This proposal is one of two parallel submissions from separate institutions constituting a single project. The Principal Investigators are: Zachary Zimmer, Population Council, and Mary Beth Ofstedal, University of Michigan. The overall goal of the project is to describe and analyze health transitions and health care utilization patterns in four Asian countries undergoing rapid population aging and social and economic change. The study involves comparative analyses of recent panel surveys of older populations in Taiwan (1989-1999), Indonesia (1993, 1997, 1998), the Philippines (1996, 2000-2001), and Singapore (1995, 1999). The Asian panel surveys represent the first nationally-representative, longitudinal data available on the older population for these countries, which span a continuum of socioeconomic development. The comparative approach allows for estimates of how the potential demand for care and support varies between countries (i.e., prevalence and transitions in health outcomes) and how generalizable the links are between socioeconomic status, social support and health that have been observed in many developed nations in the West. The project has three specific aims: (1) to estimate population prevalence levels of health outcomes (functional limitation, chronic conditions, and self-assessed health status), examine recent trends in prevalence levels within countries, determine individual-level transition rates in health status, and estimate active life expectancy; (2) to investigate the effects of socioeconomic status and family network characteristics and social support on health status transitions among older adults; and (3) to assess the roles of access and need as determinants of health care utilization by examining individual-level and community resource characteristics. A variety of analytic techniques will be employed depending on the form of the dependent variable and the goal of the particular analysis. Logistic regression models will be utilized in analyses of prevalence of health outcomes and changes in prevalence levels, and a combination of logistic and linear regression techniques will be used in analyses of health care utilization. Multinomial logit models will be used for analyses of health transitions; active life expectancy will be examined using multistate life tables for different population subgroups, and structural equation models will be used to test for cross-lagged effects of socioeconomic status and health.

National Institute of Health (NIH)
National Institute on Aging (NIA)
Research Project (R01)
Project #
Application #
Study Section
Social Sciences, Nursing, Epidemiology and Methods 4 (SNEM)
Program Officer
Shrestha, Laura B
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Population Council
New York
United States
Zip Code
Knodel, John; Williams, Nathalie; Kim, Sovan Kiry et al. (2010) Community Reaction to Older-age Parental AIDS Caregivers and their Families: Evidence from Cambodia. Res Aging 32:122
Fang, Xiang-Hua; Zimmer, Zachary; Kaneda, Toshido et al. (2009) Stroke and active life expectancy among older adults in Beijing, China. Disabil Rehabil 31:701-11
Fang, Xiang-hua; Tang, Zhe; Zimmer, Zachary et al. (2009) [Effects and trends of stroke and life expectancy among older adults--from 1990s to 2000s] Zhonghua Liu Xing Bing Xue Za Zhi 30:105-9
Zimmer, Zachary (2008) Poverty, wealth inequality and health among older adults in rural Cambodia. Soc Sci Med 66:57-71
Williams, Nathalie; Knodel, John; Kiry Kim, Sovan et al. (2008) Overlooked potential: older-age parents in the era of ART. AIDS Care 20:1169-76
Zimmer, Zachary; Martin, Linda G (2007) Key topics in the study of older adult health in developing countries that are experiencing population aging. J Cross Cult Gerontol 22:235-41
Ofstedal, Mary Beth; Zimmer, Zachary; Hermalin, Albert I et al. (2007) Short-term trends in functional limitation and disability among older Asians: a comparison of five Asian settings. J Cross Cult Gerontol 22:243-61
Kaneda, Toshiko; Zimmer, Zachary (2007) Education, gender, and functional transitions among Indonesian elderly. J Cross Cult Gerontol 22:303-22
Zimmer, Zachary; Martin, Linda G; Ofstedal, Mary Beth et al. (2007) Education of adult children and mortality of their elderly parents in Taiwan. Demography 44:289-305
Zimmer, Zachary; Martin, Linda G; Lin, Hui-Sheng (2005) Determinants of old-age mortality in Taiwan. Soc Sci Med 60:457-70

Showing the most recent 10 out of 13 publications