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A Center for Interdisciplinary Research and Training in Population Aging and Health at University of Wisconsin - Madison |
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Project Database
Development and Support for the Elderly in Indonesia
Researchers: Victoria BeardAbstract: In the last 30 years, Indonesian society has undergone profound social changes related to economic development. Despite speculation about the effects of these changes on support for the elderly, this study is the first to focus on how the development-related characteristics of adult children affect the type and level of support provided to elderly parents. The objectives of this study are: (1) To discover how the characteristics of adult children affect whether they give support in the form of co-resident living arrangements or in the form of money, time or goods provided to elderly parents living separately, and (2) to see how these characteristics affect the amount of money, time or goods given. Support has traditionally been provided in the form of co-residence with elderly parents because most elderly Indonesians do not receive a pension or any other form of social or economic support from outside of the family.
Funding Institutions: NIH-NIA (R03 AG2065203: 2003-2006)
Status: Complete
Publications: Yes (Search Project Bibliography)
Aging and the Family over the Life Course
Researchers: Larry Bumpass (Professor, Emeritus, Sociology, University of Wisconsin - Madison)Abstract: This is a proposal for an addition to the longitudinal data from the National Survey of Families and Households (NSFH). NSFH occupies a unique niche defined by the great depth of data on family interactions (up, down, and across the generational ladder) in the context of a holistic approach that includes measurement across a wide range of substantive domains. Approximately 10,907 subjects would be surveyed, including 6072 main respondents, 2948 original spouse/partners, 1072 new spouse/partners at NSFH-2, and 815 new spouse/partners at NSFH-3. This sample will range in age from the thirties to the nineties. Previous NSFH data collection has accumulated considerable information about the respondent's parents and their childhood (including childhood socioeconomic status). Complete life event history information is available for respondent's living arrangements in childhood, cohabitation, marriage and union stability, fertility, and employment. Proximity, contact, caregiving, relationship quality, co-residence, and the exchange of financial, instrumental, and emotional support with adult children and parents (and parents-in-law) have been tracked. Relationship quality with spouse, contact and support (including caregiving) exchange with siblings, other relatives, and friends has been assessed. Information on social integration in community and religious activities as well as about a wide range of social psychological attitudes, including attitudes about intergenerational obligations and orientations toward retirement is available. Detailed information about income, wealth, physical health, and psychological well being was included at both prior waves of the survey. The new wave will extend these observations for another 8 years, more than doubling the number of transitions observed between the first two waves.
Funding Institutions: NIH-NIA (R01 AG10266: 5/15/1992-3/31/2006)
Status: Complete
Publications: Yes (Search Project Bibliography)
Health and Well-being of Families in Transition
Researchers: Larry Bumpass (Professor, Emeritus, Sociology, University of Wisconsin - Madison)Abstract: With joint funding from NIH, this NIA project has supported the design and content of the 1992-94 and 2001-2002 waves of the National Survey of Families and Households (NSFH). The NSFH occupies a unique niche defined by the great depth of data on family interactions (up, down, and across the generational ladder, (as well as individual outcomes with respect to health and well-being)in the context of a holistic approach that includes measurement across a wide range of substantive domains. As a resource for researchers (and policy makers) at large, findings from the NSFH are reported in over 400 articles. An incomplete list is provided at http://www.ssc.wisc.edu/nsfh/bib.htm . A great many of these articles concern research with implications for the elderly and near elderly, for example, the over 70 listed under "Kin contact/Kin relationships." This project has been completed, but analyses continue by researchers from many institutions across the country (and the world) who represent a number of different disciplines.
Funding Institutions: NIH-NICHD (R01 HD21009: 1/1/1986-2/28/2007)
Status: Complete
Publications: Yes (Search Project Bibliography)
Exercise and Physical Activity in Older Adults
Researchers: Richard T. Campbell (Professor, School of Public Health, University of Illinois at Chicago) and Sue HughesAbstract: It is important to increase exercise activity in older adults. This project evaluates effectiveness of Fit and Strong Program in community settings. We have seen an increased number of desirable outcomes in both a laboratory setting and in community settings. We plan to extend the program to other work sites.
Status: Ongoing
Publications: Yes (Search Project Bibliography)
Race, SES and Breast Cancer
Researchers: Richard T. Campbell (Professor, School of Public Health, University of Illinois at Chicago), Richard Warnecke, and Therese DolecekAbstract: We are developing new methods for the analysis of racial, ethnic and socioeconomic disparities in breast cancer outcomes. Our objectives are : 1. Use ordinal regression methods to provide a more comprehensive analysis of stage at breast cancer diagnosis, and 2. Develop better methods of using area-based socioeconomic data from the Census. Ordinal regression methods provide a clearer understanding of health disparities. Census-tract level SES measures tend to conceal substantial within-tract heterogeneity. Empirical Bayes estimates of poverty based on a cross classification of race/ethnicity and age are more appropriate. The current analyses are based on Cook County IL. We are in the process of extending the research to a number of other areas.
Status: Ongoing
Publications: Yes (Search Project Bibliography)
State HCBS Funding and Long Term Care
Researchers: Richard T. Campbell (Professor, School of Public Health, University of Illinois at Chicago) and Naoko MuramatsuAbstract: Funding for home and community based services (HCBS) may delay nursing home placement for disabled elderly. The goal of the research is go access the effects of HCBS. States vary immensely in the provision of HCBS. We first acquired data on each state's expenditures from 1990 to the present and linked these data with a restricted version of the HRS/AHEAD survey. We then used discrete time survival models to evaluate the effect of state level HCBS on the rate of transition to nursing homes. State HCBS delayed nursing home placement for elderly persons who had one or two children but not among those with larger families. There was a clear interaction between family size and the effect of HCBS. We are extending this work to older cohorts and other samples.
Status: Ongoing
Publications: Yes (Search Project Bibliography)
Long Term Outcomes of Childhood Abuse
Researchers: Mary Lindsey Carnes (Biddick Professor of Women's Health Research, Medicine, University of Wisconsin - Madison) and Kristen W Springer (Assistant Professor, Sociology, Rutgers University)Abstract: Childhood abuse and maltreatment are linked to an array of adverse mental and physical health outcomes in early and mid adult life. The contributions of such remote abuse on health as individuals age has not been well studied. Objectives are: 1. To examine the relationship of childhood physical abuse to various mental and physical health measures in the existing WLS data 2. To develop questions capturing multiple domains of childhood abuse and maltreatment in the new WLS wave. To date, we have found that even after controlling for family background variables, education, gender, and age, self reports of experiencing physical violence "some" or "a lot" by either parent significantly increased self-reported somatic symptoms in virtually all organ systems as well as depression, anxiety, and hostility. Plans are: 1. Inclusion of more questions on childhood abuse and maltreatment in the upcoming WLS will enable a more extensive exploration of the long term health outcomes as well as examination of mediating factors.
Funding Institutions: DHHS (10/01/2002-9/30/2003)
Status: Complete
Publications: Yes (Search Project Bibliography)
Late Life Widowhood in the United States
Researchers: Deborah Carr (Associate Professor, Sociology, Rutgers University)Abstract: The death of one's spouse is considered among the most stressful life events. Late-life widowhood may pose important emotional and physical challenges for surviving spouses. This group of studies investigates the psychological, social, and interpersonal consequences of late-life spousal loss. An overarching goal is to explore how pre-loss characteristics, including marital dynamics and psychological traits, affect adjustment to loss in the short- and longer-term. Adjustment to spousal loss is closely tied to marital dynamics and social relations maintained over the life course. Current studies include an examination of couple-level concordance of assessments of marital quality and their implications for the psychological adjustment of bereaved spouses; the extent to which the psychological consequences of spousal loss are moderated by coping style (i.e., problem- or emotion-focused coping); and the extent to which the psychological consequences of spousal loss are contingent upon personality traits, measured with the Big 5 inventory (e.g., agreeableness, neuroticism).
Status: Ongoing
Publications: Yes (Search Project Bibliography)
The Consequence of End-of-Life Planning for Bereaved Family Members: a Prospective Study
Researchers: Deborah Carr (Associate Professor, Sociology, Rutgers University)Abstract: Formal preparations for end-of-life medical care are believed to protect the dying and their family from unwanted pain, psychological distress, and financial burden. Identifying the prevalence and consequences of such preparations has important implications for developing effective interventions among older adults and their family members. We document the sociodemographic and psychological correlates of end-of-life planning; explore the consequences of such planning for older adults who recently lost a parent; and explore the ability of older adults to accurately predict their spouse's preference for end-of-life care The likelihood of engaging in formal end-of-life planning is highest among the well-educated, those who recently experienced the painful death of a loved one, and those with low levels of death anxiety. Whom older adults appoint as a health care proxy varies by family status and gender, where women are more likely than men to appoint a child rather than a spouse to make such decisions. Married persons typically turn to their spouse, and parents typically turn to their children. Unmarried childless persons show great heterogeneity in their appointments of health care proxies. We plan to revise and resubmit a proposal to NIA, which requests funding to do a continuous followup of recently bereaved children, spouses, and siblings of Wisconsin Longitudinal Study graduates and their siblings. The study would enable us to document prospectively the consequences of end-of-life planning, and to obtain multiple reports on conflicts pertaining to end-of-life care.
Status: Ongoing
Publications: Yes (Search Project Bibliography)
The Impact of End-of-Life Planning on the Quality of Death & Survivor Well-Being
Researchers: Deborah Carr (Associate Professor, Sociology, Rutgers University), Betty J Kramer (Professor, Social Work, University of Wisconsin - Madison), and Karen C. Holden (Professor, Consumer Science, University of Wisconsin - Madison)Abstract: We propose to examine for a sample of recent decedents the impact of end-of-life planning on the quality of their dying process, and on the psychological and financial well-being of their survivors. We make use of data on the recent decedents’ end-of-life planning activities obtained prior to their deaths; thus, we have the unique opportunity to examine prospectively the influence of end-of-life planning on the subsequent well-being of their bereaved family members. We also will investigate whether the decedent’s end-of-life planning is associated with the quality of care received at the end of life, as well as the quality of the dying experience, where such assessments are offered retrospectively by two bereaved family members who are knowledgeable about the decedent’s end-of-life experiences. Our research will be based on data from the Wisconsin Longitudinal Study (WLS), a large survey of men and women who graduated from Wisconsin high schools in 1957, and their siblings. We propose a continuous tracking of deaths to WLS graduates and siblings who have died since the 2003-05 wave of data collection, and we will then interview two bereaved family members.
Funding Institutions: NIH-NIA (P01 AG021079: 9/15/2002-6/30/2012)
Status: Ongoing
Publications: No
Assessing Return Migration of Southerners during the Late Twentieth Century
Researchers: Katherine Curtis (Assistant Professor, Community & Environmental Sociology, University of Wisconsin - Madison)Abstract: This project produces new knowledge about the role of return migration to the American South in exacerbating or reducing racial inequality in southern poverty from 1970 to 2000. Deep racial divisions persist in this part of the country despite general declines in overall poverty and improvements in race relations. At the same time, the region has experienced net in-migration, known as return migration. Return migration is anticipated to influence racial inequality by either altering or reinforcing the race-specific socio-economic composition of the southern population, much in the way that the southern out-migration altered American race relations during the Great Migration of the early 1900s. Return migration at the closing of the twentieth century is a key sociological and demographic event for African Americans and a significant contributor to the contemporary economic expansion, population growth, and urbanization of the South. Racial dynamics are central to these processes. The project clarifies and explains aspects of this watershed demographic phenomenon. This research has an explicit consideration of community and individual factors. Our ecological and contextual analyses include advanced spatial data analysis techniques and multilevel modeling strategies to estimate the impact of the return migration on southerners and their communities.
Status: Ongoing
Publications: Yes (Search Project Bibliography)
Employment in Nonprofit Organizations
Researchers: Martin David (Professor, Emeritus, Economics, University of Wisconsin - Madison)Abstract: Employment in nonprofit organizations is measured differently in available sources: Economic Census, IRS Form 990, and BLS/QCEW. Such statistics are badly understated. This project establishes discrepancies in the latter two sources and produces a better understanding of paid employment in nonprofit organizations that serve human population. We combine the BLS/QCEW (a quarterly census of Unemployment Compensation employers) with a census of IRS Forms 990/990-EZ filed by charitable organizations (IRC 501(c)(3). The result increases the coverage of employment data on nonprofit organizations. It also demonstrates major gaps in the coverage of both record systems. We found imputed employment for nonreporters exceeds 0.6 m. Our best estimate of employment in charitable organizations, 11.7 m. in 2003 far exceeds the QCEW. The counting of employees is heavily censored and truncated in available sources. Our comprehensive comparison of nonprofit and for-profit organizations delivering educational, social or health services can be achieved by techniques tested for 2003 data. Presentations of completed research have been given to relevant statistical agencies and professionals.
Status: Complete
Publications: Yes (Search Project Bibliography)
SIPP Survey Redesign
Researchers: Martin David (Professor, Emeritus, Economics, University of Wisconsin - Madison)Abstract: Survey of Income and Program Paricipation (SIPP) is a nationwide lognitudianl survey. It has problems on misreporting of income and use of poverty-related programs occurs because of "seam bias". That relates to respondents' using heuristics when direct recovery of information from memory is not possible. The original survey design for SIPP exposed measures of measurement errors in reporting event histories. Proposals for redesigning the survey lose that capacity and replace existing within year measures by an event history approach. The design under discussion may not reduce the level of cognitive errors in reporting income. I propose overlapping panels and related measurement error research. My work examines such methodological problems affecting the quality of measurements of poverty and poverty-related programs for the Census Bureau. It will be used in planning for future data collection from SIPP.
Status: Complete
Publications: Yes (Search Project Bibliography)
The Emotional Brain across the Life Course
Researchers: Richard J. Davidson (Vilas Professor, Psychology and Psychiatry, University of Wisconsin - Madison)Abstract: The work conducted with this support is designed to examine the neural bases of emotion regulation in individuals selected from the Wisconsin Longitudinal Study. The objectives of this work are to use functional magnetic resonance imaging to examine the neural basis of emotion regulation. The MR signals will then be examined in relation to life history measures and indices of well-being to determine the correlates of individual differences in emotion regulation. We will also examine the relation between skills at emotion regulation and measures of health and immune function. To date, we have found that individuals with greater relative left-sided prefrontal activation exhibit faster recovery from negative emotional stimuli. These individuals also report higher levels of psychological well-being and have a more robust response to influenza vaccination. We plan to continue testing additional subjects.
Funding Institutions: NIH-NIA (P01 AG021079: 9/1/2002-8/30/2007)
Status: Ongoing
Publications: Yes (Search Project Bibliography)
Estimating Union Status for Living Arrangement Research
Researchers: Susan De Vos (Scientist, Sociology, University of Wisconsin - Madison)Abstract: How good internationally is the assumption that elderly married people live together while unmarried elders live without a partner? Can household data be used to estimate union status? My objective is to use recent census data for 10 countries that report marital status and also enable the estimation of union status from household data, this study juxtaposes reported and estimated status to assess the use of either variable when studying the living arrangements of elderly people. Assumptions about marital status for living arrangements are not good in Kenya but make sense elsewhere. Most elders estimated to be in a union are reported to be married except in France. Many elders estimated to be in a union may not be reported married.
Status: Ongoing
Publications: Yes (Search Project Bibliography)
Indicating Socioeconomic Status among Elderly People in Developing Societies: An Example from Brazil
Researchers: Susan De Vos (Scientist, Sociology, University of Wisconsin - Madison)Abstract: Researchers misuse the ill-defined concept of socioeconomic status in social research on the elderly population. The objective of this research is to investigate the relative advantage of using housing information, educational attainment and current household income to indicate social standing in Brazil. The three possible indicators do not provide similar information and need to be identified for what they are. Education may be the best indicator. A report is forthcoming in the journal "Social Indicators Research".
Status: Complete
Publications: Yes (Search Project Bibliography)
Living Arrangements of Elderly People in Brazil Since 1960
Researchers: Susan De Vos (Scientist, Sociology, University of Wisconsin - Madison) and Flavia AndradeAbstract: What are the trends over time in the family life of elderly people of a highly complex, stratified, developing country such as Brazil? Is the traditional co-residence of elderly people with their children giving way to more independent living among elders in all social strata? Objectives are to better identify and explain significant racial, gender and regional differentials in change over time in the independent living of elderly Brazilians. Preliminary results were presented at the CDHA seminar in April 2003. Results indicate that independent living among elderly Brazilians is on the increase, but the increase is not shared in equally by the three major racial groups and the gap between the groups appears to be increasing. This is not consistent with the theoretical view that expects modernization to result in more independent family living among all elderly people. Data from the SABE study can be used to extend the analysis in meaningful ways. Specifically, SABE can be used to explore intergenerational exchanges that are not limited to coresidence.
Status: Complete
Publications: Yes (Search Project Bibliography)
On Classifying Race in Brazil for Health Research
Researchers: Susan De Vos (Scientist, Sociology, University of Wisconsin - Madison)Abstract: The Brazilian census has a category for people of both black and white background but many researchers contend that a dichotomy of white/nonwhite would be sufficient. Is that true for research on the functional ability of older people? I will assess whether using a dichotomous or trichotomous variable is more descriptive of racial differences in functional ability among elders 60+ in Brazil. A trichotomous variable is preferable. Indeed, there is a significant cross-over effect in which brown elders end up having higher functional ability than white elders after controlling for various demographic, geographical and socioeconomic factors, especially education. My research for the situation in 1998 is completed.
Status: Complete
Publications: Yes (Search Project Bibliography)
Paying Household Expenses Among Elders in Latin America and the Caribbean
Researchers: Susan De Vos (Scientist, Sociology, University of Wisconsin - Madison) and Paulo SaadAbstract: Some elders receive financial assistance from others to pay for their household expenses whereas others do not. Why? Is this similar or different throughout the Latin American and Caribbean region? We assessed the importance of demographic characteristics including coresidence and whether had surviving children for the economic well-being of elders. Our research found that living arrangements and whether people had surviving children were conjointly important in predicting whether an elder had any assistance in paying for household expenses. So was the combination of gender and marital status. Whether the elder had enough money to cover daily expenses did not seem to matter however. Present the study as an article in a peer-reviewed journal.
Status: Ongoing
Publications: No
Race and Independent Living Among Elderly Brazilians Since 1980
Researchers: Susan De Vos (Scientist, Sociology, University of Wisconsin - Madison) and Flavia AndradeAbstract: Although there was an overall increase in independent living among Brazilian elders, that increase mainly reflects change among Whites whereas there was little change among Browns or Blacks. Since Whites tend to have higher socioeconomic status than Browns or Blacks in Brazil, one might suppose that a racial disparity merely reflects socioeconomic differences. Is that true? Our objective is to examine the situation empirically with census data from 1980 and 2000. Our findings suggest that social, cultural or minority status factors not captured in our statistical models may explain some of the difference. Additional study is needed that will ideally include information about non-coresident as well as coresident kin. This report was accepted for publication.
Status: Complete
Publications: Yes (Search Project Bibliography)
Race and the Functional Ability of Older People in Brazil
Researchers: Susan De Vos (Scientist, Sociology, University of Wisconsin - Madison) and Luisa SchwartzmanAbstract: Race in Brazil is sometimes dichotomized as white/non-white. Other times, three categories are used--white, brown, black. What is best for health research? Our research objective is to empirically examine the issue with national household survey data of 1998. Our findings show that there is reason to prefer the 3-category measure as real differences can be missed otherwise. This project has been submitted for publication and we will see that through.
Status: Ongoing
Publications: Yes (Search Project Bibliography)
Disparities in Wages by Marital Status
Researchers: Aimée R. Dechter (Assistant Professor, Sociology, University of Wisconsin - Madison) and Tara BeckerAbstract: Much attention has focused on the role of the institution of marriage in perpetuating inequality through assortative mating; however, married men also earn more and receive higher wages than single men. Few studies have explored the mechanisms for the persisting marriage premium and there is little empirical evidence to suggest what about marriage generates this advantage, and whether men's gains come at the expense of their wife's wages and human capital growth. An objective of this study is to find out whether all men benefit from marriage equally or whether some marriages possess characteristics that are more likely to positively affect men's wages than others. Examining the diversity of the effect of marriage will help to uncover some of the mechanisms that may be operating to create the marriage premium. Another objective is to explore the relationship between the marriage premium on wages for men, and the effects of marriage on their wives' wages. We find that previously married men retain a premium even though they are no longer married. Moreover, this lingering premium of marriage is the source of the so-called cohabitation premium. By treating cohabitation as a marital status, the effects of cohabitation in previous research is actually an artifact of the higher wages associated with having been married. We find weak and inconsistent evidence that the marriage premium varies by basis of pay, relationship quality, and spousal education and work, and no evidence that it differs between first and subsequent marriages. We have completed a first draft of a paper focusing on the mechanisms that generate the male marriage premium; however, we are currently evaluating the economic variables and have been developing systematic methods for improving the validity of variables with crosschecks between waves, consistency checks with spousal reports, matching of reported hours worked with a 24-hour time diary for the pervious week, and other means. After completing that paper, we plan to write a paper on the effect of the male premium on women's wages.
Status: Ongoing
Publications: Yes (Search Project Bibliography)
Implications of Services and Environment for Socioeconomic and Racial Differentials in Mortality
Researchers: Aimée R. Dechter (Assistant Professor, Sociology, University of Wisconsin - Madison), Huey-Chi Vicky Chang (Research Scientist, Sociology, University of Wisconsin - Madison), and Hyunjoon ParkAbstract: African Americans and other minority groups experience poorer health and higher mortality than whites, even when economic well-being is taken into account. Some have argued that the disparity is due to differences in where people live; however, empirical studies have focused on mean aggregated population characteristics of the places people live from census summary files. Few have examined the mechanisms through which these characteristics affect racial and ethnic differences in mortality. The primary goal of our aggregate analysis is to identify sources of racial/ethnic disparities in mortality that may be more readily modified through policy or other means. We ask the following questions: 1) To what degree does the disproportionate allocation of health care services and related goods and resources across counties explain the mortality disadvantages of African Americans, and Hispanics (at most ages)? 2) To what extent do health care programs geared to low income and other underserved populations intervene? We are first gathering data and have done no analyses. We are completing the allocation of missing data for the death data, and the standardization of county codes for the death and population data. Then we can complete the construction of the numerator and denominator for county level mortality rates from 1990 through 2003. We then plan to move on to completing the construction of the explanatory variables from data such as the Area Resource Files, the census summary files, and administrative data on community health centers. Finally, we will conduct county level analyses.
Funding Institutions: Robert Woods Johnson Foundation (10/21/2002-8/31/2003) (pilot)
Status: Ongoing
Publications: Yes (Search Project Bibliography)
Relationship Quality Differences between Marriage and Cohabitation
Researchers: Aimée R. Dechter (Assistant Professor, Sociology, University of Wisconsin - Madison), Yan Yu, and Michael SobelAbstract: Empirical studies consistently conclude that married individuals report happier unions than cohabiting individuals; however, they rely exclusively on mean levels even though happiness is typically measured on a categorical scale, with a skewed distribution. Moreover, previous studies do not distinguish among the dimensions of happiness, including magnitude and hedonomic sign of affect, which have been fundamental concepts for understanding how individuals experience their feelings and emotions in the social psychological literature. We estimate adjacent category logit models, developed by Michael Sobel, to parameterize intensity and propensity for being happy or unhappy, among other contrasts. We find that married couples are more likely to report one of the happy categories compared to cohabiting couples. Our results are unweighted and we need to figure out the appropriate sample weights. Moreover, we plan to estimate the models by assorted covariates, including race/ethnicity and childbearing status.
Status: Ongoing
Publications: Yes (Search Project Bibliography)
The Role of Attractiveness and Personality in the Gains to Marriage and Spousal Quality
Researchers: Aimée R. Dechter (Assistant Professor, Sociology, University of Wisconsin - Madison)Abstract: In addition to education, personality, facial attractiveness and healthy weights are attributes that seem to matter in labor markets. These traits are also highly valued in the marriage market. This project will use measures from the Wisconsin Longitudinal Study (WLS) to examine the effects of these traits on marriage and spousal quality. Our goal is to see weather there is a relationship between young adult attractiveness, weight and personality and later life health. In particular, we will study whether spousal quality is an important intervening variable between these typically unmeasured variables and subsequent health. For example, if there is a big effect of these traits on spousal earnings, there may be a large indirect effect on health.
Status: Ongoing
Publications: No
Who Is Privy To Their Partner’s Earnings
Researchers: Aimée R. Dechter (Assistant Professor, Sociology, University of Wisconsin - Madison) and Tara BeckerAbstract: Most theories of marriage presume that spouses know a great deal about one another and most of the data used in social science research rely on the ability of spouses and cohabiting partners to provide reliable information about one another. The use of proxy reports, a cost-effect way to retrieve information about multiple members of a household, is ubiquitous. However, little is known about how well spouses and partners know information about each other's earnings and time allocation. This paper assesses the availability and consistency of earnings reports by individuals and their spouse or partner, and asks if proxy reports from cohabiting partners are as consistent as are those from spouses. We conduct descriptive analyses of four dimensions of consistency: propensity to provide a report, convergence between reports, direction of inconsistency, and magnitude of divergence. The National Survey of Families and Households interviewed both individuals within couples, and asked each to report on assorted financial and work-life information about themselves and their spouse/partner. We find that marriage matters when it comes to knowing one another’s earnings, especially with respect to giving a valid report. However, conditional on providing a report, cohabiting males are comparable to husbands with respect to providing proxy reports that converge with their female partner’s report of her own earnings. Proxy reports on men from female cohabiting partners are more problematic. The National Survey of Families and Households interviewed both individuals within couples, and asked each to report on assorted financial and work-life information about themselves and their spouse/partner. We find that marriage matters when it comes to knowing one another’s earnings, especially with respect to giving a valid report. However, conditional on providing a report, cohabiting males are comparable to husbands with respect to providing proxy reports that converge with their female partner’s report of her own earnings. Proxy reports on men from female cohabiting partners are more problematic.
Status: Ongoing
Publications: Yes (Search Project Bibliography)
Investigating Sexual Dysfunciton Using AARP Data
Researchers: John DeLamater (Professor, Sociology, University of Wisconsin - Madison)Abstract: This research tests the influences of age, biological, and psychosocial factors on sexual expression in later life. We used the American Association of Retired Persons Modem Maturity Sexuality Survey which collected data on diagnosed illnesses, treated illnesses, sexual desire, sexual attitudes, partner circumstances, and sexual behavior from 1,384 persons ages 45 and older. We found that diagnosed illnesses and treatments are generally unrelated to frequency of sexual activity. Sexual attitudes are related to frequency of partnered behavior and sexual desire is related to frequency of masturbation among both women and men. Satisfaction with the physical relationship with a partner is strongly related to behavior. Age remains significant after all other factors are controlled.
Status: Complete
Publications: Yes (Search Project Bibliography)
Sexual Satisfaction in the Seventh Decade of Life
Researchers: John DeLamater (Professor, Sociology, University of Wisconsin - Madison), Janet Hyde (Woolley Professor, Psychology and Women's Studies Program, University of Wisconsin - Madison), and Mei-Chia FongAbstract: There is little data on the sexual aspects of the lives of people over 60. This population was estimated in 2005 to be one-sixth of the entire population of the US. The objective of this project is to present and interpret data on the sexual behavior and sexual satisfaction of a cohort of men and women ages 62 to 67. We found that psychological distress (CESD) is significantly and negatively associated with, and physical health and marital satisfaction are positively related to, reported frequency of sexual behavior. Distress is negatively associated with, and frequency of behavior and two measures of relationship quality are positively associated with satisfaction with one's sexual relationship. Analyses are ongoing. We are including an expanded set measures of health and daily functioning to see if they are related to frequency of behavior or satisfaction.
Status: Ongoing
Publications: No
Sociobehavioral Data Analysis and Archiving in Aging
Researchers: Janet Eisenhauer Smith (Data Analyst/Archivist, CDHA, University of Wisconsin - Madison)Abstract: The overall objective of this data archiving project is to maximize the likelihood that researchers will use data that has already been collected with NIA funding for innovative and high risk projects. We aim to improve the probability that a researcher will be able to discover existing data and to minimize the time it takes to determine whether those data can support the anticipated research. We also aim to minimize the time between identification of suitable data and publishable research results by providing user-friendly high-functioning standards-compliant metadata and high-quality anonymized (public-use) data for preliminary analyses.
Status: Ongoing
Publications: No
Marriage and Health: the Interpersonal Transmission of Morbidity and Mortality among Elderly Married Couples
Researchers: Felix Elwert (Assistant Professor, Sociology, University of Wisconsin - Madison)Abstract: This project investigates the health consequences of spousal loss and examines the dimensions of variation in this transmission. The widowhood effect - excess mortality due to the loss of a spouse - varies meaningfully by the race of both spouses, by the causes of death of the predecedent spouse and the surviving spouse, and by characteristics of the residential environment of the couple. A newly developed statistical technique indicates that the widowhood effect is robust to unobserved dimensions of homogamy and shared exposure bias. We will study the contribution of spousal loss to the race crossover in mortality.
Status: Ongoing
Publications: Yes (Search Project Bibliography)
Legal Issues of Aging
Researchers: Howard Erlanger (Voss-Bascom Professor, Law and Sociology, University of Wisconsin - Madison)Abstract: There are a couple of emerging issues important to the aging seniors. The first one is to keep their estate plans coordinated and up to date; the second one is to be aware of the fairly rigid rules regarding will execution. On the first point, a major problem can develop when a person gets divorced but does not remove the former spouse as a beneficiary on all parts of the plan [not just the will, but also any assets that pass outside the will, and often these are a significant part of the assets]. There can also be unfortunate results when a plan does not explicitly take into account the possibility that a child might die before the parent, but the unthinkable in fact occurs. On the second point, many people who try 'do-it-yourself' will might not be aware of many potential mistakes in drafting or in execution of such will. For example, there is currently a case being appealed to the Wisconsin Supreme Court where there seems not to be a dispute over whether the document was intended to be the decedent's will, but where there is a question of whether she 'acknowledged' the will to two witnesses, as required by the statute. The witnesses apparently saw the will in the presence of the testator, but she did not come out and say "that's my will." In March of 2006, Dr. Erlanger completed his work on a piece of legislation approximately 70 pages long. It partly addresses these issues but more needs to be done. There will be resistance by lawyers who prefer traditional approaches and by those who are concerned that if it is too easy to correct 'errors'.
Status: Complete
Publications: No
Pension Plan Termination and Retirement
Researchers: Edward W. Frees (Professor, School of Business, University of Wisconsin - Madison)Abstract: The Society of Actuaries’ Non-Mortality Decrement Task Force organized a data collection effort. Thirty-two contributors provided over 1.7 million life years of pension plan turnover data for years 1994-2000. This research summarizes the results of this data collection effort. The research objective of this report was to assess the effects of pension plan characteristics on plan turnover, while controlling for traditional individual characteristics such as age, service and gender. We document the effect of several plan characteristics: eligibility for post-retirement health benefits, benefit formula, hourly/salary and union status, as well as plan size. To assess the effects of plan characteristics while controlling for age, service and gender, we use multinomial logic analysis, a regression methodology suitable for categorical outcomes. We find that small plans have slightly higher termination probabilities compared to medium and large plans (plan size is our proxy for employer size). Union hourly plans have lower termination probabilities than salaried plans; in turn, salaried plans have lower termination probabilities than non-union hourly plans. Firms that offer richer benefits enjoy lower turnover. This work has been submitted to a referred journal. It is in the revise and resubmission stage.
Status: Complete
Publications: Yes (Search Project Bibliography)
Norms and Performance Comparisons of 5 Health Indexes
Researchers: Dennis G. FrybackAbstract: There are 5 "leading" generic health-related quality of indexes (HRQoL)- questionnaires or instruments - in wide use in research, for national and international databases that document population health, and for tracking clinical outcomes among cohorts of patients. However, data collected with one instrument cannot be directly compared to data collected by the others. The overall goal of this program of research is to begin to remedy this lack of comparability across indexes. The research objectives are as follows: 1. To conduct the National Health Measurement Study (NHMS), a national random digit dial survey of U.S. adults, aged 35-89, using all instruments simultaneously to establish joint age-, race- and gender-specific HRQoL norms. 2. To develop statistical "cross-walks" among the measures. 3. To collect longitudinal data in patient cohorts using these 5 measures simultaneously, to establish joint responsiveness to health changes. 4. To develop methods of statistical adjustment for telephone versus self-administration of all instruments. Results from the NHMS (Objective 1) indicate that the indexes exhibit similar patterns of age-related HRQoL by gender and race; however, absolute means differ across indexes. Females report slightly lower HRQoL across all age groups, compared to men. HRQoL is approximately the same for white and black males in younger age groups, but is substantially lower for black males compared to white males in older age groups. Black females report lower HRQoL than do white females at younger, but not older ages. We will utilize the data collected from the NHMS to pursue research objective 2: developing statistical "cross-walks" among the measures. Data collection remains ongoing for objectives 3 and 4 (longitudinal data in patient cohorts, and the mode of administration study).
Funding Institutions: NIH-NIA (P01 AG020679: 4/1/2004-3/31/2008)
Status: Complete
Publications: Yes (Search Project Bibliography)
Exploring Concepts of Population in Human Genetic Studies
Researchers: Joan Fujimura (Professor, Sociology, University of Wisconsin - Madison)Abstract: This project will investigate practices through which biomedical researchers operationalize the concept of "a human population." We will investigate these practices by conducting field observations and interviews in laboratories where researchers study human genetic variation. Researchers typically study genetic variation by assessing the frequencies of genetic markers in a human population, and by comparing marker frequencies among populations. Thus, genetic variation research will provide opportunities for us to observe researchers as they determine which groups to study, how those groups should be described, and how they should be constituted. Human genetic variation is complexly distributed among people around the world. Researchers study this variation for several reasons, including a desire to create tools for finding medically important genes/alleles, and to better understand human demographic history. When studying populations or groups, there are different and nested ways that people can be categorized, including by band, tribe, nation, language group, religious affiliation, geographic location, race, and ethnic group. Commentators have observed that population descriptors often differ within and across genetics studies. No one taxonomic scheme will be best for all purposes, but some might be more informative for particular purposes, some may be easier to implement and validate, and some may produce more or fewer opportunities for confounding. Our project will produce information about how and why scientists choose and institute categorization schemes, and how different concepts of population influence the design, data collection, and analysis of human genetic variation research projects. By making this information explicit we hope to help both scientists and policy makers in planning and evaluating human genetic variation research. Another aim of our project is to examine whether or how laws and regulations pertaining to the inclusion of racial and ethnic minorities in research influence the ways in which populations are constructed. We have already begun and will continue to evaluate published literature on genetic variation as well as laws, recommendations and guidelines that apply to human genetic variation research and that guide scientists in choosing or describing subjects.
Funding Institutions: 1-R03HG005030
Status: Ongoing
Publications: No
Pushed, Pulled, or Blocked? The Elderly and the Labor Market in Post-Soviet Russia
Researchers: Theodore P. Gerber (Professor, Sociology, University of Wisconsin Madison)Abstract: This project uses data from 16 surveys of the Russian population conducted from February 1991 to March 2007 to analyze whether and how labor market participation and earnings of elderly Russians have been affected by Russia’s market transition process. Preliminary analyses conducted of the period 1991-2000 have yielded the following findings: 1) Economic desperation has pushed some elderly to seek employment for income on the labor market, and this effect remained stable during these years. 2) Elderly Russians with college education enjoyed improved opportunities to find materially rewarding work as managers and professionals, especially during the latter half of the 1990s. 3) Labor market contraction and economic crisis associated with market transition blocked the access of many older Rusisans to gainful hired employment, but this mainly occurred during the initial period of reforms (early 1990s). 4) The effects of gender, college education, and unobserved factors on employment and earnings operate differently for the elderly than for middle age Russians. These results suggest that the labor market outcomes for elderly Russians has been complex, showing signs of push factors (desperation), pull factors (opportunity), and barriers (blocked access). This project will be the first phase of a broader comparative project analyzing the labor market outcomes of elderly citizens in post-socialist countries, for which funding will be sought. The next phase of the project carries forward these analyses through 2007 by incorporating additional data from surveys conducted in 2001-2004 and 2007. During this period, the Russian economy grew dramatically, reversing the trend for the preceding period. Thus, by extending the time period covered by the data analysis, it will be possible to disentangle the effects of economic performance (recession, then growth) from the effects of institutional change (market transition, which was not reversed in the 2000s).
Status: Ongoing
Publications: No
The Long Term Impact of Parenting an Adult Child with Bipolar Disorder: a Study of the Wisconsin Longitudinal Cohort
Researchers: Jan S. Greenberg (Professor, School of Social Work, University of Wisconsin - Madison) and Kelly Anne AschbrennerAbstract: The overarching goal of this dissertation research is to investigate the long term impact of parenting an adult child with bipolar disorder. Specifically, this study will use prospective longitudinal data from the Wisconsin Longitudinal Study (WLS) to investigate whether parents of adult children with bipolar disorder differ from parents of unaffected children with respect to parental health and well-being at midlife, and again, ten years later as parents transition to retirement and old age. This study will also examine if and to what extent primary stressors (i.e., child’s illness characteristics), secondary stressors (i.e., work-family strain, marital conflict, child demands), and social resources (i.e., availability of social support) are related to the health and well-being of parents of adult children with bipolar disorder at midlife and in older age. Following a series of screening procedures developed by Seltzer and Greenberg used to identify WLS respondents who are parents of children with a nonnormative condition (i.e., developmental disability or a serious mental health problem), 152 parents of biological or adopted children diagnosed with bipolar disorder have been identified. A comparison group of parents of adult children without disabilities has been drawn to estimate the relative impact of parenting an adult child with bipolar disorder. Results from preliminary analysis reveal that when parents are, on average, in their mid-60s, parents of adult children with bipolar disorder report higher levels of somatic health problems and higher levels of depressive symptoms as compared to parents of adult children without disabilities. There were no differences observed in parental levels of psychological well-being at this time point. The next steps in this dissertation are to investigate whether there were differences in parental health and well-being about ten years earlier when parents were, on average, in their early-50s, and closer to the onset of their child’s bipolar illness. Future analysis will also examine a stress and coping framework used to understand the stress process among parents of adult children with bipolar disorder.
Status: Complete
Publications: No
Estimating Health Expectancies from Two Cross-sections
Researchers: Michel Guillot (Associate Professor, Sociology, University of Wisconsin - Madison)Abstract: Health expectancies are key indicators for monitoring the health of populations, as well as for informing debates about compression or expansion of morbidity. However, current methodologies for estimating them are not entirely satisfactory. They are either of limited applicability because of high data requirements (the multistate method), or based on questionable assumptions (the Sullivan method). This project proposes to develop and test a new method for estimating health expectancies which relies on the multistate framework but uses widely available data. The idea is to use age-specific proportions of healthy individuals at two successive but independent cross-sectional surveys and together with information on general mortality, to solve for the set of transition probabilities that produces the observed sequence of proportions healthy. The system is solved by making realistic parametric assumptions about the age patterns of transition probabilities. Using panel data from the Medicare Current Beneficiary Survey (MCBS) and the Survey of Income and Program Participation (SIPP), this project proposes to test the method against both the Sullivan method and the gold-standard multistate method. The intercensal method for estimating health expectancies developed in this project appears to work perfectly when there is no sampling variability and when the parametric assumptions are exactly met. When we introduce sampling variability, the optimization does not perform as well, particularly for recovery transition probabilities. The corresponding conditional health expectancy estimates, however, appear more robust, in particular for the healthy individuals. We are exploring a number of directions for fine-tuning the method. We are hoping to submit an NIA proposal on this project, depending on how promising our results are.
Status: Ongoing
Publications: Yes (Search Project Bibliography)
Ethnic Differentials in Mortality In Kyrgyzstan
Researchers: Michel Guillot (Associate Professor, Sociology, University of Wisconsin - Madison)Abstract: The purpose of this project is to examine mortality by ethnic group in the former Soviet Republic of Kyrgyzstan from 1959 to 1999. There are major uncertainties about ethnic-specific mortality levels and trends for this population which were unable to be addressed previously due to the lack of available data. We intend to narrow substantially the range of uncertainty by using newly-available census and vital registration data from the National Statistical Committee of the Kyrgyz Republic (NatsStatKom) and by applying demographic estimation procedures that are well-suited to these data. Using a variety of demographic techniques, the quality of census and vital registration data will be assessed, and improved estimates of mortality by ethnic group will be produced. These methods include intercensal comparison of cohort size; a procedure based on the reported age distribution of deaths and age-specific growth rates; and a procedure for producing life tables directly from the age distribution of the population and age-specific growth rates. A particular focus of this research is infant and child mortality by ethnic group. Using reported monthly probabilities of dying below age 2 since 1959 and individual census reports of women regarding their number of births and child deaths in 1989 and 1999, improved and independent estimates of infant and child mortality by ethnicity will be produced for the period 1959-1999. These estimates will permit an assessment of the quality of the reported trends and allow a substantive analysis of the differential effect of the post-Soviet transition period on the child mortality conditions of the various ethnic groups. Behavioral and biomedical risk factor distributions among the various ethnic groups will then be estimated using the 1993 Kyrgyzstan Multipurpose Poverty Survey (KMPS), and the extent to which these risk factor distributions could account for the corresponding mortality differentials at the aggregate level will be assessed. We are currently conducting the second phase of the project, which consists of a direct assessment of data quality and which will help confirming or invalidating these preliminary conclusions.
Funding Institutions: NIH-NICHD (R03 HD38752-03: 4/1/2001-3/31/2005)
Status: Ongoing
Publications: Yes (Search Project Bibliography)
Methodology of Estimating Healthy Life Expectancies
Researchers: Michel Guillot (Associate Professor, Sociology, University of Wisconsin - Madison) and Alberto Palloni (Professor, Sociology, University of Wisconsin - Madison)Abstract: In the last few decades, much research has beendevoted to estimating health expectancies as well as fine tunning measures of total expectancies at older ages. The health expectancy is a population health indicator which brings together data on both quantity (through mortality) and quality of life (usually through disability). The health expectancy measures the number of years that one can expect to live in a defined health status. Health expectancies are important indicators because they can monitor the health of populations with a greater level of detail then traditional life expectancies (Murray and Evans 2003). This project plans to develop and test a new method which relies on the multistate framework, but uses widely available data. The idea is to use age-specific proportions of healthy individuals at two successive, but independent, cross-sectional health surveys and together with information on general mortality to solve for the set of transition rates (in-and-out of disability) that produces the observed sequence of proportions healthy.
Status: Ongoing
Publications: No
Mortality and Population Dynamics
Researchers: Michel Guillot (Associate Professor, Sociology, University of Wisconsin - Madison)Abstract: The aim of the project is to design innovative approaches in mortality measurement and its impact on population dynamics, including population aging. This research presents the implications of a summary mortality index, the Cross-sectional Average Length of Life (CAL). By combining the mortality experience of various cohorts in a cross-sectional fashion, CAL complements traditional one-period or one-cohort indexes and enriches our understanding of population processes. First, CAL provides an alternative insight into the analysis of mortality. By taking into account the real mortality conditions to which individuals in a population have been subject, it tends to yield less favorable mortality levels and produces different rankings of mortality levels across countries. Second, CAL is a relevant index for the study of population dynamics. In particular, change in CAL over time shows the direct impact of mortality change on population growth. It illustrates that mortality can play a non-negligible role in future population growth, even in the absence of future mortality improvements. This project will involve a series of papers. The first paper, which appeared in the March 2003 issue of Population Studies, provides an overview of the findings. A second paper, published in 2005, deals specifically with population momentum, and a third paper, published in 2006, discusses tempo effects in mortality.
Status: Complete
Publications: Yes (Search Project Bibliography)
Mortality in Central Asia
Researchers: Michel Guillot (Associate Professor, Sociology, University of Wisconsin - Madison)Abstract: The goal of this project is to improve our knowledge of mortality in former Soviet Central Asia, a region which gained importance recently. Although there is considerable interest in understanding social, economic and cultural change in the area, because of the strategic role that this region is currently playing, very little is known about local mortality processes. In addition to filling these gaps in contextual mortality information, this project will improve our understanding of the relative role that social, economic and cultural factors can play in determining mortality patterns in developing countries. This project plans to gather and analyze unpublished aggregate- and individual-level data from local statistical offices in Uzbekistan, Kazakhstan, Kyrgyzstan, Tajikistan and Turkmenistan. The analysis of these sources will be complemented by the use of data from Demographic and Health Surveys (DHS) and Living Standards Measurement Study (LSMS) household surveys. The implementation of various demographic and statistical methods will permit (a) the assessment of data quality and changes thereof for each of these five republics since 1958; (b) the estimation of ethnic-specific and cause-specific mortality rates for each of these five republics since 1958; and (c) the estimation of biomedical, economic, social and cultural factors associated with recent mortality levels, trends and differentials in Central Asia.
Funding Institutions: NIH-NICHD (R01 HD045531: 4/15/2006-2/28/2011)
Status: Ongoing
Publications: Yes (Search Project Bibliography)
Projecting Cohort Life Expectancy Using CAL
Researchers: Michel Guillot (Associate Professor, Sociology, University of Wisconsin - Madison)Abstract: Methods for projecting mortality typically rely on the extrapolation of trends in period mortality. Yet trends in cohort mortality are much more stable and thus may constitute a stronger basis for the projection of future mortality. In particular, the mortality experience of cohorts up to the present time, even if truncated, may contain useful information for predicting future mortality. A particularly stable mortality indicator is CAL, the "cross-sectional average length of life". This index, first proposed by Brouard (1986) andhrther developed by Guillot (2003), contains the mortality experience of all cohorts present in the population at a given time. This index is even less subject to annual variations than eOc, the cohort life expectancy. Recently, Goldstein (2006) has established that under certain assumptions about the pattern of mortality change, the value of CAL for a given year is equal to the value of the life expectancy at birth for the cohort born CAL years before. The implication of this correspondence is that under these assumptions, the value of the life expectancy at birth for the cohort born CAL years ago can be accurately predicted from the current value of CAL, even though this cohort is not yet extinct. Goldstein established this correspondence in theory. Yet, our preliminary work suggests that the correspondence between CAL(t) and eOc[t-CAL(t)] may in fact exist in a number of contexts, regardless of the level of mortality and the pattern of mortality change. This also suggests that recent trends in CAL could serve as a useful basis for projecting the life expectancy of cohorts which are not yet extinct, even if Goldstein's assumptions are not exactly met. The purpose of this project is to examine the empirical correspondence between CAL and eOc,and to examine the extent to which CAL can be used as a tool for projecting levels of cohort life expectancy. we will 1) calculate CAL and eOc for all countries and all possible years in the human mortality database (www.mortality.org); 2) establish empirical correspondences between CAL(t) and eOc[t-CAL(t)] whenever possible; 3) examine the patterns of changein age-specific mortality that generate these correspondences; 4) Depending on the results of (2) and (3), examine the extent to which CAL(t) can be used as an estimate of the value for the cohort born at time t-CAL(t); 5) Depending on the results of (4), compare the projected values of cohort life expectancy with estimates projected using existing methods (log-linear projection of mortality rates, Lee-Carter model).
Status: Ongoing
Publications: No
Trends of Healthy Survival in the US: Compression vs. Expansion of Morbidity
Researchers: Michel Guillot (Associate Professor, Sociology, University of Wisconsin - Madison)Abstract: A current debate in the area of population aging deals with the question of whether current increases in life expectancy are being matched by similar increases in healthy life. In recent decades, several hypotheses have emerged: (1) the expansion-of-morbidity hypothesis, which states that seriously chronically-ill individuals are being kept alive by medical interventions, creating increasing demands on health and social care systems while generating limited improvements in the well-being of the population; (2) the compression-of-morbidity hypothesis, which states that the average age at onset of disability increases faster than life expectancy, creating a decrease in the number of years spent with disability; and (3) the dynamic-equilibrium hypothesis, an intermediate hypothesis which states that when disability is defined as severe morbidity, the number of years spent with disability remains relatively constant as life expectancy increases. These are conflicting hypotheses with important implications for the future costs of health and social care systems in low-mortality countries. In spite of the significance of this debate, current methodologies for testing these hypotheses are not entirely satisfactory. They are either of limited applicability because of high data requirements (the multistate method), or based on questionable assumptions (the Sullivan method). As a result, the research on compression vs. expansion of morbidity has not been conclusive. In this project, we propose to contribute to this debate by estimating trends in healthy survival for cohorts using the National Health Interview Survey (NHIS). We will combine observed age-specific prevalences of health statuses in the population with existing cohort life tables. The advantage of this approach is that the two pieces of information (mortality and health) will be conceptually consistent, because they will both refer to actual cohorts.
Status: Ongoing
Publications: No
Cognitive Aging in Context: Abilities, Literacies, and the Social Environment
Researchers: Robert M. Hauser (Vilas Research Professor, Sociology, University of Wisconsin - Madison), Jeremy Freese (Professor, Sociology, Northwestern University), Pamela Herd (Associate Professor, Sociology, University of Wisconsin - Madison)Abstract: This research proposes to use the Wisconsin Longitudinal Study (WLS) to study several aspects of the interplay between the changing cognitive functioning of study participants and the changing circumstances of their lives. We propose first to provide an extensive assessment of the measurement structure and properties of the WLS cognitive data, and we will use overlapping measures between the WLS and Health and Retirement Study (HRS) to depict how the range of cognitive function in the WLS compares to a nationally representative distribution from the same cohort and other populations of interest. Then, we will use models of reciprocal causation to estimate how social and intellectual engagements at work and in leisure affect and are affected by cognitive functioning. We will study how cognitive variation among participants is implicated in their response to two health-related decision contexts of recent policy concern: their desired involvement in the process of making decisions about their medical treatment, and their behavior regarding the new and complicated Medicare prescription drug benefit. We will examine also how cognitive functioning is related to how much and how well respondents use and benefit from the Internet, especially in seeking information relevant for their health. Finally, we will explore and assess variations in cognitive functioning, social environments, and decision-making processes across the life course in relation to an assessment of APOE in the entire sample and in major subpopulations, such as those defined by gender, early cognitive ability, educational attainment, and economic and family roles.
Funding Institutions: NIH-NIA (P01 AG021079: 9/15/2002-6/30/2012)
Status: Ongoing
Publications: No
Development of a Workshop on Personality, Health, and Aging
Researchers: Robert M. Hauser (Vilas Research Professor, Sociology, University of Wisconsin - Madison)Abstract: Goldberg (2005) argued that "...well-constructed measures of personality traits predict the most important life events e.g., health-related behaviors and outcomes, including morbidity and mortality; job performance, including leadership styles; educational achievement, even after controlling for cognitive test scores; relationship outcomes, including marital failure; and of course virtually all serious mental disorders, including drug and alcohol abuse". However, major NIA-funded longitudinal studies are strikingly absent from the bodies of data on which this recent psychological research is based – and not merely by dint of the absence of appropriate measures of personality. This project will review and assess recent, relevant research in personality psychology and to prepare an overview of the correlates of personality in the past two waves of the Wisconsin Longitudinal Study (WLS) as a complement to other, similar reviews prepared from other bodies of data such as the Health and Retirement Study. This research, more importantly, will lead to improved measures of personality and research on personality in the future waves of the WLS and other longitudinal studies. Three of the NIA P30 Centers for research in the demography of aging will collaborate in a workshop on the measurement and correlates of personality in November 2007.
Funding Institutions: NORC (P30CD000147); UW/CDHA (P30 AG17266), Umich (P30 AG012846)
Status: Complete
Publications: No
Psychological Aging in Context: Personality, Psychological Well-Being & Distress
Researchers: Robert M. Hauser (Vilas Research Professor, Sociology, University of Wisconsin - Madison), Deborah Carr (Associate Professor, Sociology, Rutgers University), Zhen Zeng (Assistant Professor, Sociology, University of Wisconsin - Madison)Abstract: We propose to focus on psychological development during the onset of aging, i.e., from the mid 50s to ages 65-68. Our objective is to delineate psychological aging as a ultidimensional, nonlinear, and dynamic process in the context of changing life circumstances and social relationships. We will examine how maturational changes influence psychological trajectories, and how specific contexts of aging interact with developmental change. We focus primarily on three sets of psychological factors: personality, psychological well-being (PWB), and psychological distress (e.g., depressive symptoms, anxiety, anger, and alcohol use). There is both a theoretical and practical rationale for documenting the relationships of social situations and activities with psychological change among older adults; such knowledge may suggest potential lines of intervention to improve quality of life and reduce dependency. Our analyses will be based primarily on a large, longitudinal social survey, the Wisconsin Longitudinal Study (WLS). The existing WLS data, collected from 1957 through 2007, provide measures of the above-mentioned psychological variables at two time points (ages 53-54 and 65-66). The availability of the WLS sibling data multiple times and ages of measurement will allow us to develop models that account for measurement errors and for unobserved individual heterogeneity. Our specific aims are: 1. To assess the structure and temporal stability of personality and psychological well-being (PWB) in the WLS and two other large, nationally representative studies, Midlife in the United States (MIDUS) and the National Survey of Families and Households (NSFH). 2. To estimate reciprocal relationships among psychological characteristics (personality, PWB, and distress) and the social roles and activities of older adults (including work conditions, social participation, leisure activities, and the exchange of social support). 3. To examine the reciprocal relationships between personality change and changes in health, marital status, and employment. 4. To validate hypothesized relationships between selected genetic markers (5-HTTLPR, 5HTR1A, 5HTR2A, 5HTR2C, MAOA, TPH, DRD2, DRD4) and indicators of psychological distress (i.e., depressive symptoms, alcohol use, hostility, and anxiety). 5. To track both short-term and enduring effects of changing family roles and other life transitions on psychological well-being and psychological distress. 6. To assess prospectively whether the effects of family roles and transitions on psychological outcomes are moderated by genetic makeup; this analysis will draw on newly collected DNA data, including indicators of several variable number tandem repeats (VNTRs) that are related to psychological outcomes (e.g., 5-HTTLPR, DRD4).
Funding Institutions: NIH-NIA (P01 AG021079: 9/15/2002-6/30/2012)
Status: Ongoing
Publications: No
The Wisconsin Longitudinal Study: As We Age
Researchers: Robert M. Hauser (Vilas Research Professor, Sociology, University of Wisconsin - Madison)Abstract: We propose to continue the Wisconsin Longitudinal Study (WLS) with a major round of data collection, 45 years after the high school graduation of the original 10,317 participants. We want to exploit the unique scientific value of the WLS to pursue a broad agenda of research on social and economic factors in health and aging. We represent diverse scientific fields – sociology, demography, epidemiology, economics, social and cognitive psychology, industrial engineering, neuroscience, social work, psychiatry, nursing, and medicine. Our plan for data collection – of which these proposed surveys are only the first phase – will span many modes: telephone and mail surveys, brain imaging, personal interview, anthropometric measurement, bio-indicators, content analysis of recorded interviews, and linked administrative records. We intend and expect that these new data, along with the rich data presently available from the WLS, will resolve old questions and open new areas of interdisciplinary inquiry about health, aging, and the life course. All WLS data will be released to the research community as soon as they have been collected, cleaned, and documented. We propose one-hour telephone and 48 page mail surveys in 2002-03 of more than 9600 surviving American men and women who were first interviewed as graduating seniors in high school in 1957 and were followed up in 1964, 1975, and 1992; they will be 63-64 years old when they are surveyed. (b) We propose parallel telephone and mail surveys of 7150 randomly selected siblings of the graduates; they vary widely in age and most were first surveyed in 1994; about 2100 were first interviewed in 1977. (c) We propose shorter (30 minute) telephone interviews with spouses (N = 10,150) and widows of graduates and their siblings (N = 850). The WLS is unique as a large scale longitudinal study of adults and their families that will soon cover almost half a century. It is a valuable public resource for studies of aging and the life course, inter-generational transfers and relationships, family functioning, long-term effects of education and of cognitive ability, occupational careers, physical and mental well-being, and morbidity and mortality. Our goal is to extend and enrich our observations of the WLS cohort since their adolescence in ways that will answer important research questions in aging for decades to come. A rewewal application for home interviews, including functional and cognitive assessments, will be submitted on 5 July 2007.
Funding Institutions: NIH-NIA (R01 AG09775: June2002-March2012)
Status: complete
Publications: Yes (Search Project Bibliography)
The Wisconsin Longitudinal Study: Tracking the Life Course
Researchers: Robert M. Hauser (Vilas Research Professor, Sociology, University of Wisconsin - Madison)Abstract: This proposed, continuing program of projects will explore the implications of the changing social, political, economic, and technological contexts of the early 21st century for the well-being of a large cohort of men and women transitioning to old age. In this context, our several inter-related research plans are motivated by common issues related to the recent shift towards individual responsibility for health, health care, and economic well-being among older adults. In order to better understand the determinants of well-being of older Americans in an era of social, political, economic, and technological change, we propose a three-year continuation of our collaborative, multidisciplinary program of projects on aging and the life course. Our project will both exploit and add to core, public resources of the Wisconsin Longitudinal Study (WLS). We want to maximize the unique scientific value of the WLS, along with other relevant and comparable sources of data on population aging, to pursue a rich and important agenda of research on social, economic, and psychological factors in health and aging. This proposal consists of 3 Cores: Administration (A); Data Dissemination: Documentation, Outreach, and Security (B); and Complementary Data Collection and Management ©, which will serve an initial set of six research projects: The Impact of End of Life Planning on the Quality of Death & Survivor Well Being; The Effect of Nonnormative Parenting on the Normative Transitions of Aging; Cognitive Aging in Context: Abilities, Genes, and the Social Environment; Psychological Aging in Context: Personality, Psychological Well Being, and Distress; The Impact of Work and Family Careers on Life Outcomes in Late Adulthood; and Socioeconomic Status and Health in the Wisconsin Longitudinal Study. As we work together and share findings and methods, we will also share in the support and expertise of the core WLS staff, the rich existing data resources of the project, and new data created for the several projects. We intend and expect that our longitudinal analyses of old and new waves of WLS data will resolve old questions and open new areas of interdisciplinary inquiry about health, aging and the life course. All WLS data will be released to the wider research community, either directly or through a secure data enclave, to the maximum extent consistent with high standards of protection for the privacy and confidentiality of research participants, as soon as they have been collected, cleaned, and documented.
Funding Institutions: NIH-NIA (R01 AG21079: July2002-June2012)
Status: Ongoing
Publications: Yes (Search Project Bibliography)
The Timing of Retirement and Resource Adequacy at Retirement and Over the Subsequent Decade
Researchers: Robert Haveman (Bascom Professor, Emeritus, Economics and Public Affairs, University of Wisconsin - Madison), Karen C. Holden (Professor, Consumer Science, University of Wisconsin - Madison), and Barbara L. Wolfe (Professor, Economics, University of Wisconsin - Madison)Abstract: We have studied the economic well-being of individuals entering retirement over the first decade of retirement using the New Beneficiary Survey (NBS) cohorts in 1980s. More recently we studied this issue using a comparable cohort of retirees in 1990s using the Health and Retirement Survey (HRS). In the next stage of our research we will undertake a longitudinal comparison of these two retiree cohorts over the first decade of retirement. We will examine how changes in social and private policies toward retirement since the 1980s have altered the social safety net and thus the financial risks during the retirement period. In this analysis, we will focus on both retirement resource adequacy and the timing of retirement. We will distinguish differences in patterns among numerous groups of older households, distinguished by income during working years, nature of retirement support (e.g., defined benefit vs. defined contribution vs. social security), socio-economic characteristics and recent immigrant status. We will also study the timing of retirement decisions overall and among groups of older households, and assess the extent to which these decisions have changed in response to changing financial market conditions and patterns of retirement support (e.g., the shift from defined benefit to defined contribution retirement programs).
Funding Institutions: 5T 32MH018029 (National Institute of Mental Health (NIMH) and UW-Institute for Research on Poverty (IRP))
Status: Ongoing
Publications: No
Income Support Policies and the Health of the Elderly
Researchers: Pamela Herd (Associate Professor, Sociology, University of Wisconsin - Madison)Abstract: There is over two decades of research demonstrating a link between low incomes and higher rates of morbidity and mortality. If income does have a causal impact on health and mortality, then income support policies, which bolster incomes, should reduce mortality and morbidity rates. Our research objective is to test whether SSI, a means tested income support for elderly Americans, has reduced mortality and morbidity rates among the elderly. When examining changes within state maximum SSI benefits from 1990 to 2000, we find that increases in benefits were correlated with reductions in morbidity rates among the elderly. These findings held even when accounting for the link between SSI eligibility and Medicaid. After having collected mortality data and data on Old Age Assistant and SSI benefits from 1940 through 2000, we will measure the impact of within state changes in benefits over time on mortality rates among the elderly.
Funding Institutions: NIH-NIA (R03 AG027661: 3/15/2006-2/28/2008)
Status: Ongoing
Publications: Yes (Search Project Bibliography)
Onset versus Progression of Health Decline: Understanding Socioeconomic Disparities in Health
Researchers: Pamela Herd (Associate Professor, Sociology, University of Wisconsin - Madison)Abstract: This project seeks to elucidate the relationship between socioeconomic position and health by showing how different facets of socioeconomic position (education and income) affect different stages (onset versus progression) of health problems. The biomedical literature has generally treated socioeconomic position as a unitary construct. Likewise, the social science literature has tended to treat health as a unitary construct. To further our understanding of the relationship between socioeconomic position and health, and ultimately foster appropriate policies and practices to improve population health, a more nuanced approach is required that differentiates theoretically and empirically among dimensions of both socioeconomic position and health. We use the American Changing Lives Survey to test whether income and education have differential impacts on the onset of poor health versus declines into worse health. We find that education is a better predictor than income of disease onset, while income is a better predictor than education of disease progression. Education only has an independent effect on disease onset, while income does have independent effects on both onset and progression. The next state of the project will explore the mechanisms between education and income and disease onset and progression.
Status: Ongoing
Publications: Yes (Search Project Bibliography)
Relationship between Income Supports and Health
Researchers: Pamela Herd (Associate Professor, Sociology, University of Wisconsin - Madison)Abstract: While there is longstanding evidence that poverty negatively affects health, we know little about whether policies targeted at improving the incomes of the poor also affects health. Our project test whether the Supplemental Security Income program affects disability among the elderly. We find that within state changes in maximum SSI benefits are correlated within state changes in disability among the elderly. Increases in the maximum benefit are correlated with reductions in disability among the elderly. Further work is focused on exploring the links between SSI and health in the 1970s. Also, we will explore the links between SSI's predecessor (Old Age Assistance) and its impacts on mortality between 1940 and 1950.
Status: Ongoing
Publications: Yes (Search Project Bibliography)
The Link between Early Life Educational Experiences and Health across the Life Course
Researchers: Pamela Herd (Associate Professor, Sociology, University of Wisconsin - Madison), Alberto Palloni (Professor, Sociology, University of Wisconsin - Madison), and John Robert Warren (Associate Professor, Sociology, University of Minnesota - Twin Cities)Abstract: While the links between education and health are unquestioned, the explanations for what underlies this relationship are not well understood. This project will draw on early life experiences, particularly student and schooling experiences, to test the hypothesis that education exerts a direct effect on health across the life course, rather than simply serving as a proxy for student background or as a marker of socioeconomic status. We draw on a wealth of childhood background characteristics and schooling experiences included within the Add Health and the WLS to test this hypothesis.
Status: Ongoing
Publications: Yes (Search Project Bibliography)
The Relationship between Education and Health
Researchers: Pamela Herd (Associate Professor, Sociology, University of Wisconsin - Madison)Abstract: Though the causal link between education and health is largely accepted, much remains unknown regarding the mechanisms that link education to health outcomes. I explore the relationship between 1) IQ and health outcomes and 2) schooling characteristics (school quality) and health outcomes in the Wisconsin Longitudinal Study. Preliminary evidence indicates that IQ is not a confounding factor explaining the relationship between education and health outcomes. Future plans are to further test the link between schooling characteristics and health and mortality outcomes.
Status: Ongoing
Publications: Yes (Search Project Bibliography)
Women's Health and Retirement Security: How Far Have We Come and Where Do We Need to Go?
Researchers: Pamela Herd (Associate Professor, Sociology, University of Wisconsin - Madison)Abstract: Older women have experienced dramatic improvements in health and economic well-being over the past 40 years, but many challenges remain. Today, women are almost twice as likely as men to live in poverty in their later years—a situation that is no better than it was in the 1960s. In addition, although women outlive men, their later years are dominated by more health problems. Further, there are growing health and income disparities among women by race and socioeconomic status. This conference will focus on the health and economic well-being of older women, with particular emphasis on race and socioeconomic differences. How do women fare under current policies? What will be the consequences for women of proposed Social Security and Medicare reforms? And, how can we adapt these programs to better meet women’s needs? This conference is scheduled to occur the day (November 20) before the 2008 Annual Meeting of The Gerontological Society of America (GSA). The proposed conference aims to take advantage of the DC-area conference site to bring together researchers, policy experts, and staff from think tanks and older women’s organizations in the Washington area who would not typically attend a GSA conference. The conference will open with a keynote address followed by a set of two panels on health and health care. Attendees can choose between the two different panels, one devoted to current research, the other to policy issues. The next set of panels will focus on income security, one panel devoted to current research, the other to policy issues. These sessions will be followed by a moderated discussion period.
Status: Complete
Publications: No
Assessing Savings Sufficiency at the Time of Retirement and Ten Years Later
Researchers: Karen C. Holden (Professor, Consumer Science, University of Wisconsin - Madison), Robert Haveman (Bascom Professor, Emeritus, Economics and Public Affairs, University of Wisconsin - Madison), and Barbara L. Wolfe (Professor, Economics, University of Wisconsin - Madison)Abstract: This project has used the New Beneficiary Survey to examine wealth accumulation at retirement and the level of consumption that can be financed with that wealth for the remaining expected years of life of the retiree and, if married, of the surviving spouse. It also, uniquely, asks about the ex post adequacy of the full constellation of resources available to individuals over the course of their retirement years: Is the estimated steady-state retirement consumption level that is possible from wealth accumulation at retirement maintained throughout the years of retirement? In this research, we contribute evidence on the extent to which people who have been retired for a decade have maintained resources at the levels which were estimated to be sustainable at retirement. That is, we compare sustainable consumption during their expected remaining years of retired life at retirement and ten years later, asking for whom this level of potential consumption rises, fall, or remains the same. We are particularly interested in the events that appear to undermine the level of sustainable consumption (e.g., widowhood, inflation, disability) and whether the type of retirement income (e.g., share from Social Security, pensions, own savings) reduce or increase vulnerability of individuals to these events. To our knowledge, the extent to which resources are adequate well into the retirement period has not yet been studied. From this project have come several published papers and conference presentations. With UW Graduate School support we have embarked on a comparative cohort analysis of well-being at retirement using both the NBS and Health and Retirement Survey data and have a proposal (second submission) at NIA for further HRS analysis.
Funding Institutions: 5-T3MH018029
Status: Ongoing
Publications: Yes (Search Project Bibliography)
Changes in Expectations of Nursing Home Use: The Role of Demographic Characteristics, Economic Resources, Health Insurance, and Health Status
Researchers: Karen C. Holden (Professor, Consumer Science, University of Wisconsin - Madison) and Hung-Tai LinAbstract: Out of pocket expenditures on nursing home care is a major financial risk factor for older individuals. Yet nursing home insurance is a product that is purchased by a relatively small proportion of the population. We know little about the role of expected nursing home expenditures on savings and insurance purchase decisions. The objective of this project is to understand the predictors of individuals' expectations of nursing home entry, how these expectations change has the HRS cohort ages, and what appears to be the new information or conditions that affect these expectations. We explore whether and how expectations of nursing home entry, and change in those rates, affect the purchase of nursing home insurance. Even at the still relatively young ages of the HRS cohort, it appears that individuals assess the probability of future nursing home entry taking account of their own probable future risk state rather than current objective risk factors. Probabilities of a future event are expected to become more accurate over time as new information on determinants of nursing home entry become available to individuals. These results suggest that may be the case. Our variables are consistent with hypotheses about who is more likely to search for and take account of new information on actual risks. Thus the effects of higher education and changes in marital status are inconsistent with actual entry risk but are consistent with these individuals being more likely to observe the world around them and reassess what initially may have been fairly uninformed guesses. Our plans include publication of paper in a Consumer Science or Aging Journal.
Status: Ongoing
Publications: Yes (Search Project Bibliography)
Gender Differences in the Labor Force Participation of Older Persons: an International Comparative Study
Researchers: Karen C. Holden (Professor, Consumer Science, University of Wisconsin - Madison) and Jeungkun KimAbstract: This project is a cross-national comparison of the Labor Force Participation (LFPR) of older persons, with focus on gender differences in explanations of work participation across countries. The aim is to examine the relationship among socio-economic factors affecting the LFPRs of older persons in developed countries, attempting to distinguish between the effects of financial variables influencing individual retirement behavior and those that characterize the broader social norms within which individuals make those choices. This is an exploratory study, intended to lead to proposals to refine “social norm” variables in ways that enable exploration of their effects on samples of retirement-age individuals over time, using other data sets for other countries as well as panel data in the U.S. The study has used LIS data from 13 countries, linked to OECD data to provide the country level and institutional factors. It has examined male and female LFPRs, preliminarily distinguishing the effects of factors that are “individual level” from those that may be characterized as modifying individuals’ responses to comparable incentives. This analysis is not longitudinal. We are now exploring the Survey of Health, Ageing and Retirement in Europe (SHARE) in preparation for in an NIA submission, likely in June.
Status: Ongoing
Publications: No
Happiness as a Complex Financial Phenomenon: The Financial and Psychological Adjustment to Widowhood, Divorce, and Retirement in the U.S.
Researchers: Karen C. Holden (Professor, Consumer Science, University of Wisconsin - Madison)Abstract: This study will examine the changes in psychological wellbeing upon widowhood, retirement and divorce, the adjustment over time to these events and the role of financial resources in psychological adjustment to these role changes. The Wisconsin Longitudinal Survey will be the primary source of data although use of the Health and Retirement Survey will be explored as well. While the assumption in the widowhood literature is that the financial shock associated with widowhood and any persistent financial insecurity are detrimental to psychological well-being, there has been little research on how the adequacy of financial resources assist in the psychological adjustment to widowhood. There is also limited research on how financial resources mitigate the psychological well being of older individuals coping with other late life changes, including retirement and later-life divorce. The WLS data would allow us to examine these events as well. This research will add to the growing literature in economics on the relationship between economic resources and “happiness.”
Status: Ongoing
Publications: No
Have Newly Retired Workers in the U.S. Saved Enough to Maintain Well-Being through Retirement Years?
Researchers: Karen C. Holden (Professor, Consumer Science, University of Wisconsin - Madison), Robert Haveman (Bascom Professor, Emeritus, Economics and Public Affairs, University of Wisconsin - Madison), and Barbara L. Wolfe (Professor, Economics, University of Wisconsin - Madison)Abstract: There is concern that workers in the U.S. are not saving "enough" for retirement. But study results differ and measures of sufficiency are not standard across studies. Using data for a cohort of newly "retired" workers, we examine several measures of adequacy of retirement resources to estimate whose resources appear sufficient to maintain a prescribed level of consumption over their own and, if married, their spouse's expected lifetimes. In this paper we estimate permanent preretirement earnings over the prime working years of a new retiree and spouse (if married) and measure resource adequacy by comparing the annuitized value of wealth to both the household's own preretirement living standards, and to an absolute national standard of resource adequacy. Our estimates of replacement rates. based on prior earnings suggest a substantial national problem of resource adequacy, with a median replacement rate of about .5. Our results show, however, that resource inadequacy by this measure increases with greater earnings. For this reason we turned also to a measure of absolute inadequacy. About 15 percent of our new beneficiaries have insufficient wealth to allow them to live at an above-poverty line level during all years of retirement, and only half have sufficient resources to enable them to live at a level which is twice their poverty line. We find that those who receive Social Security benefits at younger ages, who do not have private health insurance, employer provided pensions, or an owned home, and who are divorced or separated are at higher risk of having insufficient resources. These estimate suggest that older person enter retirement with resources that are not sufficient to maintain a steady level of "adequate" consumption during their entire remaining lifetimes. Longer lifetimes than those embodied in U.S. life tables would make this situation even worse. Unexpected changes in assets–inflation or lower interest than assumed in our estimates–would also bode poorly for retirement well being. We next turn to estimating resource adequacy among the older SSDI beneficiaries.
Funding Institutions: Social Security Administration, UW Graduate School, and IRP (1/1/1999-3/31/2002)
Status: Complete
Publications: Yes (Search Project Bibliography)
Looking beyond Retirement-Patterns and Predictors of Formal End-of-life Planning among Retirement Age Individuals
Researchers: Karen C. Holden (Professor, Consumer Science, University of Wisconsin - Madison) and Yung-ting SuAbstract: EOL health and financial planning are typically considered separate decisions by professionals even though EOL health plans (or lack of) may have financial consequences. This study aims to understand whether individuals' behavior suggests these are thought of as separate or integrated estate planning decisions by individuals. This study uses the 2004 wave of the Wisconsin Longitudinal Study (WLS) to examine the patterns and predictors of formal EOL planning strategies among retirement age individuals and whether EOL health and financial planning are highly correlated planning behaviors. Findings show that EOL health plans appear to be done in combination with financial plans. Females, higher educated persons and those with higher net worth are more likely to have integrated EOL plans containing both EOL health and EOL financial plans. It is suggested that policy makers, health and financial professionals, and educators concerned about the consequences of the absence of EOL health plans, should facilitate the joint planning with finances, especially among those at higher risk of not having such plans (e.g. males, less educated persons, and those who have little net worth). We plan to continue exploring estate planning strategies and consequences among individuals and couples in the WLS (and possibly HRS as well).
Status: Ongoing
Publications: Yes (Search Project Bibliography)
Social Security, Age-of-Retirement, and Economic Wellbeing: Intertemporal and Demographic Patterns Among Retired-Worker Beneficiaries
Researchers: Karen C. Holden (Professor, Consumer Science, University of Wisconsin - Madison), Robert Haveman (Bascom Professor, Emeritus, Economics and Public Affairs, University of Wisconsin - Madison), and Barbara L. Wolfe (Professor, Economics, University of Wisconsin - Madison)Abstract: In part because of pending increases in the age of full retirement for Social Security benefits, there is concern about the relative well being of individuals who receive benefits early compared to those who delay receipt. Objective is to examine differences between early and late recipients of Social Security benefits and how timing of benefit receipt influences economic well being in retirement. We examine the economic status of a sample of new recipients of social security retired-worker benefits shortly after first benefit receipt (1982) and ten years later (1991), using longitudinal data on retired-worker beneficiaries surveyed in the Social Security New Beneficiary Survey. We compare differences in economic well-being by age of first benefit receipt, gender, and race. For both 1982 and 1991, the probability that these retired-worker beneficiaries are poor or near poor after taking account of social security benefits is positively and strongly associated with their acceptance of early retired-worker benefits. Early retirees, women who remained single, and women who lost their spouses experienced large declines in economic status over the decade following first receipt of benefits. A multivariate analysis of the risk of remaining or becoming poor or near poor between these two years confirms the continuing disadvantaged status of early benefit recipients. While both women and men who first received benefits at younger ages had lower economic status than did those who became beneficiaries at older ages, this retirement age-related disadvantage increases over the decade for women but not for men. We conclude with policy recommendations. This is part of a larger study of savings for retirement and economic well being in retirement. We hope to submit grant proposals to do this same analysis, using the HRS.
Funding Institutions: Social Security Administration (1/1/1999-2/28/2001)
Status: Complete
Publications: Yes (Search Project Bibliography)
The Financial Risks and Consequences of Early Widowhood
Researchers: Karen C. Holden (Professor, Consumer Science, University of Wisconsin - Madison)Abstract: This project will examine the consequences of relatively early spousal death using WLS data on widows and widowers, who were about 64 years of age when interviewed in 2004-05. At this age couples may be increasingly likely to engage in end-of-life and estate planning as retirement approaches, but not for all will this be the case. For some widowhood would have taken place prior to retirement and to the retirement planning that may have considered widowhood. For widows in the sample we have detailed information on current characteristics that was gathered from all WLS respondents. For individuals widowed in the two years just prior to the interview we have information on the death, duration of final illness, end-of-life planning (i.e., estate planning, having a living will, a DPAHC, and holding discussions) by the respondent and the deceased spouse and the economic and emotional costs of the death. In accord with the SOA RFP, we will focus specifically on financial aspects of a spouse’s death but also explore how financial stress contributes to psychological and emotional well being. We will: 1. Document the income and assets of widows and widowers as well as their psychological well-being, distinguishing surviving spouses by the duration of widowhood. 2. Focus specifically on individuals widowed in the two years just prior to the survey, including data on the death and estate distribution experience. 3. Document changes in subjective assessments of economic security, well-being, and strain among women and men within the first two years following their transition to widowhood; 4. Explore whether a late spouse’s estate planning (reported retrospectively by recently widowed individuals in the 2005 WLS interview) is associated with the objective and subjective economic well-being of widows, within the first two years following spousal death. 5. Explore changes in health insurance coverage in the two years prior to widowhood and the extent to which these are causal or coincident with a spouse’s death. 6.Examine whether age and duration of widowhood is related financial and psychological wellbeing in 2004.
Funding Institutions: Society of Actuaries (1/1/2007-7/31/2008)
Status: Complete
Publications: No
The Income Consequences of Widowhood in Britain, U.S., and Germany
Researchers: Karen C. Holden (Professor, Consumer Science, University of Wisconsin - Madison) and Jeungkun KimAbstract: This project looks at how income sources change when married women in Britain, the U.S. and Germany are widowed and draw inferences about the consequences of the different systems of covering retirees and their survivors. Earlier work on this issue was based on the Cross-National Equivalent File (1980-1997) which includes data from the German Socio-Economic Panel (1984-1997), the U.S. Panel Survey of Income Dynamics (1980-1997), and the British Household Panel Survey (1991-1998). Results were published in 2002 and 2003. With Jeungkun Kim, I am currently updating these results with the CNEF (1980-2001) which allows for larger samples of widows and thus a more sophisticated analysis of change.
Status: Complete
Publications: Yes (Search Project Bibliography)
ACCESS Study: Assessment of CAncer CarE and SatiSfaction
Researchers: Betty J Kramer (Professor, Social Work, University of Wisconsin - Madison)Abstract: The National Cancer Institute has identified several aspects of cancer care that need to be addressed. Little is know about the quality of cancer care in the state of Wisconsin and the needs of patients and family members. The goals for the larger "Quality of Cancer Care in Wisconsin" study are to identify barriers that affect patient satisfaction, quality of life and treatment options in Wisconsin cancer survivors. Dr. Kramer is adding questions to a survey disseminated to family members of persons who have died, to examine their perceptions of the quality of care provided, and the impact of that care on family conflict at the end of life, and the family member's current psychological and physical well-being (e.g., complicate d grief, depression, health). The survey is currently in the field. This study will provide pilot data for future research by illuminating understanding of how barriers and quality of care impact family members of elders who die from cancer. We hope to uncover strategies to improve cancer care, and information that may be helpful in developing family based interventions at the end of life that could be tested.
Status: Ongoing
Publications: No
Family Caregiving at the End of Life
Researchers: Betty J Kramer (Professor, Social Work, University of Wisconsin - Madison)Abstract: Increasing numbers of family members have been providing care at home for elders who have a terminal illness. Optimal care of the dying is determined, to some extent, by family caregivers and should address strategies to help them in their role. Understanding the unique aspects of end-stage caregiving becomes essential to that effort. This study aimed to understand how caregivers make the transition to end-stage caregiving and to illuminate its unique aspects using a stress process model. End-stage caregiving was characterized in the sample as (1) comprehension of terminality (the interrelationship of information, physical and cognitive decline, and personality change and role losses), (2) near-acute care, (3) executive functions, and (4) final decision making. The comprehension of terminality emerged from three interrelated experiences: receiving and assimilating concrete information about the illness, observing the progression of the disease, and observing the personality change and role loss. The primary stressors (unique end-stage caregiving tasks) were providing near-acute care, assuming an executive function, and beginning and final decision making. The secondary stressors were family role conflict, work conflict, and financial strain. Resources, such as intrinsic and extrinsic religious and faith practices and social support, were identified. Negative outcomes included intense emotional responses, and positive outcomes included heightened development of meaning making. The findings suggest that palliative care professionals have important opportunities to provide information and support to family caregivers during the final stages of the patient's terminal illness.
Status: Complete
Publications: Yes (Search Project Bibliography)
Innovations in End of Life Care for Elders with Advanced Chronic Disease
Researchers: Betty J Kramer (Professor, Social Work, University of Wisconsin - Madison)Abstract: Inadequate care of the dying is emerging as a major concern among health care providers, educators, and policy makers. The field is challenged to develop end of life care models that address the unique needs of low income elders who die with advanced chronic disease and their support network. The Elder Care Partnership program provides comprehensive community-based care for nursing-home-eligible low-income elders with complex chronic illness. As with other fully integrated managed care models, this program has the potential to influence the development of programming as other states seek to replicate and expand on these models. However, there is little known about the phenomenon of end of life care and the challenges of providing this care. The primary objectives of this case study are to 1) determine how end of life care is defined and implemented in this setting according to multiple stakeholders; 2) identify the implicit and explicit outcomes of quality end of life care; 3) identify the structures and processes of care that influence end of life care outcomes; and 4)determine the care dilemmas and challenges to providing end of life care to elders with advanced chronic disease and their family members. Several findings have been explored in this study. First, this project identified seven major themes that characterize primary end of life care challenges including the nature of advanced chronic disease, the incapacity of support systems; barriers to honoring care preferences, challenges with characteristics and needs of participants; needs of complex family systems, barriers with transitions in care; and barriers with culture and language. Second, family conflict emerged as an important phenomenon in this setting. An explanatory matrix of family conflict at the end of life with special attention to contributing factors and consequences was developed. Third, there is substantial incongruence in reports of preferences for the elder's care between the elder and their family member. Future goals of this project are to examine the contributions of the social worker to the interdisciplinary team and congruence in reports of end of life challenges, fears, and care preferences between elders and their family caregivers.
Funding Institutions: A4882
Status: Ongoing
Publications: Yes (Search Project Bibliography)
Palliative Care for Frail Elderly: Integration of Hospice with a Partnership Program
Researchers: Betty J Kramer (Professor, Social Work, University of Wisconsin - Madison)Abstract: Through ongoing research and a continuous quality improvement collaboration between the Primary Investigator (PI, Betty Kramer) and the Elder Care Partnership (ECP) Program of Dane County during the past 2 years, it was revealed that the ECP staff face many challenges, and care dilemmas in providing end of life (EOL) care and that there are several areas in which they feel they could improve the provision of palliative care. The purpose of this descriptive exploratory study is to assess the feasibility of a consultation model, whereby a 25% time hospice nurse (RN) and social worker (SW) would be available to three ECP teams over a year. This pilot seeks to: (a) determine the extent to which and ways in which consultants will be used by the teams; (b) identify the potential outcomes and benefits of consultation from the perspective of the staff, and (c) examine the extent to which consultation will assist ECP team members to enhance perceived success in the provision of palliative care. A total of 30 patient's needs were addressed during the study period; 19 of these (approximately two-thirds) died during the course of the study. Consults occurred primarily during regularly scheduled 2 hour ECP interdisciplinary team meetings as patient care plans were discussed (84% and 77% for nurse and social worker respectively). A larger number of consults were sought from the nurse than the social worker; 140 versus 44 respectively, reflecting greater attention given by the teams to physical care needs. Team members identified nine benefits of the model that were validated by consultant reports that may be translated into measurable outcomes in future research. The feasibility of this consultation model is influenced by several barriers to be addressed in future study. First, early misperceptions that hospice consultants could only be utilized in care situations involving active dying, constrained consultant involvement. Second, although home visits appeared to be a very important method for feedback and modeling, team member's apprehension about introducing consultants to participants as hospice employees limited this form of consultation. Third, scheduling difficulties from both agencies limited planned and impromptu visits. Fourth, the consultants' time was not fully utilized during the weekly team meetings. Fifth, some team members felt defensive receiving suggestions from outsiders and challenged to convey sufficiently the complexity of long-term care plans. Two alternative models are being considered to address the aforementioned barriers.
Status: Complete
Publications: Yes (Search Project Bibliography)
Death of a Sibling and Health of the Survivor Sibling in Later Adulthood
Researchers: H.-H. Daphne Kuo (Associate Researcher, School of Medicine and Public Health, University of Wisconsin - Madison)Abstract: This project is mainly derived from findings of a preliminary study using Wisconsin Longitudinal Study (WLS). I found that experiencing the death of a sibling before age 36 had direct and robust harming effects on many measures of physical health of WLS men and women at age 50 after controlling for childhood family environment (SES, family configuration, and others), socioeconomic attainment in adulthood, and other important life events. This project is to examine the long-term negative consequences of death of a sibling on health of the survivor siblings in later adulthood. My research objectives are : 1. To dissect the effects of the death by the age and the cause of the death. 2. To look into the associations between the sibling's death, early parental death (before age 50), family medical history, and childhood health of the respondents. 3. To examine whether the effect is spurious due to lack of control for unmeasured heterogeneity. 4. To explore sibling data in PSID (and NLSY), national data with detailed information on age, birth, and death of each known biological sibling, for an external grant proposal. Results from my research show 1. Death of a sibling before age 35 only have impact on health at midlife, but not in later adulthood. 2. Respondents who experienced sibling death before age 60 usually report bad health and more medical conditions. 3. The harming effects of sibling death are not moderated by childhood health and early death of mother or father. I plan to use sibling data to study the effect of sibling death, and to analyze data from a national sample hopefully with future external funding.
Status: Complete
Publications: Yes (Search Project Bibliography)
Boston Area Community Health (BACH) Survey
Researchers: Karen LutfeyAbstract: Despite the increasing prevalence of urologic conditions in the US, data assessing the distribution of symptoms across various socioeconomic groups are relatively scant. Boston Area Community Health (BACH) Survey is designed to fill these gaps with community-based epidemiologic data on a wide range of urogynecologic symptoms and risk factors among a random, multi-stage, cluster sample of racially diverse residents between the ages of 30 and 79 (N=5,506 men and women). Manuscripts are ongoing and intended for a range of epidemiologic, health policy, and sociological audiences. Specific papers include the prevalence and correlates of female sexual dysfunction as well as the prevalence of adult and childhood physical, sexual, and emotional abuse. Analysis are ongoing for a series of manuscripts.
Status: Ongoing
Publications: Yes (Search Project Bibliography)
Cognitive Basis of CHD Disparities: a Factorial Experiment
Researchers: Karen LutfeyAbstract: This R01 study is one in a series of 4 generations of video vignette factorial experiments studying non-medical influences on physicians' clinical decision making. Previous and current studies show a significant influence of patient characteristics, provider characteristics, and healthcare system characteristics on clinical diagnostic and treatment decisions. The current study extends previous work by considering a 4th factor, cognitive processing, through the use of priming as a design factor. This study begins data collection in summer 2006. Analyses and manuscripts from the most recently completed experiment are underway while the cognitive priming one prepares to enter the field.
Status: Complete
Publications: No
Medical Error and Chronic Illness Management
Researchers: Karen LutfeyAbstract: Over the course of several decades, this Quality Assurance (QA) movement has developed into a massive, interdisciplinary undertaking with goals of identifying potential sources of error and minimizing their (economic, social, and outcome-related) effects. Implicit in the QA movement, however, is a conflict between (1) efforts from external agents, alarmed by high rates of error and cost-inefficiency, trying to encourage the medical profession to adopt strategies for systematically evaluating and minimizing errors; and (2) the historical entrenchment of notions of uncertainty in medical work (Fox 1957; Light 1972); the indigenous nature of error in such work (Paget 1988); the importance of collegiality in protecting providers from the potential risks associated with such uncertainty (Bosk 1979; Freidson 1970); and the ways in which these processes inhibit the medical profession’s self-regulation in terms of quality assurance (Sharpe & Fadin 1998). To better understand this tension, I focus on questions related to the routine, everyday practicalities of medical work and the ways it is conceptualized, executed, and accounted for by providers. In a work environment necessarily characterized by uncertainty and contingency, how is it that some actions come to be defined as errors? How do providers' conceptualizations of medical error resonate with those offered by QA proponents? To what extent might we expect QA efforts to be integrated into provider behavior? To examine these questions, I use in-depth interviews and ethnographic data from two diabetes clinics in a large, Midwestern, university-based medical center. Findings suggest that there are important limitations to be considered in the application of the “medical error” concept in a chronic care setting. For instance, activities such as measuring error, setting goals for treatment, making sense of unexplained outcomes, and customizing treatments to individual patients operate differently for chronic and acute illness care, and in ways that imply diminishing returns for the concept of “medical error” as a mechanism to improve quality of care in chronic illness management. To be broadly effective in the context of chronic illness management, the QA movement may need to need to attend to mundane internal workings of medical practice by reconceptualizing “medical error” in ways that more accurately capture mundane medical work (e.g., iterative treatment decisions/outcomes, the active role of patients in self-management, the importance of customizing treatment plans according to patients’ social behaviors), as well as identifying potential systematic resistances to QA efforts and mounting interventions in ways that are likely to be effective given nature of the profession.
Status: Complete
Publications: Yes (Search Project Bibliography)
Provider Assessments of Patient Compliance with Diabetes Treatment Regimens
Researchers: Karen LutfeyAbstract: Extensive interdisciplinary research programs on patient compliance offer competing explanations for a relatively narrow range of questions focusing on why patients behave in certain ways, the reasons for their deviant behavior, and the ways such behavior can be changed so it is more commensurate with the needs of the medical system. By contrast, I address the question of how practitioners assess patients in terms of their compliance by evaluating patients' cognitive abilities, talking with patients during consultations, and simultaneously dealing with bureaucratic constraints of clinics. The objective of this study was to use multiple types of ethnographic data (observations, in-depth interviews, videotaped interaction, focus groups, and limited survey data) from two diabetes clinics to examine the processes by which providers try to assess how closely patients are following medical recommendations, and the implications of those assessments for medical care. Findings suggest that the traditional notion that assessing compliance is only a matter of "correctly" determining what patients are doing outside of the clinic oversimplifies what appears to be a much broader undertaking. For example, during in-depth interviews, providers articulated several different roles they assume to help maximize patient compliance--such as educators, detectives, negotiators, salesmen, and motivators--which imply that they are not passive observers of compliance behavior, but active participants in a process that contributes to the very phenomenon they attempt to assess. Based on analyses of videotaped doctor-patient interaction, compliance assessments are not simply a matter of what patients report about their behavior, but also of how they interact with practitioners. Similarly, organizational features of the clinics, such as continuity of care and teaching responsibilities, significantly affect practitioners assessments of and responses to patients independent of how closely patients follow recommendations. Finally, compliance assessments have significant implications for treatment regimens such that patients of high socioeconomic status are more likely than their low SES counterparts to have sophisticated treatment regimens that help ward off long-term and life-threatening diabetes complications; non-medical factors such as individual patient characteristics (income, occupation, age, social support), motivation and willingness, and cognitive ability are critical in this process.
Status: Complete
Publications: Yes (Search Project Bibliography)
Families Manage High-Tech Home Care: the Case of Bone Marrow Transplantation
Researchers: Cameron Macdonald (Assistant Professor, Sociology, University of Wisconsin - Madison)Abstract: The shift of health care from hospital to home has been one of the most dramatic changes over the past decade. Not only are patients moving from inpatient to outpatient care, but families are taking on medical care responsibilities formerly performed by hospital staff and visiting nurses. Nowhere is this change more significant than in bone marrow transplantation. Once held in isolation for up to three months post-transplant, adult transplant recipients are now routinely sent home after as little as three weeks, and that time frame may soon be shrinking. While this development has resulted in increased satisfaction and quality of life for many patients, and reduced cost for hospitals it has also resulted in increased stress and caregiver burden for family members. How do family members manage the tasks delegated to them, including line care, medication management, and monitoring an array of complex symptoms? Because no studies of adult transplant patients have ventured into the home for any period of time, we simply do not know the answers to most of these questions. The world of home care post bone marrow transplant is a "black box" to physicians and medical researchers. Until we understand how families and patients adapt to the challenges of complex health care in the home, we cannot know what, if any interventions might be developed to increase patient safety and treatment efficacy. This prospective study will address this crucial gap in our understanding of families providing home cancer care with an aim to develop assistive interventions. It will be the first and only research project to critically assess the needs of bone marrow transplant patients and their caregivers by following them through regular home observations for the first full year after discharge. This project will thus fill an urgent need. It is unlikely that the days of lengthy post transplant hospitalizations will return; it is therefore necessary to ensure that home care can be provided in the most comprehensive and least burdensome manner possible. To examine this complex set of concerns, we will implement an in-depth assessment of patient/caregiver needs for social and educational support in the home. The study will entail one year of regularly scheduled in-home ethnographic observations, in-depth interviews with patients and caregivers, and a phone survey administered to caregivers at five critical points during the post-transplant year. At the end of this data-gathering process, we will conduct a multi-method assessment of caregivers' needs for social support, education, and for improved communication with physicians. This assessment will allow us to create an intervention that will be clinically tested in phase two of the study.
Funding Institutions: 8 K12RR023268
Status: Ongoing
Publications: No
The Home as Hospital: Home Outpatient Antimicrobial Therapies; An Assessment of Patient and Caregiver Training Needs
Researchers: Cameron Macdonald (Assistant Professor, Sociology, University of Wisconsin - Madison)Abstract: An estimated 250,000 patients receive outpatient parenteral antimicrobial therapy (OPAT) every year, making OPAT the most prevalent form of high-tech home care in the United States. However, most patients in the US context receive only a small amount of pre-discharge training on catheter care and infusion. The combination of insufficient training and patient/caregiver anxiety may increase rates of complication and error. Up to a third of patients receiving OPAT develop complications that can result in re-hospitalization or even death. This collaborative, multi-method pilot study involves researchers from the University of Wisconsin Department of Sociology and the School of Medicine and Public Health. Approximately 50 patients receiving home OPAT through the University of Wisconsin Infectious Disease clinic will be followed prospectively mixed methods to determine the influence that home OPAT training and has on patient outcomes. Knowledge from this pilot will be used in the design of a randomized clinical trial of interventions that will: 1) help optimize identification of patients most likely to do well with home OPAT and 2) better prepare patients and their caregivers for the home OPAT process. Achieving these long-term objectives will reduce rates of therapy-related complications and improve the quality of care of patients who require home OPAT.
Status: Ongoing
Publications: No
Combat Exposure and Health and Socioeconomic Outcomes
Researchers: Alair MacLean (Assistant Professor, Sociology, Washington State University Vancouver)Abstract: The overall aim of this project continues to be to estimate the long-term effects of combat exposure on socioeconomic attainment. Identify the factors that determine who was exposed to combat. Identify the consequences of this exposure. Unequal exposure to combat has resulted from the intersection of personal and institutional choices based on human capital and screening. Combat exposure led to increased disability and unemployment rates among veterans. Submit for publication two papers related to selection into combat positions and exposure. Submit for publication at least one and likely two papers related to the consequences of combat exposure.
Funding Institutions: 5R03AG029275-02
Status: Ongoing
Publications: Yes (Search Project Bibliography)
Consequences of Cold War Military Service
Researchers: Alair MacLean (Assistant Professor, Sociology, Washington State University Vancouver)Abstract: Little is known about the effects of serving in the decade between the Korean and Vietnam Wars, the peacetime Cold War period. This project attempts to assess the impact of such service on some of the 5 million men who served during that time. The project has already examined the effects of Cold War service on education, occupation, income and wealth. It will also examine the effects on physical and mental health. Education: Cold War military service disrupted the educational trajectories of academically ambitious men. Occupation, Income and Wealth: Such service was a supplement to rather than a substitute for a college education, as only men who completed college before entering the armed forces, and those who served as officers benefited from their service. I plan to estimate the effects of peacetime Cold War military service on mental and physical health outcomes.
Status: Ongoing
Publications: Yes (Search Project Bibliography)
Social Inequalities, Psychosocial Factors, and Health
Researchers: Nadine F. Marks (Professor, Human Development and Family Studies, University of Wisconsin - Madison)Abstract: This research will investigate linkages between life course social inequalities, psychosocial factors, and adult physical health. Specifically, differences in several dimensions of socioeconomic status (SES) and race-ethnicity will be examined as potential social determinants of differences in psychological factors (e.g., affect, personality style, sense of control, self-evaluation, perceived discrimination, religiosity/spirituality) and social relationship factors (e.g., marital history and quality; intergenerational relationships and quality; other kin and nonkin relationships and quality). These psychological and social relationship factors, in turn, will be examined in terms of their influence on health status (health perceptions, functional status, symptom and illness reports, mortality). The hypothesis that differences in psychological factors and social relationship factors help mediate and moderate the influence of SES and race-ethnicity on health will be explored. Further, two hypotheses about the pathways linking psychological and social factors to physical health will be evaluated: 1) the "health behavior mediation" hypothesis, which posits that differences in psychological and social relationship factors lead to differences in health behaviors, which, in turn lead to differences in physical health, and 2) the "psychosocial stress moderation" hypothesis, which posits that differences in psychological and social factors lead to differences in the way individuals adapt to life histories of cumulative disadvantage, which, in turn, lead to differences in physical health. All analyses also will explore differences across gender. This work will use expansive new data from three large longitudinal population sample surveys: 1) the Wisconsin Longitudinal Study (WLS), a study of 10,317 Wisconsin high school graduates in 1957, which includes information from main respondents in 1957 (age 18), 1964 (age 25), 1975 (age 36), 1992-93 (age 54), and 2003- 04 (age 65); information from siblings in 1977,1992-93, 2004; and information from graduate spouses and widows in 2004; 2) the National Survey of Families and Households (NSFH) 1987-88,1992-93, 2002-03, a study of 13,007 U.S. adults aged 19-95 in 1987-88; and 3) the National Survey of Midlife in the United States (MIDUS), 1995, 2004, which includes information from 3,485 primary respondents aged 25-74 in 1995 and 1,000 siblings of primary respondents. Multivariate regression models, event-history models, hierarchical linear models, and structural equation models will be estimated as appropriate.
Funding Institutions: NIH-NIA (R01 AG026983: 9/30/2005-8/31/2009)
Status: Ongoing
Publications: No
Recruiting Respondents to the Survey Interview
Researchers: Douglas W. Maynard (Professor and Chair, Sociology, University of Wisconsin - Madison) and Nora Cate Schaeffer (Sewell-Bascom Professor, Sociology, University of Wisconsin - Madison)Abstract: Declining participation in survey interviews is a problem of urgent importance for much social science, and refusals account for an increasing proportion of nonresponse. In recent times, the difficulty of reaching potential respondents to request participation has increased, and these respondents are more likely to say they do not have time and/or that they are not interested. This research will complete a systematic inquiry into how response rates might be improved for computer-aided telephone surveys (CATIs) by identifying effective interviewer practices for soliciting survey participation. By applying the well developed procedures of conversation analysis (CA) to the data opportunity provided by the digital recordings of the 2004 administration of the Wisconsin Longitudinal Study (WLS), the PI will develop coding tools to specify and measure how expertly introductions to surveys are done and how well they are tailored. From this, in a larger quantitative investigation, the research will estimate the extent to which different kinds of interviewer expertise and tailoring influence survey participation rates. The aim of the study is to better understand the moment-to-moment contingencies involved in obtaining survey participation. The research combines both qualitative and quantitative investigation and is relevant to a number of social science and methodological areas, include sociology, social psychology, conversation analysis, survey methodology, and statistical modeling. The research has the potential to provide input for social psychological experimentation both in the lab and in the field and develop interaction coding instrumentation, and codes and processes that could potentially aid in increasing survey response rates through interviewer selection and training. Increasing response rates in surveys will lower survey costs and lead to samples that are more generalizable to wider populations.
Funding Institutions: NSF (SES-0550705: 7/1/2006-6/30/2009)
Status: Ongoing
Publications: Yes (Search Project Bibliography)
Early Life Influences on Elderly Health in the Developing World
Researchers: Mary McEniry (Associate Scientist, Sociology, University of Wisconsin - Madison)Abstract: Differences in the evolution of mortality in the developing world during the 20th century will have important implications for elderly health status for at least the next 20 to 30 years. Due to the particular nature of mortality decline in the developing world, we hypothesize that early life conditions have important effects on later adult health in these countries and that the effects are more salient in some types of demographic regimes than in others. The proposed research assesses the relation between early childhood conditions and adult morbidity and mortality among different demographic regimes in Latin American and Caribbean (LAC), Asian and African elderly populations, using as benchmarks data from relevant industrialized elderly populations such as the US, UK and Taiwan. The research builds upon preliminary results obtained among the LAC elderly. Continuing with this work, we test guiding hypotheses using comparable cross national and panel data in health outcomes, early childhood conditions, adult SES and adult lifestyle. We use multivariate analyses to examine health profiles, determinants of health status and individual health transitions. We also incorporate procedures such as vignettes to adjust for under (over) reporting of health; try new estimation procedures for the over (under) reporting of health conditions and procedures to adjust for differential survival in chronic diseases; and use Waaler-type surfaces to estimate expected relative mortality risk.
Funding Institutions: NIH-NIA (K25 AG027239: 9/30/2006-8/31/2011)
Status: Ongoing
Publications: No
The Health Status of the Elderly Population in Columbia
Researchers: Mary McEniry (Associate Scientist, Sociology, University of Wisconsin - Madison)Abstract: While we have data from comprehensive surveys conducted in the Latin American and Caribbean (LAC) region with projects such as PREHCO, MHAS, SABE, CRELES, we know relatively little about the conditions of aging in Colombia beyond knowing that Colombia is beginning to experience the same rapid rate of aging as in other LAC countries. A preliminary search for studies or research conducted on the elderly Colombian population suggests that there has been no recent major research study on aging in Colombia. Our objectives are: 1. Develop collaborative ties with 2-3 researchers in Colombia, South America who are conducting (or who have interests in) research on aging, and 2. Develop a collaborative R03 or R21 proposal to be submitted to NIA which builds on current research on understanding influences of early life conditions of adult health in the Latin American and Caribbean (LAC) region and which has the potential to lead to a significant research proposal (R01). In June 2006, I attended the Colombian Gerontological Association's annual meeting in Cartagena and met with its president to discuss possible collaboration. At the same meeting, I also met with researchers from the University of Texas at Galveston to discuss collaboration. I plan to keep in touch with these contacts and develop new research possibilities in Colombia.
Funding Institutions: 5K25AG027239
Status: Complete
Publications: No
Sexual Behavior, Sexual Networks and STDs in China
Researchers: M. Giovanna Merli (Associate Professor, Sociology, University of Wisconsin - Madison)Abstract: Sexually transmitted diseases (STDs) have made a comeback in China after their virtual eradication during the Mao era. Current levels of STDs provide a strong indication that a growing number of Chinese are engaging in high-risk sexual behaviors. The proposed project will investigate sexual behavior and sexual mixing patterns of Chinese adults through a cross-sectional sample survey of sexual behavior and sexual networks to be conducted among 3 populations in the Shanghai greater metropolitan area: the adult resident population, rural migrants and women working in entertainment establishments at risk of engaging in prostitution. Respondents will be asked to give details about themselves, their partners and the behavioral repertoires of their partnerships. They will also be asked to provide information on their health status and symptoms associated with STDs. Biomarkers (urine) will be collected from respondents who agree to provide them and assays performed to measure Chlamydia and gonorrhea. From the data thus obtained, we will derive empirically grounded, population-specific behavioral input parameters for use in mathematical models that will allow an exploration of the implications of sexual behaviors observed in Shanghai for the spread of STDs in the Chinese population at large. In addition, we propose to utilize the data collected towards the identification of key attributes of the social organization of sexual partnering in Shanghai, the understanding of the relationship between the organization of sexual partnering and differences in prevalence of STDs within and across populations, and the identification of epidemiologically relevant populations to the transmission and spread of STDs.
Funding Institutions: CDHA/NIA supplemental for Pilot; NIH-NICHD (R21 HD047521: 4/15/2006-3/31/2009)
Status: Ongoing
Publications: No
The Impact of HIV/AIDS Mortality and Morbidity on Household Organization in South Africa and Consequences for the Elderly
Researchers: M. Giovanna Merli (Associate Professor, Sociology, University of Wisconsin - Madison) and Alberto Palloni (Professor, Sociology, University of Wisconsin - Madison)Abstract: While we know a fair amount about the direct demographic impact of HIV/AIDS in Sub-Saharan Africa, we know far less about indirect influences and, in particular, about the effects that the presence of the disease has on residential arrangements of adults, children and elderly. Identify the impact of HIV/AIDS morbidity and mortality on family structure, living arrangements and well-being of members of South African families afflicted by HIV/AIDS with particular emphasis on the elderly. Our attempt to identify the effects includes various approaches: (a) we implement macro models of the epidemic with backward and forward projections of HIV incidence and related mortality to estimate expected current availability of adult children for the elderly, prevalence of sickness among the children born to elderly people, and to project changes in availability and sickness. (b) we examine observed changes in living arrangements of the elderly over time using data enumerations conducted prior to and after the onset of HIV/AIDS. (c) We compare expected outcomes from the macromodels with observed changes in living arrangements of the elderly over time. The results from the model suggest that a grim scenario will take hold not too far down into the future. The bereavement load for the elderly associated with adult children aged 20-30 dying of AIDS in the next 10 years will be indeed great. 20% of adult children will die of AIDS before attaining ages 20-35 in 2005, while this proportion will increase to 35% in 2010. Moreover, our model predicts that the fraction of elderly with no children alive will increase from around 10 percent in 1995 to 18% and 20% in 2005 and 2010 respectively as result of HIV/AIDS. The results from the descriptive analyses of living arrangements of the elderly are consistent with expected changes in availability of adult children for the elderly suggested by the model. We notice especially an increased the propensities of grandparents to take in their grandchildren, possibly to ease the burden on their sick adult children or to care for their orphaned grandchildren. In collaboration with the University of Pennsylvania, we have made a parallel R01 submission to NIA. The overall aim of this project is to evaluate the consequences of changes in morbidity and associated mortality in Sub-Saharan Africa for burdens on the elderly and the care of children as quantified by kin availability and co-residence. We propose to combine the use of a micro simulation model and empirical data to quantify the impacts of disease and mortality on kin availability, health status of relevant kin, living arrangements of various types of kin, and resulting household configurations. Data to estimate the input parameters come from South Africa and Malawi. The proposal did not receive a fundable score. We are in the process to revise it and resubmit it.
Status: Ongoing
Publications: Yes (Search Project Bibliography)
Mortality Following Spousal Illness: Does Education Matter?
Researchers: Claire Noel-Miller (Affiliate, CDHA, University of Wisconsin - Madison)Abstract: The purpose of this pilot project is to explore the relationship between one elderly spouse’s chronic illness and the mortality risk of their partner and to assess the buffering role of socio-economic status in the transmission of such health risks between elderly marriage partners. In order to examine such a transmission of negative health outcomes between marital partners I propose to rely on a couple analyses of both members of the marital dyad. The specific aims of the pilot project are: (1) To replicate and confirm recent findings which predict an increased risk of death following a spouse’s prior experience of chronic illness; (2) To examine whether education buffers the effect of prior spousal chronic illness on elderly partner’s risk of death; and (3) To explore the pathways by which education protects from increases in the risk of death following spousal illness.
Funding Institutions: NIH (F32 AG031636: 9/1/2007-
Status: Ongoing
Publications: No
Biomarkers Study in PRECHO
Researchers: Alberto Palloni (Professor, Sociology, University of Wisconsin - Madison)Abstract: The current population-based study in Puerto Rico offers a valuable opportunity to include biomarkers in a study of aging. A central problem facing the current aging cohort is glucose intolerance and diabetes. In recent years, research on diabetes has made important advances in several areas, including environmental, biochemical and genetic measures. Using the current follow-up data from this study an efficient design would involve a nested-case control study of incident diabetes. In addition, useful pilot data could be obtained on measures of physical activity, which is obviously a key causal exposure for diabetes. These samples could not be assayed before the onset of the condition, since stored samples are not available, so a different set of participants–perhaps persons with glucose intolerance but not frank diabetes, or first degree relatives –might also need to be included as controls. The data to be collected would be pilot data to lay the basis for a larger cohort study. Thus the sample size could be modest. To extract added value, we will choose the PREHCO II subpopulation that has African descent thus making it directly comparable to similar data from African-origin populations in other parts of the Caribbean and four countries in Africa collected by Ricahrd Cooper and colleagues from Loyola University.
Status: Ongoing
Publications: No
Ethnic Disparities of Early health Effects on Early Academic Achievement
Researchers: Alberto Palloni (Professor, Sociology, University of Wisconsin - Madison)Abstract: We will use the ECLS-K to ascertain gaps in cognitive scores at various ages among various ethnic groups (NHW, African Americans, Asians and Hispanic). We will then try to account for this using batteries of SES variables and parental indicators. The ultimate aim of the project is to determine the degree to which early health affects ultimate individual achievement. Thus, this is subproject of a larger one that I am conudcting with other data sets including AddHeatlh, NLSY and the two British cohorts.
Status: Ongoing
Publications: No
Health Conditions among Elderly in Latin America
Researchers: Alberto Palloni (Professor, Sociology, University of Wisconsin - Madison)Abstract: This project is to examine patterns, transitions, and determinants of health in a comparative framework within countries of the Latin American and Caribbean region. The study seeks to contrast patterns within the region and also with those found in the U.S., in particular with populations of Mexican origin, taking advantage of recently gathered, high- quality, comparable, and as of yet under-analyzed survey data on elderly people. The goal is to exploit the available cross-country data to identify conditions that promote (inhibit) the emergence of relations between health status and disability and well-specified determinants, and to assess how recurrent and generalizable are relations found in any one country. The specific aims of the project are: to estimate profiles and determinants of health status and disability of elderly populations in Mexico, and in seven capital cities of Latin America (Argentina, Barbados, Brazil, Cuba, Chile, Mexico, and Uruguay); to identify determinants of health and disability status using cross-sectional data to contrast health and disability profiles of populations in Mexico with that of Mexicans and Mexican-origin populations living in the U.S.; to estimate correlates of health status changes, disability transitions and mortality in Mexico and the U.S. with particular emphasis on the role of early childhood conditions, experiences with illness, and on the influence of income and wealth. Because of their increasing importance in the region, the project focuses more narrowly on diabetes and obesity, and proposes to estimate models for incidence and duration of diabetes as well as health-related costs associated with these conditions. In pursuing these goals the study adds to and fine-tunes existing methods and procedures to help address two issues: health selection among immigrants to the U.S., and estimation of couple-models to assess the effects of select determinants on health and mortality net of shared attributes.
Funding Institutions: NIH-NIA R37-AG25216, R01-AG16209, 9/1/2005 - 6/30/2009)
Status: Ongoing
Publications: Yes (Search Project Bibliography)
Socialeconomic Status and Health in the Wisconsin Longitudinal Study
Researchers: Alberto Palloni (Professor, Sociology, University of Wisconsin - Madison), Pamela Herd (Associate Professor, Sociology, University of Wisconsin - Madison), H.-H. Daphne Kuo (Associate Researcher, School of Medicine and Public Health, University of Wisconsin - Madison)Abstract: To what extent are health selection processes responsible for adult health disparities among different socioeconomic groups? Is it possible that at least part of the long-lasting presence of quite vigorous adult health and mortality inequalities in the US and other developed countries owes a non trivial contribution to processes whereby individuals who experience early child health problems end up in lower ranking classes as well as in poorer health status? And if so, is it a large or a small part? This project attempts to answer these questions for individuals who belong to the high school class of 1957 in the Wisconsin Longitudinal Study (WLS). In order to do so, we undertake three different tasks. The first task is to empirically estimate relatively ‘pure’ effects of education and wealth on adult health status and mortality, that is, purged from contamination due to unobservables. The second task is to estimate alternative models for the production of adult health and mortality that take account of early conditions and bringing. The estimates of these alternative models can then be deployed (via Monte Carlo simulation) to classify the estimated effects of education and wealth into two categories: the first includes only direct effects, that is those associated with characteristics inherent to wealth and education; the second class is comprised of ‘indirect effects’, namely,those resulting from mechanisms that link health status and mortality as well as wealth and education to processes that occur early in the life of the individual. The third task we propose to accomplish is to evaluate if and to what an extent the results we obtain are peculiar to the WLS (given its unique configuration) or rather, apply more generally to the US population. For this purpose we use the cohorts followed in the Health and Retirement Survey.
Funding Institutions: NIH-NIA (P01 AG021079: 9/15/2002-6/30/2012)
Status: Ongoing
Publications: No
The Volunteering-Health Relationship in the WLS Sample
Researchers: Jane Allyn Piliavin (Professor, Sociology and Women's Studies Program, University of Wisconsin - Madison)Abstract: Past research has shown that there are positive effects of volunteer work on both mental and physical health and even mortality in middle aged and elderly populations. Three things have been largely lacking in the research on this topic to date: 1) investigation of the mechanisms by which volunteering and other forms of community participation have their effects, 2) exploration of the extent of continuity from adolescence through old age in volunteering and social participation, and 3) the study of possible different effects of kinds and amounts of volunteering. The proposed analyses seek to discover the positive effects of past and recent social participation, most specifically volunteer work, on health outcomes among participants in the Wisconsin Longitudinal Study (WLS), using both core and sibling samples. Moderating variables (age, social integration) and mediating variables (volunteer motives, identity, and mattering) are explored as is the impact of high school social participation on lifelong volunteering. In the Core WLS sample, the usual volunteering-health relationship holds, more strongly for psychological well-being than for depression or self-reported health. The impact is greater for individuals not otherwise well-integrated into society (e.g., unmarried, not working, with few friends). Past volunteering has a very strong relationship to sense of mattering and volunteer identity reported in the most recent wave. High school social participation is significantly related to later community participation. In the next few years, we intend to fully analyze the most recent wave (2004-5); most results above are based on the 1992 wave of the 1957 grads only. We plan to analyze the sibling data to investigate the moderating role of age on the volunteering-health effect. We also intend to further investigate the role of high school participation on not only later social participation but also stratification effects.
Funding Institutions: NIH-NIA (R03 AG21526: 9/30/2002-8/31/2004)
Status: Ongoing
Publications: Yes (Search Project Bibliography)
The Spatial Distribution of Elderly Populations: Trends, Implications, and Cross-National Differences
Researchers: James Raymo and Katherine Curtis (Assistant Professor, Community & Environmental Sociology, University of Wisconsin - Madison)Abstract: This is a multi-year study of trends in the spatial distribution of elderly populations in aging societies and relationships between regional characteristics and multiple dimensions of well-being at older ages. The specific aims of the proposed research are: (1) to describe change over time and differences across countries in the geographic concentration of elderly (65+) and oldest-old (80+) populations, (2) to describe change over time and differences across countries in the concentration of elderly populations with respect to regional characteristics (e.g., urban-rural, high/low economic growth, high/low in amenities), (3) to describe change over time and differences across countries in individual characteristics associated with residence in different types of geographic areas (e.g., urban-rural) at older ages, and (4) to explore the ways in which regional characteristics are associated with multiple measures of well-being at older ages and how these relationships differ across countries. Initial analyses will focus on the U.S. and Japan, two countries with very different levels of geographic mobility at older ages. The long-term comparative goals of this project are more ambitious and current plans include utilizing data from the U.S., Japan, China, and Taiwan, and other countries including, but not necessarily limited to, the U.K. and Russia.
Status: Ongoing
Publications: No
Life Course Trajectories and the Retirement Process
Researchers: James M. Raymo (Associate Professor, Sociology, University of Wisconsin - Madison)Abstract: Concurrent trends toward greater individual responsibility for planning and preparing for retirement and greater variation in individual experiences across the life course suggest that life trajectories may play an increasingly important role in shaping the retirement process. Using data from the Wisconsin Longitudinal Study, we will examine linkages between occupational trajectories across the life course and four aspects of the retirement process: (1) the timing of labor force transitions (including full and partial retirement); (2) retirement intentions articulated when respondents were in their early 50s; (3) the congruence (or lack thereof) between retirement intentions and actual outcomes; and ( 4) emotional well-being following the transition to re tirement. We show that career stability, occupational mobility, and self-employment across the life course as well as labor union membership and absence of earlier occupational aspirations are all associated with the likelihood of achieving one’s preferred work status at ages 63-64. We also show that many of these same characteristics of work trajectories are associated with the timing of first retirement and the relative likelihood of retiring for health reasons and reemployment following retirement. To some extent these relationships are explained by pre-retirement job characteristics but many remain significant after controlling for a wide range of temporally proximate correlates of retirement outcomes. We plan to examine linkages between work trajectories and post-retirement well-being and will use the HRS data to examine relationships between characteristics of career jobs and life table measures of the retirement process.
Funding Institutions: NSF (SES-0550752: 7/1/2006-6/30/2008)
Status: Ongoing
Publications: Yes (Search Project Bibliography)
Planning and the Social Psychology of Retirement
Researchers: James M. Raymo (Associate Professor, Sociology, University of Wisconsin - Madison)Abstract: Understanding the role of retirement planning is important in the context of increasing longevity, insufficient financial preparation for retirement, decreasing institutional incentives to leave the labor force at specific ages, policy efforts to encourage extended labor force attachment at older ages, and evidence of widespread interest in partial or phased retirement and post-retirement employment. We propose to examine whether and how psychological correlates of retirement planning and preparation influence the retirement process. Preliminary results indicate psychological correlates of planfulness are inversely associated with uncertainty about retirement timing and pathways. We also find that these relationships are not mediated by economic, occupational, health, and family circumstances in late midlife. We plan to extend our preliminary analyses to a wide range of psychological and behavior correlates of planfulness and several other retirement outcomes. We are also preparing to conduct similar analyses using data from the HRS.
Status: Not Active
Publications: Yes (Search Project Bibliography)
The Family Context of Work and Health at Older Ages in Japan
Researchers: James M. Raymo (Associate Professor, Sociology, University of Wisconsin - Madison)Abstract: Increasing labor force participation among older Americans suggests that the distinctive characteristics of work, family, and health at older ages in Japan may be valuable source of insight. In this work, we examine whether the relationship between poor health and labor force exit depends upon family characteristics. We also examine the extent to which continued labor force attachment is associated with health and whether these relationships differ by family characteristics. We find that the relationship between health and the likelihood of labor force exit is conditioned by both family characteristics and the level of health but not necessarily in ways that are consistent with our hypotheses. We also find that marriage is ass ociated with better self-rated health and lower depressive symptoms among older men but not women but find limited evidence that the presence of children contributes to well-being. We plan to focus on evaluating the extent to which work and family circumstances (and changes therein) are associated with trajectories of health and well-being at older ages.
Status: Complete
Publications: Yes (Search Project Bibliography)
The Family Context of Work at Older Ages in Japan and the United States
Researchers: James M. Raymo (Associate Professor, Sociology, University of Wisconsin - Madison)Abstract: Recent research makes increasingly clear the importance of family context for understanding individual variation in the retirement process. However, because most of this work has focused on the U.S., very little is known about work-family relationships among older men and women in other countries. In this study I will examine the ways in which later-life labor force participation is influenced by family structure and family relations in Japan and the U.S. Preliminary analyses of Japanese data suggest that the relationships between family structure and labor force participation are generally similar to those in the U.S.. One important difference is the strong relationship between labor supply and coresidence with married children in Japan. Using data from three nationally representative longitudinal surveys (Health and Retirement Study, Wisconsin Longitudinal Study, and National Survey of Japanese Elderly), I will model labor force transitions as a function of measures of family structure and family relations. I will also model family relations as a function of labor supply and recent work history.
Funding Institutions: Social Science Research Council (Abe Fellowship: 6/1/2003-1/15/2004 and 6/1/2004-8/31/2004)
Status: Complete
Publications: Yes (Search Project Bibliography)
Case Managers’ Gendered Expectations and Impacts on Long-term Care
Researchers: Stephanie A. Robert (Associate Professor, School of Social Work, University of Wisconsin - Madison)Abstract: Gendered expectations regarding caregiving roles may be perpetuated and reinforced through formal long-term care service systems. This study examines whether case managers have gendered expectations regarding the roles that sons and daughters should each play in caring for older parents. Care managers were read a vignette about a frail older woman, with half the sample providing additional information about a nearby daughter and half about a son. Care managers were then asked closed-ended questions about their expectations for what the daughter/son should do to assist the frail mother. Preliminary bivariate analysis from the partially-collected sample indicates that the gender of the potential caregiving child affects some, but not all, expectations of care managers. Care managers were more likely to agree that daughters, rather than sons, should be encouraged to provide care and to apply to be reimbursed for this care.
Status: Complete
Publications: Yes (Search Project Bibliography)
Community Context and Health over the Life Course
Researchers: Stephanie A. Robert (Associate Professor, School of Social Work, University of Wisconsin - Madison)Abstract: The overall goal of this study is to better understand how socioeconomic and racial disparities in health, well-being, and mortality are produced and maintained by both community and individual processes over the life course. One of our in-press papers examines the association between racial residential segregation, neighborhood socioeconomic context, and health among older adults. We find that there are only weak associations between racial residential segregation and health in two national surveys of adults in the U.S. However, socioeconomic status at multiple levels contributes to race disparities in health. Our new work is examining health and health trajectories among older adults in poor neighborhoods.
Funding Institutions: NIH-NIA (R01 AG20247: 9/1/2002-7/31/2007)
Status: Complete
Publications: Yes (Search Project Bibliography)
Long-term Support in Wisconsin: the Perspective of Case Managers
Researchers: Stephanie A. Robert (Associate Professor, School of Social Work, University of Wisconsin - Madison)Abstract: Wisconsin is piloting a new publicly-funded long-term care program titled Family Care. Research is needed to examine how implementation of this program impacts the health and well being of Wisconsin residents with long-term care needs and their families. This project examines the process and outcomes of the Family Care pilot from the perspective of care managers working in the system. Two waves of phone surveys have been conducted with care managers in 5 Family Care counties. Family Care improves access and quality of community-based long-term care. However, several challenges remain regarding funding, coordination of services, and measuring consumer and family outcomes.
Status: Complete
Publications: Yes (Search Project Bibliography)
Assessing Sources of Variability in Cognitive Function in the Healthy Elderly
Researchers: Timothy T. Rogers (Assistant Professor, Department of Psychology, University of Wisconsin - Madison)Abstract: This project will design an extensive battery of cognitive tests in a sample of approximately 100 healthy “young-old” individuals with four specific aims: 1) To pre-test all aspects of the cognitive battery to be included in the upcoming round of graduate testing for the Wisconsin Longitudinal Survey. 2) To determine which cognitive tests in this longer battery are best included in the shorter battery that will be used in the field for all WLS graduates. 3) To provide a preliminary analysis of sociodemographic factors that predict cognitive variability in the young-old. 4) To determine which aspects of cognition, if any, best discriminate populations with/without a family history of Alzherimer’s disease.
Status: Ongoing
Publications: No
Integrative Pathways to Health and Illness
Researchers: Carol Ryff (Professor, Psychology, University of Wisconsin - Madison)Abstract: The purpose of this program project grant is to carry forward MIDUS, a national survey (N= 7,189), conducted in 1994/95 by the MacArthur Midlife Research Network. The sample included adults aged 25 to 74, as well as twins and siblings. Conceived by a multidisciplinary team, the study investigated the role of behavioral, psychological, and social factors in accounting for age-related variations in health and illness. MIDUS II will add a second wave to the study, approximately 9-10 years later. In addition, it will include a sample of African Americans in Milwaukee, WI (N= 400).
Funding Institutions: NIH-NIA (P01 AG020166: 9/30/2002-7/31/2008)
Status: Ongoing
Publications: No
Social Demography and Adolescent Obesity
Researchers: Gary Sandefur (Professor, Sociology, University of Wisconsin - Madison)Abstract: Concern about the adolescent obesity epidemic in the United States largely rises from the health consequences of overweight, i.e., its connections to diabetes, heart disease, and other medical conditions. Overweight, however, also has other effects on individual lives that are not well-studied or understood. Further, many of the causes of overweight must have to do with social and behavioral variables as well. That is, the population has not genetically transformed in the past several years to become more inclined to be overweight. Instead individual's behaviors and environments have led to the activation of genes that may lead to a greater incidence of both adolescent and adult overweight. Consequently, it is important to do more research on the social and behavioral causes and consequences of overweight throughout the life course in order to get a better understanding of the dimensions of this major public health problem. In this proposal we use data from the National Longitudinal Survey of Adolescent Health to investigate these issues.
Funding Institutions: NIH-NICHD (R01 HD050144: 6/6/2005-5/31/2009)
Status: Ongoing
Publications: Yes (Search Project Bibliography)
Interaction and Cognition in Surveys of Older Adults
Researchers: Nora Cate Schaeffer (Sewell-Bascom Professor, Sociology, University of Wisconsin - Madison) and Douglas W. Maynard (Professor and Chair, Sociology, University of Wisconsin - Madison)Abstract: This research uses data from the Wisconsin Longitudinal Study to analyze the interactive aspects of cognitive processing in the interaction between respondents and interviewers, focusing particularly on cognitive assessments. We address several overarching goals: describing the interactional dimensions of what we often think of as "cognitive" processing or functioning, examining how the interaction between the interviewer and respondent contributes to the outcomes of cognitive assessments, seeking interactional indicators of cognitive functioning, and identifying features of the interaction that can be used to improve measurement in Computer-Assisted Telephone Interview (CATI) surveys of older adults. Our conversation analytic work (Phase I) provided a detailed analysis of compliment sequences and identified features of interaction for coding. The development of the coding system (Phase II) is now complete. In developing our coding system we have described a range of ways that respondents signal difficulties -- either cognitive or procedural -- with the interview, such as reporting answers that do not match the question. We have also examined ways interviewers respond to these signals, such as immediate coding of answers. In our analysis (Phase III), we examine the relationship between features of the interaction and the cognitive outcomes using data generated using our coding system.
Funding Institutions: NIH-NIA (P01 AG021079-03S3: 10/1/2004-9/30/2006)
Status: Ongoing
Publications: Yes (Search Project Bibliography)
Interactional Dimensions of Cognition in Interviews of Older Adults
Researchers: Nora Cate Schaeffer (Sewell-Bascom Professor, Sociology, University of Wisconsin - Madison) and Douglas W. Maynard (Professor and Chair, Sociology, University of Wisconsin - Madison)Abstract: The data for the project are provided by digitally recorded interviews of the now older adults from the 2004 Wisconsin Longitudinal Study (WLS), which also provides measures of social characteristics and cognitive ability when the respondent was younger. Our study presents a project that focuses on two cognitive tests administered in the WLS: “verbal fluency” and “digit ordering”. Besides quality of survey measurement, our research addresses issues relevant to a wide range of topics surrounding cognition and interaction, including the effects of positive feedback on performance, the use of interactional resources to compensate for cognitive difficulties, and metacognition (the respondent’s judgment about his or her own cognitive abilities). For the present project on cognition, our work with the WLS interviews has led to what we think are groundbreaking developments in interaction coding. However, the rigor and sophistication of our approach has meant unanticipated complications because each section of the interview that we investigate has required intensive revisions of previous coding systems. Furthermore, we discovered that different types of questions gave rise to different sorts of interactions, and this has mandated further in-depth elaboration of the codes. This pilot project is funded to supplement full production coding on our larger project about the interactional dimensions of cognitive functioning and its measurement in the CATI survey interview. Our poroduction coding for 200-300 cases will begin in late summer and early fall and position us to have results that will inform our next proposal to NIA that will expand both the numbers of cases we can analyze and the modeling we wish to do to examine the effects of interactional practices on cognition and cognitive measurement.
Status: Ongoing
Publications: No
Altruism and Family Well-being: Evidence from the HRS/AHEAD
Researchers: John Karl Scholz (Professor, Economics, University of Wisconsin - Madison), Meta Brown (Assistant Professor, Economics, University of Wisconsin - Madison), Maurizio Mazzocco (Assistant Professor, Economics, University of Wisconsin - Madison)Abstract: Our proposed work promises to improve the methodology and measurement of issues related to inter-family transfers of time and money. Enhancing understanding of inter-vivo transfers, bequests and in-kind exchanges may have potentially important implications for efforts to better understand the interplay of health, work and retirement and the financial well-being of aging households. In the first part of the project we will develop formal models of intergenerational altruism in a life-cycle framework. The key ingredients in our approach, which will determine when exactly parents transfer resources to their children, are uncertainty in length of life for the parent; uncertainty in income for the child; and the "Samaritan's dilemma," induced by the dynamic considerations inherent in the framework. The interplay between these three ingredients will provide a valuable framework with which to structure our empirical analyses using the HRS/AHEAD. Standard models of altruism incorporate reciprocal altruism-parents care for (adult) children and children care for their parents. The direction of transfers in these models will depend on relative lifetime incomes.
Funding Institutions: NIH-NIA (R01 AG024048: 9/30/2003-8/31/2007)
Status: Complete
Publications: No
Fundamental Factors Affecting the Wealth and Retirement of Elderly Americans
Researchers: John Karl Scholz (Professor, Economics, University of Wisconsin - Madison) and Ananth Seshadri (Professor, Economics, University of Wisconsin - Madison)Abstract: This proposal describes five projects that promise to provide new information on fundamental factors affecting wealth accumulation and the degree to which American households are financially well-prepared for retirement. We rely on an augmented life-cycle model, modified to incorporate features that are essential to meet our project objectives. Our first project highlights the role children play in wealth accumulation. Despite a vast life-cycle literature examining wealth accumulation, surprisingly few papers focus on the role of children. Our work will address this gap. Our second project provides a comprehensive look at the adequacy of retirement wealth preparation of households in different U.S. birth cohorts. In earlier work we showed that members of the original HRS cohort, born between 1931 and 1941, overwhelmingly were on track in 1992 to having resources in retirement necessary to maintain their accustomed living standards. A critical unresolved issue, however, is the degree to which these results hold for other cohorts, particularly those born after 1941. Our third project examines health capital and the effects of the health care safety net on wealth. Several recent contributions emphasize the role that precautionary saving for end-of-life medical expenses plays in influencing age-asset profiles of the elderly. Our project will help quantify these effects by modeling explicitly the fact that health expenditures may affect life-span. Our fourth proposed project examines the interactions of wealth and retirement (and retirement expectations). One way for some households to respond to actual or perceived shortfalls (surpluses) in retirement wealth is to defer (hasten) retirement. We will use differences between actual and “optimal” net worth to study the way retirement expectations and wealth are correlated with retirement decisions. We will also develop and estimate the parameters from a new model of retirement. Our fifth project examines the role of pensions on non-pension wealth accumulation. Past estimates of the effects of pensions on non-pension wealth accumulation are difficult to interpret if there is a mixture of credit constrained and unconstrained households in the samples used for estimation. We clarify these issues, account fully for lifetime (past and future) resources, and offer a new way of thinking about the effects of pensions on wealth accumulation.
Funding Institutions: NIH-NIA (R01 AG032043: 8/15/2008-6/30/2013)
Status: Ongoing
Publications: No
Day Reconstruction Method
Researchers: Norbert Schwarz (Professor, Psychology, University of Michigan)Abstract: This project deals with the development of new methods for the measurement of well-being and health that aggregate particular experiences rather than eliciting global evaluations. The objective of this project is to understand changes in affective experience across the life-span. For current findings, please see Kahneman, D., Krueger, A. B., Schkade, D., Schwarz, N., &Stone, A. A. (2004). A Survey Method for Characterizing Daily Life Experience: The Day Reconstruction Method (DRM). Science, 306, 1776-1780. Future plans include further development of the method.
Status: Ongoing
Publications: Yes (Search Project Bibliography)
The Health and Well-Being of African Immigrant Children and their Families: Madison Pilot
Researchers: Sherrill L. Sellers (Associate Professor, Social Work, University of Wisconsin - Madison)Abstract: The purpose of the research is to investigate the physical and mental health outcomes of African immigrant children and their families. The paucity of African immigrant families in prior research, theorizing, and empirical studies of immigrants, as well as the recent and projected changes in immigrant populations prompted the study. The Madison Pilot will serve as a model for four other cities conducting similar research. Specific aims of the project are to 1. gain an improved understanding of the physical health and well being of African immigrant children (ages 10-17) and their families; 2. investigate intra- and inter-group differences in vulnerability and responsiveness to immigrant experience, as measured by differences in health outcomes, social resources, and coping strategies; and 3. gain an understanding of program and policy ingredients of a culturally competent network of care for African immigrant children and families. The pilot project has been completed.
Funding Institutions: Robert Woods Johnson Foundation (10/21/2002-8/31/2003)
Status: Complete
Publications: Yes (Search Project Bibliography)
Cortisol Collection from Parents of Nonnormative Children of the Wisconsin Longitudinal Study
Researchers: Marsha Mailick Seltzer (Director, Waisman Center, University of Wisconsin - Madison)Abstract: Although parenthood is a normative role occupied by nearly all adults, fully 20% of parents have children with some type of disability or developmental problem (Ehrenkrantz et al., 2001; Newacheck et al., 1998). We have found that such nonnormative parenting experiences have deleterious effects on parents' health and psychological well-being during midlife (Seltzer et al., 2001, 2004). In the WLS, we have identified two groups of respondents who have children with disabilities: respondents who have an adult child with developmental disabilities (DD; n = 253) and respondents who have an adult child with severe mental illness (MI; n = 301). Past research, including our own, on the impacts of such nonnormative parenting experiences has focused on the psychosocial consequences of child disability or death on parental psychological distress and wellbeing. In the proposed research, we aim to explore the “biological signature” of nonnormative parenting through new data collection of salivary cortisol. Salivary cortisol is useful in assessing stress reactivity. Along with the extensive psychosocial data already collected as part of the WLS, the analysis of this biomarker has the potential to elucidate the physiological correlates of acute parenting stress and chronic parenting strain during the later years of the life course. The proposed new data collection will consist of daily diary data collected over an 8-day period and salivary cortisol collected 4 times a day over a 4-day period (days 2-5 of the daily diary study). For this pilot study, we will focus on those WLS parents who have a co-resident son or daughter with DD or MI, and we will randomly select 20 respondents whose child has a DD and 20 whose child has MI. A comparison group (n = 20), matched on key background characteristics will be constructed, consisting of WLS respondents who have caregiving responsibilities for their aging spouse.
Status: Ongoing
Publications: No
Life Course Impacts of Nonnormative Parenting
Researchers: Marsha Mailick Seltzer (Director, Waisman Center, University of Wisconsin - Madison), Jan S. Greenberg (Professor, School of Social Work, University of Wisconsin - Madison), and Frank J. Floyd (Professor, Psychology, Georgia State University)Abstract: The question of the effects of the death of a child or parenting a child with a disability on parental life course trajectories and well-being has not been addressed extensively in past life course research. The WLS provides an unprecedented opportunity to study the effects of nonnormative parenting in a probability sample that was recruited before the parenting events occurred, allowing us to examine how nonnormative parenting events alter the subsequent shape of the life course for parents to how it affects the parents' well-being at midlife and beyond. We will investigate how the life course in educational, occupational, marital, psychological, and childbearing domains diverges when parents have long-term caregiving responsibilities for a child with a developmental disability, a serious long-term mental illness, or when they experience the death of a child. Thus far, the WLS has been used to examine four examples of nonnormative parenting: parents of children with developmental disabilities, parents of children with severe mental health problems, parents who themselves have low levels of intellectual ability, and parents who have lost a child to an early death. In all of these examples, the expected patterns of vulnerability are evident, but importantly, patterns of resiliency are also present. Identifying pathways to resiliency in this unique probability sample or parents who have experienced nonnormative parenting events will be the focus of upcoming years' investigations. Using the data collected in the 2003 wave of the WLS, we will conduct comparative analyses to identify the pathways to resiliency among nonnormative parents.
Funding Institutions: NIH-NIA (R01: AG20558 5/1/2002-4/30/2007)
Status: Complete
Publications: Yes (Search Project Bibliography)
Study of Siblings in Families with Nonnormative Children in the Wisconsin Longitudinal Study
Researchers: Marsha Mailick Seltzer (Director, Waisman Center, University of Wisconsin - Madison)Abstract: We would like to add two additional groups to this pilot study - respondents who have an adult child with Down syndrome (28 in the WLS) and respondents who have experienced the death of a child. The rationale for including the DS cases is because there is now a trans-NIH Down syndrome initiative, and NIA is participating in this initiative. Nothing is known about the unique biiological toll of stress on parents of adults with DS. These parents tend to be older than their counterparts whose child's disability is due to other causes (due to the association between maternal age and DS) and they are at risk of experiencing elevated stress due to the increased risk and earlier onset of Alzheimer's in adults with DS. The rationale for including the sub-sample who have experienced the death of a child in our daily diary and cortisol study is based on our recent paper (Rogers et al., in press in Family Psychology) showing that the effects of losing a child persist over decades and continue to affect parents in unexpected and previously undocumented ways. We have a unique opportunity to study recent deaths - i.e., deaths that occurred between the 1992 and 2003 rounds of data collection. There has been virtually no research on the experience of losing an adult child in parents in their 60s, a stage of life when this nonnormative parenting event is increasing in probability. We hypothesize that such parents would have a different pattern of responding to daily stress than if they had not experienced this devastating loss. We anticipate that this might be the basis of an R01 to NIA, depending on the results of the pilot study.
Status: Ongoing
Publications: No
The Effect of Nonnormative Parenting on the Normative Transitions of Aging
Researchers: Marsha Mailick Seltzer (Director, Waisman Center, University of Wisconsin - Madison), Frank J. Floyd (Professor, Psychology, Georgia State University), Jan S. Greenberg (Professor, School of Social Work, University of Wisconsin - Madison)Abstract: The research will continue our longitudinal investigation of nonnormative parenting experiences to examine how they influence life course trajectories and well-being during the transition into retirement and in the early years of old age. It builds on the progress of previous awards (R03 AG15549, R01AG20558, and Project 3 of P01 AG21079), which have used the Wisconsin Longitudinal Study (WLS) to investigate the long-range effects of nonnormative parenting through midlife. Parents who have either a child with developmental disability (DD), severe mental illness (SMI), or who have experienced the death of a child are compared with unaffected parents with respect to the parents’ life course attainment and well-being. The sample members have been followed from the age of 18, before they became parents, throughout adulthood. The latest follow-up occurred when parents were in their mid 60s, on average. Using new screening procedures, we identified 1513 parents who have had nonnormative experiences. The proposed investigation will extend the focus to intergenerational influences involving life course attainment and shared caregiving by non-disabled brothers and sisters of the individuals with DD and SMI. This research integrates the life course perspective with models of process and change from the stress and coping framework to understand life-long patterns of adaptation associated with nonnormative parenting, now extended to adaptations during the transition to retirement and the early years of old age. The WLS provides an unprecedented opportunity to study the effects of nonnormative parenting for a sample that was recruited before parenthood, and is thus uniquely able to address self-selection biases that have compromised previous research. Furthermore, the distinctive sibling data structure of the WLS allows us to construct a sibling control design in which those who have experienced a nonnormative parenting event will be compared with their siblings who have not, thereby controlling for potentially confounding family background variables. The combination of a pre-parenthood data point and the possibility of using a sibling control design offers the opportunity to advance our understanding of the unique effects of nonnormative parenting on the normative transitions of retirement and the early years of old age.
Funding Institutions: NIH-NIA (P01 AG21079: 9/15/2002-6/30/2012)
Status: Ongoing
Publications: No
Retirement Wealth in the United States
Researchers: Ananth Seshadri (Professor, Economics, University of Wisconsin - Madison)Abstract: To understand the wide variation in retirement wealth and to examine whether a vast majority of Americans are undersaving. To present an economic model of savings behaviour over the life-cycle and to simulate the model using data from the Health and Retirement Survey. This model is able to capture the wide variation in retirement wealth. And there is very little evidence that Americans are saving too little. To explore in detail the causes underlying the low wealth holdings of the very poor. The idea is that aside lower lifetime earnings, the single most important reason underlying the low wealth holdings of the very poor is their higher fertility rate.
Status: Complete
Publications: Yes (Search Project Bibliography)
Access to Care and Health Outcomes in the Near Elderly
Researchers: Maureen Smith (Associate Professor, Population Health Services & Family Medicine, University of Wisconsin - Madison)Abstract: There are widespread concerns that near-elderly Americans (55-64 years old) face increasing barriers to obtaining health care during a time of significant life transitions and deteriorating health. This study builds on the strengths of the Wisconsin Longitudinal Study (WLS). The long-term objective of the proposed research is to examine determinants of access to care, including attitudes and satisfaction with the health care system, use of services, and health-related outcomes in the near-elderly. The specific aims are to determine the role of 1) significant recent life transitions, 2) financial and non-financial incentives in a person's current health insurance plan, 3) the healthcare environment, and 4) patient physician communication. The overwhelming majority of older adults want to be given treatment options and have their physician know everything about their medical history; however, there are substantial differences in how they want to be involved in discussing and selecting treatments. Patients with increased health needs and longer provider relationships are more likely to feel unsafe when seeing someone other than their usual physician. One-third of WLS respondents sought health information via the internet, but there were important differences in timing. Half of these searched for health information unrelated to their last doctor visit, while 1/3 searched after a visit, and 1/6 searched before. Regarding utilization, women who experienced insurance disruptions due to their spouses transitioning to Medicare were more likely to visit the emergency room compared to women who did not experience a disruption. We plan to link the WLS data with the WI tumor registry to obtain information regarding cancer stage at diagnosis and initial treatment to examine other mechanisms by which a cancer diagnosis may impact health care utilization. We also will examine whether sustained continuity of care with a physician and/or a site has a beneficial effect on the health of older adults, and examine disparities in access to care for women and persons with low income or poor health, as these vulnerable subgroups may have additional difficulties overcoming barriers to care.
Funding Institutions: NIH-NIA (P01 AG21079 9/15/2002-6/30/2007)
Status: Complete
Publications: Yes (Search Project Bibliography)
Minnesota Stroke Survey: Follow-up Study of Quality of Life
Researchers: Maureen Smith (Associate Professor, Population Health Services & Family Medicine, University of Wisconsin - Madison)Abstract: Many stroke survivors experience a decline in their quality of life in terms of impaired physical, functional, psychological, and social health. However, these studies often exclude patients with serious cognitive, speech, and language disorders. The long-term objective of this study is to examine factors influencing long-term outcomes after stroke for patients with a wide range of deficits, and for their caregivers, by following newly diagnosed stroke cases in one of the largest Health Maintenance Organizations (HMO) in the Minneapolis-St. Paul metropolitan area. Family members provide much of the care required by stroke survivors. The magnitude of change, not patient’s baseline status, influences a stroke’s degree of impact on a caregiver’s personal life as well as the number of hours spent caring for the patient. We plan to link survey data regarding quality of life after stroke with abstracted information on clinic visits and hospital discharges, administrative data, and the Minnesota Death Index.
Funding Institutions: NIH-NINDS (R01 NS 39028-01A1: 10/01/2000-6/30/2005)
Status: Complete
Publications: Yes (Search Project Bibliography)
Older Adults and Specialty Care Use in Managed Care
Researchers: Maureen Smith (Associate Professor, Population Health Services & Family Medicine, University of Wisconsin - Madison)Abstract: Managed care organizations (MCOs) have been one response to the health care cost-containment dilemma. As the health care market evolves it is important to update our understanding of how MCOs manage care, especially for the most vulnerable populations such as patients with acute stroke. The long-term objective of this project is to examine the contribution of both MCO incentives and hospital characteristics in explaining variation in specialty care use (including the age gradient), outcomes, and costs for older patients who are hospitalized with acute stroke. Traditional measures of quality such as 30-day rehospitalization may not be valid when comparing MCO and fee-for-service (FFS) patients if differences might refle ct an alternative service mix. More generally, sociodemographic factors and initial discharge site distinguish patients with multiple bounce-backs (e.g., return to the hospital or emergency room) within 30 days. Patients experiencing multiple bounce-backs within 30 days have poorer survival and higher health care costs over the subsequent year than their counterparts with one bounce-back. Neurologists improve outcomes specifically by reducing the potential for aspiration (through increased swallowing evaluations) or improving functioning (through use of rehabilitation therapy). Examine the relationship between MCO membership and use of intensive care and hospice for severely ill stroke patients. Examine the relationship between MCO membership and follow-up care for diabetic patients with acute stroke.
Funding Institutions: NIH-NIA (R01: 9/15/2001-6/30/2003)
Status: Complete
Publications: Yes (Search Project Bibliography)
The Health Care Impact on Women from Their Husbands' Transition to Medicare
Researchers: Maureen Smith (Associate Professor, Population Health Services & Family Medicine, University of Wisconsin - Madison)Abstract: Women under 65 may lose access or experience disruptions in health insurance when their husbands’ employer-sponsored coverage ends or changes at retirement or age 65. Little is known about whether a husband’s transition to Medicare significantly disrupts his wife’s access to health insurance and health care. We propose to examine the availability of health insurance and its impact on access to care for a cohort of women as their husbands transition to Medicare. The specific aims of this study are to: 1. describe dependent coverage provisions of major health insurance policies and the potential changes in coverage retirees and dependents may experience when a spouse transitions to Medicare; 2. describe the frequency and types of disruptions in health insurance for women whose husbands turn 65 and transition into Medicare, and 3. describe the consequences of these disruptions for health care access, continuity of care, satisfaction with care, and out-of-pocket costs.
Status: Complete
Publications: No
Vascular Access Devices: Complications and Patterns of Care in Older Cancer Patients
Researchers: Maureen Smith (Associate Professor, Population Health Services & Family Medicine, University of Wisconsin - Madison)Abstract: Modern cancer care relies upon the use of long-term indwelling vascular access devices (VADs) to deliver therapies directly to the central blood system, even though these devices have a relatively high rate of infectious and thrombotic complications. Multiple conflicting and unresolved concerns remain regarding vascular access in the elderly cancer patient. These include growing concerns about physician age bias and under use of treatments such as chemotherapy in older patients, while at the same time clinicians have logical concerns that older patients are also more likely to have a complicated clinical course due to multiple comorbidities, polypharmacy, and other geriatric syndromes. However, there are no clear guidelines that define the optimal use of VADs in cancer patients and there is wide variation among practitioners. We know little about the process by which age influences VAD complications and care patterns in cancer patients. It is critical to untangle this relationship and to determine the relative importance of age in affecting treatment decisions and outcomes. The goals of this project are: 1) to identify age-related trends in device survival time and complications as well as related post-procedure testing (i.e., laboratory and radiology) for older cancer patients, and 2) to provide pilot data on sample sizes, tests of data quality, and guidance for subsequent research that will combine these administrative data with additional diagnostic and therapeutic information from clinical databases. Using data from the Veterans Administration (VA) national health care system SAS datasets, we will identify beneficiaries who had a cancer diagnosis and underwent AD placement from January 1, 2001 to June 30, 2001. We will use Cox models to examine how patient age and cancer site related to VAD survival time and post-procedure medical testing while accounting for important covariates. This research will provide vital pilot data to support future proposals examining the role of patient age and comorbidities in the use and outcomes of VADs in older cancer patients.
Funding Institutions: NCI-NIA (P20 CA103697: 9/30/03-8/31/2004)
Status: Ongoing
Publications: Yes (Search Project Bibliography)
Grandma, Grandpa and Big Brother: Elders' Understandings of Clinical Information-Technology Governance
Researchers: Mark C. Suchman (Professor, Sociology, University of Wisconsin - Madison)Abstract: Recent years have seen a resurgence of policy interest in clinical information technologies, most notably electronic medical records (EMRs), computerized practitioner order-entry (CPOE), web-based health information (e-health), and to a lesser extent remote out-patient monitoring. Although some of these technologies have existed for decades, their spread has largely been stymied by unresolved governance challenges, such as difficulties in establishing uniform standards and fears about endangering patient privacy. This pilot project would explore how the elderly experience and understand clinical information technologies (such as electronic medical records) and the governance issues that those technologies raise (such as health privacy). During the grant period, the project would have three concrete objectives: 1. Conduct qualitative interviews, 2. Develop an NIA grant proposal, and 3. Develop synergies with provider-side research on clinical IT governance.
Status: Ongoing
Publications: No
Healthcare Information Technology Study (HITS)
Researchers: Mark C. Suchman (Professor, Sociology, University of Wisconsin - Madison)Abstract: The research will guide policymakers in constructing appropriate "governance mechanisms" -- laws, rules and norms – to realize the immense potential of clinical information technologies such as electronic medical records and computerized practitioner order-entry, while avoiding the equally immense pitfalls. At the same time, the research will also guide social scientists in developing richer theoretical understandings of the central governance dynamics underlying innovation, standardization, trust, accountability and legal compliance in the healthcare arena. The study has three major objectives: (1) to identify the likely policy challenges that new CITs will pose in the next 3 to 5 years; (2) to analyze current organizational structures, practices and beliefs surrounding CIT use; and (3) to establish a baseline against which future studies can assess the impact of emerging CITs and CIT-related policy initiatives, as such developments arise. This project is still in the data-gathering stage. The project as a whole comprises 3 interconnected investigations: (1) a series of open-ended exploratory interviews with expert informants in the CIT field, (2) an intensive field observation of the technology-implementation and legal-compliance process at a large teaching and research hospital, and (3) a broad-based survey of CIT adoption patterns and governance practices at 320 hospitals in 64 markets across 16 states. This design pairs qualitative and quantitative methods, to facilitate empirical triangulation.
Status: Ongoing
Publications: Yes (Search Project Bibliography)
Data Quality: Hispanic and Immigrant Mortality
Researchers: Karen Swallen (Assistant Professor, Sociology, University of Wisconsin - Madison)Abstract: Hispanics appear to live longer than other persons do in the United States. Does data quality bias the mortality statistics? We use the NMFS to examine how much misclassification there is on death certificates. We look at classification of ethnicity and nativity jointly and separately. Age-specific adjustment for misclassification of ethnicity in death rates causes Hispanic male life expectancy to go from a 1.01 year advantage over white non-Hispanics to a 1.83 year deficit. The female pattern is similar. Looking at ethnicity and nativity jointly, the US-born Hispanics are most affected. Plans are to complete the joint misclassification paper.
Funding Institutions: NIH-NIA (R03-AG18190, 2000-2003)
Status: Ongoing
Publications: Yes (Search Project Bibliography)
Does Population Composition (And Previous High Migration) Explain the US Advantage in Old-age Mortality?
Researchers: Karen Swallen (Assistant Professor, Sociology, University of Wisconsin - Madison)Abstract: Previous research indicated that once Americans achieve age 80, they have longer life expectancy than European populations. A number of potential explanations for this finding have been proposed, including selective immigration. This paper investigates whether the inclusion of immigrants in the American population deflates mortality rates enough to explain the crossover. First, mortality rates are calculated controlling for nativity; second, mortality of second-generation Americans is taken into account. Excluding these populations from the white, non-Hispanic American population is not sufficient to remove the crossover, although it does push the crossover two years older. Analyses indicate that Hispanic ethnicity (often included within the "white" population in American demographic data) may exert a more powerful compositional effect than nativity. Plans are (1) To complete and publish this paper, (2) To extend research into future examinations of the biological and social determinants of the "healthy migrant effect". A funding application was submitted to NIA (K01) in December 2002.
Status: Ongoing
Publications: Yes (Search Project Bibliography)
Early Parental Loss, Risk Taking, and Health
Researchers: Karen Swallen (Assistant Professor, Sociology, University of Wisconsin - Madison)Abstract: Our objective was to examine the influence of parental age at death on respondents' risk-taking behaviors and health during the mid-life period. We used multivariate statistical analysis of the Wisconsin Longitudinal Study (10,137 respondetns graduated from Wisconsin high school in 1957) and the Health and Retirement Study (12,654 respondents born between 1931 and 1941). We found that those persons whose parents died younger are more likely to take rishks with their health and finances and are more likely to be in poor health. Early parental death is determined both in terms of genetic and behavioral risks.
Status: Complete
Publications: Yes (Search Project Bibliography)
Comparative Analyses of Sterilization in the Life Course
Researchers: Elizabeth Thomson (Professor, Emerita, Sociology, University of Wisconsin - Madison)Abstract: The proposed research will investigate the implications of high rates of union instability and repartnering for contraceptive sterilization. The investigators will first document the extent to which voluntary sterilization occurs in marriage or during periods of cohabitation and singlehood. The investigators will then conduct event-history analyses of the effects of union history and status on the risk of sterilization. These analyses will consider union formation, transition (to marriage from cohabitation) and union dissolution as processes potentially endogenous to the decision for sterilization. Where data allow, the investigators will also consider partner's sterilization as potentially endogenous to the decision to be sterilized oneself. Non-contraceptive sterilization will be treated as exogenous to contraceptive sterilization and to union formation, transition and dissolution. The investigators will use union and birth histories from nationally representative surveys of women, conducted between 1982 and 1995 in Australia, New Zealand, the United Kingdom and the United States, and from two nationally representative surveys of U.S. men. The comparative analyses will identify common patterns in societies that have undergone similar changes in union formation/dissolution and fertility and that have relatively high rates of contraceptive sterilization. Potential differences across countries in the relationships between union processes and sterilization will be linked to variations in the fertility control regime, provision of social welfare and gender equality.
Funding Institutions: NIH-NICHD (R03 HD041514:9/1/2003-8/31/2005)
Status: Complete
Publications: Yes (Search Project Bibliography)
The Impact of Work and Family Roles on Life Outcomes in Late Adulthood
Researchers: John Robert Warren (Associate Professor, Sociology, University of Minnesota - Twin Cities) and James M. Raymo (Associate Professor, Sociology, University of Wisconsin - Madison)Abstract: We will investigate the extent to which work and family trajectories across the life course affect physical and mental health and financial well-being in later adulthood either directly or through their effects on more proximate predictors of these outcomes. To what extent are health and financial well-being among older adults affected by individuals’ contemporaneous work, family, and other circumstances and to what extent are such outcomes due to life-course patterns of experiences in the family and the labor market? How do all of these processes differ for women and men? The meaning and nature of the retirement years has changed in fundamental ways in recent decades. Given that successful aging has increasingly come to depend on individuals’ own planning and resources at earlier ages; given broad social changes that have redefined employment relationships, women’s rates of participation in the paid labor market, and rates of marital dissolution; given growing heterogeneity in men’s and women’s work and family trajectories; and given growing heterogeneity in the well-being of older Americans in recent cohorts, our investigation of the impact of life course patterns of work and family circumstances on health and financial well-being in later adulthood is timely and important. Using data from the Wisconsin Longitudinal Study, we will employ group-based trajectory modeling techniques to characterize the trajectories of family circumstances and transitions from birth through age 65 and trajectories of labor force experiences and exposures from age 36 through age 65.
Funding Institutions: NIH-NIA (P01 AG021079: 9/15/2002-6/30/2012)
Status: Ongoing
Publications: No
Work, Health, & Well-being
Researchers: John Robert Warren (Associate Professor, Sociology, University of Minnesota - Twin Cities) and Peter HonnakkerAbstract: The goal of this project is to investigate the extent to which working conditions account for observed associations between SES and physical and mental health. Using data from the Wisconsin Longitudinal Study we sought to estimate (1) the impact of working conditions on physical and mental health and (2) the extent to which working conditions account for observed associations between SES and health in the WLS. From sociological research on the stratification of employment outcomes we expected that people with less education, lower earnings, and lower levels of occupational standing would have more physically and psychosocially demanding jobs. From the occupational stress, ergonomics, and job design literatures, we expected that people with more physically and psychosocially demanding jobs would have less favorable health outcomes. Consequently we expected to find that job characteristics and working conditions play an important mediating role in associations between SES and self-assessed overall health, cardiovascular health, musculoskeletal health, and depression and psychological well-being. We found support for these hypotheses, although the extent to which working conditions mediate SES-health relationships varies across health outcomes and by sex. We are investigating the impact of the physical and psychosocial characteristics of paid employment on a variety of physical and mental health outcomes from midlife to ages 63-64 using data from the Wisconsin Longitudinal Study (WLS).
Status: Ongoing
Publications: Yes (Search Project Bibliography)
Interactions between Childhood Illness and the Family
Researchers: Whitney P. Witt (Assistant Professor, Population Health Sciences, University of Wisconsin - Madison)Abstract: Little is known about the long-term socio-economic, family functioning, and health impact on children with chronic illness in families across the US. The results from this research may lead to a new understanding of the longitudinal perceived and biological impact of childhood chronic illness on the family and help improve the health and well being of children with chronic illness and their families. My long-term goal is to develop an interdisciplinary research program dedicated to improving the health and mental health of children with chronic conditions and their families through better understanding how childhood chronic illness affects family members over time. This goal will be achieved through a 5-year program of didactic training and mentored research with two objectives: 1) to acquire new skills in behavioral biology, econometric and sociological research, and child and family demography and 2) to develop a framework of preliminary results to support an independent research proposal at the end of the award. Bivariate results indicate that children with activity limitations are more likely to have psychosocial adjustment problems than children without limitations. Parents of children with limitations were more likely to report adverse changes in their mental health status over the study period, as compared with parents of children without limitations. Moreover, these parents also had significantly higher mean work days lost and were more likely to not be working due their own illness or disability. Analyses are being performed using the Statistical Analysis System (SAS) and then reanalyzed in SUDAAN, to correct the standard errors due to the complex MEPS sampling. Multivariate results are underway and will be forthcoming. This proposed NICHD K01 Mentored Research Scientist Development Award will provide the necessary support to facilitate a successful transition from a junior to independent investigator in the field of child and family population health research.
Funding Institutions: NIH-NICHD (K01 HD049533: 6/1/2005-5/31/2010)
Status: Ongoing
Publications: Yes (Search Project Bibliography)
Physiological and Perceived Impact of Caring for Individuals with Long-Term Illness or Disability
Researchers: Whitney P. Witt (Assistant Professor, Population Health Sciences, University of Wisconsin - Madison), Marsha Mailick Seltzer (Director, Waisman Center, University of Wisconsin - Madison), and Javier Nieto (Professor, Population Health Sciences, University of Wisconsin - Madison)Abstract: Caregivers have worse health, mental health, and die faster than their non-caregiving counterparts. However we do not understand the biological process by which this happens. Little is known about the relationship between caregiver-reported stress and its physiological manifestation or how caregiver perception and biology interact over time. Indeed, a paucity of research exists on the physiological, behavioral, and social pathways by which health perceptions affect the health of caregivers and the individuals they care for. The primary aim of this proposed pilot research is to examine the physiological and perceived impact of caring for individuals with long-term illness or disability among a population-based sample of informal caregivers. Specifically, this study will determine the cross-sectional relationship between perceived caregiver stress and cellular aging among caregivers. This pilot study is directly related to the goals of the mission of the CDHA in fostering an interdisciplinary approach to biomedical and epidemiological research by melding aspects of behavioral biology, demography, aging, and family health research.
Status: Ongoing
Publications: No
Stress and Cellular Aging among Parental Caregivers of Childhood Cancer
Researchers: Whitney P. Witt (Assistant Professor, Population Health Sciences, University of Wisconsin - Madison)Abstract: I will examine the relationship between perceived stress and cellular aging in a cross-sectional study of primary caregivers of childhood cancer patients. This research aims to improve our understanding of the biological and psychological impact of caring for a survivor of childhood cancer. The long-term goal of this program of research is to understand how childhood cancer survivorship affects the family, determine how caregivers experience stress and cope, and ultimately to improve the health-related quality of life of cancer survivors.
Status: Ongoing
Publications: No
Stress and Health in the U.S.
Researchers: Whitney P. Witt (Assistant Professor, Population Health Sciences, University of Wisconsin - Madison), Elliot Friedman (Associate Scientist, Institute on Aging, University of Wisconsin - Madison), and Carissa GottliebAbstract: This project will study if and to what extent perceived stress is associated with adverse health and mental health outcomes among US adults. Moreover, the role of stress-reducing behavior will be examined for moderating effects on these relationships. This research will also determine the individual and family-level sociodemographic, health-behavior, and healthcare factors associated with stress affecting the health of US adults.
Status: Ongoing
Publications: No
Stress in Mothers in the Newborn Lung Project Statewide Cohort Study
Researchers: Whitney P. Witt (Assistant Professor, Population Health Sciences, University of Wisconsin - Madison)Abstract: Little is known about the impact of very low birth weight (VLBW) infants and children on families, particularly mothers. The primary aim of this research is to examine symptoms of stress in mothers of surviving VLBW children and to compare them with mothers of normal birth weight (NBW) children.
Status: Ongoing
Publications: No
The Impact of Antepartum Mental Health Problems on Long-Term Health and Economic Outcomes of Mothers and their Children
Researchers: Whitney P. Witt (Assistant Professor, Population Health Sciences, University of Wisconsin - Madison) and Thomas DeLeire (Associate Professor, Population Health Sciences, University of Wisconsin - Madison)Abstract: The impact of antepartum mental health problems on proximate and long-term outcomes of mothers and their children will be studied in this project. Our primary goal is to better understand the impact of women's self-reported poor mental health status and conditions during pregnancy on health-related outcomes among mothers and their children. Understanding these relationships is essential to improving the mental health of pregnant women as well as that of women and children in the postnatal period. These studies use a nationally representative population based sample of pregnant women in the U.S.
Status: Ongoing
Publications: No
Treatment of Maternal Depression and the Impact on Children's Mental Health and Use of and Expenditures for Healthcare
Researchers: Whitney P. Witt (Assistant Professor, Population Health Sciences, University of Wisconsin - Madison)Abstract: This is a series of studies examining the role of treatment for maternal depression and the subsequent effect on children's mental health outcomes and use of and expenditures for healthcare. Maternal depression results in adverse health and mental health outcomes among children and is hypothesized to be associated with children's increased use of and payments for healthcare. Primary health and mental healthcare systems have the potential to meet the psychosocial needs of family members and may reduce children's over-utilization of healthcare. Therefore, this study will also look at the mothers? Receipt of mental healthcare and how such services imp act children's mental health outcomes and the use of general health services.
Status: Ongoing
Publications: No
Estimating the Demand for States of the Elderly with Endogenous Local Fiscal Policy
Researchers: Seokjin WooAbstract: The elderly population strongly influences the formation of local fiscal policy. Thus, the local fiscal policy is endogenous to how many elderly live in a locality, location decision. This paper suggests an econometric model in which local fiscal policy is allowed to be correlated to the location decisions of the elderly. Under minimal assumptions, we found out that the signs of fiscal variables (especially tax burden) are as expected (negative). Based on the cross-elasticities, it is found out that two elderly magnets, Florida and Texas, are very distinct each other. More specifically, Florida is found to attract elderly because of her nice natural amenity. On the other hand, the elderly chooses Texas because of her favorable local fiscal policy. This paper will be submitted to Review of Economics and Statistics after some revisions.
Status: Complete
Publications: Yes (Search Project Bibliography)
Structural Estimation of Dynamic Elderly Migration
Researchers: Seokjin WooAbstract: Static models of elderly migration tend to underestimate the effect of determinants of location choice, and have 'initial condition' problem which states that the location that we first observe is not exogenous to how they will determine a location of residence after retirement. This paper develops dynamic elderly migration model in which an elderly chooses retirement and location decisions to maximize the life-time utility. It also suggests an econometric method which can solve the 'initial condition' problem. The project is at the stage of estimation in which the primitives of the model are to be backed out using method of simulated moments. After estimation is done, policy experiments are to be implemented.
Status: Complete
Publications: No
Personality Change in Adulthood
Researchers: Zhen Zeng (Assistant Professor, Sociology, University of Wisconsin - Madison)Abstract: Using data from the Wisconsin Longitudinal Study, this project examines the relationship between life events and the “big five” personality traits -- extroversion (E), agreeableness (A), conscientiousness (C), neuroticism (N), and openness to experience (O). The objective of this study is to understand whether and how personality traits evolve between 53 to 64 years of age. In particular, do personality traits change in response to the two major life events that many individuals experience around retirement, namely, withdrawal from the labor force and decline in health? The results are consistent with previously known patterns of personality change in adulthood: as individuals grow older, they become more agreeable and less neurotic. Better health is associated with higher scores on E, A, C, and O, and lower scores on N. Fixed-effects models further indicate that this pattern holds not only across persons, but also within individuals. Labor force participation is positively associated with E, C, and O, and negatively associated with N, but only in between-person models. I plan to refine the analyses by adding detailed multi-dimensional health measures.
Status: Ongoing
Publications: Yes (Search Project Bibliography)
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