and Help with Activities of Daily Living Among Older Adults Living
Alone with Cognitive Impairment,"
Dementia June 26, 2020.
There is limited research on difficulties with activities of daily
living (I/ADLs) among older adults living alone with cognitive
impairment, including differences by race/ethnicity.
For U.S. Health and Retirement Study (2000–2014) participants aged 55+
living alone with cognitive impairment (4,666 individuals; 9,091
observations), we evaluated I/ADL difficulty and help.
Among 4.3 million adults aged 55+ living alone with cognitive
impairment, an estimated 46% reported an I/ADL difficulty; 72%
reported not receiving help with an I/ADL. Women reported more
difficulty than men. Compared to white women, black women were 22%
more likely to report a difficulty without help, and Latina women were
36% more likely to report a difficulty with help. Among men,
racial/ethnic differences in outcomes were not significant. Patterns
of difficulty without help by race/ethnicity were similar among
Findings call for targeted efforts to support older adults living
alone with cognitive impairment.
If My Blood
Pressure Is High, Do I Take It To Heart?
Behavioral Impacts of Biomarker Collection in
the Health and Retirement Study
Demography 55(2): 403-434, April 2018.
NBER Working Paper 19311, August
Starting in 2006, respondents in the Health and
Retirement Study were asked to submit biomarkers and notified of
certain results. Respondents with very high blood pressure were
notified during the interview; all were notified by mail of their
BP, hemoglobin A1c, and total and HDL cholesterol alongside
recommended thresholds. Average effects of biomarker collection were
near zero, but notification of rare and dangerous readings triggered
new diagnoses, increased pharmaceutical usage, and altered health
behaviors among respondents and spouses. Very high BP or A1c
readings raised new diagnosis and medication usage by 20 to 40
percentage points. Uncontrolled high BP triggered reductions in
smoking and own and spouse's drinking. High A1c was associated with
a 2.2 percent drop in weight and an increase in exercise among
undiagnosed respondents, but with no changes among those already
diagnosed, whose self-reported health and disability worsened.
Health, SES, and the Timing of Education Among Military Retirees
Economics 24(4): 383-410, 2016.
Previously NBER Working Paper 15778,
In this paper, I explore how the timing of education across the life
cycle is associated with older-age health outcomes and socioeconomic
status among military retirees, a subpopulation with common levels of
adolescent health but variation in educational timing. The marginal
effect of education on the probability of fair or poor health around
age 55 declines about half a percentage point with each decade of age
at acquisition, but the effects on income and wealth are more
constant. This suggests that education improves health through
fostering the lifelong accumulation of healthy behaviors and habits
rather than raising income or wealth.
Difference: It's Flat. A Medley of SES Gradients in Health Among
Unpublished working abstract, September 2014.
Numerous studies have revealed an Hispanic health paradox, in which
health and mortality outcomes for U.S. Hispanics are better than one
would expect based on socioeconomic status (SES). Less well understood
is the SES gradient in health among Hispanics, which tends to be
flatter than among non-Hispanics, may be nonexistent or even downward
sloping, and is also flatter in countries of origin. Previous
investigations have focused on mortality and on self-reports, and they
have highlighted the role of immigrant status. In this study, I extend
the analysis of the Hispanic SES gradient to the broad array of
subjective and objective health outcomes and behaviors in the
U.S. Health and Retirement Study, a biennial panel with retrospective
data on migration and health that includes 1,700 Hispanics, half
foreign born. Flatter SES gradients are the remarkably consistent
finding especially in self-reported health metrics. Gradients in
objective measures resemble those of non-Hispanics.
Spinning the Wheels and Rolling the Dice:
Life-Cycle Costs and Benefits of Bicycle
Commuting in the U.S.
Medicine 64: 8-13, July 2014.
We assess average net longevity benefits of bicycle commuting in the
U.S. by constructing age-specific fatality rates from official
fatality statistics and the 2009 National Household Travel Survey. We
model the impact on the life table of switching from car to bicycle
commuting. Bicycling fatality rates in the U.S. are an order of
magnitude higher than in Europe. These costs follow an age pattern
that punishes both young and old, while the health benefits guard
against causes of mortality that rise rapidly with age. The lifetime
health benefits of bicycle commuting appear to outweigh the costs, but
individuals who sufficiently discount or disbelieve the health
benefits may delay or avoid bicycling. Bicycling in middle age avoids
much fatality risk while capturing health benefits. Significant
cross-state variation in bicycling mortality risks suggest that safety
improvements in the built environment might spur changes in transit
Live As Long As I Think? Determinants of the
Subjective Survivorship Function
Working paper, October 2012.
Length of life is a key indicator of well being, and expectations
about longevity are important for life-cycle behavior. Earlier
research shows that subjective survival probabilities reveal
information about health and mortality; here, we also consider the
age-shape of survivorship. We examine how subjective survivorship
probabilities vary across age at a point in time in the U.S. Health
and Retirement Study, how the level and shape of subjective
survivorship compares with official life tables and changes with
individual characteristics, how they evolve over time in response to
new information like health shocks and parental death, and how they
reflect actual mortality experiences in the panel. Beliefs can deviate
from life tables but reflect relevant private information. The death
of a same-sex parent appears to be more salient to individuals than
physicians' diagnoses, but the latter are more predictive of future
mortality and the shape of the survivorship curve.
Portfolio Choice When Utility Depends on
International Journal of Economic Theory
6(2): 205-225, June 2010.
This paper examines optimal portfolio choice when health can change
the shape of the utility function. If adverse health shocks threaten
to increase the marginal utility of consumption, that is, if they are
Edgeworth-Pareto substitutes, risky health prompts individuals to
lower their risky portfolio shares. Health naturally becomes more
uncertain with age, so this theory may help explain why aging
investors gradually decrease their risk exposure even when asset
returns display no mean reversion and relative risk aversion is
Risk and Portfolio Choice
Journal of Business and Economic
Statistics 26(4): 472-485, October 2008.
This paper investigates the role of self-perceived risky health in
explaining continued reductions in financial risk taking after
retirement. If future ad- verse health shocks threaten to increase the
marginal utility of consumption, either by absorbing wealth or by
changing the utility function, then health risk should prompt
individuals to lower their exposure to financial risk. I examine
individual-level data from the Study of Assets and Health Dynamics
Among the Oldest Old (AHEAD), which reveal that risky health prompts
safer investment. Elderly singles respond the most to health risk,
consistent with a negative cross partial deriving from health shocks
that impede home production. Spouses and planned bequests provide some
degree of hedging. Risky health may explain 20% of the age-related
decline in financial risk taking after retirement.
Public Transit, Obesity, and Medical Costs: Assessing the Magnitudes
46(1):14-21, January 2008.
This paper assesses the potential benefits of increased walking and
reduced obesity associated with taking public transit in terms of
dollars of medical costs saved and disability avoided.
I conduct new analysis of a nationally representative
U.S. transportation survey to gauge the net increase in walking
associated with public transit usage. I translate minutes spent
walking into en- ergy expenditures and reductions in obesity
prevalence, estimating the present value of costs and disability that
may be avoided.
Taking public transit is associated with walking 8.3 more minutes per
day on average, or an additional 25.7-39.0 kcal. Hill et al. (2003)
estimate an increase in net expenditure of 100 kcal/day can stop the
increase in obesity in 90% of the population. Additional walking
associated with public transit could save $5,500 per person in present
value by reducing obesity-related medical costs. Savings in
quality-adjusted life years could be even higher.
While no silver bullet, walking associated with public transit can
have a substantial impact on obesity, costs, and well-being. Further
research is warranted on the net impact of transit usage on all
behaviors, including caloric intake and other types of exercise, and
on whether policies can promote transit usage at acceptable cost.
The Economic Effects of Providing Legal
Status to DREAMers
IZA Journal of Labor
Policy, forthcoming 2019.
Paper 11281, January 2018.
This study quantifies the economic effects of two major immigration
reforms aimed at legalizing undocumented individuals that entered the
United States as children and completed high school: Deferred
Action for Childhood Arrivals (DACA) and the DREAM Act. The former
offers only temporary legal status to eligible individuals; the
latter provides a track to legal permanent residence. Our analysis
is based on a general-equilibrium model that allows for shifts in
participation between work, college and non-employment. The model
is calibrated to account for productivity differences across
workers of different skills and documentation status, and a rich
pattern of complementarities across different types of workers. We
estimate DACA increased GDP by almost 0.02% (about $3.5 billion),
or $7,454 per legalized worker. Passing the DREAM Act would
increase GDP by around 0.08% (or $15.2 billion), which amounts to
an average of $15,371 for each legalized worker. The larger
effects of the DREAM Act stem from the expected larger take-up and
the increased incentive to attend college among DREAMers with a
high school degree. We also find substantial wage increases for
individuals obtaining legal status, particularly for individuals
that increase their educational attainment. Because of the small
size of the DREAMer population, legalization entails negligible
effects on the wages of US-born workers
Hispanic Names, Acculturation, and Health
Papers September 5, 2018.
The Hispanic Health Paradox is that despite their disadvantaged
socioeconomic status, Hispanics in the U.S. experience
mortality outcomes that are similar to those of non-Hispanic
whites. Why being Hispanic is protective remains an active subject of
In this paper, we explore how a novel, continuous metric of Hispanic
identity based on an individual's first name helps us better
understand health among Hispanics in the U.S. Health and Retirement
Study (HRS), a rich dataset of Americans aged 50 and older.
We document and characterize the Hispanic Health Paradox in mortality
and health status in the HRS, and we examine the information contained
within first names. We uncover a striking asymmetry in how the
Hispanicity of the first name is associated with health outcomes and
to a lesser extent with
For foreign-born Hispanics, a more Hispanic first name
often signals healthier outcomes; but for native-born Hispanics, the
reverse is true.
The evidence is consistent with a story of an immigrant health
advantage and differential assimilation among the second and later
generations in which the more assimilated, with less distinctively
Hispanic names, are healthier.
But disadvantages among native Hispanics with more Hispanic names do
not appear to be attributable to drinking, smoking, or exercise.
A New Look at Immigration and Employment in the U.S. Since
Papers June 4, 2018.
The foreign-born share of the U.S. population has been gradually
rising in recent decades and is approaching its historic maximum.
We compare recent trends in the employment rates of native workers in
immigrant-receiving geographical areas to recent trends in other
areas. We utilize the rich geographic resolution offered by the annual
U.S. American Community Survey, which samples roughly 1 percent of the
entire U.S. population and allows us to examine trends in public data
within areas as small as 80,000 residents. The time period covered by
the ACS, 2005-2016, provides us a unique look at employment outcomes
during a period of much economic turbulence and differential
immigration patterns across states and regions.
These results suggest that during the first two decades of the 21st
century, the presence of foreign-born workers was not detrimental to
the employment prospects of native workers and may have been a net
benefit. Whether immigrant labor actually raises the employment of
natives on its own or is a marker of third factors that are causal is
less clear and remains the subject of future investigations.
Recent Immigration Has Been Good for Native-Born Employment
Report, June 2018.
Groups in favor of reducing immigration often voice the concern that
immigrants compete with native-born Americans for jobs, and that
this competition reduces the rates at which native U.S. workers are
employed. This perspective often stems from the basic economic law
of supply and demand in which an increase in the supply of workers
should push down wages or produce unemployment when other things are
This study employs a difference in differences estimation to distill
the effect of increasing levels of immigration on native-born
employment, and finds that immigration is positively correlated with
enhanced employment opportunities for natives. These results lend
credence to the belief that immigrants boost the economic prospects
of America and its workers writ large.
Does Immigration Help American Employment?
Will More Deportations Bring "Back" American Jobs?
Contribution of Unauthorized Workers: An Industry Analysis
Regional Science and Urban Economics 67:
119-134, November 2017.
NBER Working Paper 22834,
This paper provides a quantitative assessment of the economic
contribution of unauthorized workers to the U.S. economy, and the
potential gains from legalization. We employ a theoretical framework
that allows for multiple industries and a heterogeneous
workforce. Capital and labor are the inputs in production and the
different types of labor are combined in a multi-nest CES framework
that builds on Borjas (2003) and Ottaviano and Peri (2012). The
model is calibrated using data on the characteristics of the
workforce, including an indicator for imputed unauthorized status
(Center for Migration Studies, 2014), and industry output from the
BEA. Our results show that the economic contribution of unauthorized
workers to the U.S. economy is substantial, at approximately 3.1% of
GDP annually, which amounts to roughly $6 trillion over a 10-year
period. These effects on production are smaller than the share of
unauthorized workers in employment, which is close to 5%. The reason
is that unauthorized workers are less skilled and appear to be less
productive, on average, than natives and legal immigrants with the
same observable skills. We also find that legalization of
unauthorized workers would increase their contribution to 4.8% of
private-sector GDP. The source of these gains stems from the
productivity increase arising from the expanded labor market
opportunities for these workers which, in turn, would lead to an
increase in capital investment by employers.
See Media Citations: Immigration
Economic Benefits of Passing the Dream Act
for American Progress Report, September 2017.
To better understand the potential economic impact of passing the
Dream Act, this issue brief calculates the economic gains that would
stem from legalizing potentially eligible individuals already in the
workforce. This analysis builds on the groundbreaking work of the
Center for American Progress' earlier study, "The Economic Impacts of
Removing Unauthorized Immigrant Workers," which calculated the
economic contributions of unauthorized workers to each individual
industry, each state, and the nation as a whole, and updates and
applies that economic model to the population of workers eligible for
the Dream Act. Overall, the data from this study are clear: Passing
the Dream Act would significantly improve the American economy.
The Economic Impacts of Removing Unauthorized Immigrant Workers: An Industry- and State-Level Analysis
for American Progress Report, September 2016.
In every state and in every industry across the United States,
immigrants - authorized and unauthorized - are contributing to the
U.S. economy. Immigrant labor and entrepreneurship are believed to be
powerful forces of economic revitalization for communities struggling
with population decline. Estimates suggest that the total number of
unauthorized immigrants currently residing in the United States is
approximately 11.3 million, or about 3.5 percent of the total 2015
resident population of 324.4 million. Of those 11.3 million, we
estimate that 7 million are workers. What is the economic contribution
of these unauthorized workers? What would the nation stand to lose in
terms of production and income if these workers were removed and
returned to their home countries?
A policy of mass deportation would immediately reduce the nation's GDP
by 1.4 percent, and ultimately by 2.6 percent, and reduce cumulative
GDP over 10 years by $4.7 trillion.
Viewed in this context, our results suggest that a policy of mass
deportation faces a high bar in terms of a cost-benefit calculation.
Uncertain life spans
The Cost of Uncertain
Journal of Population Economics
26(4): 1485-1522, October 2013.
NBER Working Paper 14093, June 2008.
A considerable amount of uncertainty surrounds the length of human
life. The standard deviation in adult life span is about 15 years in
the U.S., and theory and evidence suggest it is costly. I calibrate a
utility-theoretic model of preferences over length of life and show
that one fewer year in standard deviation is worth about half a mean
life year. Differences in the standard deviation exacerbate
cross-sectional differences in life expectancy between the U.S. and
other industrialized countries, be- tween rich and poor countries, and
among poor countries. Accounting for the cost of life-span variance
also appears to amplify recently discovered patterns of convergence in
world average human well-being. This is partly for methodological
reasons and partly because unconditional variance in human length of
life, primarily the component due to infant mortality, has exhibited
even more convergence than life expectancy.
Changes in World
Inequality in Length of Life:
Population and Development Review 37(3):
499-528, September 2011.
NBER Working Paper 16088, June 2010.
Previous research has revealed much global convergence over the past
several decades in life expectancy at birth and in infant mortality,
which are closely linked. But trends in the variance of length of
life, and in the variance of length of adult life in particular, are
less well understood. I examine life-span inequality in a broad,
balanced panel of 180 rich and poor countries observed in 1970 and
2000. Convergence in infant mortality has unambiguously reduced world
inequality in total length of life starting from birth, but world
inequality in length of adult life has remained stagnant. Underlying
both of these trends is a growing share of total inequality that is
attributable to between-country variation. Especially among developed
countries, the absolute level of between-country inequality has risen
over time. The sources of widening inequality in length of life
between countries remain unclear, but signs point away from trends in
income, leaving patterns of knowledge diffusion as a potential
Variance in Death and Its Implications for Modeling and Forecasting
24(21): 497-526, March 2011.
NBER Working Paper 15288, August 2009.
The slope and curvature of the survivorship function reflect the
considerable amount of variance in length of life found in any human
population. Part is due to the well- known variation in life
expectancy between groups: large differences according to race, sex,
socioeconomic status, or other covariates. But within-group variance
is large even in narrowly defined groups, and changes substantially
and inversely with the group average length of life. We show that
variance in length of life is inversely related to the Gompertz slope
of log mortality through age, and we reveal its relationship to
variance in a multiplicative frailty index. Our findings bear a
variety of implications for modeling and forecasting mortality. In
particular, we examine how the assumption of proportional hazards
fails to account adequately for differences in subgroup variance, and
we discuss how several common forecasting models treat the variance
along the temporal dimension.
Inequality in Life Spans and a New Perspective on Mortality
Convergence Across Industrialized Countries
Population and Development Review
31(4): 645-675, December 2005.
The second half of the twentieth century witnessed much convergence
in life expectancy around the world. We examine differences in the age
pattern of mortality between countries over time to show that
inequality in adult life spans, which we measure with the standard
deviation of life table ages at death above age 10, S10, is
increasingly responsible for the remaining divergence in mortality. We
report striking differences in level and trend of S10 across
industrialized countries since 1960, which cannot be explained by
aggregate socioeconomic inequality or differential external-cause
mortality. Rather, S10 reflects both within and between-group
inequalities in life spans and conveys new information about their
combined magnitudes and trends. These findings suggest that the
challenge for health policies in this century is to reduce inequality,
not just lengthen life.
American Time Use Over the Business Cycle
Unpublished working paper prepared for session 114 of the 2011 Annual
Meeting of the Population Association of America, April 2011.
By the end of 2009, the Great Recession that began in December 2007
had doubled the unemployment rate, reduced stock prices by 25 percent,
and lowered housing prices by 10 percent. The advent of the monthly
American Time Use Survey (ATUS) in 2003 facilitates a detailed
examination of trends in time allocations following these large
macroeconomic shocks to the prices of time and assets. Previous
research has explored the effects of being unemployed on time use and
well-being, while here I explore the broader impacts of macroeconomic
fluctuations on time use by all consumers using the 2003-2009 waves of
the ATUS. When unemployment is high, consumers report spending more
time sleeping, preparing food and eating or drinking, socializing and
relaxing, and using the telephone, while they spend less time working
and traveling for work. High unemployment also increases time spent by
some subgroups on caring for children and adults outside the
household. These effects are largely independent of labor force
status, suggesting they are broad-based and reflective of incremental
changes in the price of time rather than large jumps associated with
the onset of unemployment. Wealth effects associated with lower
housing prices shift time use toward home production and away from
leisure. These results shed new light on the channels through which
macroeconomic fluctuations affect health and well-being.
Adult Mortality, Institutions, and Cross-Country Income Differences
Unpublished working paper prepared for session 101 of the 2010 Annual
Meeting of the Population Association of America, April 2010.
Do reductions in mortality lead to increases or decreases in income
per capita? Recent research has called into question the emergent view
from the late 1990s of health improvements as an important contributor
to labor productivity and thus income per capita. While improved
health certainly raises the quality of labor, the technique of
development accounting typically recovers a relatively small direct
effect of health on growth through this channel. Other studies have
revealed evidence that improvements in health produce increases in
population size and thus capital shallowing, which reduces income per
capita through a "Solow effect." In this paper, I use a new dataset on
the average and variance of adult length of life around the world to
reexamine the role of the mortality transition in promoting economic
growth. I find that longer adult life is associated with higher levels
of capital accumulation, as life-cycle theory suggests, and with
higher technology, even when controlling for the effects of
institutions. But institutions appear to be relatively more important
than the mortality environment for human capital accumulation.
The Cost of Cyclical Mortality
The B.E. Journal of Macroeconomics:
Contributions 9(1): Article 7, March 2009.
Sustained growth in both incomes and life spans are the hallmarks of
modern development. Fluctuations around trend in the former, or
business cycles, have been a traditional focus in macroeconomics,
while similar cyclical patterns in mortality are also interesting and
are now increasingly studied. In this paper, I assess the welfare
implications of cyclical fluctuations in mortality using a standard
model of intertemporal preferences. Mirroring the classic result of
Lucas (1987) regarding business cycles, my findings suggest that
short-term fluctuations in mortality are not very costly. Secular
improvements in life expectancy and gains against static health
inequalities appear to be much more important.
Who Is Hurt By Procyclical Mortality?
Social Science & Medicine
67(12):2051-8, December 2008.
There is renewed interest in understanding how fluctuations in
mortality or health are related to fluctuations in economic
conditions. The traditional perspective that economic recessions lower
health and raise mortality has been challenged by recent findings that
reveal mortality is actually procyclical. The epidemiology of the
phenomenon --- traffic accidents, cardiovascular disease, and smoking
and drinking --- suggests that socioeconomically vulnerable populations
might be disproportionately at risk of "working themselves to death"
during periods of heightened economic activity. In this paper, I
examine mortality by individual characteristic during the 1980s and
1990s using the U.S. National Longitudinal Mortality Study. I find
scant evidence that disadvantaged groups are significantly more
exposed to procyclical mortality. Rather, working-age men with more
education appear to bear a heavier burden, while those with little
education experience countercyclical mortality.
Declining Mortality Among British Scientists During the Age of Enlightenment
Population and Development Review
34(S): 103-125, March 2008.
Traditional theories posit a line of causality running from
technological change into mortality decline. But that relationship
be self-sustaining if longer life spans contribute to increased
knowledge production. The productivity of scientists appears to
only gradually with age, implying that a reduction in adult mortality
will stimulate knowledge production by leaving more productive
scientists alive. The growth in empirical scientific knowledge in the
17th century preceded any widespread mortality declines, which
occurred in the 19th century. But the vital statistics of members of
Royal Society of London indicate that the life spans of British
scientists were increasing at the same time that scientific knowledge
to grow rapidly, the latter fostered by the Society itself. How
significantly the emergence of these early health inequalities
contributed to the massive increases in population health following
industrialization is unclear and deserving of further inquiry.
Macroeconomic Implications of the Earned Income Tax Credit
National Tax Journal
57(1): 45-65, March 2004.
Changes in the monthly pattern of Earned Income Tax Credit
disbursements over the past decade identify a large macroeconomic
consumption response from EITC checks. This paper recovers a large and
significant MPC out of EITC disbursements based on a comprehensive
array of macroeconomic data and econometric specifications. Point
estimates of the contemporaneous consumption response average 0.7
and do not attribute a disproportionate share of consumption to
durable goods. Results are consistent with other empirical findings
that consumption is excessively sensitive to income, and they suggest
that the EITC is a much more effective fiscal stimulus tool than
broad-based tax refunds.
Fiscal policy & projections
Uncertain Demographic Futures and Government Budgets in the U.S.
in Shripad Tuljapurkar, Naohiro Ogawa, and Anne H. Gauthier, eds.,
Riding the Age Waves - Vol. 3: Aging in Advanced Industrial
New York: Springer, 79-100, 2010.
Recent decades have seen the emergence of massive public sector
transfer programs in industrial nations. Because many transfers are
age related, the population age distribution is a powerful influence
on government budgets, and aging will be very costly. We construct
stochastic projections of the budgets for the federal and state/local
governments, disaggregated by program. These are driven by stochastic
population projections and by stochastic projections of productivity
growth and real interest rates. The demography influences budgetary
outcomes through the age specificity of seven categories of tax
payment and 28 government spending programs, as well as through public
goods expenditures, debt service, and provision of congestible
services. Forecasts of
government deficits and debt under current tax and benefit
trajectories make it clear that adjustments will have to be made in
the future to avoid implausibly high and unsustainable debt
levels. Subsequent forecasts are conditional on an upper bound to the
federal debt/GDP ratio of 0.80. There is a very slight chance (2.5%)
that the overall tax burden will barely rise, but most likely it will
have to increase by 62% (from 24% in
1994 to 38% of GDP in 2070), and there is a slight chance that taxes
would rise by 120% (to 53%). We have not yet explored adjustment
through reduction of benefits. The expected GDP shares of child
related expenditures and age neutral expenditures are both flat up to
2070. The expected share of old age expenditures, however, rises from
8.5% of GDP in 1994 to 22.5% in 2070. We find that there is a strong
negative correlation between rates of expenditure on child-oriented
programs and on elder-oriented programs, as one would expect given the
importance of fertility for both outcomes. Thus focusing exclusively
on the tax burden resulting from population aging could somewhat
exaggerate the increases needed in the future. We also find that the
rising cost of Social Security benefits (OASDI) accounts for only 28%
of the rise in old age expenditures; fixing Social Security will not
in itself fix the federal budget. The rising costs of health care will
contribute even more, and must be addressed as well.
Forecasting Government Revenue and Expenditure in the U.S. Using Data
on Age-Specific Utilization
National Transfer Accounts Working Paper WP10-01,
Government finances depend on a vast array of variables, but there is
a clear hierarchy among them, and forecasting requires a parsimonious
treatment of complicated budget rules and behavior. The number of
people paying taxes or receiving benefits and the intensity by which
they do so are the most fundamental of these inputs. In this paper, we
describe our approach to forecasting federal and state and local
government finances using forecasts of the U.S. population by age and
sex and measures of our assumptions about the intensity of program
utilization by age and sex, or “age profiles” in common usage.
The Growth and Aging of California's Population: Demographic and
Fiscal Projections, Characteristics, and
a special report of the California Policy Research Center,
This report provides a composite demographic profile of California's
aging population over the next 50 years. Estimates of future
demographic characteristics utilize a "probabilistic" projection
method that simulates 10,000 possible futures, in an effort to
overcome the built-in biases of most population projections and
inconsistencies in standard demographic assessments of "most likely"
futures. This method enables us to explore future needs while
recognizing the degree of uncertainty associated with our projections.
The Fiscal Impact of Population Aging in the US: Assessing the Uncertainties
in J.M. Poterba, ed.,
Tax Policy and the Economy 16: 141-181,
Population aging, accelerating as the Baby Boom generations age, will
have important fiscal consequences because expenditures on social security, Medicare, and institutional Medicaid make up more than a third
of the federal budget. However, the projected fiscal pressures are far
in the future, and long-term projections are very unreliable. Our
analysis here has two goals: to examine the fiscal impact of population
aging, and to do this in a probabilistic setting. We find that the old
age dependency ratio is virtually certain to rise by more than 50%
through the 2030s, and will probably continue to increase after 2050,
possibly by a great deal. Under current program structures, population
aging would be virtually certain to increase the costliness of Federal
programs as a share of GDP by 35 percent (+/- 2 percent) by the 2030s,
and by 60 percent (+/- 15 percent) in the second half of the
century. We project Federal expenditures (excluding interest payments
and pre-funded programs) to rise from 16 percent of GDP in 2000 to 30
percent in 2075, almost doubling, while state and local
expenditures rise only modestly relative to GDP. Almost all of this
increase is for programs going primarily to the elderly, which rise
from 8 percent of GDP in 1999 to 21 percent of GDP in 2075, due mainly
to costs of health care for the elderly, with pensions a distant
second. We expect that governments will respond to these aging-induced
cost changes by altering program structures, so that these
conditional projections will not be realized. Looking at social
security, we find that raising the payroll tax rate by 1.89 percent
would have relatively little effect on the probabilities of early
exhaustion, raising the 2.5 percent bound for the exhaustion date from
2024 to 2036, but raising the median date of exhaustion from 2036 to
2070, and with a 55 percent chance of insolvency within the 75 year
horizon. Looking at Medicare, which now costs 2.2 percent of GDP, we
project a median share in 2075 of 11 percent, five times as great, with
a 95 percent probability interval at 5 percent to 26 percent of
GDP. Thus there is a 97.5 percent chance that the ratio will at least
double, and a 2.5 percent chance that it will increase at least
twelve-fold. Although the future is highly uncertain in many respects,
unforeseen demographic or economic change will almost certainly not
avert the long-run fiscal crunch. Changing demographic realities will
require some combination of substantial tax increases or substantial
benefit cuts, or other forms of restructuring.
The Fiscal Impact of Population Change
in J.S. Little and R.K. Triest, eds., Seismic Shifts: The Economic
Impact of Demographic Change, Federal Reserve Bank of Boston
Conference Series No. 46, 2001.
Population aging is a natural and inevitable stage in the process of
the demographic transition, a transition that has been unfolding in
the US over the past 200 years. Because the US has, and may continue
to have, fertility close to the replacement level of two children per
woman, as compared to the substantially lower fertility throughout
much of the industrial world, population aging in the US is expected
to be relatively mild. Nonetheless, the ratio of those aged 65 and
above to those aged 20 to 64 is expected to double, and could rise
higher, over the next 75 years.
Longer life and smaller families are fiscally costly. Major changes in
taxes, benefits, or program funding structures are necessary. Policy
makers and the public must be educated to these new realities, and
difficult decisions must be made.
Economics of the family
What Mom and Dad's Match Means for Junior: Marital Sorting and Child Outcomes
Labour Economics 40(C): 43-56
This paper employs recently developed marital matching models to
examine empirically the role played by marital sorting in observed
measures of marital production. Using the US Collaborative Perinatal
Project (CPP), a large-scale study from the 1960s, we find that
marital surplus is strongly correlated with indexes of child quality,
as measured by cognitive test scores, and with the durability of the
marital union. At ages beyond infancy, correlations between
neurocognitive outcomes and marital surplus are independent of the
parental characteristics that generate the match, suggesting that they
may represent effects of the match itself. They are also robust to
controlling for household income and number of siblings. High marital
surplus is associated with assortative mating on education and age,
suggesting complementarity in parental inputs in child production and
a joint effect of parental education and age on child outcomes that
exceeds the linear sum of the parts. To the extent that marital
surplus can be considered a proxy for the subjective well-being of the
couple, our results suggest that parental happiness is an important
input for child quality above and beyond its indirect effects on
marital stability and earnings.
Negative Effects of Paternal Age on Children's Neurocognitive Outcomes Can Be Explained By Maternal Education and Number of Siblings
5(9): e12157, 1-9, September 2010.
Recent findings suggest advanced paternal age may be associated with
impaired child outcomes, in particular neurocognitive skills. Such
patterns are worrisome given relatively universal trends in advanced
countries toward delayed nuptiality and fertility. But nature and
nurture are both important for child outcomes, and it is important to
control for both when drawing inferences about either pathway.
We examined cross-sectional patterns in six developmental outcome
measures among children in the US Collaborative Perinatal Project (n =
31,346). Many of these outcomes at 8 mo, 4 y, and 7 y of age (Bayley
scales, Stanford Binet Intelligence Scale, Graham-Ernhart Block Sort
Test, Wechsler Intelligence Scale for Children, Wide Range Achievement
Test) are negatively correlated with paternal age when important
family characteristics such as maternal education and number of
siblings are not included as covariates. But controlling for family
characteristics in general and mother's education in particular
renders the effect of paternal age statistically insignificant for
most developmental measures.
Assortative mating produces interesting relationships between maternal
and paternal characteristics that can inject spurious correlation into
observational studies via omitted variable bias. Controlling for both
nature and nurture reveals little residual evidence of a link between
child neurocognitive outcomes and paternal age in these
data. Results suggest that benefits associated with the upward trend
in maternal education may offset any negative effects of advancing
Veterans & military
Military Service, Combat Exposure, and Health in the Later Lives
of U.S. Men
and Life Course Studies
8(2): 122-137, 2017.
Researchers have produced mixed findings regarding the relationship
between military service, war-zone deployment, combat exposure,
post-traumatic stress disorder (PTSD), and physical health at older
ages. This article uses data drawn from the Health and Retirement
Study (HRS) to estimate growth curve models that predict how
self-rated health and life-threatening illness vary across groups of
men defined as combat and non-combat veterans, who are compared to
non-veterans. According to the findings, combat veterans have worse
health than do men who did not experience combat during the draft era
decades after their service, while non-combat veterans have health
that is similar to if not better than non-veterans. Combat veterans
were less healthy than these other men based both on a subjective
measure of self-rated health and on an objective count of
life-threatening illnesses several decades after service. Studies that
simply compare veterans to non-veterans may thus continue to produce
mixed findings, because particular types of veterans serve in ways
that relate differently to health.
Overseas Deployment, Combat Exposure, and Well-Being in the 2010
National Survey of Veterans
Journal of Human Capital 9(1): 64-93, 2015.
18227, July 2012.
Recent engagements in Iraq (OIF) and Afghanistan (OEF) raise questions
about impacts on service members of overseas deployment. The 2010
National Survey of Veterans asked a broad cross section of veterans
about deployment to OEF/OIF and combat exposure. Analysis of these
data suggests that impacts of deployment and combat on the current
socioeconomic well-being of OEF/OIF veterans may be small, but combat
appears to reduce self-reported health and other nonpecuniary
indicators. Among older cohorts, with clearer sorting into treatment
and control groups, patterns are similar, consistent with a system
that compensates for lost earnings but not necessarily other
Soldiering On Through Aging? The Subjective and Objective Health of
Older U.S. Veterans
Unpublished working abstract,
September 2014. Accepted for presentation at the 2015 Annual Meeting
of the Population
Association of America.
Veterans of the Vietnam War, the last large-scale U.S. engagement
prior to the All-Volunteer Force era, have now largely reached
retirement age, with record high rates of service-connected disability
compared with veterans of earlier wars. Understanding the determinants
of healthy aging among this cohort is important for assessing current
and future needs of veterans, especially now that policies and events
have generated another large wartime cohort, and for gaining insights
into health dynamics over the life cycle. In this paper, we compare
objective and subjective metrics of health across male veterans and
nonveterans in a population- based panel survey of Americans over age
50, the Health and Retirement Study, which recently began collecting
biomarkers. We revisit earlier results that suggest subjective
self-reports by veterans may be overstated, a "soldiering on" effect,
relative to objective measures of health. Our findings speak to the
lifelong influences of earlier-life conditions and of the lingering
challenges posed by exposure to combat.
U.S. War Costs: Two Parts Temporary, One Part Permanent
Journal of Public Economics 113: 54-66, May 2014.
NBER Working Paper
16108, June 2010.
Military spending, fatalities, and the destruction of capital, all of
which are immediately felt and are often large, are the most overt
costs of war. They are also relatively short-lived. But the costs of
war borne by combatants and their caretakers, which includes
families, communities, and the modern welfare state, tend instead to
be lifelong. In this paper I show that a significant component of the
budgetary costs associated with U.S. wars is long-lived. One third to
one half of the total present value of historical war costs are
benefits distributed over the remaining life spans of veterans and
their dependents. Even thirty years after the end of hostilities,
typically half of all benefits remain to be paid. Estimates of the
costs of injuries and deaths suggest that the private burden of war
borne by survivors, namely the uncompensated costs of service-related
injuries, are also large and long-lived.
Medical Costs of War in 2035: Long-Term Care Challenges for Veterans
of Iraq and Afghanistan
This paper focuses on the long-term challenges that families,
communities and governments will face in caring for veterans
of the wars in Iraq (OIF) and Afghanistan (OEF). It briefly
reviews the medical impacts of war --- examining new patterns of
injury and illness in the current conflicts for which the
government, military, Veterans Affairs (VA) and related
services will need to provide medical and psychological care
to wounded servicemen and women, especially as they reach
middle age in 2035. This paper specifically discusses the
future, long-term burdens of veterans' current medical
maladies --- a topic not often discussed --- and suggests proactive
health programs that may help contain costs and ensure the
provision of quality care.
Major medical conditions among OEF/OIF veterans are Post-Traumatic
Stress Disorder (PTSD), Traumatic Brain Injury (TBI),
amputations/polytrauma, and the complications that develop either from
or together with these disorders. There are short-term medical
expenses that include transportation, surgery, and hospitalization;
and long-term medical costs, which include mental health care,
rehabilitation, and disability. Communities or families adapting to
care for wounded veterans will absorb costs that include private
medical care, informal at-home care, lost job productivity, and the
effects of family stress.
Developing appropriate mitigating interventions for our
wounded service personnel in the near term --- such as smoking
cessation, alcohol-abuse counseling, weight control,
resilience programs, and physical therapy --- will not only better
serve these veterans, but may also reduce the potentially
enormous cost burden of their future health care.
The Pervasive Role of Rank in the Health of U.S. Veterans
Armed Forces & Society
The following paper tests the hypothesis that veterans have better
health if they were officers when they were in the US military than if
they served in the enlisted ranks. It examines this hypothesis by
presenting results from logistic regressions that are based on four
surveys: the National Survey of Veterans, the Survey of Retired
Military, the Panel Study of Income Dynamics, and the Wisconsin
Longitudinal Study. In all four of these surveys, the evidence is
consistent with the hypothesis that military rank is associated with
health, particularly among veterans who served longer. It also
suggests that the health gradient by rank is independent of similar
gradients by education and income, as well as health differences by
race. These findings indicate that health may be influenced not just
be differences in civilian society, but also by those in the military.
A Review of War Costs in Iraq and Afghanistan
NBER Working Paper
16163, July 2010.
As of this writing, the wars in Iraq and Afghanistan are in their
eighth and tenth years, having accrued nearly a trillion dollars in
direct military costs. I review the history of cost forecasts for
these ongoing engagements, highlighting the differences across them in
scope and accuracy, assessing the methods and practice of cost
forecasting, and exploring the implications of the war costs
themselves. Besides the mostly unanticipated length and breadth of the
military conflicts themselves, a related and equally important
component of costs is the life cycle of costs associated with caring
for veterans. The forecasts we have of such costs imply high levels of
public spending per veteran and very high levels of costs associated
with pain and suffering per veteran, as high as 10-25 percent of
lifetime wealth. I also discuss the methods and motivations associated
with war cost forecasts by comparing them with other types of
aggregate forecasts, which are prone to similar types of errors. The
history of war cost forecasts calls for a concerted effort to improve
them by increasing their frequency and transparency.
Widening Health Inequalities Among U.S. Military Retirees Since 1974
Social Science & Medicine
I explore trends in mortality among U.S. military retirees using a new
dataset of payroll records that include pay grade. Trends in mortality
by pay grade reveal that health inequalities steadily widened between
1974 and 2004. Additive differentials in mortality rates remained
stable, but since mortality declined exponentially, by a factor of
about one third, proportional differentials in mortality and thus
additive differentials in life expectancy have widened. The advantage
in life expectancy enjoyed by retired officers grew roughly from 3 to
4 years. The sources of these trends remain unclear and are beyond the
ability of the data to inform, but the results bear implications for
trends in inequality and for policy.
The Demography of 2232 Piedmont Avenue
Unpublished working paper, June 2013.
The building at 2232 Piedmont Avenue in Berkeley, California, which
has housed the Department of Demography since 1988, was designed by
renowned architect Julia Morgan and occupied by one family prior to
its sale to the University in 1958. Like other genealogies, the family
history of the Kelloggs is traceable through ancestry.com via ProQuest
and other public databases. In particular, U.S. census records from
1940 and earlier provide snapshots of the family that occupied 2232
Piedmont from its construction in 1909. An overview of these records
offers some ethnographic insights into the earliest occupants of the
building, their way of life, and into the building's configuration. It
also provides a primer for the building's current occupants on using
tools familiar to genealogists for demographic research. Finally,
these records are interesting because of what they reveal about the
objective quality in this particular instance of a type of historical
population data that demographers frequently use. The substantial age
difference between the head of household and spouse, 14 years and 7
months, was inaccurately recorded in 4 of 5 post-marital decennial
censuses, with inconsistencies affecting the records of both spouses.
Exhibits are available upon request. They are large image files drawn
from the ancestry.com database that are apparently public but also
Measuring Socioeconomic Differentials in Mortality
Unpublished working paper, June 2008.
Research on socioeconomic inequalities in health often examines
inequality in mortality rates or life expectancy. The choice of
inequality measure is important because it should be consistent with
the dominant temporal trend in the characteristic of interest. The
author argues that proportional measures of inequality in mortality
rates and additive measures of inequality in life expectancy are
preferable to the alternatives because the dominant temporal pattern
in mortality has been one of proportional decline in mortality rates
concomitant with additive increase in life expectancy. Proportional
differentials in mortality rates are mathematically consistent with
additive differentials in life expectancy, and both are stable
measures of inequality given the temporal trends.
Individual Perceptions of Mortality Decline
Unpublished working paper prepared for session 74 of the 2006 Annual
Meeting of the Population Association of America, March 2006.
Demographers are well aware of the vast decreases in mortality among
industrialized countries during the past century, and they generally
expect mortality decline to continue into the future. But how do
individuals perceive the chances for their future survival?
Survivorship expectations should influence a wide array of economic
and thus well-being, from the amount of education to obtain to the
amount of money to save for retirement. Previous research exploring
survivorship expectations in panel data has shown that they are
correlated with current health status, behaviors, and with future
mortality, and that they approximate life table quantities. In this
paper, I take a closer look at the accuracy of survivorship
expectations along two main dimensions. I examine systematic biases in
self-reported survivorship expectations by racial group, and I assess
the updating of survivorship expectations over time within a cohort
and between cohorts. I find an interesting mix of irrational optimism
and pessimism among groups identified by race, sex, and age, but I
also find evidence that over time, individuals appear to understand
that mortality decline is occurring.