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ARRA Investments in Economics of Aging Research

Public Health Burden
Economic status, well-being, and health care are interrelated in complex ways for older adults.  As record numbers of Americans reach retirement age, programs such as Social Security and Medicare will face unprecedented challenges.  In addition, demographic and retirement income trends are expanding economic risks in old age.  Longer life expectancy can increase the likelihood of outliving retirement savings, and the shift in pensions from defined benefit to defined contribution plans suggests that more Americans will reach retirement with Social Security as their only annuity.  Although housing often represents the most significant part of retiree wealth, relatively few retirees make use of reverse mortgages to insure against retirement income shortfalls.  Many Americans will require long-term care, but few purchase private insurance to support formal care expenses.

Understanding How Economic Concerns Impact Older Adults
ARRA funds are being used in several large population studies to better understand the economic needs of older adults.  For example:
  • Investigators with the Health and Retirement Study (HRS), an NIH-supported longitudinal study known as the Nation’s leading resource for data on the combined health and economic conditions of older Americans, will be able to add new measures to the study to support more comprehensive examination of trends in health, labor supply, and wealth accumulation, extend their data systems to include linkages with Social Security and Medicare records, employer pension records, and the National Death Index, and improve public use data to better understand the needs of the aging population.1
  • An NIH-supported Center on the Demography and Economics of Health and Aging will have enhanced capacity to better understand debilitating conditions that take an economic toll on the elderly.  Center investigators will examine trends in demography, economics, health, and health care of the elderly by evaluating the effects of medical technology on costs and examining changes in survival, health, and well-being among older people over time.2
  • Economists at the National Bureau of Economics Research will examine the financial circumstances of older Americans to include work and retirement behavior, health and functional ability, and the many public and private policies that influence individual well-being.  Understanding the complexities of financial concerns among the elderly and the relationships among demographics, policy, behavior, economics, and health will inform new interventions to assist older adults.3
Evaluating Interventions
ARRA funds are also being used to evaluate the success of various interventions to address economic concerns among the elderly.  For example:
  • Researchers are examining the impact of Medicare Part D implementation on racial disparities in medication use and control of chronic diseases such as hypertension and ischemic heart disease.  The study objective is to reduce racial disparities in health outcomes by examining the impact of this policy intervention for increasing prescription drug coverage among the elderly.  Both hypertension and ischemic heart disease (IHD) are more common and more likely to be inadequately controlled in older African Americans when compared to older Caucasians.  One key pathway to these racial disparities is greater cost related medication non-adherence in older African Americans when compared to Caucasians. 4
  • Researchers in another study will examine a unique health insurance lottery currently underway in Oregon.  Understanding the consequences of gaining access to health insurance is central to evaluating proposals to expand or modify health insurance coverage in the U.S.  It also has important fiscal implications for Medicare.  Because it is difficult to disentangle the effects of health insurance from other factors that also affect health, researchers will examine the effects of insuring the uninsured on health care utilization, health outcomes, and overall well-being.5
Enhancing Research Resources
ARRA-supported scientists are also engaged in developing interactive technologies to improve research on economics and health behavior.  For example:
  • Researchers are developing an information technology infrastructure that will provide a state-of-the-art platform on which to build, test, and deploy large- scale behavioral intervention studies and advance the science at the intersection of behavioral economics and health.  High rates of unhealthy behaviors underlie many of the chronic conditions that burden Americans.  Interventions derived from theories of behavioral economics have shown promise in increasing the rate of healthy behaviors.6

  1. 3U01AG009740-20S1, -- HRS 2010 Data Collection Supplement -- David R. Weir (MI); 3U01AG009740-20S2 -- HRS Minority Sample Expansion Competitive Revision -- David R. Weir (MI); 3R01AG020717-07S1 and 07S3 -- Internet Interviewing and the HRS -- Arie Kapteyn (CA); 1 RC2 AG036619-01 -- Mega Meta Data Set of the Health and Retirement Surveys around the World -- Arie Kapteyn (CA)
  2. 3P30AG017253-10S1 -- Center on the Demography and Economics of Health and Aging -- Alan Garber (CA)
  3. 3P30AG012810-16S1, and3P30AG012810-16S2 -- NBER Center for Aging and Health Research -- David A. Wise (MA)
  4. 1R01AG034056-01 -- Racial Disparities in Older Adults: Impact of Medicare Part D -- Joseph T. Hanlon (PA)
  5. 1RC2AG036631-01 -- The Effect of Health Insurance on Utilization and Outcomes: The Oregon Lottery -- Katherine Baicker (contact) and Amy N. Finkelstein (MA)
  6. 1RC2AG036592-01 -- Developing Interactive Technologies to Improve Research and Health Behavior -- David A. Asch (contact) and Kevin G. Volpp (PA)

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