The U.S. elderly population is projected to grow significantly in the future, in part, due to increasing life expectancy at later ages, and in part, due to the passing of age 65, from 2011 to 2028, by the large cohorts born after WWII. The investigators will examine the effects of those cohorts and the cohorts born immediately before and after them, on Medicare and other projections of health service needs. The investigators will examine projections not only for the period when the cohorts first pass age 65 but also for subsequent periods during which they will age, have health needs increase, and then start to die more rapidly out of federal and other health programs. Thus, the investigators will examine health, and health service, projections, for the entire period 1997 to 2070 - a period that covers the range of most current health services projections. The investigators will evaluate the impact of improved education, income, and the different health experiences of post-WWII birth cohorts. This requires using biologically motivated population forecasting models developed earlier in this project to predict health service needs -- a natural extension of the models because they were designed to model health changes in elderly populations to improve mortality and population projections. This extension of their health forecasting models to project health service needs is important because current actuarial/demographic models of, e.g., the Medicare program a) treat health as a latent variable, and b) do not anticipate effects of new biomedical technologies and therapies of health service use. In evaluating forecasts of future health service needs the investigators will examine: a) mortality and life expectancy assumptions, b) projected changes in chronic disability and morbidity, c) effects of technological innovations on health trends, d) the relation of health changes to health care productivity, e) backward projections of current health service projections to examine health changes implicit in existing Medicre projections, f) implications for estimating program burden using different support ratios, g) effects of mortality changes on future age specific health needs and costs, and h) changes in types of services used.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Method to Extend Research in Time (MERIT) Award (R37)
Project #
5R37AG007025-13
Application #
6043022
Study Section
Social Sciences and Population Study Section (SSP)
Program Officer
Patmios, Georgeanne E
Project Start
1987-08-15
Project End
2002-07-31
Budget Start
1999-08-15
Budget End
2000-07-31
Support Year
13
Fiscal Year
1999
Total Cost
Indirect Cost
Name
Duke University
Department
Social Sciences
Type
Schools of Arts and Sciences
DUNS #
071723621
City
Durham
State
NC
Country
United States
Zip Code
27705
Manton, K G; Stallard, E (1996) Changes in health, mortality, and disability and their impact on long-term care needs. J Aging Soc Policy 7:25-52
Manton, K G; Stallard, E; Corder, L (1995) Changes in morbidity and chronic disability in the U.S. elderly population: evidence from the 1982, 1984, and 1989 National Long Term Care Surveys. J Gerontol B Psychol Sci Soc Sci 50:S194-204
Manton, K G; Woodbury, M A; Stallard, E (1995) Sex differences in human mortality and aging at late ages: the effect of mortality selection and state dynamics. Gerontologist 35:597-608
Manton, K G; Stallard, E; Woodbury, M A et al. (1994) Time-varying covariates in models of human mortality and aging: multidimensional generalizations of the Gompertz. J Gerontol 49:B169-90
Manton, K G; Stallard, E; Woodbury, M A (1994) Home health and skilled nursing facility use: 1982-90. Health Care Financ Rev 16:155-86
Potthoff, R F (1994) Telephone sampling in epidemiologic research: to reap the benefits, avoid the pitfalls. Am J Epidemiol 139:967-78
Manton, K G; Corder, L; Stallard, E (1993) Changes in the use of personal assistance and special equipment from 1982 to 1989: results from the 1982 and 1989 NLTCS. Gerontologist 33:168-76
Manton, K G; Vertrees, J C; Clark, R F (1993) A multivariate analysis of disability and health, and its change over time in the National Channeling Demonstration data. Gerontologist 33:610-8
Manton, K G (1992) Forecasting health: data needs and implications for model structure. World Health Stat Q 45:80-8
Pekkanen, J; Manton, K G; Stallard, E et al. (1992) Risk factor dynamics, mortality and life expectancy differences between eastern and western Finland: the Finnish Cohorts of the Seven Countries Study. Int J Epidemiol 21:406-19

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