The annual Trio award competition is jointly sponsored by the PSC, the Population Aging Research Center, and Boettner Center for Pension Retirement Research. The competition promotes high quality and innovative research in demography, economics, and related social and behavioral sciences. Trio awards are funded for one year (or less) in duration and are selected through competitive peer review. A list of funded Trios can be searched by typing in key words or the name of the PI, or sorted by the year the funding began.
Aim 1: Determine whether the receipt of aggressive care in the last 30 days of life among hospitalized older adults with cancer is associated with hospital Magnet recognition. Hypothesis: Patients in Magnet hospitals will be less likely to receive aggressive care, including chemotherapy in the last 14 days of life; more than 1 emergency room visit in the last 30 days of life; more than 1 hospitalization in the last 30 days of life; 1 or more ICU admissions in the last 30 days of life; in-hospital death; not admitted to hospice, or admitted to hospice for less than 3 days. Aim 2: Determine whether Black patients in Magnet hospitals receive less aggressive care in the last 30 days of life compared with Black patients in non-Magnet hospitals. Hypothesis: Black patients will be less likely than Whites to be cared for in Magnet hospitals. Black patients in Magnet hospitals will be less likely to receive aggressive care compared with Black patients in non-Magnet hospitals. Despite widespread efforts to improve patient-centered end of life care, older adults with cancer often receive poor quality care characterized by aggressive medical intervention which is often in conflict with their preferences for maximizing quality of life. We build on previous research, to generate new knowledge about the role of hospital nurses’ work environments in the provision of patient and family-centered care for terminally ill patients. If our hypotheses are confirmed, the findings from our study will inform efforts to improve care for seriously ill older adults who are hospitalized at the end of life.
(1) To design and pilot a mobile-phone-based high-frequency survey platform to measure sexual behavior and contraceptive use among young women. The app will be used to gather weekly data on sexual behavior and contraception use in a highly anonymized, private forum. By developing an appealing, user-friendly mobile app, we will both increase participant adherence and the accuracy of this sensitive data. We will also be able to gather data at a much higher frequency than is practical with in-person surveys, allowing the measurement of how contraception use varies across partners and encounters, which will reveal which barriers are materially important to use. (2) To launch this survey to 1,000 female undergraduates at the University of Zambia and collect weekly data for 12 months, beginning in fall 2018. This population is important and under-studied: they are women with a high demonstrated value of education, and thus high opportunity cost of pregnancy. Nonetheless, focus groups suggest barriers to contraception use still persist in this group, but little is known about the actual incidence of unintended pregnancy, or it’s consequences. This weekly survey, consisting of 5-10 questions about last sexual encounter, including method of contraceptive (for users), and barriers to usage (for non-users), pregnancy if it occurs, and subsequent outcomes, will allow us to generate high frequency data on women’s contraceptive choices and outcomes. We will recruit women in their dorms using female surveyors at the beginning of the term. Each week, women will be prompted by the application to fill out the survey, and their responses will be sent to the researchers on a secure server. (3) To analyze these data to better understand the extent to which pregnancy can be a barrier to tertiary education among this population, and to document potential barriers to contraceptive use. The unique, high frequency data on sexual encounters, pregnancy, and contraceptive use across different encounters collected through the app will provide several new insights, providing evidence that could be used in the optimal design of policy and contraception-promoting interventions. Multiple observations across encounters and partners for a given woman will help disentangle the quantitative importance of different barriers to contraceptive use, including those that are woman-specific (which require access or informational interventions, partner-specific (and could be addressed by bargaining interventions, or example), or encounter-specific (which might be addressed by greater access to long-acting methods). The longitudinal nature of the data will allow us to document the incidence of pregnancy in this important population, as well as the frequency of unintended pregnancy. Moreover, we will use the fine timing of the data to document the extent to which pregnancy could be causing dropout, as well as other outcomes following pregnancy.
Conduct a pilot randomized controlled trial with ~100 men engaged in fishing and other income-generating activities and offer 50 of them 3 months of lottery-based incentives to save money using mobile phone-based savings accounts. We will develop the prize-linked savings intervention through consultation with Kenya’s leading ‘mobile money’ service provider. We will also develop education and counseling materials to accompany the intervention. Over a 3-month follow-up period, we will compare financial savings and expenditures on key items such as food and items of interest from the perspective of HIV risk (alcohol, gifts and transfers to sexual partners, and sexual behavior) between those offered the prize-linked savings intervention and the control group. We will primarily use survey methods to measure the main outcomes and assess whether the intervention has adverse consequences. In summary, the pilot project will assess the feasibility and acceptability of an innovative prize-linked savings intervention. It will also generate vital preliminary data on likely effect sizes and develop recruitment procedures and data collection tools – all of which will be useful for an R01 proposal to conduct a larger randomized trial that will rigorously test the effect intervention on health and economic outcomes.
Aim 1: Empirically quantify the impact of automatic enrollment retirement policies on retirement savings and total savings. Aim 2: Test the hypothesis that the perceived costs of retirement saving prevent workers from saving for retirement. Aim 3: Estimate the size of the upfront costs. Aim 4: Explore alternative optimal default policies
The proposed research will improve understanding of the health profile of the aging Hispanic population in the United States and shed new light on social and biological mechanisms and life course processes underlying racial, ethnic, and nativity-status disparities in health. By examining how exposure to a diverse and comprehensive set of acute and chronic stressors across the life course relates to the biological risk and physical functioning of aging Hispanics, this research will provide new knowledge of the social patterning and determinants of population health disparities and inform prevention and intervention efforts aimed at achieving health equity.
Analyzing motor vehicle crash data that is linked to other existing administrative data sources (e.g., driver licensing data) has the potential to catalyze advancements in our understanding of older driver crashes—an important cause of morbidity and mortality among older adults in the US. The proposed study, which includes analysis of the unique and comprehensive New Jersey Traffic Safety Outcomes data warehouse, will be the first longitudinal study of older adults’ rates of driver licensure and adverse driving outcomes (2004-2014). Findings will serve as initial analyses for a planned program of research that will directly inform and impact rehabilitation and treatment efforts, licensing policies, and other strategies to enhance older driver safety and reduce the burden of older driver crashes and injuries.
The project will advance global knowledge of long-term care delivery and financing systems, providing a new evidence base for both public policy design and private services development. By exploring a new long-term care funding mechanism, the project aims to support the development of long-term care services globally and in China. Lessons learned for China will be informative for other countries facing the challenge of how to finance long-term care costs such as the U.S.
Learning about your taxes is aversive. However, when making decisions about a retirement savings strategy, about labor supply, or indeed about most financially consequential economic decisions, it is critical to have a complete understanding of the tax consequence of these actions. In this project, we aim to better understand the nature of “tax information avoidance,” and to integrate knowledge of this behavior into our models of decision-making in these environments.
Chronic pain has the potential to limit the lives of millions around the globe as they age -- impeding their ability to have a healthy, inspiring, and productive life in their later years. The interdisciplinary team involved in this research project will draw on expertise in fields including public health, economics, aging, and psychology to examine the potential broader impacts of pain on cognitive function and productivity over the life course using a rigorous RCT. This research will contribute new knowledge to the understudied subject of the consequences of physical pain, providing evidence of both academic interest and policy relevance.
A lack of safe, accessible transportation leads to degradation in medical care as 3.6 million Americans do not obtain non-emergency medical care because of a lack of transportation in a given year. The specific barriers and breaks in the transportation travel chain that limit elder mobility, particularly in their access to healthcare facilities, remain largely unknown. This project will unite transportation engineering and public health together with the goal of understanding the physical infrastructure constraints and the perceived constraints of elderly travelers as they traverse the transportation network and how these factors ultimately determine the mobility of the elderly.
This project will develop and estimate a model to understand the impact of personality traits on individual’s schooling and occupational choices and the potential feedback effect of schooling and occupational experience on the evolution of personality traits. The analysis will inform about the determinants of unobserved heterogeneity, which has been found to be important in the prior literature, and provide us a baseline framework to evaluate the effect of educational policies, such as college tuition subsidy. Thus, this project helps to: (1) understand the potential causal relationship between personality traits and educational and occupational choices; (2) quantify how heterogeneity of workers’ personality traits affects lifetime earnings and inequality, and (3) evaluate the redistribution effect of college tuition subsidy policy.
The Project aims to determine whether outcomes for patients with AD are better when they are cared for in hospitals with better nursing resources (patient-to-nurse staffing ratios, skill mix, nurses’ education, and the quality of the work environment). We expect to confirm that outcomes are worse for patients with AD than for similar patients without AD. However, patients with AD will fare better when cared for in hospitals with better nursing resources. It also aims to determine whether racial and ethnic disparities in AD outcomes are narrowed in hospitals with better nursing resources (patient-to-nurse staffing ratios, nurses’ education, skill mix, and the quality of the work environment). We expect to find that outcomes are worse for patients with AD who are minorities but the gap between minorities and non-minorities will be less in hospitals with better nursing resources.
Our project seeks to evaluate how UI differentially affects older versus younger workers’ labor supply and the impact of UI extensions (and their removal). Our results will improve understanding of how people with heterogeneous characteristics respond differently to policy changes. If the proposed aims are achieved, the results can provide guidance to policymakers on designing more effective UI policies in future recessions.
The design of pension and health care policies for the elderly requires that we understand the expenditure decisions of the old. Two fundamental characteristics of the elderly are that their health worsens with age and that it does so at different rate for people in different socio-economic groups (Pijoan-Mas and Rıos-Rull (2015)). The question that we plan to address is how do age and health shape preferences and consumption decisions. Surprisingly, very little work exploring effects of health on consumption Specifically, we aim to estimate the effect of health on the marginal utility of consumption. For this we use a model where the evolution of health is itself endogenous. However, we only need to use the consumption Euler equation to estimate structural parameters. This feature greatly reduces the complications of the process and allows us to be agnostic about how is the actual technology that improves health. We exploit plan to exploit differences in consumption growth by age, education, wealth, and health groups that provide enough variation to allow for identification. We use estimates of health transitions by age, education, and wealth that we can interpret as the outcome of optimal behavior and that provide the variation in the data necessary to produce tight estimates.
Mental health, and specifically depression and anxiety, is a particularly important subset of non-communicable diseases in sub-Saharan African low-income countries. This project will help understand the determinants and consequences of poor mental heath and depression/anxiety in sub-Saharan African lowincome countries. The knowledge gained as part of this project has the potential to help societies to improve the mental well-being of mature adults in context where the public health system is likely to remain inadequate to provide support for depression/anxiety and poor mental health.
In this proposed pilot project, we aim to demonstrate that in the presence of intergenerationally-correlated endowments, the many studies that purport to estimate the effects of parental and grandparental characteristics on child outcomes are misinterpreted in ways that are likely to overstate substantially direct parental effects and indirect grandparental effects, and maybe even have the sign wrong for direct grandparental effects. By “intergenerationally-correlated endowments” we mean important factors that affect the outcomes of interest that are usually not observed in social science data, and that are transmitted from one generation to the next, such as family culture or genes. The basic purposes of this pilot project are to develop this point, summarize and reinterpret three-generational studies in the literature in light of this point, develop a model that will permit identification of grandparental effects with data on four generations, locate data across four generations, and then prepare a National Institute of Health (NIH) grant application to explore and reinterpret intergenerational relations in depth to understand better their causal nature.
Policies related to aging often seek to support wellbeing among individuals who may have lower human capital or ability to participate in the labor force and declining financial assets. The asymmetric aging of the reproductive system may have important distributional impacts on older individuals, leading to older women having fewer avenues for financial support (since they may no longer be considered eligible marriage partners). By studying a policy that aimed to ameliorate the impact of aging on women’s ability to have children through access to IVF and other medical interventions, this project contributes to measuring the scope for policymakers to address the gender-specific impacts of aging, and, in particular, how such policies may lead to women making different decisions earlier in life, due to the later-life insurance provided by access to assisted reproduction technologies.
Research on population aging generally focuses on a particular elderly population in a specific location. However, a growing literature on transnationalism emphasizes that for immigrant populations, societies of origin and settlement are linked through a dense web of economic, cultural, and political connections. While these connections hold the potential to powerfully shape aging on both sides of the border, the relationship between migration and aging remains understudied. This paucity of information is particularly problematic in the case of Latin American migration to the United States, due to rapid population aging and high levels of need on both sides of the border.
RC28 Conference is a well-known venue for scholars from various parts of the world to meet and discuss theoretical and policy issues related to social inequality which is of growing concern in many countries. Having sessions particularly related to aging and life course in RC28 conference, we hope to stimulate public conversations on socioeconomic disparities in aging, life course trajectories, and inter-generational wealth transfers and savings from comparative and international perspectives. The conference will provide an important opportunity for scholars and public policymakers to discuss various experiences and challenges each country faces in relation to aging population.
Good health care for the aging U.S. population is inextricably tied to the “health” of the also-aging nursing workforce. The willingness of nurses to continue working is tied to their job satisfaction, which includes benefits (retirement, health). More information linking the organizational aspects of nursing—including benefits and nurses’ knowledge about benefits—to nurse job satisfaction, burnout, and plans for retirement is crucial to national healthcare.
In the United States, prescription drug spending is a large and growing component of both total health spending and overall GDP; understanding the determinants of drug spending is important from an economic perspective and as a matter of national policy. This project focuses particular attention on generic pharmaceutical pricing, and the extent to which two crucial inputs – manufacturer market structure and government intervention – determine the prices paid throughout the supply chain. In doing so, we hope to shed new light on the causal welfare effects of several policies regarding pharmaceutical competition and regulation.
To enhance the scientific value of the forthcoming 5th round of the Malawi Diffusion and Ideational Change Project (MDICP) by collecting data on the non-resident parents of respondents in the MDICP.
The specific aim of this project is to understand how the widespread adoption of the new generation of anti-depressants known collectively as selective serotonin reuptake inhibitors has affected labor market outcomes.
To test the hypothesis that HIV-negative individuals living in a community of high HIV-AIDS prevalence have a greater risk of contracting the disease if their high-sensitivty C-Reactive Protein is elevated > 3.0mg/L; and to evaluate the overall health of some 1000 persons living in Balaka region in Northern Malawi.
To develop computer programs to put Framingham Study data into a format that can be read into the demographic programs; to revise the analysis programs to increase the speed with which they process the data; and to develop a mechanized approach to scanning the results and identifying SNPs that appear to be associated with longevity.
To investigate the effects of early life socioeconomic status, place of birth, and household structure on cause-specific mortality and familial clustering of cause-specific mortality in Finland during the latter half of the Twentieth Century.
To analyze the empirical determinants of Chilean workers’ decision to annuitize at retirement or not.
To determine whether or to what extent control beliefs differ by personal attributes; to determine whether or to what extent financial well-being differs by personal attributes; and to determine whether or to what extent control beliefs mediate the relationship between personal attributes and financial well-being.
The specific aims of this project include: Create the first large-scale complete-sexual-network study with detailed phylogenetic data in sub-Saharan Africa; Use the molecular-genotype data to establish chains of HIV infection; and investigate the impact of sexual network structures on the rate at which recombinant forms of the virus, dual infections as well as superinfections, emerge within a population.
To test two hypotheses using data from a nationally representative sample of 18,102 American adults (NAAL): 1) health literacy is positively associated with self-rated health for both men and women, net of various covariates; 2) the effect of health literacy on self-rated health increases by age for both men and women.
To examine how people's perceptions about local rates of infection, about their own or their spouse's HIV status, and their perceived risk of infection affects their behavior with regard to decisions to get tested for HIV, to engage in extramarital affairs, and to use barrier methods of contraception.
To examine the relationship between physical activity and risk of Alzheimer's and other dementia, between physical activity and change in cognitive function from baseline to follow up, between dose of physical activity and risk of dementia as well as change in cognitive function; and to explore the effectiveness of various types of physical activity on cognitive health
In the US, most employees offered defined contribution (DC) pension plans are provided a wide variety of investment options to chose from, when allocating their retirement saving portfolios. This study will investigate what happens when workers are offered a new type of investment option, namely, Life Cycle (LC) funds, which have been introduced in the last five years by pension plan sponsors.
To investigate the extent to which the impact of childhood disease and nutrition on adult outcomes can be captured by the more commonly-available data on height and lower leg length.
To create the Malawi AIDS Research Database (MARD) to be housed at the College of Medicine (COM) at the University of Malawi, which will include (1) unpublished articles and reports that constitute the bulk of research on AIDS in Malawi; (2) links to published articles that are available without subscription on the Web; and (3) published articles accessible through the PSC Demography library.
To evaluate the effect of Chile’s pension system rules and regulations on individuals’ contribution patterns.
To collect measures of health and time preference among a new sample of adults and elderly in peri-urban Durban, South Africa, with each age-stratum further divided into those who are healthy versus those who are not; to collect longitudinal measures of health and time preference among micro- and small-enterprise owners around Durban (also previously collected 2004); and to analyze relationships between health and the ‘individual discount rate’ and between changes in health and changes in the ‘individual discount rate.’
To evaluate the effectiveness of financial incentives in promoting weight loss among obese individuals and to use the difference in weight loss measured at 16 weeks to project the long-term cost-effectiveness if weight loss is sustained.
To determine whether dual eligibles in states with higher copayments will have lower antidepressant use and adherence than those in states with lower or no copayments.
To advance our understanding of variations in health status among native-born and foreign-born Hispanics, NH-Whites, African-origin populations, and Asian Americans, including sub-populations within these broad race/ethnic groups.
To measure the efficiency shortfall patterns in pension plan menu offerings and to characterize these patterns according to employee and plan characteristics.
To assess the variation in literacy skills among older adults, particular the literacy gap between those with high levels of formal educational attainment and those with low levels of educational attainment.
To document mortality patterns in Bulgaria during 1992-98, providing the first reliable life tables and other mortality measures according to religion and ethnic group; and to analyze mortality differentials between Muslims and non-Muslims, focusing on the principal factors expected to account for lower Muslim mortality.
To evaluate the effect of attitudinal, subjective norms, and perceived behavioral control/structural factors on achieving sustained blood pressure (BP) control in hypertensive elderly patients aged >70 and to examine the impact of functional status/comorbidities as barriers to control.
To examine the dynamic effects of price fluctuations on trading behavior when investors are averse toward anticipated regret.
To determine the cross-sectional relationships between weight status and SES/class and conduct cross-cohort comparisons to evaluate secular shifts in the relationship over time.
To develop a behavioral model of decisions about schooling and work, prepare datasets, and do some preliminary data analysis.
To seek explanations of the recent poor performance of mortality among older women in the United States, relative both to older men and to women in previous eras.
To examine empirically the population-level structure of sexual networks and explore the role they may play in fostering the spread of HIV as well as in explaining the discrepancies observed between indicators of sexual behavior and epidemic outcomes.
To apply existing and develop new models of intergenerational and inter vivos transfers to explain motivations for such transfers in a high HIV prevalance county and to investigate whether transfers differ by households that are and are not affected by AIDS
To further the public dissemination of primary qualitative data to other researchers by using the Malawi project data to set a standard and by collaboration with ICPSR to promote the development of new software and/or technology to facilitate the process of anonymizing qualitative data.
To examine interactions among three generations in Guatemala using unusually rich longitudinal data over 35 years that will increase the research productivity of an existing project through added data collection that is not already funded by the existing project.
To exploit the panel feature of the Panel Study of Income Dynamics (PSID) to estimate income volatility directly for many individuals.
To fill a gap by quantifying the effects of the policy change on the general health status, life expectancy, and medical care consumption of Medicare beneficiaries.
To uncover the motivations underlying transfers by examining transfers patterns derived from experimental economics games combined with data derived from survey and qualitative interviews
To evaluate what Chileans do and do not know about their retirement system after two decades of the new program, and, to the extent that current participants and potential participants prove under- or mis-informed, to learn what aspects of the plan seem particularly difficult to fathom and what might be done to correct the lack of information and/or misinformation.
To demonstrate the pattern of change in the DSRS and the variation in progression rates among cases
To understand the relationship between both (a) the survival and (b) the co-residency of grandparents and their grandchildren’s mortality, based on the 1993 Gambia census.
To understand the impact of intra-household co-insurance consumption commitments and precautionary saving
To analyze the factors associated with the use of self-medication in Mexico using survey data on adults aged 50 and older from the Mexican Health and Aging Study
Variations in rates of aging and in age distributions across local areas.
Causal links between health insurance, health, and labor force behavior using MHAS.
Household decisions regarding savings, consumption, employment and health behavior over the life-cycle.
Health disparities among the elderly and old population by socioeconomic status, race and ethnicity in the US and Mexico.
Educational and income inequality in all cause and cause-specific mortality by age and sex in Finland and the US.
Determinants of the living arrangements by constructing and estimating models where mothers and children make choices that bear in whether they live together or separate.
Pension regulatory and supervisory structure.
This study is designed to (1) extend previous analyses of trends in socioeconomic inequality in all cause and cause-specific mortality by age and sex in the United States, (2) investigate whether these trends have been similar among whites and African Americans, and (3) examine trends in the distribution of various risk factors, such as obesity and smoking, by socioeconomic status. The results of these analyses will help determine whether the documented increase in socioeconomic inequalities in mortality between 1960 and the 1980s has continued into the 1990s. The cause-specific investigations together with the analyses of trends in mortality risk factors by SES will point to areas where public health interventions might be most effective. The results will also provide input into further studies designed to illuminate the processes that link SES to health and mortality.