Current Awareness in Aging Research (CAAR) Report #205--September 25, 2003


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:


I. Reports and articles:

1. NCHS REPORT: "Deaths: Final Data for 2001," by Elizabeth Arias, Robert N. Anderson, Hsiang-Ching Kung, Sherry L. Murphy, and Kenneth D. Kochanek (US National Center for Health Statistics, National Vital Statistics Reports Vol. 52, No. 3, September 2003, .pdf format, 116p.). The report is linked to from a NCHS news release: "New Report Looks at Latest Mortality Trends" (Sep. 25, 2003).

Click on "View/Download PDF" for full text.

2. AARP REPORT: "Staying Ahead of the Curve 2003: The AARP Working in Retirement Survey," by S. Kathi Brown (September 2003, .pdf format, 151p.).

Click on "Full Report" at the bottom of the page for full text.


A. "Ambulance Services: Medicare Payments Can Be Better Targeted to Less Densely Populated Rural Areas (US General Accounting Office GAO-03-986, September 2003, .pdf format, 36p.).

B. " Medicare: Modest Eligibility Expansion for Critical Access Hospital Program Should Be Considered" (US General Accounting Office GAO-03-948, September 2003, .pdf format, 35p.).

Note: These are temporary addresses. GAO reports are always available at:

4. DHHS OIG REPORT: "Expansion of the Diagnosis Related Group Payment Window" (US Department of Health and Human Services, Office of the Inspector General, A-01-02-00503, August 2003, .pdf format, 22p.).


Included in the Medicare diagnosis related group (DRG) payments hospitals receive are nonphysician outpatient services, such as laboratory, radiology, and other diagnostic tests, provided (1) up to 3 days prior to the date of admission and (2) by the hospital or a related provider. The intent of the 3-day payment window provision is to prevent hospitals from claiming separate payments for preadmission services that should already be included in the inpatient DRG payment. This final report points out, however, that providers often render such services 4 or more days prior to the inpatient admission. Based on a statistical sample, we estimate, for 10 specific DRGs, that during calendar year 2000 Medicare reimbursed providers approximately $37 million for preadmission services rendered 4 to 14 days prior to the date of a related inpatient admission. Additionally, the beneficiaries were assessed $35 million for coinsurance and deductibles for these services. We recommended that the Centers for Medicare and Medicaid Services (CMS) consider proposing legislation to expand the DRG payment window. The CMS concurred with our recommendation, but raised a concern as to whether such an action could influence medical practice and increase the health risks for beneficiaries. We agree that CMS should take such factors into consideration before proposing a legislative change expanding the payment window.

5. BOSTON COLLEGE CENTER FOR RETIREMENT RESEARCH GLOBAL BRIEF: "Reforming the U.S. Retirement Income System: The Growing Role of Work," by Steven A. Sass (BCCRR Global Brief No. 1, September 2003, .pdf format, 15p.).

6. UNIVERSITY CENTER FOR SOCIAL AND URBAN RESEARCH [UCSUR] REPORT: "The State of Aging and Health in Pittsburgh and Allegheny County," by Donald Musa, Jason F. Seiler, Paul Flora, Christopher Briem, Lynn Martire, and Richard Schulz (University of Pittsburgh, UCSUR, May 2003, .pdf format, 106p.).

7. UK DEPARTMENT OF WORK AND PENSIONS PRESS RELEASE:"Record employment at heart of poverty fight - Smith," (Sept. 18, 2003).

8. CENTRE FOR EUROPEAN REFORM NEWS RELEASE: "Old Europe? Demographic change and pension reform," by David Willetts (September 2003, .pdf format, 1p.).

For information about ordering the full report see:

9. IRISH ASSOCIATION OF PENSION FUNDS PRESS RELEASE: "Pensions 'Time Bomb' Faces Defined Contribution Scheme Members," (Sept. 24, 2003).

10. AUSTRALIA DEPARTMENT OF HEALTH AND AGEING NEWS RELEASE: "1.2 Million Dollars For Satellite Technology In Aged Care Homes" (Sep. 23, 2003).


A. "The Effects of Parathyroid Hormone and Alendronate Alone or in Combination in Postmenopausal Osteoporosis," by Dennis M. Black, Susan L. Greenspan, Kristine E. Ensrud, Lisa Palermo, Joan A. McGowan, Thomas F. Lang, Patrick Garnero, Mary L. Bouxsein, John P. Bilezikian, and Clifford J. Rosen (_New England Journal of Medicine, Vol. 349, No. 13, Sep. 25, 2003, p. 1207-1215).

B. "The Effects of Parathyroid Hormone, Alendronate, or Both in Men with Osteoporosis," by Joel S. Finkelstein, Annmarie Hayes, Joy L. Hunzelman, Jason J. Wyland, and Robert M. Neer (_New England Journal of Medicine, Vol. 349, No. 13, Sep. 25, 2003, p. 1216-1226).

12. _BMJ_ CLINICAL REVIEW: "Alcohol use disorders in elderly people--redefining an age old problem in old age," by Henry O'Connell, Ai-Vyrn Chin, Conal Cunningham, and Conal Cunningham (_British Medical Journal_ Clinical Review, Vol. 327, No. 7416, Sep. 20, 2003, HTML and .pdf format, p. 664-667).

13. _TIME_ ARTICLE: "Hobby Heaven: For some seniors, hobbies are not mere distractions, they're full-blown obsessions," by Stephanie Clifford (_Time_, Vol. 162, No. 13, Sep. 29, 2003).,9171,1101030929-488818,00.html

14. _NEWSWEEK_ ARTICLE: "High on Testosterone: As the NIH ponders the risks and benefits of this drug, millions are taking it--and prescriptions are soaring," by David Noonan (_Newsweek_, Sep. 29, 2003).


II. Working Papers:

15. LIS: "Social Transfers and Income Inequality in Old-age: A Multi-national Perspective," by Robert L. Brown and Steven G. Prus (Luxembourg Income Study Working Paper No. 355, August 2003, .pdf format, 10p.).


This paper examines variation in old-age income inequality between industrialized nations with modern welfare systems. The analysis of income inequality across countries with different retirement income systems provides a perspective on public pension policy choices and designs and their distributional implications. Because of the progressive nature of public pension programs, we hypothesize that there is an inverse relationship between the quality of public pension benefits and old-age income inequality -- that is, countries with comprehensive, universal, and generous public pension systems will exhibit more equal distributions of income in old age. Luxembourg Income Study data indeed show that cross-national variation in old-age income inequality is partly explained by differences in the percentage of seniors total income derived from public pension transfers. Sweden, for example, has the highest level of government transfers and the lowest level of old-age income inequality, while Israel and the U.S. have the lowest levels of dependency on government transfers and the highest levels of income inequality. A notable exception is Canada where public transfers represent only a moderate portion of elderly income, yet old-age income inequality is relatively low. This suggests that other factors besides quality of public pension benefits play a role in differences in old-age income inequality across countries.

16. MPIDR: "German unification and the plasticity of mortality at older ages," by Rembrandt D. Scholz and Heiner Maier (Max Planck Institute for Demographic Research WP-2003-033, September 2003, .pdf format, 21p.).


German unification can be seen as a natural experiment that allows us to study the health effects of political and economic transition. This study examined old-age survival following German unification in cohorts born in 1895, 1900, 1905 and 1910. People born in these years were in their 80s and 90s at the time of unification in 1990. Before unification, mortality in these cohorts was considerably higher in East Germany than in the West. Following unification, mortality in the East declined toward prevailing levels in the West, particularly among women. This indicates that even the very-old East Germans were able to profit from the medical, social, and economic improvements associated with unification. Study results support the view that old-age mortality is plastic and amenable to intervention, and they attest to the importance of late-life events.

17. PENN PARC: "The Shifting Signification of Self-Rated Health," by Jason Schnittker (University of Pennsylvania Population Aging Research Center, September 2003, .pdf format, 37p.).


Although self-rated health is one of the most common measures of health in the social sciences, scholars know little about the psychological processes behind it. Scholars generally argue that individuals assess their health through social comparison--that is, by considering their own health relative to that of their peers. Most empirical research, however, provides only mixed support for social comparison. In an attempt to reconcile these inconsistencies, this article tests four different theories of self-rated health using a large, nationally-representative, and longitudinal data set. The changing association between objective measures of health and self rated health between age-groups is examined. Three objective measures--the presence of chronic conditions, the degree of functional limitations, and the extent of depression--show three distinct age-patterns that, together, suggest a reconsideration of the importance of social comparison. Consistent with social comparison, the correspondence between chronic conditions and self-rated health generally declines with age, although not all conditions show the same pattern and the declines are not equally steep for all conditions. Similarly, the correspondence between functional limitations and self-rate health is exceptionally strong, but decreases precipitously in later life. The most striking finding, however, is entirely inconsistent with social comparison: the correspondence between depression and self-rated health increases substantially with age, despite an increasing prevalence of depression in later life. Indeed, after the age of 74, the correspondence between self-rated health and some common symptoms of depression is stronger than that between self-rated health and several potentially fatal chronic conditions. The results are discussed in light of (i) the many demographic studies that employ self-rated health as an outcome and (ii) research on the psychology of aging.

18. NBER: "Generational Accounting in Korea," by Alan J. Auerbach and Young Jun Chun (National Bureau of Economic Research w9983, September 2003, .pdf format, 53p.).


This paper reassesses the long-term fiscal position of Korea using Generational Accounting, modified to reflect the special features of the Korean fiscal situation, such as prospective changes in public pension benefit profiles and social welfare expenditures due to the maturing of public pensions, increasing demand for social welfare expenditures, and population aging. Our findings suggest that unless policy toward existing generations is substantially altered, future generations will face an excessively heavy fiscal burden. For reasonable growth and interest rate assumptions, the difference between 2000 newborns and those born after 2000 ranges from 60% to 120%. We also find that a substantial part of the fiscal burden on the future generations is explained by the long-run budgetary imbalance of public pensions and Medical Insurance.

Click on "PDF" or submit your email address for full text.


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

19. American Journal of Epidemiology (Vol. 158, No. 7, Oct. 1, 2003).

20. Experimental Aging Research (Vol. 29, No. 4, 2003). Note: Full electronic text of this journal is available in the EBSCO Host Academic Search Elite database. Check your library for the availability of this database and this issue.

21. Journals of Gerontology (B): Psychological and Social Sciences (Vols. 58B, Nos. 3, September 2003). Note: Full electronic text of this journal is available in the ProQuest Research Library. Check your library for the availability of this database and this issue.

22. INGENTA Tables of Contents: INGENTA provides fee based document delivery services for selected journals.

A. Point your browser to:

B. click on "browse by publication"
C. Click the "fax/ariel" radio button, type the Journal Name in the "by words in the title" search box and click "search".
D. View the table of contents for the issue noted.

Educational Gerontology (Vol. 29, No. 7, 2003). Note: Full electronic text of this journal is available in the EBSCO Host Academic Search Elite database. Check your library for the availability of this database and this issue.

23. AMEDEO MEDICAL LITERATURE: Note: "AMEDEO has been created to serve the needs of healthcare professionals, including physicians, nurses, pharmacists, administrators, other members of the health professions, and patients and their friends. They can easily access timely, relevant information within their respective fields... All AMEDEO services are free of charge. This policy was made possible thanks to generous unrestricted educational grants provided by AMGEN, Berlex, Eisai, Glaxo Wellcome, Novartis, Pfizer, Roche, and Schering AG."

A. Osteoporosis: Literature for the week of Sep. 23, 2003:

B. Alzheimer's Disease: Literature for the week of Sep. 23, 2003:

C. Parkinson's Disease: Literature for the week of Sep. 23, 2003:

D. Prostate Cancer: Literature for the week of Sep. 23, 2003:

AMADEO Literature Guide:


IV. Funding Opportunities:

24. NIH: "Interactions Between Stem Cells and the Microenvironment In Vivo" (US National Institutes of Health, National Institute on Aging, in conjunction with several other agencies, PAS-03-172, Sep. 16, 2003). For more information see:


V. Legislation Information Updates:


A. "Forum: Ageism in Health Care: Are Our Nation's Seniors Receiving Proper Oral HealthCare?" a hearing held Sep. 22, 2003.

Selected hearing testimony (.pdf format):

B. "HIPAA Medical Privacy and Transaction Rules: Overkill or Overdue?" a hearing held Sep. 23, 2003.

Hearing testimony (.pdf format):

Note: This hearing can also be viewed in its entirety (RealPlayer format, running time: 2 hours, 9 minutes, 22 seconds).


VI. Websites of Interest:

26. AUSTRALIA DEPARTMENT OF HEALTH AND AGEING/AUSTRALIAN INSTITUTE OF HEALTH AND WELFARE: "Ageing Research Online." This new collaborative website "was established in 2003 under the Building Ageing Research Capacity (BARC) Project as a collaboration between the Australian Government Department of Health and Ageing and the Australian Institute of Health and Welfare." ... Ageing Research Online provides a broad range of facilities to a wide range of users. You can: "register to upload information on recent, current and proposed research projects as well as details on available courses of study, grants and scholarships; find out about the work of other researchers, research centres and new and emerging research fields; access information about data availability and publications as well as contact details, references and associated resources; review policy developments and publications such as the Australian Ageing Research Agenda; and participate in forum discussions or post a notice about an upcoming event of interest."

Jack Solock
Data Librarian--Center for Demography and Ecology and Center for
Demography of Health and Aging
4470 Social Science
University of Wisconsin-Madison
Madison, WI 53706