OR = .68, 95\% CI = .61-.75) were associated with a lower likelihood of engaging in regular vigorous physical activity during longitudinal follow-up, after adjusting for covariates. CIND or dementia was not significantly associated with the likelihood of smoking or alcohol consumption. Conclusions: CIND and dementia are risk factors for physical inactivity among older adults. Promotion of regular physical activity should be an essential component of health promotion programs for persons with cognitive impairment.}, keywords = {Cognition, health}, issn = {1087-3244}, doi = {doi:10.5993/AJHB.44.2.4}, url = {https://www.ingentaconnect.com/content/png/ajhb/2020/00000044/00000002/art00004}, author = {Kang, Sung-wan and Xiang, Xiaoling} } @article {11257, title = {The Interaction of Health, Genetics, and Occupational Demands in SSDI Determinations}, number = {NB20-11}, year = {2020}, institution = {National Bureau of Economic Research, Retirement and Disability Research Center}, address = {Cambridge, MA}, abstract = {Evaluations of Social Security Disability Insurance (SSDI) applications are based not only on poor health, but in many cases, consider the vocational factors of age, education and work experience to determine whether individuals can work. SSDI determinations based on these factors have grown threefold since 1985 (Michaud, Nelson, and Wiczer 2016). Yet little is known about the relationship between SSDI activity and the ability to meet occupational requirements (Rutledge, Zulkarnain, and King 2019). Moreover, there is strong evidence that morbidity and mortality are distributed unequally across occupations (Marmot et al. 1991), perhaps because differential work environments may exacerbate disability but also because individual-level underlying health is unlikely to be randomly distributed across occupations (Mackenbach et al. 2017). Together, these phenomena result in complex relationships of SSDI determinants with both the independent and joint effects of health and occupational demands. Disentangling the contributions of these forces is challenging, because selection into occupations by health is often unobserved and because data on occupational demands for employment histories is limited. We propose to triangulate between these factors by using a rich set of data linkages from the Health and Retirement Study, including linkage to the Social Security Administration (SSA) disability application file (831 file), and the Department of Labor{\textquoteright}s O*Net job classification system.}, keywords = {Genetics, health, Occupation, SSDI}, url = {https://www.nber.org/programs-projects/projects-and-centers/retirement-and-disability-research-center/center-papers/nb20-11}, author = {Harrati, Amal and Lauren L Schmitz} } @article {10556, title = {Job Characteristics and Transitions Among Older Self-Employed Individuals with Work-Limiting Health Conditions}, year = {2020}, institution = {U.S. Small Business Administration}, abstract = {Older workers are an economically important group as they represent a large and growing portion of the United States workforce. These workers are more likely to experience health conditions that limit their options in terms of the type and amount of work they pursue. Self employed workers who report a new work-limiting health condition are more likely to remain in the workforce than wage and salary workers who also report a work-limiting health condition. Previous research suggests that self-employment provides more opportunities to accommodate work-limiting health conditions; this report explores whether self-employed workers with work limiting health conditions report less physically demanding jobs or different hours and weeks worked than wage and salary workers who also report work-limiting health conditions.}, keywords = {health, Labor, Self-employment}, url = {https://advocacy.sba.gov/2020/01/15/new-research-from-advocacy-job-characteristics-and-transitions-among-older-self-employed-individuals-with-work-limiting-health-conditions/}, author = {Gurley-Calvez, Tami and Williams, Jessica and Kandice Kapinos} } @article {2020-27251-00120200420, title = {Novel information processing at work across time is associated with cognitive change in later life: A 14-year longitudinal study.}, journal = {Psychology and Aging}, volume = {35}, year = {2020}, pages = {793{\textendash}805}, type = {Journal}, abstract = {This study examined whether the degree of novel information processing at work (NPW) attenuates cognitive aging across 14 years for adults 50+ in the United States and how NPW links with job complexity. To answer these questions, we used data (N = 4,252) from the Health and Retirement Study. Detailed information on occupational characteristics from ONet between 2000 and 2014 was used to assess NPW and matched with participants{\textquoteright} occupational codes across time. Multilevel transition models were employed to estimate the relationship between NPW and cognitive functioning across time and to explore the moderating effect of cognitive level. Our results showed that exposure to more NPW across time attenuates cognitive decline as indicated by immediate word recall and serial 7s performance, while adjusting for baseline age, leisure, volunteering activities, cognition at previous wave, and other covariates. This buffering effect of NPW is reduced but sustained when controlling for change in jo}, keywords = {Cognitive Ability, cognitive aging, Cognitive Processes, health, Job characteristics, job complexity, novelty processing, Retirement, Stimulus Novelty, Test Construction}, issn = {0882-7974}, doi = {10.1037/pag0000468}, url = {http://proxy.lib.umich.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true\&db=psyh\&AN=2020-27251-001\&site=ehost-live\&scope=site}, author = {Ursula M. Staudinger and Yu, Yan-Liang and Cheng, Bin} } @article {10797, title = {Occupations and Work at Older Ages: Varied Responses to Policy}, year = {2020}, institution = {University of Wisconsin-Madison}, address = {Madison}, abstract = {There are a number of differences between individuals in {\textquotedblleft}blue-collar{\textquotedblright} and {\textquotedblleft}white-collar{\textquotedblright} occupations in the timing of retirement, savings, Social Security OASI claiming ages, and SSDI applications. This paper presents descriptive evidence of these differences and develops and estimates the parameters of a model of later-life labor supply, savings, and Social Security OASDI behavior. The model accounts for a number of differences across blue- and white-collar workers in particular and is then used to predict behavior and measure welfare under the counterfactual policy scenarios of increases in the Early Retirement and Full Retirement Ages for claiming Social Security benefits. I find that increasing the Early Retirement Age has large labor supply and disutility effects for blue-collar workers, and results in greater SSDI application for this group. This is driven primarily by those in blue-collar occupations experiencing more steeply declining productivity with age and less margin on which to respond to policy changes. Increasing the Full Retirement Age affects the labor supply of white-collar but not blue-collar workers. It does, however, increase the savings somewhat for the latter group.}, keywords = {health, Labor Supply, OASDI, Older workers, Retirement}, url = {https://cfsrdrc.wisc.edu/files/research-briefs/WI19_02_Jacobs_FinalPaper_11.22.19.pdf}, author = {Lindsay Jacobs} } @article {11064, title = {Optimism, pessimism, and health biomarkers in older couples.}, journal = {British Journal of Health Psychology}, year = {2020}, month = {2020 Sep 10}, abstract = {

OBJECTIVE: Studies have demonstrated the importance of optimism in predicting perceived general health. However, the handful of studies focusing on cardiovascular biomarkers show inconsistent effects. Additionally, no study examined whether spousal levels of optimism and pessimism affect an individual{\textquoteright}s biological markers of cardiovascular health. Thus, our objectives were to examine whether partners{\textquoteright} optimism and pessimism affect individual biological markers, differentiating between between-dyad associations and within-dyad predictive processes.

METHODS: Three waves of the Health and Retirement Study collected in 2006, 2010, and 2014 were used to test actor and partner effects of optimism and pessimism on C-reactive protein (CRP) and high-density lipoprotein. Multilevel longitudinal actor-partner models were used to examine the contribution of a partner{\textquoteright}s optimism and pessimism to each biomarker, adjusting for respondent{\textquoteright}s age, sex, depression, body mass index, daily activity levels, and a summary score of respondent{\textquoteright}s doctor-diagnosed chronic conditions.

RESULTS: Partners{\textquoteright} pessimism and optimism levels were moderately associated. Results for within-person effects were all non-significant, both within and across waves. Associations at the between-person level were also non-significant, with the exception of a positive association between husbands{\textquoteright} pessimism and their own CRP, and husbands{\textquoteright} optimism and their wives{\textquoteright} CRP.

CONCLUSIONS: Results suggest that optimism and pessimism may not play a pertinent role in within variability of biomarkers of cardiovascular diseases and have a minor role in predicting to between-person variability of biomarkers of cardiovascular diseases.

}, keywords = {Biomarkers, Couples, health, Older Adults, Optimism, pessimism}, issn = {2044-8287}, doi = {10.1111/bjhp.12466}, author = {Arbel, Reout and Dikla Segel-Karpas and William J. Chopik} } @article {11338, title = {Self-Related Views of Aging After Age 50: The Long-Term Effects of Poor Health in Childhood}, journal = {Innovation in Aging}, volume = {4}, year = {2020}, pages = {326}, abstract = {Age stereotypes and expectations about one{\textquoteright}s own aging commence in childhood but most research focuses on predictive associations with midlife health behaviors, later-life chronic conditions, and longevity. Surprisingly little is known about the role of poor childhood health in these associations. This study aims to fill this gap. Using data from the Health and Retirement Study (HRS: N = 5807; aged 50-98), we investigated whether diagnosed chronic illness before age 16 and self-rated childhood health predict late-life self-perceptions of aging (SPA) and subjective age discrepancy (AD). We conducted multivariate multiple regressions to determine the joint and unique effects of childhood health. Models included controls for current health (functional limitations), memory status, and demographic covariates (age, gender, race/ethnicity, marital status, and education). Multivariate tests (Pillai{\textquoteright}s trace) revealed that both childhood health indicators were significant predictors. Over and above all covariates and the covariation of the two views of one{\textquoteright}s own aging, univariate models showed that the number of childhood diagnoses was significant predictor of AD (p < .007) but not for SPA. In contrast, self-rated childhood health was a significant predictor of SPA (p < .001) but not for AD. This study provides new insight into precursors of self-evaluations of aging. Whereas childhood diagnoses of chronic illness attenuated the extent that individuals felt younger than their actual age, ratings of poor childhood health enhanced negative SPA. The non-normative experience of poor health in early life is a lifelong foundation for both late life beliefs and health.}, keywords = {Childhood, health, Self-Assessment}, isbn = {2399-5300}, doi = {10.1093/geroni/igaa057.1045}, author = {Jacqui Smith and Larkina, Marina} } @article {10794, title = {Sleep Disturbance Mediates the Association Between Loneliness and Health in Older Americans}, journal = {International Journal of Behavioral Medicine}, year = {2020}, abstract = {Background As the research documenting loneliness as a risk factor for morbidity and mortality continues to grow, it becomes increasingly critical to understand the mechanics of this relationship. This study assessed whether sleep disturbance mediates the relationship between loneliness and health. Method Data came from the 2006, 2010, and 2014 waves of the Health and Retirement Study, a longitudinal study of older Americans; participants >= 65 who completed the Psychosocial and Lifestyle Questionnaire in 2006 were included (n = 5067). Measures include the Hughes loneliness scales, a modified version of the Jenkins sleep scale, and self-reported health. Cross-lagged mediation models (i.e., path analysis) were used to model the relationships between loneliness, sleep disturbance, and self-reported health over the 8-year span. Results Loneliness predicted subsequent sleep disturbance, which in turn predicted subsequent self-reported health. Moreover, there was evidence of both direct and indirect effects (via sleep disturbance) of loneliness on self-reported health. These effects remained after controlling for demographics, isolation, and depression. Conclusion Sleep disturbance partially mediates the relationship between loneliness and self-reported health over 8 years. These findings are not attributable to isolation or depression. Further research is necessary to develop and assess a more comprehensive model of how loneliness shapes health. This study indicates that targeting sleep disturbance may mitigate the health risks of loneliness in older Americans.}, keywords = {Aging, health, Loneliness, Older Adults, Sleep}, isbn = {1532-7558}, doi = {10.1007/s12529-020-09897-2}, author = {Sarah C. Griffin and Samantha N Mladen and Williams, Allison Baylor and Dautovich, Natalie D. and Lageman, Sarah K. and Joseph M. Dzierzewski and Paul B. Perrin and Bruce D. Rybarczyk} } @conference {11348, title = {Social Security Eligibility Age and the Health Outcomes and Health Behaviors of the Elderly}, booktitle = {113th Annual Conference on Taxation}, year = {2020}, publisher = {National Tax Association}, organization = {National Tax Association}, abstract = {I use a regression discontinuity design to investigate the causal relationship between Social Security eligibility age and the health outcomes and health behaviors of elderly individuals. Specifically, I examine changes when individuals attain the Earliest Eligibility Age (EEA) of 62. Given the aging of the U.S. population and the heated debate about whether the EEA should be increased to solve Social Security{\textquoteright}s fiscal imbalance problem, understanding such a relationship is important. I use data from the Health and Retirement Study (HRS) to explore this relationship. I find that at the EEA, the probability of receiving Social Security benefits increases by over 30 percentage points. However, there is no evidence that the EEA impacts health. This finding coincides with the idea that health is a stock, the change in which is slow. There is little evidence that the EEA influences mental health. I also show suggestive evidence that when people reach the EEA, they reduce their smoking. I find that males drink more frequently when they reach the EEA. Retirement might be one of the main mechanisms behind the changes in health behaviors. }, keywords = {health, Health Behavior, Social Security, Social Security Benefits, Social Security Eligibility}, url = {https://nta.confex.com/nta/2020/meetingapp.cgi/Paper/3775}, author = {Jun Hyun Yun} } @mastersthesis {10851, title = {Three Papers on Social Participation over the Life Course}, volume = {Doctor of Philosophy}, year = {2020}, school = {University of Michigan}, address = {Ann Arbor}, abstract = {Social participation encapsulates the involvement and participation of individuals in social activities (e.g., informal social gatherings, affiliations to community organizations), and has long been a subject of interest for sociologists. Recent scholarship has since established a strong positive association between social participation and health, suggesting that social participation can buffer the negative health effects of stress and promote healthy behavior through social influence, among other pathways. There are however three key limitations of prior research. First, perhaps driven by anxieties around rising health costs of an aging population, studies on social participation and health overwhelmingly focus on older populations. Second, many are interested in examining societal change in social connectedness over time, but given the use of repeated cross-section data, are at risk of conflating age and cohort effects. Third, research often treats social participation solely as a characteristic of the individual, even though the social participation of proximate others may also affect one{\textquoteright}s own outcomes {\textendash} e.g., spouses may be influenced by their friends{\textquoteright} health behavior, and in turn influence their partners. We know very little about how social participation operates in the context of interdependent individuals such as spousal dyads. This dissertation addresses existing gaps in the literature by applying the life course perspective to the study of social participation and health. I do this through a series of papers that (1) examine how social participation varies over age and cohort; (2) establish how the association between social participation and health changes with age; and (3) investigate how social participation and health is associated in the context of marital dyads. The first paper uses data from the Americans{\textquoteright} Changing Lives (ACL) study, a longitudinal dataset collected from the same individuals over 25 years (1986-2011). I employ a Multivariate Bayesian generalized additive mixed model to estimate age-cohort trajectories of formal and informal social participation. I find that changes in social participation by age and cohort are less drastic than commonly assumed; older adults seem to compensate for age-graded declines in informal social participation by increasing their formal social participation. Any anxiety around societal declines in social connectedness precipitated by past studies is overblown {\textendash} later-born cohorts seem to have similar (or greater) levels of social participation compared to older cohorts. In the second paper, I use data from ACL once again, employing growth curve models to estimate how the association between social participation and health changes with age. I find that formal social participation (e.g., attendance and engagement in community groups and organizations) becomes more important for males as they age {\textendash} the negative association between formal social participation and depressive symptoms becomes stronger in old age. Using data from the Health and Retirement Study, the final paper utilizes actor-partner interdependence models to examine social participation and mental health among married couples. I find evidence supporting the hypothesis that spousal social participation is positively associated with one{\textquoteright}s own mental health (i.e., partner effects), even after accounting for interdependencies in mental health between spouses. Overall, the dissertation applies life course principles to provide a more comprehensive view of social participation and its associations with health outcomes. Findings suggest that social participation in late life should be considered alongside social participation earlier in the life course, and that the social participation of proximate others can also influence our own health outcomes.}, keywords = {health, life course perspective, Social participation}, url = {https://deepblue.lib.umich.edu/bitstream/handle/2027.42/155235/shanang_1.pdf?sequence=1\&isAllowed=y}, author = {Ang, Shannon} } @mastersthesis {11108, title = { Title Living Longer but Unhealthier? Spouse Caregivers{\textquoteright} Health and Mortality in the US (2004-2014)}, volume = {Doctor of Philosophy}, year = {2020}, school = {Miami University}, address = {Oxford, OH}, abstract = {This longitudinal population-based study addressed the paradox of poorer health and lower mortality risk among spouse caregivers by proposing and examining the "living- longer- but- unhealthier" hypothesis. Consistent with the stress-buffering effect of caregiving, this hypothesis proposes that the survival advantages of caregiving can be accompanied by a higher prevalence of poorer health. A caregiving mortality advantage might be accompanied by poorer health because caregiving can have a buffering effect by providing prosocial protective effects against stress. The present study sought to better elucidate this paradox by hypothesizing that caregiving intensity may buffer the impact of the positive aspects of spousal caregiving on their mortality such that the mortality advantage does not emerge among spouses with more demanding caregiving duties. This study utilized the Bayesian multistate life table technique to examine the "living- longer- but- unhealthier" hypothesis by estimating total life expectancy (TLE), healthy life expectancy (HLE), and the proportion of remaining life to be spent healthy (PLE) among spouse caregivers with low intense caregiving duties, those with more demanding caregiving duties and noncaregiver peers. This study used six waves of the Health and Retirement Study (HRS) from 2004 to 2014. In general, the analyses revealed partial support for the "living- longer- but- unhealthier" hypothesis for the subset of spouse caregivers who provided relatively less intense caregiving duties (operationalized as less than 14 hours of care per week). That is, spouse caregivers with less intense caregiving duties could expect to live longer and healthier than married noncaregivers. In contrast, spouse caregivers with more intense caregiving responsibilities tended to experience relatively similar total and healthy life expectancy when compared to married noncaregivers. This suggests that low-intensity, but not high-intensity spousal caregiving had protective effects. More time-intensive spousal caregiving may threaten caregivers{\textquoteright} health and mortality advantages by increasing caregivers{\textquoteright} anxiety, depression and psychological distress through a complex process involving objective, but more importantly, subjective aspects of the caregiving process. Also, more time-intensive spousal caregiving may ebb the potentially positive aspects of caregiving due to its emotionally taxing nature. For example, high-intensity caregivers are more likely to make treatment decisions for the family members for whom they care. The mechanisms and processes whereby the primary stressor of caregiving intensity may erode the potentially positive aspects of caregiving were discussed through concepts suggested in the stress press model (i.e., background and context, job-related stress, religiosity).}, keywords = {health, Mortality, multistate life table, spousal caregiving}, url = {http://rave.ohiolink.edu/etdc/view?acc_num=miami1597417799087383}, author = {Mehri, Nader} } @article {11898, title = {Use of Health Savings Accounts Among US Adults Enrolled in High-Deductible Health Plans.}, journal = {JAMA Network Open}, volume = {3}, year = {2020}, pages = {e2011014}, abstract = {

Importance: Health savings accounts (HSAs) can be used by enrollees in high-deductible health plans (HDHPs) to save for health care expenses before taxes. Expansion of and encouraging contributions to HSAs have been centerpieces of recent federal legislation. Little is known about how US residents who may be eligible for HSAs are using them to save for health care.

Objective: To determine which patients who may be eligible for an HSA do not have one and what decisions patients with HSAs make about contributing to them.

Design, Setting, and Participants: This cross-sectional national survey assessed an online survey panel representative of the US adult population. Adults aged 18 to 64 years and enrolled in an HDHP for at least 12 months were eligible to participate. Data were collected from August 26 to September 19, 2016, and analyzed from November 1, 2019, to April 30, 2020.

Main Outcomes and Measures: Prevalence of not having an HSA or not making HSA contributions in the last 12 months and reasons for not making the HSA contributions.

Results: Based on data from 1637 individuals (American Association of Public Opinion Research response rate 4, 54.8\%), half (50.6\% [95\% CI, 47.7\%-53.6\%]) of US adults in HDHPs were female, and most were aged 36 to 51 (35.7\% [95\% CI, 32.8\%-38.6\%]) or 52 to 64 (36.8\% [95\% CI, 34.1\%-39.5\%]) years. Approximately 1 in 3 (32.5\% [95\% CI, 29.8\%-35.3\%]) did not have an HSA. Those who obtained their health insurance through an exchange were more likely to lack an HSA (70.3\% [95\% CI, 61.9\%-78.6\%]) than those who worked for an employer that offered only 1 health insurance plan (36.5\% [95\% CI, 30.9\%-42.1\%]; P < .001). More than half of individuals with an HSA (55.0\% [95\% CI, 51.1\%-58.8\%]) had not contributed money into it in the last 12 months. Among HDHP enrollees with an HSA, those with at least a master{\textquoteright}s degree (46.1\% [95\% CI, 38.3\%-53.9\%]; P = .02) or a high level of health insurance literacy (47.3\% [95\% CI, 40.7\%-54.0\%]; P = .03) were less likely to have made no HAS contributions. Common reasons for not contributing to an HSA included not considering it (36.8\% [95\% CI, 30.8\%-42.8\%]) and being unable to afford saving for health care (31.9\% [95\% CI, 26.2\%-37.6\%]).

Conclusions and Relevance: These findings suggest that many US adults enrolled in an HDHP lack an HSA, and few with an HSA saved for health care in the last year. Targeted interventions should be explored by employers, health plans, and health systems to encourage HSA uptake and contributions among individuals who could benefit from their use.

}, keywords = {Costs and Cost Analysis, Deductibles and Coinsurance, Female, health, Insurance, Male, Medical Savings Accounts}, issn = {2574-3805}, doi = {10.1001/jamanetworkopen.2020.11014}, author = {Jeffrey T Kullgren and Cliff, Elizabeth Q and Krenz, Christopher and Brady T. West and Helen G Levy and A. Mark Fendrick and Angela Fagerlin} } @article {11165, title = {Why Does Consumption Fluctuate in Old Age and How Should the Government Insure it?}, number = {40}, year = {2020}, institution = {Federal Reserve Bank of Minneapolis}, address = {Minneapolis, MN}, abstract = {In old age, consumption can fluctuate because of shocks to available resources and because health shocks affect utility from consumption. We find that even temporary drops in income and health are associated with drops in consumption and most of the effect of temporary drops in health on consumption stems from the reduction in the marginal utility from consumption that they generate. More precisely, after a health shock, richer households adjust their consumption of luxury goods because their utility of consuming them changes. Poorer households, instead, adjust both their necessary and luxury consumption because of changing resources and utility from consumption.}, keywords = {CAMS, health, Income}, doi = {https://doi.org/10.21034/iwp.40}, author = {Richard Blundell and Commault, Jeanne and Borella, Margherita and Mariacristina De Nardi} } @article {10848, title = {Why Does Consumption Fluctuate in Old Age and How Should the Government Insure It?}, number = {27348}, year = {2020}, institution = {The National Bureau of Economic Research}, address = {Cambridge}, abstract = {In old age, consumption can fluctuate because of shocks to available resources and because health shocks affect utility from consumption. We find that even temporary drops in income and health are associated with drops in consumption and most of the effect of temporary drops in health on consumption stems from the reduction in the marginal utility from consumption that they generate. More precisely, after a health shock, richer households adjust their consumption of luxury goods because their utility of consuming them changes. Poorer households, instead, adjust both their necessary and luxury consumption because of changing resources and utility from consumption.}, keywords = {consumption, Finance, health}, url = {https://www.nber.org/papers/w27348}, author = {Richard Blundell and Borella, Margherita and Commault, Jeanne and Mariacristina De Nardi} } @article {11201, title = {Why Does the Importance of Education for Health Differ across the United States?}, year = {2020}, institution = {American Sociological Association}, abstract = {The positive association between educational attainment and adult health ({\textquotedblleft}the gradient{\textquotedblright}) is stronger in some areas of the United States than in others. Explanations for the geographic pattern have not been rigorously investigated. Grounded in a contextual and life-course perspective, the aim of this study is to assess childhood circumstances (e.g., childhood health, compulsory schooling laws) and adult circumstances (e.g., wealth, lifestyles, economic policies) as potential explanations. Using data on U.S.-born adults aged 50 to 59 years at baseline (n = 13,095) and followed for up to 16 years across the 1998 to 2014 waves of the Health and Retirement Study, the authors examined how and why educational gradients in morbidity, functioning, and mortality vary across nine U.S. regions. The findings indicate that the gradient is stronger in some areas than others partly because of geographic differences in childhood socioeconomic conditions and health, but mostly because of geographic differences in adult circumstances such as wealth, lifestyles, and economic and tobacco policies.}, keywords = {Education, health}, url = {https://journals.sagepub.com/doi/full/10.1177/2378023119899545}, author = {Blakelee R Kemp and Jennifer Karas Montez} } @article {10383, title = {Aging in the USA: Similarities and disparities across time and space}, year = {2019}, month = {10/2019}, institution = {University of Goettingen (Gottingen)}, abstract = {We study biological aging of elderly U.S. Americans born 1904-1966. We use thirteen waves of the Health and Retirement Study and construct a health deficit index as the number of health deficits present in a person measured relative to the number of potential deficits. We find that, on average, Americans develop 5 percent more health deficits per year, that men age slightly faster than women, and that, at any age above 50, Caucasians display significantly less health deficits than African Americans. We also document a steady time trend of health improvements. For each year of later birth, health deficits decline on average by about 1 percent. This health trend is about the same across regions and for men and women, but significantly lower for African Americans compared to Caucasians. In non-linear regressions, we find that regional differences in aging follow a particular regularity, akin to the compensation effect of mortality. Health deficits converge for men and women and across American regions and suggest a life span of the American population of about 97 years.}, keywords = {Aging, health, health deficit index, United States}, doi = {https://dx.doi.org/10.2139/ssrn.3465597}, author = {Ana Lucia Abeliansky and Devin Erel and Holger Strulik} } @article {2019-63611-00120191017, title = {Change in weight and personality in middle-aged and older adults.}, journal = {Psychology \& Health}, year = {2019}, abstract = {Objective: Personality is associated with weight change and the development of obesity across adulthood. The present study examines whether significant weight change, including weight loss and weight gain, is related to personality change in a large longitudinal sample of middle-aged and older adults.Design: Participants were adults aged 50{\textendash}92 years (N > 5000; 59\% women, Mean age= 65.51, SD= 8.20) drawn from the Health and Retirement Study (HRS). Personality, demographic, health and staff assessed weight and height were obtained at baseline and 8 years later.Main Outcome Measures: Personality traits.Results: Both weight loss and weight gain greater than 10\% of baseline weight were related to a steeper decline in extraversion, openness and conscientiousness. Weight loss was further associated with the maintenance of neuroticism and to a steeper decline in agreeableness. This overall pattern of personality change was also associated with both unhealthy and healthy weight change. The associations were not moderated by BMI and generally remained significant after accounting for disease burden.Conclusion: The present study provides new evidence that both weight loss and weight gain are related to change in personality.}, keywords = {health, longitudinal, No terms assigned, Personality, weight}, issn = {0887-0446}, doi = {10.1080/08870446.2019.1679372}, url = {https://www.ncbi.nlm.nih.gov/pubmed/31631712}, author = {Yannick Stephan and Angelina R Sutin and Antonio Terracciano} } @article {10231, title = {The effect of education on health: evidence from national compulsory schooling reforms}, journal = {SERIEs}, year = {2019}, month = {2019/08/01}, chapter = {1-21}, abstract = {This paper sheds light on the causal relationship between education and health outcomes. We combine three surveys (SHARE, HRS and ELSA) that include nationally representative samples of people aged 50 and over from fourteen OECD countries. We use variation in the timing of educational reforms across these countries as an instrument for education. Using IV-probit models, we find causal evidence that more years of education lead to better health. One additional year of schooling is associated with 6.85 percentage points (pp) reduction in reporting poor health and 3.8 pp and 4.6 pp reduction in having self-reported difficulties with activities of daily living (ADLs) and instrumental ADLs, respectively. The marginal effect of education on the probability of having a chronic illness is a 4.4 pp reduction. This ranges from a reduction of 3.4 pp for heart disease to a 7 pp reduction for arthritis. The effects are larger than those from a probit model that does not control for the endogeneity of education. However, we do not find conclusive evidence that education reduces the risk of cancer, stroke and psychiatric illness.}, keywords = {Causality, Compulsory schooling laws, Education, health}, isbn = {1869-4195}, doi = {https://doi.org/10.1007/s13209-019-0201-0}, url = {https://link.springer.com/article/10.1007/s13209-019-0201-0}, author = {Raquel Fonseca and Pierre-Carl Michaud and Yuhui Zheng} } @mastersthesis {10499, title = {Essays on health outcomes, economic wellbeing and mismeasured discrete health variables}, volume = {PhD}, year = {2019}, pages = {109}, school = {Rutgers}, abstract = {This thesis studies the labor supply effects of health shocks for aging Americans. To address the mismeasured binary health variables used in the labor supply equation, this thesis develops a new theoretical approach to the non-classical measurement error. In addition to Chapter 1 which provides an overview of the thesis, there are three primary chapters explaining the theoretical development and the empirical studies. Chapter 2 theoretically addresses the estimation bias due to the misclassification of a binary regressor in treatment models. Different from the assumption of a valid instrument in the literature, this paper allows the potential instrument to be correlated with the measurement error. In such a general setting, I propose an estimator relying only on those extreme observations that are free of misclassification. This proposed estimator is proven to have large sample properties and much better performance than OLS and traditional IV estimates in finite samples. Chapter 3 uses the method proposed in Chapter 2 to handle the binary, misclassified health variable in studying the labor supply effects of health shocks. Extracting information on true health from objective health measures, for example functional limitations ii and doctors{\textquoteright} diagnoses, this new method relies on such information to dynamically select observations that are free of misclassification. Using the 2012 wave of the Health and Retirement Study (HRS), this paper primarily examines the labor supply effects of health shocks for men and women aged 45-61. This study finds that individuals in middle age will greatly reduce their labor supply when experiencing health shocks and that the estimation results are very sensitive to the health measures used. In Chapter 4, I examine how an individual{\textquoteright}s labor supply responds in the short- and long-run to a negative shock to her spouse{\textquoteright}s health. I propose an optimal instrument strategy with fixed effects to study labor supply effects of spousal health shocks. Analysis of the 1996-2012 data from the Health and Retirement Study (HRS) indicates that in the short run, both husbands and wives change their labor supply very little when their spouses become ill. However, in the long run, husbands adjust their labor supply in response to their wives{\textquoteright} health problems. As the duration of wives{\textquoteright} health problems increases by two years, husbands work 165 fewer hours per year. }, keywords = {Economics, health, Well-being}, url = {https://rucore.libraries.rutgers.edu/rutgers-lib/61795/}, author = {Ning, Li} } @mastersthesis {10285, title = {Exploring Ethnoracial Disparities in Planning for End-of-Life Care}, volume = {PhD}, year = {2019}, note = {Copyright - Database copyright ProQuest LLC; ProQuest does not claim copyright in the individual underlying works; Last updated - 2019-04-12}, pages = {113}, school = {University at Buffalo}, type = {phd}, address = {Buffalo, NY}, abstract = {Over the last 35 years, high profile court cases have drawn attention to planning for end-of-life care. Despite strong opinions about life-sustaining medical treatment, expressed through public protests and political debates, the majority of Americans do not have advance directives, which state preferences for end-of-life care. Rates are significantly lower for blacks and Hispanics than for non-Hispanic whites; however, the reasons for these disparities remain unclear. Using data from the 2012 and 2014 waves of the Health and Retirement Study (HRS), I examine ethnoracial differences in completing three types of advance care planning: (1) having discussions about life-sustaining treatment preferences; (2) designating a proxy{\textemdash}legally called a durable power of attorney for health care (DPAHC){\textemdash}to make end-of-life care decisions on one{\textquoteright}s behalf; and (3) writing a living will that states treatment preferences. Specifically, I conduct an exploratory descriptive analysis, estimate logistic regression models, and apply Fairlie{\textquoteright}s decomposition technique{\textemdash}an extension of the Blinder-Oaxaca decomposition method for nonlinear models{\textemdash}to investigate the likelihood of planning for end-of-life care and to quantify the reasons for ethnoracial differences in advance care planning among non-Hispanic black, non-Hispanic white, and Hispanic adults age 65 and older. Findings suggest that education, wealth, income, and having a last will and testament predict the likelihood of and account for most of the explained ethnoracial gap in advance care planning. This study helps to improve our understanding of population characteristics that influence advance care planning. Additionally, while research generally presumes that advance care planning is beneficial, this study also discusses the potential flaws with this view.}, keywords = {0351:Gerontology, 0573:Public health, 0626:Sociology, Advance care planning, Advance directives, Aging, End of life care, Ethnoracial difference, Gerontology, health, Health and environmental sciences, Public Health, Social Sciences, Sociology}, isbn = {9780438944572}, url = {https://ubir.buffalo.edu/xmlui/handle/10477/79346}, author = {Tompkins,Joanne} } @article {10508, title = {Gradual Change, Homeostasis, and Punctuated Equilibrium: Reconsidering Patterns of Health in Later Life}, journal = {Demography}, volume = {56}, year = {2019}, note = {Copyright - Demography is a copyright of Springer, (2019). All Rights Reserved; Last updated - 2020-01-02}, month = {12}, pages = {2323-2347}, abstract = {Longitudinal methods aggregate individual health histories to produce inferences about aging populations, but to what extent do these summaries reflect the experiences of older adults? We describe the assumption of gradual change built into several influential statistical models and draw on widely used, nationally representative survey data to empirically compare the conclusions drawn from mixed-regression methods (growth curve models and latent class growth analysis) designed to capture trajectories with key descriptive statistics and methods (multistate life tables and sequence analysis) that depict discrete states and transitions. We show that individual-level data record stasis irregularly punctuated by relatively sudden change in health status or mortality. Although change is prevalent in the sample, for individuals it occurs rarely, at irregular times and intervals, and in a nonlinear and multidirectional fashion. We conclude by discussing the implications of this punctuated equilibrium pattern for understanding health changes in individuals and the dynamics of inequality in aging populations.}, keywords = {Aging, Demography, Equilibrium, health, Health problems, Homeostasis, Inequality, Life stage transitions, Life Tables, Longitudinal analysis, Multistate, Older people, Psychology, Sequence analysis, Statistical models, trajectory}, isbn = {00703370}, url = {https://www.ncbi.nlm.nih.gov/pubmed/31713126}, author = {Michal Engelman and Heide Jackson} } @article {GEIGER201918, title = {The growing American health penalty: International trends in the employment of older workers with poor health}, journal = {Social Science Research}, volume = {82}, year = {2019}, pages = {18 - 32}, abstract = {Many countries have reduced the generosity of sickness and disability programs while making them more activating {\textendash} yet few studies have examined how employment rates have subsequently changed. We present estimates of how employment rates of older workers with poor health in 13 high-income countries changed 2004{\textendash}7 to 2012{\textendash}15 using HRS/SHARE/ELSA data. We find that those in poor health in the USA have experienced a unique deterioration: they have not only seen a widening gap to the employment rates of those with good health, but their employment rates fell per se. We find only for Sweden (and possibly England) signs that the health employment gap shrank, with rising employment but stable gaps elsewhere. We then examine possible explanations for the development in the USA: we find no evidence it links to labor market trends, but possible links to the USA{\textquoteright}s lack of disability benefit reform and wider economic trends.}, keywords = {Disability, Employment, health, Panel data, Social Security, Welfare}, issn = {0049-089X}, doi = {https://doi.org/10.1016/j.ssresearch.2019.03.008}, url = {http://www.sciencedirect.com/science/article/pii/S0049089X1830560X}, author = {Ben Baumberg Geiger and Ren{\'e} B{\"o}heim and Thomas Leoni} } @article { ISI:000501770800007, title = {Health disparities and the socioeconomic gradient in elderly life-cycle consumption}, journal = {JOURNAL OF THE ECONOMICS OF AGEING}, volume = {14}, year = {2019}, pages = {UNSP 100176}, type = {Article}, abstract = {We quantify the importance of health disparities in explaining consumption differences at older ages by estimating a panel VAR model of elderly consumption, health, and mortality using data from the Health and Retirement Study. We use the estimated model and initial joint distribution of health and consumption to simulate elderly life-cycle paths and construct a measure of the net present value of expected remaining lifetime consumption at age sixty (NPVC). We first document a steep education gradient in elderly lifetime consumption. We then decompose the gradient in NPVC to quantify the effect of 1) differences in the health distribution at age sixty and 2) differential health and mortality transitions after age sixty. Our decomposition results suggest that roughly 10-12\% of the education gradient in NPVC at age sixty could be closed by eliminating elderly health differences.}, keywords = {Aging, Consumption inequality, Education gradient, health, Life-cycle}, issn = {2212-828X}, doi = {10.1016/j.jeoa.2018.11.001}, author = {Ray Miller and Bairoliya, Neha and Canning, David} } @mastersthesis {10236, title = {Loneliness and Sleep Disturbance in Older Americans}, volume = {Doctor of Philosophy}, year = {2019}, month = {2019}, pages = {92}, school = {Virginia Commonwealth University}, address = {Richmond, VA}, abstract = {Loneliness is a risk factor for premature mortality but the mechanics of this relationship remain obscure. A potential mechanism is sleep disturbance. The present study aimed to examine the association between loneliness and sleep disturbance, evaluate loneliness as a risk factor for sleep disturbance and vice-versa, model effects between loneliness and sleep disturbance over time, and evaluate a mediation model of loneliness, sleep disturbance, and health. Data came from the 2006-2012 waves of the Health and Retirement Study, a nationally-representative study of older Americans; participants > 65 were included (n=11,400). Analyses included (i) linear regressions accounting for complex sampling and (ii) path analysis (cross-lagged panel and mediation models). Loneliness and sleep disturbance were correlated and were risk factors for one another. Cross-lagged panel models showed reciprocal effects between loneliness and sleep disturbance. Cross-lagged mediation models showed that loneliness predicted subsequent sleep disturbance, which in turn predicted poor self-reported health. Moreover, there was evidence of a direct and indirect effect of loneliness on sleep disturbance. All associations were weakened{\textemdash} but remained{\textemdash}when accounting for demographics, isolation, and depression. Collectively, these findings are consistent with the theory that sleep disturbance is a mechanism through which loneliness damages health. However, effects between loneliness and sleep are reciprocal, rather than unidirectional. Moreover, longitudinal effects were very small. Further research is necessary to speak to causality, assess daily associations between loneliness and sleep, assess a comprehensive model of the mechanics of loneliness and health, and examine loneliness and sleep in the context of other factors.}, keywords = {Aging, Clinical Psychology, health, Loneliness, mechanisms, Sleep}, url = {https://scholarscompass.vcu.edu/etd/5965/}, author = {Sarah C. Griffin} } @article {11138, title = {Reciprocal Effects Between Loneliness and Sleep Disturbance in Older Americans.}, journal = {Journal of Aging and Health}, year = {2019}, abstract = {

To model the relationship between loneliness and sleep disturbance over time. : Data came from the Health and Retirement Study (2006, 2010, 2014 waves; age >= 65 years; = 5,067). Loneliness was measured via the Hughes Loneliness Scale and sleep disturbance via a four-item scale assessing sleep and restedness. Cross-lagged panel modeling (path analysis) was used to jointly examine reciprocal effects between loneliness and sleep disturbance. : Higher loneliness correlated with higher sleep disturbance at baseline. There was evidence of reciprocal effects between loneliness and sleep across timepoints. These associations overall remained when accounting for demographics, objective isolation, and depression. : Although causality cannot be established, the findings indicate that the relationship between loneliness and sleep disturbance is bidirectional. This requires revision to the current theory on sleep disturbance as a mechanism for the relationship between loneliness and health and indicates that effective treatment of sleep disturbance may reduce loneliness.

}, keywords = {health, insomnia, Loneliness, Older Adults, Sleep}, issn = {1552-6887}, doi = {10.1177/0898264319894486}, author = {Sarah C. Griffin and Williams, Allison Baylor and Samantha N Mladen and Paul B. Perrin and Joseph M. Dzierzewski and Bruce D. Rybarczyk} } @article {10229, title = {SeaTE: Subjective ex ante Treatment Effect of Health on Retirement}, journal = {National Bureau of Economic Research Working Paper Series}, volume = {No. 26087}, year = {2019}, note = {Author contact info:Pamela GiustinelliDepartment of EconomicsBocconi UniversityMilan, ItalyE-Mail: pamela.giustinelli@gmail.comMatthew D. ShapiroDepartment of EconomicsUniversity of Michigan611 Tappan StAnn Arbor, MI 48109-1220Tel: 734/764-5419Fax: 734 764-2769E-Mail: shapiro@umich.edu}, month = {2019}, abstract = {The Subjective ex ante Treatment Effect is the difference between the probabilities of an outcome conditional on a treatment. The SeaTE yields ex ante causal effects at the individual level. The paper gives an interpretation in two workhorse econometric frameworks: potential outcomes and dynamic programming. It finds large effect heterogeneity of health on work in two surveys of older workers, the VRI and the HRS. It shows how reduced-form estimates of health on work are biased when there is unobserved heterogeneity in taste for work. Using the VRI{\textquoteright}s panel structure, it validates the elicited conditional probabilities of work given health.}, keywords = {health, Retirement, SeaTE}, doi = {10.3386/w26087}, url = {http://www.nber.org/papers/w26087}, author = {Giustinelli, Pamela and Matthew D. Shapiro} } @mastersthesis {10253, title = {Self-Perceptions of Aging and Health: The Embodiment of Age Stereotypes.}, volume = {Ph.D. Psychology}, year = {2019}, month = {10/2019}, pages = {181}, school = {University of Michigan}, address = {Ann Arbor, MI}, abstract = {Age stereotypes are pervasive in contemporary American society. A growing body of research has shown that the internalization of societal age stereotypes can affect older adults{\textquoteright} self-perceptions of aging (SPA), or attitudes towards their own aging process, in ways that can have significant implications for health and well-being. Based on Levy{\textquoteright}s stereotype embodiment theory, this dissertation used data from the Health and Retirement Study to examine the behavioral, biological, and psychological processes that potentially underlie the relationship between SPA and health among older US adults. On a behavioral level, Study 1 found that, over a 1-year follow-up, individuals with negative SPA were more likely to delay necessary medical care and report more barriers to care, such as limited access to transportation and disliking going to the doctor. On a biological level, Study 2 considered the association between SPA, perceived discrimination, and changes in cystatin c (a biomarker of kidney function). Over the 4-year follow-up, having more negative SPA was associated with larger increases in cystatin c (e.g., worse kidney functioning) among those who reported being the target of discrimination. On a psychological level, Study 3 investigated the relationship between two different perceptions of the self, self-perceptions of grip strength and SPA, in predicting 4-year change in mobility limitations among adults over age 65. Individuals with more positive SPA had fewer mobility limitations four years later, even after adjusting for measured/perceived grip strength and other risk factors. Having more positive SPA, however, was only predictive of fewer mobility problems among respondents who also perceived their grip strength to be strong, highlighting the importance of considering both domain-specific and domain-general self-perceptions when designing interventions to improve functional health. Together, these studies extend the literature linking SPA and health by investigating proposals about three underlying processes. The final chapter discusses the implications of study findings, with a special focus on the design of interventions to promote more positive attitudes toward aging and the need to change age-related attitudes among health care professionals.}, keywords = {Aging, health, Self-perception, Stereotypes}, url = {https://deepblue.lib.umich.edu/handle/2027.42/151399?show=full}, author = {Jennifer K Sun} } @mastersthesis {10424, title = {Trajectories and Patterns of Wealth in Later Life: Implications for Physical, Mental, and Cognitive Health}, volume = {PhD}, year = {2019}, school = {Washington University in St. Louis}, abstract = {This study aims to contribute to our understanding of the longitudinal link between wealth and health in later life. Prior research on the wealth-health relationship has focused on general households, with little consideration for older adults. Further, several gaps are identified in the literature. For example, studies often utilize a shorter window of observation and treat wealth as a static measure without considering the trajectory and the heterogeneity of wealth over time. In addition, prior studies often explore the impact of wealth on a single aspect of health, ignoring the {\textquotedblleft}codependent{\textquotedblright} nature of health at older ages. Further, the impacts of life course factors on the development of wealth are not often tested, and such effects are not accounted for when examining the {\textquotedblleft}wealth-health{\textquotedblright} nexus, creating issues of endogeneity. Using life-cycle hypothesis, cumulative dis/advantage model, and asset-based welfare theory, this study addresses these issues by exploring how life course factors relate to wealth trajectory in later life, and investigating the longitudinal relationship between wealth and multidimensional health when life course factors are simultaneously modeled. Using latent growth curve modeling (LGCM) and latent growth mixture modeling (LGMM) via the structural equation modeling approach and generalized propensity score analysis, this study analyzes data from six biennial waves of the Health and Retirement Study (HRS), a national representative panel study of Americans aged 51 and older. This study has three research aims. It first explores the trajectory of wealth of older Americans between 2004 and 2014, and examines how life course factors correlate with wealth trajectory. Models of quadratic function and piece-wise function that allow the testing of the spline in the wealth trajectory are used as additional tests to examine the impact of the 2008 economic recession on the wealth trajectory. Second, physical, mental, and cognitive health are entered in the model to examine how health outcomes individually and jointly respond to the wealth trajectory. Finally, it uses LGMM to identify heterogeneous patterns in both wealth and health, and employs generalized propensity score analysis to explore the longitudinal associations between wealth patterns and health patterns when the effect of life course factors on wealth were modeled. This study contributes to the field methodologically and substantively. It uses novel methods to explore the trajectory and patterns of wealth in later life and examines the longitudinal wealth-health nexus by accounting for endogeneity. It offers strong evidence about the relationship between wealth and health, and provides policy and research implications for strengthening economic security and positive health at older ages.}, keywords = {health, Wealth}, url = {https://openscholarship.wustl.edu/art_sci_etds/1892/}, author = {Chen, Yu-shih} } @article {10501, title = {Trends in Health and Mortality Inequalities in the United States}, number = {WP 2019-401}, year = {2019}, month = {09/2019}, institution = {Michigan Retirement Research Center}, address = {Ann Arbor, MI}, abstract = {Recent literature has documented a widening gap in mortality in the United States between individuals with high socioeconomic status (SES) and low SES. An important question is whether this trend will continue. In this paper we document trends and inequalities in the health status at ages 54 to 60 of individuals born between 1934 and 1959. We do so by using detailed subjective and objective measures of health in the Health and Retirement Study to examine contributors to mortality inequality and to forecast life expectancy. We found that the health of individuals 54 to 60 years old has generally declined in recent years. In particular, we found large increases in obesity rates, notable increases in diabetes and reported levels of pain, and lower self-reported health and subjective survival probabilities. We also found strong evidence for increasing health inequalities, as the health of individuals in these cohorts with high SES remained largely stable while that for individuals with low SES declined. When we forecast life expectancies using these predictor variables, as well as gender- and SES-specific time trends, we predict overall life expectancy to increase further. However, the increase is concentrated among high SES individuals, suggesting growing mortality inequality. Results are similar among men and women. }, keywords = {health, Inequality, Mortality}, url = {https://mrdrc.isr.umich.edu/pubs/trends-in-health-and-mortality-inequalities-in-the-united-states/}, author = {P{\'e}ter Hudomiet and Michael D Hurd and Susann Rohwedder} } @mastersthesis {11233, title = {Unraveling the Relationship between Education and Health: Genetic Controls, Heterogeneity across Sociodemographic Groups, and Variation across Biomarkers of Health Risk}, volume = {Doctor of Philosophy}, year = {2019}, school = {Harvard University}, address = {Cambridge, MA}, abstract = {Despite decades of research demonstrating better health among the higher educated, the causal effect of education on health is still debated. This is due in part to mixed evidence obtained in quasiexperimental work. These puzzling patterns could be explained by the influence of uncontrolled confounders in observational research, by effect heterogeneity across individuals or environments, or by variation in effects across manifestations of health. The empirical chapters of this dissertation draw motivation from these observations to further unravel the relationship between education and health among older adults in the United States. First, I assess the utility of a novel control variable: a measure of genetic selection into education. Genetic selection is operationalized using a polygenic score (PGS) that predicts years of schooling based on many hundreds of thousands of genetic variants across the genome. Among European-ancestry respondents to the Health and Retirement Study (HRS) and the Wisconsin Longitudinal Study (WLS), I find that controlling for the PGS significantly attenuates the association between education and later health. The level of attenuation I observe is comparable to that obtained when controlling instead for measures of other known confounders, including family background and childhood health. Additional results suggest that the education PGS reflects more proximal confounders of the education-health link that may not be adequately controlled using survey measures alone. Crucially, however, the positive relationship between education and health is robust to this particular measure of genetic selection into years of schooling. Next, I evaluate whether the association of education with health varies across sociodemographic groups defined by socioeconomic (SES) origin, race, and gender using data from the HRS. In so doing, I take a more complex intersectional perspective than has been used in prior work. This is important, as exposure to discrimination, which shapes opportunities to use resources in support of health, may depend on multiple sociodemographic characteristics simultaneously. Results underscore the importance of one intersection in particular: that between SES origin and race. In line with prior work, I find that the association of years of schooling with self-reported health is stronger for those from low-SES backgrounds; however, this is only the case among whites. Seen from the other angle, the association of education with self-reported health and mortality is weaker for blacks than for whites, but primarily among those from low-SES origins. For both self-reported health and mortality, I find the smallest gain in health per year of schooling among low-SES origin black men, the group with the highest risk of poor health and mortality overall. In the final empirical chapter, I use data from the HRS to assess whether educational disparities in biomarkers of health risk vary across their distributions. Fundamental cause theory implies that such disparities will be largest where related resources can most successfully be leveraged to improve outcomes. For many biomarkers, this could be in the unhealthy tail of the distribution, where unequal access to and efficacy of medical interventions may exacerbate disparities. Consistent with this theory, I find that educational disparities in blood sugar and blood pressure are largest at their least healthy levels, precisely the points where impacts on subsequent morbidity and mortality are greatest. Meanwhile, highdensity lipoprotein (HDL) or {\textquotedblleft}good{\textquotedblright} cholesterol{\textemdash}a biomarker that is not regularly targeted by medication{\textemdash}does not display such a pattern. These results are not only of theoretical and substantive interest; they also provide methodological guidance for future work on biomarkers of health risk, which is timely given the recent proliferation of such measures in social science datasets.}, keywords = {Education, health}, url = {http://nrs.harvard.edu/urn-3:HUL.InstRepos:42013161}, author = {Zacher, Meghan} } @article {10356, title = {CORRELATES AND HEALTH OUTCOMES OF LONG-TERM VOLUNTEERING: EVIDENCE FROM 16 YEARS OF THE HEALTH AND RETIREMENT STUDY}, journal = {Innovation in Aging}, volume = {2}, year = {2018}, month = {11}, pages = {331-331}, abstract = {The importance and benefits of volunteering in later life has long been an interest for gerontological professionals. Most existing literature have studied volunteering using cross-sectional data or within a short period of time. While some people never stop volunteering and some never start, little is known about the profiles of these individuals. This study contributes to the literature by investigating correlates and health outcomes of long-term volunteers and non-volunteers using nationally-representative data from the 1998 to 2014 Health and Retirement Study. The present study includes individuals who were 50+ in 1998 and were alive through 2014. We further selected people who either never-stopped (25.88\%) or never-started (74.12\%) volunteering in the study period, yielding a final sample of 3,408. Logistic regression results showed that compared to non-volunteers, long-term volunteers tend to be younger, white, married, and have higher levels of education, economic status, and health status. Other significant correlates included religiosity (p\<.000), having friends living nearby (p\<.000), and living in non-urban areas (p=0.016). For health outcomes, OLS and ordered logit regression results showed that long-term volunteers had fewer number of depressive symptoms (b= -0.41, p\<.000) and better self-rated health status (OR=1.83, p\<.000), respectively. Given the significant health benefits of long-term volunteering, practitioners and policymakers are encouraged to make volunteering opportunities more accessible for people who were less likely to involve in long-term volunteering, so that they could also benefit from engaging in volunteering. Future research is encouraged to examine the mechanism among correlates, health outcomes and continuous/no engagement in volunteering.}, keywords = {health, long-term volunteering, Volunteering, volunteering and health}, issn = {2399-5300}, doi = {10.1093/geroni/igy023.1211}, url = {https://doi.org/10.1093/geroni/igy023.1211}, author = {Y Wang and Shen, H and Wong, R and Amano, T} } @article {9850, title = {Divorce and health in middle and older ages}, journal = {Review of Economics of the Household}, year = {2018}, month = {May-10-2018}, abstract = {The prevalence and incidence of divorce at older ages have doubled since 1990. We use Health and Retirement Study data to describe associations between divorce, remarriage and health in middle and later life, following individuals and couples through divorce and remarriage in models with individual or couple fixed effects. At middle and older ages, divorce is more often associated with adverse physical and mental health changes for women than for men. Remarriage is associated with a restoration of health and depression to pre-divorce levels for men and women. However, men are more likely to remarry. Evidence from couple models suggests that for husbands, but not wives, remarriage may be associated with less depression than the baseline marriage. Differences in self-reported health associated with divorce appear linked to (diagnosed) mental health conditions among wives and physical health conditions among husbands. }, keywords = {Depressive symptoms, Divorce, Gender Differences, health, Mental Health, Remarriage}, issn = {1569-5239}, doi = {10.1007/s11150-018-9435-z}, url = {http://link.springer.com/10.1007/s11150-018-9435-zhttp://link.springer.com/content/pdf/10.1007/s11150-018-9435-z.pdfhttp://link.springer.com/content/pdf/10.1007/s11150-018-9435-z.pdfhttp://link.springer.com/article/10.1007/s11150-018-9435-z/fulltext.html}, author = {Alice Zulkarnain and Korenman, Sanders} } @mastersthesis {10254, title = {Effect of Retirement on Health and Mortality.}, volume = {Master of Science}, year = {2018}, month = {05/2018}, pages = {231}, school = {Harvard University}, address = {Cambridge, MA}, abstract = {Retirement involves a reduction in work hours, and is usually associated with a reduction in household income, and both these factors can affect health. This dissertation comprises of three studies that, together, explore the (1) effect of own and spousal statutory pension eligibility on health outcomes; (2) effect of retirement and change in household income on self-reported and objectives measures of general health, mental health, and functional health; and (3) effect of retirement and change in household income on mortality. The first study analyzes the effect of pension eligibility on health using data from the Health and Retirement Study (HRS) and the Survey on Health, Ageing and Retirement in Europe (SHARE). It finds that own pension eligibility is associated with better health for both sexes. The results also suggest intra-household spillovers as spousal pension eligibility reduces the odds of poor health outcomes for men and raises the odds of depression for women. The second study estimates the effect of retirement and reduction in household income on health, controlling for the potential reverse causality from health, using pension eligibility and payment amounts as instruments that affect both retirement decisions and income in retirement. It uses longitudinal data on men and women from HRS and SHARE on retirement, income, and health, combined with data on statutory pension eligibility and payment amounts in each country. It finds that both being retired, and higher household income, are significantly associated with better health outcomes, such as lower risks of poor self-rated health, depression, or difficulty with activities of daily living. Overall, the results suggest that taken together these two effects combine to give a small improvement in health on average when people stop working and replace labor income with a lower pension. The third study analyzes the impact of retirement and household income on the mortality of men in the United States using data from the HRS. It undertakes a survival analysis using a control function approach to allow for the fact that retirement and income may reflect unobserved health conditions that affect mortality. It identifies the model using early, and normal, statutory pension eligibility as instruments that affect retirement decisions and household income but do not directly affect mortality. The study finds that retirement and higher household income both substantially lower the hazard of mortality. Pension eligibility increases the likelihood of retirement, but reduces household income, but we estimate the net effect through both mechanisms to be a small reduction in mortality hazard.}, keywords = {health, Mortality, Retirement}, url = {https://dash.harvard.edu/handle/1/37945628}, author = {Saxena, Akshar} } @mastersthesis {10240, title = {An Intersectional Perspective on the Relationships Among Social Status, Self-reported Discrimination, and Low-grade C-Reactive Protein in the Health and Retirement Study}, volume = {Doctor of Philosophy}, year = {2018}, month = {06/2018}, pages = {205}, school = {The Pennsylvania State University}, address = {State College, PA}, abstract = {A broad literature has documented social patterning of health, such that those with lower social status (e.g., racial minorities, women, and people of lower socioeconomic status) bear a disproportionate burden of morbidity and mortality relative to those with higher status. Disparities may be larger for some individuals, particularly those who are socially disadvantaged in more than one status. Variations in stress exposure, like experiences of discrimination, and resulting low-grade inflammation, may explain such disparities. A limited body of literature has examined the social distribution of low-grade inflammation, which is implicated in chronic diseases that are responsible for excess deaths in the United States. Limited work has examined how social statuses might interact to predict inflammatory markers like C-reactive protein (CRP), or tested psychosocial mechanisms responsible for the social distribution of CRP. The present study will examine the relationship between race, gender, and SES; everyday and lifetime discrimination exposure; and CRP. Aim 1 will test whether an interaction of race, gender, and SES are associated with CRP levels. Aim 2 will assess how race, gender, and SES shape exposure to lifetime and everyday discrimination, and whether this discrimination exposure mediates the relationship between race x gender x SES and CRP. Data were drawn from 5,486 respondents in the Health and Retirement Study, a nationally representative sample of midlife and older adults, to analyze the relationships between social status (e.g., race, gender, SES), everyday discrimination, lifetime discrimination, and CRP levels at baseline and after a four-year follow-up. Aim 1 study results demonstrate that race, gender, and SES interact to produce differential CRP levels at baseline and follow-up. The results suggest that there are incremental benefits for each additional level of SES for all race and gender groups except Black women. Significant three-way interactions of race, gender, and SES also indicate that Black women experience higher CRP levels with increases in SES, and that Black men with low SES are have the highest levels of CRP. Aim 2 study results show that everyday and lifetime discrimination exposure varies across social status groups. However, there were no significant interactions among race, gender, and SES on discrimination exposure. Further, results showed that both everyday and lifetime exposure to discrimination were significantly associated with CRP levels at baseline but not with change in CRP over four years. In clarifying the complexity inherent in disparities in low-grade inflammation, as well as potential psychosocial mechanisms responsible for these mechanisms, this work will contribute to a greater understanding of the factors underlying major causes of excess morbidity and mortality in the United States, and may identify potential intervention points for addressing health disparities.}, keywords = {C-reactive protein, developmental perspective, Gerontology, health, health discrimination, Intersectionality, Lifespan, Racial Disparities, social determinants, social status and health}, url = {https://etda.libraries.psu.edu/catalog/15539hrc117}, author = {Heather R. Farmer} } @article {NICHOLAS2018100184, title = {Lifetime job demands and later life disability}, journal = {The Journal of the Economics of Ageing}, year = {2018}, pages = {100184}, abstract = {Occupational characteristics may improve or harm health later in life. Previous research, largely based on limited exposure periods, reached mixed conclusions. We use Health and Retirement Study data linked to the Department of Labor{\textquoteright}s O*Net job classification system to examine the relationship between lifetime exposure to occupational demands and disability later in life. We consistently find an association between non-routine cognitive demands and lower rates of Social Security Disability Insurance (SSDI) receipt and work-limiting health conditions. Routine manual demands are associated with moderately worse health and increased SSDI receipt in most lifetime specifications. These results are robust to various specifications of occupational demand measures and controlling for transitions between jobs of different levels of occupational intensity. We show that failure to account for job characteristic exposure early in a worker{\textquoteright}s tenure obscures the relationship between physical job demands and disability later in life. While characteristics of jobs worked at ages 30 and 55 are both predictive of later-life health outcomes, early-life job characteristics frequently dominate in models containing early and late exposures.}, keywords = {Aging workers, disability insurance, health, Retirement, Working conditions}, issn = {2212-828X}, doi = {https://doi.org/10.1016/j.jeoa.2018.12.003}, url = {http://www.sciencedirect.com/science/article/pii/S2212828X18300276}, author = {Lauren Hersch Nicholas and Nicolae Done and Micah Y. Baum} } @article {9867, title = {A longitudinal study of work-related injuries: comparisons of health and work-related consequences between injured and uninjured aging United States adults}, journal = {Injury Epidemiology}, volume = {5}, year = {2018}, month = {Jan-12-2018}, abstract = {Background: Age may affect one{\textquoteright}s susceptibility to the myriad physical hazards that may pose risks for work-related injuries. Aging workers are not only at risk for work-related injuries but, also, at even higher risk for more severe health and work-related consequences. However, limited longitudinal research efforts have focused on such injuries among the aging workforce. This study aimed to investigate the association between physical work-related factors and injuries among United States (U.S.) workers, and then compare the injured and uninjured workers with regard to consequences including, functional limitations, and reduced working hours post injury. A cohort of 7212 U.S. workers aged 50 years and above from the U.S. Health and Retirement Study were retrospectively followed from 2004 to 2014. Data on exposures were lagged by one survey wave prior to the outcome of work-related injuries and consequences, respectively. Crude and adjusted incident rate ratios, and hazard ratios were estimated using generalized estimating equations and Cox models. Results: Risk of experiencing a work-related injury event was over two times greater among those whose job had work requirements for physical effort, lifting heavy loads, and stooping/kneeling/crouching, compared to those who did not. Over time, injured compared to uninjured workers had higher risks of functional limitations and working reduced hours. Conclusions: The aging workforce is at a high risk of experiencing injuries. Further, injured adults were not only more likely to incur a disability prohibiting daily life-related activities, over time, but, also, were more likely to work reduced hours. It will be important to consider accommodations to minimize functional limitations that may impair resulting productivity. {\textcopyright} 2018, The Author(s).}, keywords = {health, Injury, Physical Health, Workers\&$\#$039; compensation}, doi = {10.1186/s40621-018-0166-7}, url = {https://www.scopus.com/record/display.uri?eid=2-s2.0-85053897689\&origin=SingleRecordEmailAlert\&dgcid=raven_sc_search_en_us_email\&txGid=c198e96897366b934b1253093117b258}, author = {Navneet Kaur Baidwan and Susan Goodwin Gerberich and Kim, Hyun and Andrew D Ryan and Timothy Church and Benjamin D Capistrant} } @article {9855, title = {Measuring Sarcopenia Severity in Older Adults and the Value of Effective Interventions}, journal = {The journal of nutrition, health \& aging}, year = {2018}, month = {Jun-09-2019}, abstract = {Objectives: Little is known about the severity and long-term health and economic consequences of sarcopenia. We developed a sarcopenia index to measure severity in older Americans and estimated the long-term societal benefits generated by effective interventions to mitigate severity. Design: Using a micro-simulation model, we quantified the potential societal value generated in the US in 2010{\textendash}2040 by reductions in sarcopenia severity in older adults. All analyses were performed in Stata and SAS. Setting \& Participants: Secondary data from the National Health and Nutrition Examination Survey (NHANES) (N = 1634) and Health and Retirement Study (HRS) (N = 952) were used to develop a sarcopenia severity index in older adults. Measurements: Multitrait multi-method and factor analyses were used to validate and calibrate the sarcopenia severity index, which was modeled as a function of gait speed, walking without an assistive device, and moderate physical activity. Results: In representative elderly populations, reducing sarcopenia severity by improving gait speed by 0.1 m/s in those with gait speed under 0.8 m/s generated a cumulative benefit of $65B by 2040 (2015 dollars). Improving walking ability in those with walking difficulty generated cumulative social benefit of $787B by 2040. Conclusions: Reducing sarcopenia severity would generate significant health and economic benefits to society{\textemdash} almost $800B in the most optimistic scenarios. {\textcopyright} 2018, The Author(s). }, keywords = {Economics, health, Physical activity, Sacropenia}, issn = {1279-7707}, doi = {10.1007/s12603-018-1104-7}, url = {http://link.springer.com/10.1007/s12603-018-1104-7http://link.springer.com/content/pdf/10.1007/s12603-018-1104-7.pdf}, author = {MacEwan, Joanna P. and Thomas M Gill and Johnson, K. and Doctor, J. and Jeffrey Sullivan and Shim, J. and Dana P Goldman} } @mastersthesis {10293, title = {Modeling Job-demand Conditional Dynamics in Physical and Cognitive Functioning on Changes in Older Workers{\textquoteright} Wellbeing over Time}, volume = {PhD}, year = {2018}, note = {Copyright - Database copyright ProQuest LLC; ProQuest does not claim copyright in the individual underlying works; Last updated - 2018-07-22}, pages = {104}, school = {Saint Louis University}, type = {phd}, abstract = {Workforce aging presents organizations and researchers with the possibility that older workers will eventually retire, taking with them their accumulated skills and industry knowledge. Thus, it is important to understand the factors that promote the working individual{\textquoteright}s wellbeing across the lifespan to maintain their employability. Part of these efforts is the study of successful aging at work, which can be generally understood as achieving and maintaining positive outcomes across one{\textquoteright}s work lifespan. Successful aging theories emphasize the importance of understanding the person and contextual factors that influence wellbeing across the lifespan. Indeed, person factors such as health and fluid intelligence both indicate decrements in older individuals that likely result in decreases in wellbeing over time. The Job-Demands Resources (JD-R) model provides insight into how contextual, work-related factors like levels of job demands are also likely to have a negative, main effect on wellbeing over time. Moreover, older workers likely differ in the extent to which changes in health and cognition impact wellbeing, and job demands likely serve as a moderator of these relationships. The current study draws from the JD-R model and lifespan theories to understand the extent to which job demands exacerbate the effects that changes in health and fluid intelligence have on changes in wellbeing in a sample of older workers from the Health and Retirement Study.}, keywords = {0624:Occupational psychology, Aging, Fluid intelligence, health, Health and Retirement Study, Job demands, Occupational psychology, Psychology, Wellbeing}, isbn = {9780438127869}, url = {https://search.proquest.com/docview/2070621126?pq-origsite=gscholar}, author = {Toomey,Eileen C.} } @mastersthesis {10300, title = {Volunteering Helps Unemployed Older Workers{\textquoteright} Mental Health: How, Why, and Does It Work for All?}, volume = {PhD}, year = {2018}, note = {Copyright - Database copyright ProQuest LLC; ProQuest does not claim copyright in the individual underlying works; Last updated - 2018-08-28}, pages = {93}, school = {Boston College}, type = {phd}, abstract = {Despite the fact that older workers (50+) are much overrepresented among the long-term unemployed and often suffer from multiple mental health problems, the social work literature has rarely tackled this issue. In my dissertation, guided by Jahoda{\textquoteright}s Latent Deprivation Theory and the productive aging framework, I examined the positive coping strategies of unemployed older workers. I set out to understand whether engaging in formal volunteering in an organization would buffer the negative impact of unemployment on older workers{\textquoteright} mental health. I also fill out the gap in the literature regarding the mechanism of the positive effect of volunteering on mental health by examining two latent benefits from working as mediators: purpose in life and perceived social status. I used fixed effects modeling for the moderation analysis. I analyzed six waves (12 years) of longitudinal data from the Health and Retirement Study (HRS). I used structural equation modeling and analyzed two waves of HRS for the mediation analysis. I used full information maximum likelihood method to handle missing values. I found that there was a significant moderation between engaging in formal volunteering and unemployment status on older workers{\textquoteright} depressive symptoms. Unemployed older workers who engaged in volunteering fared better than those unemployed workers who did not volunteer. Consistent with previous studies using the HRS, I also found that those unemployed older workers who volunteered over 200 hours/year did not benefit from volunteering compared to those volunteered under 100 hours/year. Mediation analysis results showed that perceived social status and purpose in life mediate the protective effect of volunteering. Both the moderation and mediation results varied by race and ethnicity. Results from this dissertation have important implications for future intervention development. For example, interventions targeting the unemployed older workers may incorporate formal volunteering as one element for participants to gain social contact, purpose in life, and enhance perceived social status. Interventions can also create an environment that mirrors an office to enhance these latent benefits (mediators) in order to improve mental health.}, keywords = {0452:Social work, health, Helps, Mental, Older, Social Sciences, Social work, Unemployed, Volunteering, Work, Workers}, isbn = {9780438245907}, url = {https://dlib.bc.edu/islandora/object/bc-ir:108094}, author = {Jie Yang} } @article {560501, title = {Health, Longevity, and Welfare Inequality of the Elderly}, year = {2017}, abstract = {\ We propose a framework to understand the distribution of individual wellbeingand its change over time with an application to the U.S. elderly population.Using data from the Health and Retirement Study, we estimate life-cycle dynamicsand simulate individual outcome paths starting from age sixty. We use anexpected utility framework and the simulated profiles to construct a measure ofindividual welfare that incorporates differences in consumption, leisure, health,and mortality. Our measure suggests substantial variation in welfare across individualsdriven foremost by gaps in health and mortality followed by gaps inconsumption. Incorporating the utility cost of living with poor health into elderlywelfare substantially increases overall inequality. Elderly welfare inequality hasincreased over time due to growing gaps in consumption, health, and mortality.Disparity measures based on cross-sectional income or consumption at age sixtyunderestimate aggregate welfare inequality. Moreover, health at age sixty is abetter indicator of individual well-being rank than income or consumption.\ }, keywords = {health, Inequality, Longevity, Welfare}, url = {https://scholar.harvard.edu/nbairoliya/publications/pp1-margin-00px-00px-00px-00px-font-205px-helvetica-spans1-font-145px}, author = {Ray Miller and Bairoliya, Neha} } @article {8855, title = {Identifying adults aging with disability using existing data: The case of the Health and Retirement Study.}, journal = {Disabil Health J}, volume = {10}, year = {2017}, month = {2017 Oct}, pages = {611-615}, abstract = {

BACKGROUND: The population of persons aging with disabilities is growing. Being able to segment aging with disability sub-populations within national data sets is becoming increasingly important in order to understand the relationship of aging with disability to a range of outcomes in later life including health and wellness, economic security, and health and long-term service and support need and use.

OBJECTIVE: The purpose of this study was to identify viable sub-samples of adults aging with disabilities within the Health and Retirement Study, one of the most used secondary data sets to study aging and older adults.

METHOD: Samples used in this research are drawn from wave 11 (2012) of the HRS. Five operationalizations of disability were used: childhood disability (n~=~719), childhood chronic condition (n~=~3070), adult chronic condition (n~=~13,723), functional limitation in adulthood (n~=~4448) and work disability (n~=~5632).

RESULTS: These subsamples are not mutually exclusive. Among respondents that reported having a childhood disability, 87\% also report having at least one chronic disease in adulthood, 50\% report having functional limitations in adulthood and 38\% report interruption in their ability to work due to a disability. Compared to the childhood disability samples, rates of reporting fair/poor health are nearly double among adults with functional limitations or those with work disruptions because of disability.

CONCLUSION: Work disability and functional limitation appeared to be the most viable sub-sample options to consider when using the HRS to study experiences of adults aging with disability. Overall, age at onset is unclear.

}, keywords = {Activities of Daily Living, Adolescent, Age of Onset, Aged, Aged, 80 and over, Aging, Child, Child Health, Chronic disease, Disabled Persons, Female, health, Health Status, Health Surveys, Humans, Male, Middle Aged, Retirement, Self Report, Work}, issn = {1876-7583}, doi = {10.1016/j.dhjo.2016.12.016}, url = {https://linkinghub.elsevier.com/retrieve/pii/S1936-6574(16)30191-1}, author = {Caitlin E. Coyle and Putnam, Michelle} } @article {8542, title = {Lagged Associations of Metropolitan Statistical Area- and State-Level Income Inequality with Cognitive Function: The Health and Retirement Study.}, journal = {PLoS One}, volume = {11}, year = {2016}, month = {2016}, pages = {e0157327}, abstract = {

PURPOSE: Much variation in individual-level cognitive function in late life remains unexplained, with little exploration of area-level/contextual factors to date. Income inequality is a contextual factor that may plausibly influence cognitive function.

METHODS: In a nationally-representative cohort of older Americans from the Health and Retirement Study, we examined state- and metropolitan statistical area (MSA)-level income inequality as predictors of individual-level cognitive function measured by the 27-point Telephone Interview for Cognitive Status (TICS-m) scale. We modeled latency periods of 8-20 years, and controlled for state-/metropolitan statistical area (MSA)-level and individual-level factors.

RESULTS: Higher MSA-level income inequality predicted lower cognitive function 16-18 years later. Using a 16-year lag, living in a MSA in the highest income inequality quartile predicted a 0.9-point lower TICS-m score (β = -0.86; 95\% CI = -1.41, -0.31), roughly equivalent to the magnitude associated with five years of aging. We observed no associations for state-level income inequality. The findings were robust to sensitivity analyses using propensity score methods.

CONCLUSIONS: Among older Americans, MSA-level income inequality appears to influence cognitive function nearly two decades later. Policies reducing income inequality levels within cities may help address the growing burden of declining cognitive function among older populations within the United States.

}, keywords = {Cities, Cognition, Female, health, Humans, Income, Interviews as Topic, Linear Models, Male, Middle Aged, Multivariate Analysis, Residence Characteristics, Retirement, Socioeconomic factors, Statistics as Topic, Telephone, United States}, issn = {1932-6203}, doi = {10.1371/journal.pone.0157327}, url = {http://dx.doi.org/10.1371/journal.pone.0157327}, author = {Kim, Daniel and Griffin, Beth Ann and Mohammed U Kabeto and Jos{\'e} J Escarce and Kenneth M. Langa and Regina A Shih}, editor = {M. Maria Glymour} } @mastersthesis {11127, title = {Essays in Labor and Health Economics}, year = {2015}, school = {University of Minnesota}, abstract = {This dissertation consists of two essays. The first essay studies the effect of different kinds of pension plans on the labor market decisions of the older workers. Due to the aging population, Social Security{\textquoteright}s projected annual cost is expected to increase to about 6.2 percent of the Gross Domestic Product by 2035, thus posing significant challenges to the U.S. policy makers. This has fueled an interest in research geared towards understanding the determinants of retirement. Past research has shown that pensions have a significant effect on retirement decisions. But the pension landscape in the U.S. has changed dramatically in the last few decades. From being once dominated by the traditional annuity-based Defined Benefit (DB) plans, the trend has now moved towards account-based Defined Contribution (DC) plans. This change has been accompanied by a reversal in the participation trend of older workers resulting in an increasing labor force participation of the elderly in the United States over the last thirty years. This essay investigates the link between the two by building a life cycle model of retirement and pension plan types. By conducting counterfactual experiment which changes all DB plans to DC plans, I hope to understand the role played by the differences in the nature of pension wealth accumulation under different pension plans in explaining the differences in retirement behavior observed across different pension plan holders. The second essay explores policy questions pertinent to the aging population in the healthcare field. Medicare Part D is a government program introduced in 2006 to offer outpatient drug benefits to Medicare beneficiaries. A lot of the brand-name drugs covered under Medicare Part D are also available in generic versions and it has been argued by policy makers that a higher level of utilization of these generic drugs would result in significant cost savings for the government. However, the cost savings of forcing consumers onto generics may lead to large welfare losses for consumers of non-generic alternatives if they highly value them. This issue is addressed in this essay where a structural model of drug demand that allows for heterogeneity in match quality between consumers and drugs and also allows for consumer learning about the stochastic match quality of the drug is estimated. The 2007-2008 administrative claims data for the 5\% Medicare Sample is used for demand estimation. By conducting counterfactual experiment which eliminates branded drugs for which the generic is available from the choice-sets of consumers, I hope to understand the effect of generic substitution on consumer welfare and the resulting cost savings for the government.}, keywords = {Economics, health, Health Economics, Labor economics}, url = {https://conservancy.umn.edu/handle/11299/175427}, author = {Bairoliya, Neha} } @mastersthesis {11129, title = {The Influence of the Built Environment on the Driving Behaviors and Mental Health of Older Adults.}, volume = {Health Behavior and Health Education}, year = {2015}, school = {University of Michigan}, abstract = {Due to increases in life expectancy, the aging of the baby boom generation, and a decline in birth rates, the US population is aging rapidly. In the future, older people will not only comprise a larger proportion of the general population, but also the driving population. This issue is characterized by a conflict between roadway safety for those who can no longer safely drive, and loss of independence when driving reduction and cessation become necessary. Previous research on driving decision making among older adults has largely focused on individual- and interpersonal-level factors. This study examined the influence of the physical transportation environment on driving reduction and cessation, after controlling for the effects of other predictors. Differences by gender and race were also assessed, as was the influence of the transportation environment on depressive symptoms. Longitudinal survival analysis techniques and generalized estimating equations were used to analyze seven waves of data spanning a 12-year period from 1998 through 2010. Results showed that after controlling for the effects of demographics, health, and social support, there was a significant influence of the transportation environment on both driving reduction and driving cessation. As roadway density and congestion increased, the odds of driving reduction and cessation also increased. Men were more affected than women by the transportation environment, and Whites and Hispanics were more affected than African Americans and those of Other race. Driving reduction, driving cessation, and the transportation environment also significantly predicted the rate of depressive symptoms over time. Depressive symptoms were positively associated with driving limitations, while a more congested environment predicted fewer depressive symptoms. Other predictors of driving reduction and cessation included relationship status, household size, and having a friend who lives nearby. Results suggest that policy changes and modifications to the physical environment should be made to improve older drivers{\textquoteright} ability to remain engaged in life. Creating mixed-use livable communities with goods and services in close proximity are warranted to mitigate some of the mobility challenges of older adulthood. Older individuals should also consider and plan for how their transportation environment will affect their desire to age in place.}, keywords = {Driving, driving behavior, Environment Design, health, Mental Health}, url = {https://deepblue.lib.umich.edu/handle/2027.42/113589}, author = {Jonathon M Vivoda} } @article {10988, title = { The Health Consequences of Retirement}, journal = {Journal of Human Resources}, volume = {49}, year = {2014}, pages = {195-233}, abstract = {This paper examines the impact of retirement on individuals{\textquoteright} health. Declines in health commonly compel workers to retire, so the challenge is to disentangle the simultaneous causal effects. The estimation strategy employs an instrumental variables specification. The instrument is based on workers{\textquoteright} self-reported probabilities of working past ages 62 and 65, taken from the first period in which they are observed. Results indicate that the retirement effect on health is beneficial and significant. Investigation into behavioral data, such as smoking and exercise, suggests that retirement may affect health through such channels. With additional leisure time, many retirees practice healthier habits.}, keywords = {health, Retirement}, doi = {doi: 10.3368/jhr.49.1.195}, author = {Insler, Michael} } @inbook {NBERc12964, title = {The Nexus of Social Security Benefits, Health, and Wealth at Death}, booktitle = {Discoveries in the Economics of Aging}, year = {2014}, pages = {159-182}, publisher = {University of Chicago Press}, organization = {University of Chicago Press}, abstract = {Social Security (SS) benefits are the most important component of the income of a large fraction of older Americans. A significant fraction approach later life relying heavily on SS benefits. Persons in poor health in old age have a higher-than-average probability of having experienced low earnings while in the labor force, increasing the risk of having low SS benefits in retirement. While the progressivity of the SS benefit formula provides a safety net to support low-wage workers in retirement, a noticeable fraction still have income below the poverty level in their last years. In general, low assets and low income in old age are strongly related to poor health. We explore this nexus and describe the relationship between SS benefits and the exhaustion of non-annuity assets near the end of life. We examine the relationship between the drawdown of assets between the first year an individual is observed in the AHEAD data (1995) and the last year that individual is observed before death, and that individual{\textquoteright}s health, SS benefits, and other annuity benefits. SS and defined benefit pension benefits are strongly "protective" of non-annuity assets, with a negative relationship between these income flows and the likelihood of exhausting non-annuity assets.}, keywords = {health, Social Security Benefits, Wealth}, url = {http://www.nber.org/chapters/c12964}, author = {James M. Poterba and Steven F Venti and David A Wise} } @article {NBERw19902, title = {The Role of Health in Retirement}, year = {2014}, institution = {NBER}, abstract = {This paper constructs and estimates a dynamic model of the evolution of health for those over the age of 50 and then embeds that model of health dynamics in a structural, econometric model of retirement and saving. The health model traces the effects of smoking, obesity, alcohol consumption, depression and other proclivities on medical conditions, including hypertension, diabetes, cancer, lung disease, heart problems, stroke, psychiatric problems and arthritis. These in turn influence an overall index of health status based on self-reported health, work limitations and ADLs, which is used to classify the population into good, fair, poor or terrible health. Compared to a situation where the entire population is in good health, the current health status of the population reduces the retirement age of the entire population by an average of about one year. While poor health or terrible health have a great impact on the disutility of work and thus on retirement, fair health as opposed to good health has a relatively minor effect. Smoking depresses full-time work effort by up to 3.5 percentage points by those in the early sixties, reducing the average retirement age by four to five months. Effects of trends in health care and health policies on retirement are also analyzed. Including detailed measurement of health dynamics in a retirement model improves understanding of the effects of health on retirement. It does not, however, influence estimates of the marginal effects of economic incentives on retirement.}, keywords = {health, Health and well-being, Health Behavior, Retirement, Retirement Decision}, doi = {10.3386/w19902}, url = {http://www.nber.org/papers/w19902}, author = {Alan L Gustman and Thomas L. Steinmeier} } @article {8118, title = {Self-rated health in the last 12 years of life compared to matched surviving controls: the Health and Retirement Study.}, journal = {PLoS One}, volume = {9}, year = {2014}, note = {Times Cited: 0 0}, month = {2014}, pages = {e107879}, publisher = {9}, abstract = {

Self-rated health (SRH) is a valid measure of health status and associated with mortality. Based on individual-level biannual repeat data on SRH we sought to characterize the natural history of poor SRH during the 12 years prior to death in men and women in different age groups. We conducted a retrospective analysis of the Health and Retirement Study participants who died between 1998 and 2010 and had at least two SRH measurements in the 12 years prior to death. We used a nested case-control design to compare SRH trajectories of deceased men and women aged 30-64, 65-79 and 80 years versus surviving participants. The cases comprised 3,350 deceased participants who were matched to surviving controls (n = 8,127). SRH was dichotomized into good vs. poor health. Men and women dying at age 65-79 and >= 80 years had 1.5 to 3 times higher prevalence of poor SRH already 11-12 years prior to death compared to surviving controls. The risk estimates remained statistically significant even after adjusting for life-style related risk factors and diagnosed diseases. Prevalence of poor SRH before death was lowest among those aged >= 80 years and highest in 30-64 year-olds. In conclusion, men and women who subsequently die perceive their health worse already 11-12 years prior to death compared to their surviving controls.

}, keywords = {Adult, Aged, Aged, 80 and over, Diagnostic Self Evaluation, Female, health, Health Status, Humans, Life Style, Male, Middle Aged, Mortality, Retirement, Retrospective Studies}, issn = {1932-6203}, doi = {10.1371/journal.pone.0107879}, author = {Stenholm, Sari and Pentti, Jaana and Ichiro Kawachi and Westerlund, Hugo and Mika Kivim{\"a}ki and Vahtera, Jussi} } @article {RePEc:upf:upfgen:1451, title = {Source of health insurance coverage and employment survival among newly disabled workers: Evidence from the health and retirement study}, year = {2014}, institution = {Universitat Pompeu Fabra}, abstract = {We use prospective longitudinal data on newly disabled older workers to examine the effect of employer sponsorship of health insurance (ESHI) on post-onset employment and disability insurance claiming. We compare outcomes of workers with ESHI and no access to spousal coverage prior to onset with outcomes of two comparison groups: individuals with ESHI who also have access to spousal coverage and those who are covered by a spouse{\textquoteright}s employer prior to onset. We find evidence of \"employment lock\" among the 20 percent of individuals whose disabilities do not impact their immediate physical capacity but are associated with high medical costs.}, keywords = {Disabilities, disability insurance, Disability onset, health, Health Insurance}, url = {https://ideas.repec.org/p/upf/upfgen/1451.html}, author = {Matthew J Hill and Nicole Maestas and Kathleen J Mullen} } @article {7721, title = {An examination of healthy aging across a conceptual continuum: prevalence estimates, demographic patterns, and validity.}, journal = {J Gerontol A Biol Sci Med Sci}, volume = {67}, year = {2012}, month = {2012 Jun}, pages = {783-9}, publisher = {67}, abstract = {

BACKGROUND: Although the notion of healthy aging has gained wide acceptance in gerontology, measuring the phenomenon is challenging. Guided by a prominent conceptualization of healthy aging, we examined how shifting from a more to less stringent definition of healthy aging influences prevalence estimates, demographic patterns, and validity.

METHODS: Data are from adults aged 65 years and older who participated in the Health and Retirement Study. We examined four operational definitions of healthy aging. For each, we calculated prevalence estimates and examined the odds of healthy aging by age, education, gender, and race-ethnicity in 2006. We also examined the association between healthy aging and both self-rated health and death.

RESULTS: Across definitions, the prevalence of healthy aging ranged from 3.3\% to 35.5\%. For all definitions, those classified as experiencing healthy aging had lower odds of fair or poor self-rated health and death over an 8-year period. The odds of being classified as "healthy" were lower among those of advanced age, those with less education, and women than for their corresponding counterparts across all definitions.

CONCLUSIONS: Moving across the conceptual continuum--from a more to less rigid definition of healthy aging--markedly increases the measured prevalence of healthy aging. Importantly, results suggest that all examined definitions identified a subgroup of older adults who had substantially lower odds of reporting fair or poor health and dying over an 8-year period, providing evidence of the validity of our definitions. Conceptualizations that emphasize symptomatic disease and functional health may be particularly useful for public health purposes.

}, keywords = {Aged, Aged, 80 and over, Aging, Cognition, Female, health, Humans, Male, Odds Ratio, Prevalence, Reproducibility of Results}, issn = {1758-535X}, doi = {10.1093/gerona/glr234}, author = {Sara J McLaughlin and Alan M Jette and Cathleen M. Connell} } @inbook {NBERc12443, title = {"Healthy, Wealthy and Wise?" Revisited: An Analysis of the Causal Pathways from Socioeconomic Status to Health}, booktitle = {Investigations in the Economics of Aging}, year = {2011}, pages = {267-317}, publisher = {University of Chicago Press}, organization = {University of Chicago Press}, abstract = {In health economics, there is little dispute that the socioeconomic status (SES) of individuals is positively correlated with their health status. The size of the body of literature documenting that wealthy and well- educated people generally enjoy better health and longer life is impressive.1 The robustness of this association is underscored by the fact that the so- called health- wealth gradient has been detected in different times, countries, populations, age structures, and for both men and women. Moreover, the results are largely insensitive to the choice of SES measures (such as wealth, income, education, occupation, or social class) and health outcomes.}, keywords = {health, socioeconomic status}, url = {http://www.nber.org/chapters/c12443}, author = {Till Stowasser and Florian Heiss and Daniel McFadden and Joachim Winter} } @conference {10822, title = {Health and Concentrated Disadvantage in Later Life: Evidence from the Health and Retirement Study}, booktitle = {Population Association of America 2009 Annual Meeting}, year = {2009}, publisher = {Princeton University}, organization = {Princeton University}, abstract = {Not only are adults who live in racially segregated areas exposed to disadvantage on myriad levels over the lifetime, but, in aging, they also may become even more reliant upon the resources embedded in their neighborhoods. This paper uses multi-level analysis to study residential segregation, concentrated disadvantage, and the health of adults in mid- to late-life. Using data from the 2004 Health and Retirement Survey, I analyze the extent to which health disparities between black and white adults over age 50 are associated with neighborhood-level concentrated disadvantage. Random intercept models show that neighborhood-level factors are associated with both fair or poor health and chronic illness. Concentrated disadvantage is significant and in the expected direction, although the magnitude is small. Findings are consistent with previously identified connections between education and health, suggesting that improving educational outcomes for students in highly disadvantaged areas may yield enduring health benefits.}, keywords = {Disadvantage, health}, url = {https://paa2009.princeton.edu/abstracts/91231}, author = {Carr, Stacie} } @article {10934, title = {Education versus savings as explanations for better health: Evidence from the Health and Retirement Survey}, number = {03-04}, year = {2002}, institution = {George Mason University}, address = {Fairfax, VA}, abstract = {The paper reports on the results of a study of the health status of 4,917 middle age couples in the HRS. The main finding is that savings propensity appears to be a key component to health outcome. Savers make consumption choices that improve their health, accumulate fewer ailments and enjoy lower mortality rates. The results are consistent with either Becker-Mulligan who posit that education makes individuals more forward looking; or Fuchs who hypothesizes that individuals with lower rates of time preference select themselves into higher levels of education. While education as such matters less after inclusion of savings and other variables, it still affects choices about consumption that affects health, though its effect is not explained by better information. It also affects the rate of ill health, holding constant consumption decisions and existing maladies. If the family{\textquoteright}s investment behavior importantly influences health outcome, then longer long-term improvements in overall health may depend less on improved flows of health information, and more on a gradual spread of a longer-term outlook among larger portions of the population. Whether far-sighted behavior is learned in the family or through the education process is an important and open question. }, keywords = {Education, health, Savings}, url = {https://www.law.gmu.edu/assets/files/publications/working_papers/03-04.pdf}, author = {Ippolito, Richard A.} } @article {12177, title = {Evaluation of Health Questions in HRS}, year = {2002}, publisher = {National Institute on Aging}, address = {Bethesda, MD}, keywords = {health}, author = {David M Cutler} } @article {12174, title = {HRS external review: Longitudinal aspects of health}, journal = {DMC Commissioned Papers}, year = {2002}, publisher = {National Institute on Aging}, address = {Bethesda, MD}, keywords = {health, longitudinal analyses}, author = {Bandeen-Roche, Karen} } @article {12182, title = {Minorities and the Health and Retirement Survey: Future Analytic Opportunities and Data Requirements}, year = {2002}, publisher = {National Institute on Aging}, address = {Bethesda, MD}, keywords = {administrative data, health, minorities}, author = {Tienda, Marta} } @article {6639, title = {The associations between self-rated vision and hearing and functional status in middle age.}, journal = {Ophthalmology}, volume = {106}, year = {1999}, month = {1999 Feb}, pages = {401-5}, publisher = {106}, abstract = {

OBJECTIVES: To describe the associations between self-reported visual and hearing impairment and an index of global functional status among community-dwelling, middle-aged Americans.

DESIGN: Cross-sectional.

PARTICIPANTS: A total of 9744 U.S. community-dwelling persons 51 to 61 years of age participated.

METHODS: Multivariate analyses of functional status based on cross-sectional data from Wave I (1992) of the Health and Retirement Study (HRS), controlling for demographic and socioeconomic status, common chronic medical conditions, and general health status, were performed.

MAIN OUTCOME MEASURE: A global index of functional status based on self-reported limitations in 17 activities was measured.

RESULTS: Approximately 3\% of respondents in the HRS rated their vision or hearing as poor. Even after controlling for demographic factors, socioeconomic status, medical conditions, and general health status, limitations in both vision and hearing were independently correlated with worse functional status. In addition, controlling for income, wealth, and education reduced the strength of the associations between vision and hearing impairment and function, but did not eliminate them. The magnitude of effect of poor vision exceeded all medical conditions except stroke.

CONCLUSIONS: Visual and hearing impairment appear to have a significant relationship with overall functional status, among even community-dwelling, middle-aged Americans and even after controlling for general health status, medical comorbidities, and socioeconomic status.

}, keywords = {Cross-Sectional Studies, Female, health, Health Status, Health Surveys, Hearing Disorders, Humans, Male, Middle Aged, Outcome and Process Assessment, Health Care, Quality of Life, Self Disclosure, Vision Disorders}, issn = {0161-6420}, doi = {10.1016/S0161-6420(99)90082-9}, url = {http://www.ncbi.nlm.nih.gov/pubmed/9951498?dopt=Abstract}, author = {Paul P Lee and James P Smith and Raynard Kington} } @article {12090, title = {The grandparent/grandchild caregiving gradient: Hours of caring for grand children and its relationship to health}, journal = {The Southwest Journal on Aging}, volume = {14}, year = {1998}, pages = {31-39}, keywords = {Caregiving, grandchildren, grandparent, health}, url = {https://www.researchgate.net/profile/Jonathan-Marx-2/publication/256685991_The_grandparentgrandchild_caregiving_gradient_Hours_of_caring_for_grand_children_and_its_relationship_to_health/links/614b2dfea595d06017e2eb74/The-grandparent-grandchild-caregiving}, author = {Jennifer Crew Solomon and Marx, Jonathan} }