Improving Health Outcomes for an Aging Population This application extends a long-running NBER program project on the health and wellbeing of an aging population. Our research plan focuses on better understanding health trends and disparities, the determinants of health, and the effective use of health care resources to improve outcomes for an aging population in an evolving landscape. Project 1 (Case and Deaton) explores variations in health trends across geography, race and ethnicity, education, and cohort, identifying and analyzing the life circumstances of those whose health and wellbeing have worsened. Project 2 (Maestas) focuses on the increasing prevalence of pain and opioid use, and their relationship to health outcomes, work, and disability program enrollment. Project 3 (Duflo) analyzes the rapid rise in chronic disease in aging, poorer populations (focusing on India), and the potential role of public policy interventions in improving health in a global context. Project 4 (Baicker and Obermeyer) applies machine learning tools to administrative data to identify overuse (reflecting care with little health benefit relative to its cost or risks) and underuse (reflecting missed opportunities for health benefits) of medical services, focusing on the case of diagnostic testing. Project 5 (Kolstad and Handel) analyzes the impact of information technology in physician treatment decisions, and the potential health benefits of expanded use of IT in health care. Project 6 (Chandra and Sacarny) looks at how information about provider quality affects patients' decisions about their medical care, and whether information on quality improves health care market performance through competition. Project 7 (Baicker and Finkelstein) looks at the effect of public health insurance on health care and outcomes for poor adults, using a randomized controlled design enabled by Oregon's health insurance lottery. Project 8 (Williams) looks at policies that stimulate or impede research and innovation in medicine, and the degree to which the ?new uses? problem results in underinvestment in innovations with a potentially positive social value. The program project leverages synergies in methods, data sources, and health issues addressed, building on common themes of health trends and disparities, the role of information for patients and providers, and the potential for different policies to improve health. This research has particular importance in the context of societal changes in demographics, population health, health policy, health care organization, and medicine. The program project will also continue to serve as the organizational foundation for a much larger community of scholars engaged in health-related research at the NBER, attracting some of the most talented scientists from each new generation of economists to the study of health issues. Linking this community to health researchers in other disciplines, particularly in medical and clinical fields, is an important new aim of the program, fostering the cross-disciplinary approaches needed to tackle the most pressing health issues facing an aging population.

Public Health Relevance

? PUBLIC HEALTH RELEVANCE The goal of the program project is to better understand health trends and disparities, the determinants of health, and approaches to improving health in an evolving landscape. It does this through eight component research projects on health and health care, and three cores that coordinate, integrate and leverage the program as a whole. Key themes are understanding recent trends in health and morbility, the disparities in health care and health across the population, the role of patient and provider information, and the potential for different policies to improve health outcomes.

National Institute of Health (NIH)
National Institute on Aging (NIA)
Research Program Projects (P01)
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Special Emphasis Panel (ZAG1)
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Bhattacharyya, Partha
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National Bureau of Economic Research
United States
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Pakpahan, Eduwin; Hoffmann, Rasmus; Kröger, Hannes (2017) Retrospective life course data from European countries on how early life experiences determine health in old age and possible mid-life mediators. Data Brief 10:277-282
Stone, Arthur A; Schneider, Stefan; Broderick, Joan E (2017) Psychological stress declines rapidly from age 50 in the United States: Yet another well-being paradox. J Psychosom Res 103:22-28
Deaton, Angus; Cartwright, Nancy (2017) Understanding and misunderstanding randomized controlled trials. Soc Sci Med :
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Chandra, Amitabh; Frakes, Michael; Malani, Anup (2017) Challenges To Reducing Discrimination And Health Inequity Through Existing Civil Rights Laws. Health Aff (Millwood) 36:1041-1047
Rezayatmand, Reza; Groot, Wim; Pavlova, Milena (2017) Smoking behaviour and health care costs coverage: a European cross-country comparison. Int J Health Econ Manag 17:453-471
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Kaschowitz, Judith; Brandt, Martina (2017) Health effects of informal caregiving across Europe: A longitudinal approach. Soc Sci Med 173:72-80

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