Journal of the Economics of Ageing最新文献

This paper explores the residential mobility of older adults, with a focus on the influence of distance to children on those decisions. Using the geocoded Health and Retirement Study, we statistically estimate the importance of adult child proximity on older adult moves after controlling for a host of other factors. We find that having adult children nearby is associated with a lower propensity to move, with closer proximity generally having a stronger negative relationship, up to a distance of 50 miles. These results are more pronounced if we define mobility as having moved at least 30 miles, or across metropolitan areas. We also show that the relationship is stronger for those with care needs, and for renters compared with homeowners. Results for the baby boomer cohort suggest that the proximity of children continues to have an important influence on older adult mobility among more recent cohorts of older adults.

For the population over 65, long-term care (LTC) expenditure constitutes a considerable share in health care expenditures. In this paper, we decompose health care into medical care, intended to improve one’s state of health, and personal care required for daily routine. Personal care can be either carried out autonomously or by a third party. In the course of aging, autonomous personal care is gradually substituted by LTC. We set up a life-cycle model in which individuals are subject to physiological aging, calibrate it with data from gerontology, and analyze the interplay between medical care and LTC. In comparative dynamic analyses, our theory-based approach allows us to causally investigate the impact of better health and rising life expectancy, triggered by higher income and better medical technology, on the expected expenditures for LTC in the future. We predict that a one percentage increase in life expectancy is associated with a 1.75-percentage increase in expected LTC expenditure. In terms of present value at age 20, this elasticity declines to about 1.0 percent. Even when considering different magnitudes and compositions of shocks in medical technology and income, we find that these elasticities remain remarkably stable.

With a rapidly aging global population, Long Term Care Insurance (LTCI) for older people is a pressing policy issue. While long-term care services are designed to assist people with limited functional ability, the breadth of coverage considerably varies from country to country. There is a debate on the costs of such programs and the adequacy of benefits. Understanding the impacts of LTCI programs is central to informing LTCI policies as few countries have embraced them. In 2008, the Korean government initiated a national public contributory LTCI program to help older people lead more independent and secure lives and support family caregivers. We use the Korean Welfare Panel Study (KOWEPS) and a difference-in-differences model combined with propensity score matching to assess the effect of the program on self-rated health, healthcare utilization, household expenditures, and savings. While older adults in beneficiary households tend to have better self-rated health and receive fewer regular health check-ups, those with inpatient visits tend to stay longer in the hospital compared to those in non-beneficiary households. We find that LTCI beneficiary households have lower savings and higher out-of-pocket healthcare expenses compared to non-beneficiary households. Overall, results suggest a positive effect of LTCI on self-rated health but detrimental effects on household out-of-pocket healthcare expenses and savings for those with less comprehensive health insurance coverage, the near-poor, and older singles. LTCI requires further research and policy attention in Korea and beyond.

Health misperception can have serious consequences on health. Despite their relevance, the role of such biases in determining healthcare utilisation is severely underexplored. Here we study the relationship between health perception and doctor visits for the population 50+ in Europe. We conceptualise health misperception as arising from either overconfidence or underconfidence, where overconfidence is measured as overestimation of health and underconfidence is measured as underestimation of health. Comparing objective performance measures and their self-reported equivalents from the Survey of Health, Ageing and Retirement in Europe, we find that individuals who overestimate their health visit the doctor 17.0% less often than individuals who correctly assess their health, which is crucial for preventive care such as screenings. In contrast, individuals who underestimate their health visit the doctor more often (21.4% more). Effects are similar for dentist visits, but we find no effects on hospital stays. The results are robust to several sensitivity tests and, more important, to various conceptualisations of the health perception measure.

Focusing on the Korean case of social pensions, we evaluated the extent to which the basic pension scheme (BPS), a means-tested public assistance program, affects consumption. Data came from two years (2013 and 2015) of the Korea Welfare Panel Study (KoWePS) (N = 3615 households). Applying the Propensity Score Matching (PSM), Difference in Difference (DiD), and triple difference (DDD) approach, we used linear regression models with the fixed-effect model to estimate the effects of BPS. We found a significant increase in the expenditure ratio in absolute and relative poverty levels and total expenditure. BPS led to increased spending on essential living items (food, clothing) and health care, but not leisure. The results also supported that the social pension positively affects spending among the more disadvantaged population as the beneficial effects were more prominent among those living alone than those living with other household members. However, we did not find a significant effect among the poor, likely because the Korean policies reduce the benefits obtained from other public assistance programs if the poor old adult receives BPS benefits. Our findings provide useful insights for economies that encounter challenges associated with rapid population aging.

We track low-income respondents in the longitudinal Health and Retirement Study for 23 years, to observe how their financial situations unfolded as they aged. We document that (a) real incomes remained relatively stable as individuals entered retirement and progressed through their later years; and (b) labor force participation declined and thus earnings became less important with age, while Social Security and retirement savings rose as a proportion of annual income. Low-income people near retirement also tended to fare poorly during retirement.

Alcohol consumption has significant health implications. This study estimates the impact of drinking on all-cause mortality, total life expectancy, and disability-free life expectancy for Chinese males aged 65 and above. Using a nationally representative sample from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), we compare mortality risks in Cox regressions among lifelong abstainers, former drinkers, and current drinkers. We find that current male drinkers had lower risks of death than lifelong abstainers in general and the differences were statistically significant among those aged between 68 and 87 years. The interpolated Markov chain (IMaCh) approach is then adopted to calculate life expectancies. After adjustment for socioeconomic factors, we find that an average current male drinker at age 65 could expect to live 18.0 (95% CI: 17.4–18.6) years in total, compared with 16.3 (95% CI: 15.6–17.0) years for lifelong abstainers. His disability-free life expectancy at age 65 was about 16.1 (95% CI: 15.6–16.7) years, longer than the 14.2 (95% CI: 13.6–14.9) years for lifelong abstainers. Our findings are relevant for both social protection policy design and life insurance business practice.

Given the strong health–ageing connection, provision of care for the aged places a significant economic burden on a society, whether it is privately or state provided. Assessment of the health care needs of the aged is problematic due to the ordered categorical nature of self-reported health status, since results based upon arbitrary attribution of cardinal measure to ordinal categories are ambiguous due to scale and weighting issues. Here scale independent methods, particularly useful in multilateral, multidimensional analysis with ordered outcomes for measurement and comparison of treatment group wellness are proposed and exemplified in a study of poor health–loneliness and ageing relationships in China. Substantial differences in health and loneliness experiences across age, gender, urban–rural, and partner status divides are revealed, highlighting the exceptional health care needs of the aged in particular areas.

This paper investigates whether and to what extent long-run trends in population health affected income inequality in the United States over the period 1960–2000. To isolate exogenous variation in health over time, the analysis exploits the sharp decline in cardiovascular disease mortality across states that originated from medical advances in the treatment and prevention of these diseases after 1960. The results demonstrate that health improvements contributed to rising income inequality through mechanisms related to education.