SUBPROJECT 1: CHARACTERIZING DISABILITY AND ITS TRENDS AMONG OLDER AMERICANS This subproject explores the multiple dimensions of health and functional ability, how they are changing, and the factors that have been most important in improving health. Understanding trends in the health of the elderly population is important for forecasting health and work capacity in old age, for evaluating proposals to change Social Security, and for designing health policy. Disability in an elderly population is typically defined as the need for assistance with one or more self care tasks, such as bathing or eating, called activities of daily living (ADLs), or tasks required to live independently, such as grocery shopping or preparing meals, called instrumental activities of daily living (lADLs). Using this definition, literature over the past decade has shown improved health of the elderly, with disability rates declining 1-2 percent per year for several decades. However, there are often discrepancies in the types of limitations the elderly report, and a need to more rigorously characterize the multiple dimensions of health.
The aims of this subproject are (1) to combine survey measures of physical and mental functioning and social performance into several summary health measures that describe the multiple dimensions of elderly health;(2) to document individual-specific trajectories of health as people age, as well as health trends for the population as a whole;(3) to link health changes to the onset of medical conditions;and (4) to relate disease onset and subsequent disability outcomes of disease to medical care. We seek to understand why health has changed, and the importance of medical care in improving health outcomes over time. We focus on the older population because health improvements have been largest, medical spending is highest, and the data are best.

Public Health Relevance

Our results will be of major importance in the formation of sound economic and social policy toward the elderly. Understanding the trajectory and reasons for changes in health will help several aspects of policy, including forecasting population health needs and capacities, estimating the value of medical advances, and modeling the impact of interventions that will affect the elderly.

National Institute of Health (NIH)
National Institute on Aging (NIA)
Research Program Projects (P01)
Project #
Application #
Study Section
Special Emphasis Panel (ZAG1-ZIJ-9)
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
National Bureau of Economic Research
United States
Zip Code
(2016) Understanding Changes in Healthy Life Spans. Natl Bur Econ Res Bull Aging Health :4
Beshears, John; Choi, James J; Laibson, David I et al. (2016) Vaccination Rates are Associated With Functional Proximity But Not Base Proximity of Vaccination Clinics. Med Care 54:578-83
Deaton, Angus (2016) On Death and Money: History, Facts, and Explanations. JAMA 315:1703-5
Bordone, Valeria; de Valk, Helga A G (2016) Intergenerational support among migrant families in Europe. Eur J Ageing 13:259-270
GBD 2015 DALYs and HALE Collaborators (2016) Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet 388:1603-1658
Palladino, Raffaele; Tayu Lee, John; Ashworth, Mark et al. (2016) Associations between multimorbidity, healthcare utilisation and health status: evidence from 16 European countries. Age Ageing 45:431-5
Aitken, Murray; Berndt, Ernst R; Cutler, David et al. (2016) Has The Era Of Slow Growth For Prescription Drug Spending Ended? Health Aff (Millwood) 35:1595-603
Sowa, Agnieszka; Golinowska, Stanisława; Deeg, Dorly et al. (2016) Predictors of religious participation of older Europeans in good and poor health. Eur J Ageing 13:145-157
Okbay, Aysu; Baselmans, Bart M L; De Neve, Jan-Emmanuel et al. (2016) Genetic variants associated with subjective well-being, depressive symptoms, and neuroticism identified through genome-wide analyses. Nat Genet 48:624-33
Rappange, David R; Brouwer, Werner B F; van Exel, Job (2016) Rational expectations? An explorative study of subjective survival probabilities and lifestyle across Europe. Health Expect 19:121-37

Showing the most recent 10 out of 293 publications