Current Awareness in Aging Research (CAAR) Report #21--February 17, 2000

CAAR (Current Awareness in Aging Research) is a weekly email report produced by the Center for Demography of Health and Aging at the University of Wisconsin-Madison that helps researchers keep up to date with the latest developments in the field. For more information, including an archive of back issues and subscription information see:

http://www.ssc.wisc.edu/cdha/caar/caar-index.htm

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I. Data:

1. CENSUS BUREAU: The Census Bureau has released a table: "Population 65 Years and Over and 85 Years and Over, Region, and State: 1998."

http://www.census.gov/population/estimates/state/st98elderly.txt
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2. SSA: The Social Security Administration has released "OASDI Beneficiaries by State and County, 1998" (.pdf format). "This compilation presents information on the number of persons receiving Social Security benefits and the amount of monthly benefits by type of benefit. Also shown are the number of men and women aged 65 or older receiving benefits." Note: At this time 1998 data is available only in Tables No. 1, 2, and 3.

http://www.ssa.gov/statistics/oasdi_sc/index.html

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II. Reports and articles

3. _MMWR_ ARTICLE: "Age-Specific Excess Deaths Associated with Stroke Among Racial/Ethnic Minority Populations -- United States, 1997" (_Morbidity and Mortality Weekly Report_, February 11, 2000 / 49(05);94-7).

http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/mm4905a2.htm
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4. SSA ELECTRONIC NEWSLETTER: The Social Security Administration has launched a free electronic newsletter "Social Security E-News," that will provide subscribers with "Social Security news as it happens." The service consists of a monthly newsletter containing general news, with subscriber options for "timely updates" on any or all of the following topics: disability; retirement; survivors; law and regulations; press office; wage reporting; Social Security Income (SSI issues); data, studies and research; and Medicare. For subscription options and information see:

http://www.ssa.gov/enews/
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5. SSA PERIODICAL: The Social Security Administration has released _Social Security Bulletin_ (Vol. 63, No. 3, 1999, .pdf format, 57p.).

http://www.ssa.gov/policy/pubs/SSB/v62n3y1999/index.html
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6. _JAMA_ ARTICLE: "Conflicts Regarding Decisions to Limit Treatment: A Differential Diagnosis," by Susan Dorr Goold, Brent Williams, and Robert M. Arnold (_Journal of the American Medical Association_, 2000 (Feb. 16, 2000); 283:909-914).

>From the Abstract:

Conflicts between physicians and families about end-of-life decisions create challenging and emotionally difficult situations. In this article, we propose a "differential diagnosis" of such conflicts, distinguishing and describing the characteristics of families, physicians, and organizations and society that contribute to the "etiology" of the situation, as well as strategies for "diagnosing" the dominant factors. As a medical model, the differential diagnosis can be a useful tool to help physicians understand and manage conflicts about end-of-life care.

http://jama.ama-assn.org/issues/v283n7/full/jsc90064.html
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7. _NEJM_ SOUNDING BOARD AND BOOK REVIEW: (_New England Journal of Medicine_, Vol. 342, No. 7, Feb. 17, 2000).

A. "Pharmacologic Paralysis and Withdrawal of Mechanical Ventilation at the End of Life," by Robert D. Truog, Jeffrey P. Burns, Christine Mitchell, Judy Johnson, and Walter Robinson.

http://www.nejm.org/content/2000/0342/0007/0508.asp

B."Parting Company: Understanding the Loss of a Loved One -- The Caregiver's Journey, by Cynthia Pearson and Margaret L. Stubbs, reviewed by Anne R. Somers. (See also below, under books).

http://www.nejm.org/content/2000/0342/0007/0523a.asp

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III. Working Papers

8. NBER WORKING PAPERS IN AGING: The National Bureau of Economic Research has released the following Working Papers in Aging:

A. "How Liability Law Affects Medical Productivity," by Daniel P. Kessler and Mark McClellan, (W7533, February 2000, .pdf format, 45p.).

>From the Abstract:

Previous research suggests that "direct" reforms to the liability system -- reforms designed to reduce the level of compensation to potential claimants -- reduce medical expenditures without important consequences for patient health outcomes. We extend this research by identifying the mechanisms through which reforms affect the behavior of health care providers. Although we find that direct reforms improve medical productivity primarily by reducing malpractice claims rates and compensation conditional on a claim, our results suggest that other policies that reduce the time spent and the amount of conflict involved in defending against a claim can also reduce defensive practices substantially. In addition, we find that "malpractice pressure" has a larger impact on diagnostic rather than therapeutic treatment decisions. Our results provide an empirical foundation for simulating the effects of untried malpractice reforms on health care costs and outcomes, based on their predicted effects on the malpractice pressure facing medical providers.

http://papers.nber.org/papers/W7533

B. "Medical Liability, Managed Care, and Defensive Medicine," by Daniel P. Kessler and Mark B. McClellan (W7537, February 2000, .pdf format, 34p.).

>From the Abstract:

Because the optimal level of medical malpractice liability depends on the incentives provided by the health insurance system, the rise of managed care in the 1990s may affect the relationship between liability reform and defensive medicine. In this paper, we assess empirically the extent to which managed care and liability reform interact to affect the cost of care and health outcomes of elderly Medicare beneficiaries with cardiac illness. Malpractice reforms that directly reduce liability pressure -- such as caps on damages -- reduce defensive practices both in areas with low and with high levels of managed care enrollment. In addition, managed care and direct reforms do not have long-run interaction effects that are harmful to patient health. However, at least for patients with less severe cardiac illness, managed care and direct reforms are substitutes, so the reduction in defensive practices that can be achieved with direct reforms is smaller in areas with high managed care enrollment. We consider some implications of these results for the current debate over the appropriateness of extending malpractice liability to managed care organizations.

http://papers.nber.org/papers/W7537
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9. LUXEMBOURG INCOME STUDY: "Private Pensions - A Viable Alternative? Distributive Effects of Private Pensions in a Comparative Perspective," by Christina Behrendt (LIS Working Paper No. 220, December 1999). Note: Electronic text of this paper is not available at this time.

>From the Abstract:

Pension reforms have been on the political agenda of governments and of international organisations as the OECD and the World Bank for some time. However, the strengthening of private elements in pension systems is often believed to intensify existing inequalities in the distribution of pensions among the population and to contribute to the marginalisation of large groups of the elderly. This paper explores the distributive effects of private pensions on the basis of LIS microdata for twelve industrialised welfare states. Its results confirm that private pensions indeed tend to produce specific inequalities, but also emphasise the importance of policy factors in mitigating the distributive effects of private pensions.

For hard copy ordering information, including pricing information, see:

http://lissy.ceps.lu/wpapersentire.htm
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10. PENSION RESEARCH COUNCIL (WHARTON SCHOOL, UNIVERSITY OF PENNSYLVANIA): "New Trends in Pension Benefit and Retirement Provisions," by Olivia S. Mitchell (PRC WP 2000-1, January, 2000, .pdf format, 59p.).

This study illustrates and interprets changes in pension plan retirement formulas and benefit provisions over the last two decades, using extensive information on private sector pension plans gathered by the U.S. Department of Labor since 1980. Data generated from the Employee Benefits Survey (EBS) of medium and large firms shows that pension provisions have changed a great deal in companies that have traditionally been the most consistent providers of employer-sponsored retirement benefits in the US. In the defined benefit environment, vesting rules were loosened somewhat; plans have eased access to normal retirement; and pension benefit formulas have moved toward final rather than career earnings, with increased weight on straight-time pay. In addition, these plans became more integrated with social security, but the form of this integration has changed substantially. Defined benefit pension replacement rates appear to have fallen over time, though the time series is not complete. In addition, benefit caps remain in place, generally by limiting years of service in the formula; disability benefit provisions have also become more stringent; and it is increasingly possible to take a lump sum from ones defined benefit pension. The defined contribution environment has also seen substantial change, as documented in the BLS series. Participation and vesting rules appear most lenient for workers in 401(k) plans; most employees must contribute to their plans, generally as a function of earnings; and employee access to pension fund assets appears to be on the upswing over time. Participants in these plans have also gained access to diversified stock and bond funds, with fewer permitted to invest in own-employer stock, common stock funds and guaranteed insurance contracts. We conclude with a discussion of how future data collection efforts could be improved.

http://prc.wharton.upenn.edu/prc/2000-1.PDF
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1. SOCIAL POLICY RESEARCH CENTRE (UNIVERSITY OF NEW SOUTH WALES, AUSTRALIA):

A. "The Responsibility for Child and Aged Care: Shaping Policies for the Future," by Michael Fine (SPRC Discussion Paper 105, August 1999, .pdf format, 38p.).

>From the Abstract:

Like other comparable English-speaking countries, Australia is looking increasingly to the market as the means of meeting human needs. This raises questions about the responsibility of providing care for those, who, by virtue of their age or other characteristics, are excluded from the labour market and are unable to provide for or care for themselves. It is widely accepted that, in most instances, families have had and continue to assume primary responsibility for the care of young children and older people in need of support. However, experience in the fields of aged care and child support suggests that state support and intervention has been required when families are unable to continue in those roles. As the existing safety net of state intervention is coming under unprecedented demographic, economic and political pressure, there is a need to re-examine alternative options for providing care in an ageing society. Following a brief, comparative review of the history of aged care and child care in Australia, this paper considers the options and implications of shifting the balance between the various potential sources of support. These include care provided by unpaid family caregivers, care provided by the voluntary community-based agencies, market-based care provisions, and care provisions supported by the state. Attention is drawn to the implications of the changing character of aged care as well as to the links between labour force participation and the ability of family caregivers (especially women) to provide care, and to the impact of different forms of provision on equity between and across generations.

http://www.sprc.unsw.edu.au/dp/dp105ab.htm

and click on "PDF" at the bottom of the page for full text.

B. "Home and Away: Reflections on Long-term Care in the UK and Australia," by Melanie Henwood (SPRC Discussion Paper 101, June 1999, .pdf format, 32p.).

>From the Abstract:

The challenges posed by an ageing population are major preoccupations of governments throughout the developed world. There are many dimensions to such challenges, and this paper focuses on issues relating to long-term care in old age. The debate around such matters has been similar in the UK and in Australia. In both countries, a history of incrementalism and poorly presented policy reform has contributed to widespread public mistrust, and a sense of injustice at the extension of means-testing or user pays principles. This paper examines the analysis and conclusions of a Royal Commission in the UK, set up to explore options for the finance and structure of long-term care. A fundamental principle advanced by the Commission is that the risk of needing long-term care should be shared by all citizens, rather than borne by those who have the misfortune to need such care. A separation of the personal care costs of long-term care from the living and housing costs components has been proposed as the most equitable way of sharing costs between individuals and the state. Major reforms to the structure community care in the early 1990s in the UK (and similar developments in Australia) were concerned largely with improving management and accountability of local services and with promoting community rather than residential-based models of care. These failed to address the larger underlying question about the balance of responsibilities between individuals and the state and how to achieve a sustainable model for funding long-term care. The proposals by the Royal Commission in the UK can be seen to offer one such model. It is not without flaws and a cautious initial political response is evident. Nonetheless, the model has an immediate appeal in the simplicity of its argument, and in the prospect of offering improved individual security and enhanced social cohesion.

http://www.sprc.unsw.edu.au/dp/dp101ab.htm

and click on "PDF" at the bottom of the page for full text.

C. "Women and Retirement Income in Australia: Social Rights, Industrial Rights and Property Rights," by Merrin Thompson (SPRC Discussion Paper 98, May 1999, .pdf format, 20p.).

>From the Abstract:

The last decade has witnessed an important shift in public policy concerning retirement incomes, and correspondingly, in the roles of the state and the market in financing provisions for older Australians. The Hawke/Keating Labor Government, which institutionalised compulsory superannuation for most employees, claimed its policies would see superannuation become a primary vehicle for income in later life, and thereby reduce demand for the age pension. This paper, which forms part of the theoretical backdrop to a qualitative study of peoples plans and perceptions regarding retirement incomes, starts with a brief history of retirement income provisions in Australia and then discusses the concept of social rights, as developed by T.H. Marshall. The paper addresses the question of how superannuation is to be conceptualised in terms of rights, with particular attention to the consequences of such rights for women. It argues that the concept of social right is not applicable to superannuation, based as it is on self-provision and labour market performance, and explores other sorts of rights that surround superannuation: property and industrial rights, rights which have historically been less accessible to women than to men.

http://www.sprc.unsw.edu.au/dp/dp98ab.htm

and click on "PDF" at the bottom of the page for full text.
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12. INSTITUTE FOR FISCAL STUDIES (UK):

A. "Individual choice of pension arrangement as a pension reform strategy," by Richard Disney, Robert Palacios and Edward Whitehouse (W99/18, July 1999, .pdf format, 37p.).

>From the Abstract:

The paper examines social security (public pension) reforms in which the programme is partially shifted from a public unfunded basis to a private, pre-funded, basis. It focuses on reforms where individuals have a choice in switching from public funded to private unfunded programmes (as in the contracting out scheme in the UK), or where some individuals are forced to join the funded scheme, or reforms which combine both these options. The welfare consequences of such reform strategies are analysed both from an individual and a macroeconomic perspective. The paper also examines whether individuals respond rationally to the incentives inherent in such programmes.

http://www1.ifs.org.uk/research/workingpapers/wp9918.pdf

B. "What can we learn from Retirement Expectations Data?" by Richard Disney and Sarah Tanner (W99/17, 1999, .pdf format, 31p.).

>From the Abstract:

This paper analyses retirement expectations and outcomes using the two waves of the UK Retirement Survey, undertaken in 1988-89 and 1994. We argue that responses to questions on expectations are not straightforward to interpret where individuals are asked to report point expectations. As in the studies for the US by Bernheim, the evidence here suggests that individuals tend to report their most likely retirement date. About half of the sample retired when they expected. Men tend to retire earlier than expected on average, but with only two waves of data we cannot reject that this is caused by a common shock over the period. Changes in health and marital status are linked to divergences between expectations and realisations. We extend the analysis to consider don't know responses, which we argue may be a rational response when individuals face greater uncertainty over their future retirement date. We provide evidence to support this hypothesis. Finally, we show that information on expectations can improve the accuracy of models of actual retirement behaviour, most likely because they provide a suitable proxy for unobserved tastes for income and leisure.

http://www1.ifs.org.uk/research/workingpapers/wp9917.pdf

C. "What can we learn about pension reform from Generational Accounts for the UK?" by James Banks, Richard Disney and Zoe Smith (W99/16, 1999, .pdf format, 26p.).

>From the Abstract:

This paper considers the relevance of a set of generational accounts in informing policy debate in the UK. With regard to transparency, generational accounts can, under sensible assumptions, provide a useful summary statistic to supplement our analysis of government policy. Interpreting differences in the accounts across groups as measures of the incidence or redistributiveness of existing or proposed policies is more problematic. With respect to UK pension reform, within-cohort differences raise important issues. Finally we argue that past pension reforms have been characterised by inaccurate forecasts as opposed to a lack of understanding of the generational incidence of proposed policy.

http://www1.ifs.org.uk/research/workingpapers/wp9916.pdf

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IV. Journal Tables of Contents (check your library for availability)

13. Journal of Gerontology Biological Sciences (A): (Vol. 55A, No. 1, No. 2, January and February 2000). Note: This journal is available in electronic full text in the ProQuest Research Library. Check your library for the availability of this database and of this issue. Search under Journals of Gerontology.

http://www.geron.org/journals/biocontents.html
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14. Journal of Gerontology Social Sciences (B): (Vol. 55B, No. 1, January 2000). Note: This journal is available in electronic full text in the ProQuest Research Library. Check your library for the availability of this database and of this issue. Search under Journals of Gerontology.

http://www.geron.org/journals/soccontents.html
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15. Archives of Gerontology and Geriatrics (Vol. 30, No. 1, Feb 2000).

http://www.elsevier.nl/locate/jnlnr/08003

and click on "Tables of Contents" on the left side of the screen for TOC and abstracts.
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16. Population and Development Review (Vol. 25, No. 4, December 1999). Click on titles for abstracts.

http://www.popcouncil.org/publications/pdr/pdrtoc.html
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17. CARL Uncover Journal Tables of Contents. Follow the instructions below to access tables of contents. CARL Uncover provides fee based document delivery services for selected journals.

A. Point your browser to:

http://uncweb.carl.org:80/

B. click on "Search Uncover"
C. click on "Search Uncover Now"
D. Type the Journal Name in the search box and click the radio button "Journal Title Browse"
E. click on the journal name
F. click on "journal issues"
G. click on the issues identified below

Clinical Gerontologist (Vol. 20, No. 4, 1999).

Social Biology (Vol. 46, No. 1/2, Spring 1999).

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V. Books

18. _Parting Company, Understanding the Loss of a Loved One: The Caregiver's Journey_, by Cynthia Pearson and Margaret L. Stubbs (1999, Seal Press, 348p., ISBN 1-58005-019-0).

http://www.nauticom.net/www/pstubbs/

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VI. Funding Opportunities:

19. NIA INSTITUTIONAL TRAINING AWARDS: The National Institute on Aging (NIA) will award new and competing renewal National Research Service Award (NRSA) Institutional Training Grants (T32) to eligible institutions to develop or enhance research training opportunities for individuals, selected by the institution, who are training for careers in specified areas of aging research. The purpose of this announcement is to help ensure a broad cadre of researchers trained in the content and methods of aging research and in the major biomedical, behavioral and social areas of research most closely related to their field of study within aging. NIA supports both predoctoral and postdoctoral training in aging. The Institute also supports short-term research training for students in health-professional programs as part of an overall T32 program. For more information see:

http://grants.nih.gov/grants/guide/pa-files/PA-00-057.html

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VII. Legislation Information Updates

20. HOUSE WAYS AND MEANS SUBCOMMITTEE ON SOCIAL SECURITY AND HUMAN RESOURCES:

A. HEARING: "Examining Social Security's Readiness for the Impending Wave of Baby Boomer Beneficiaries," a hearing held Feb. 10, 2000.

http://www.house.gov/ways_means/socsec/106cong/ss-9wit.htm

B. GAO TESTIMONY: "SSA Customer Service: Broad Service Delivery Plan Needed to Address Future Challenges," by Cynthia M. Fagnoni, Director of Education, Workforce, and Income Security Issues, before the Subcommittee on Human Resources and Social Security, House Committee on Ways and Means (General Accounting Office Testimony T-HEHS/AIMD-00-75, Feb. 10, 2000, .pdf format, 33p.).

http://www.gao.gov/new.items/h100075t.pdf

Note: GAO Internet addresses are valid for only a limited period of time. After that time, documents can be found by searching the Government Printing Office:

http://www.access.gpo.gov/su_docs/aces/aces160.shtml

and searching on title or report number.

C. "Improving Social Security Work Incentives," a hearing held Feb. 15, 2000.

http://www.house.gov/ways_means/socsec/106cong/ss-10wit.htm
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21. HOUSE WAYS AND MEANS SUBCOMMITTEE ON HEALTH:

A. "Seniors' Access to Prescription Drug Benefits," a hearing held Feb. 15, 2000.

http://www.house.gov/ways_means/health/106cong/hl-12wit.htm

B. GAO TESTIMONY: Prescription Drugs: Increasing Medicare Beneficiary Access and Related Implications," by David M. Walker, Comptroller General of the United States, before the Subcommittee on Health, House Committee on Ways and Means. (T-HEHS/AIMD-00-99, Feb. 15, 2000, .pdf format, 28p.).

http://www.gao.gov/new.items/h100099t.pdf

Note: GAO Internet addresses are valid for only a limited period of time. After that time, documents can be found by searching the Government Printing Office:

http://www.access.gpo.gov/su_docs/aces/aces160.shtml

and searching on title or report number.
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22. SENATE SPECIAL COMMITTEE ON AGING PUBLICATIONS: The Senate Special Committee on Aging has released two publications.

A. _Developments In Aging: 1997 & 1998_ (106-229, print availability only). This publications is available free of charge and can be ordered from the site.

http://www.senate.gov/~aging/pubs.htm

B. _Protecting Older Americans Against Overpayment of Income Taxes_ (106-TAX, available in HTML format).

http://www.senate.gov/~aging/tax.htm

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VIII. Conferences and Workshops

23. ADDITIONS TO GERONTOLOGICAL SOCIETY CONFERENCE CALENDAR:

A. "Health in Aging: The Challenge and Promise of the New Decade." Annual Scientific Meeting of the American Geriatrics Society and the American Federation of Aging Research. Nashville, TN. May 17-21, 2000. For more information see:

http://www.americangeriatrics.org/meeting/index.shtml

B. "Passages Through Time: Facing Change, Finding Meaning." American Society on Aging 46th Annual Meeting, March 25-28, 2000, San Diego CA. For more information see:

http://www.asaging.org/am/annual_meeting_00/index.html

C. "Summer Training Workshop on African American Aging Research." Program for Research on Black Americans, Michigan Center for Urban African American Aging Research, Insitute for Social Research, University of Michigan, Ann Arbor Michigan, June 7-9, 2000. Application deadline is April 15, 2000. For more information (.pdf format) see:

http://mcuaaar.iog.wayne.edu/4cores/si2000.pdf

D. "Old Age in a New Age." Keble College, Oxford, England. September 8-10, 2000. The conference is sponsored by the British Society of Gerontology. For more information see:

http://www.soton.ac.uk/~aoh/test/conf.html

Gerontological Society Conference Calendar:

http://www.geron.org/calendar.html

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IX. Websites of Interest

24. MAX PLANCK INSTITUTE FOR DEMOGRAPHIC RESEARCH WEB BOOK: The Max Planck Institute for Demographic Research has recently made electronically available, with the permission of Odense University Press, _The Advancing Frontier of Survival_, by Vaino Kannisto (Odense Monographs on Population Aging #3, 1996, ISBN 87-7838-185-1). It joins three other Odense Monographs on Population Aging (_Development of Oldest-old Mortality, 1950-1990: Evidence from 28 Developed Countries_; _Population Data at a Glance: Shaded Contour Maps of Demographic Surfaces over Age and Time_; and _The Force of Mortality at Ages 80 to 120_) at the Max Planck website. Note: Your browser must support frames to view these monographs.

_The Advancing Frontier of Survival_
http://www.demogr.mpg.de/Papers/Books/Monograph3/The_advancing.htm

Odense Monographs on Population Aging
http://www.demogr.mpg.de/Papers/PapersPres.htm


Jack Solock
Data Librarian--Center for Demography and Ecology
4470 Social Science
University of Wisconsin-Madison
Madison, WI 53706
608-262-9827
jsolock@ssc.wisc.edu