Current Awareness in Aging Research (CAAR) Report #256--September 30, 2004


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. Data:


A. "HRS 2002 Core (Final, Version 1.0)," September 24, 2004.

B. On September 27, 2004, HRS updated the Question Concordance to reflect the addition of the 2002 Core file. The URL for the concordance is:

In addition, the concordance was updated to include questions from the 1993 AHEAD survey. The 1993 AHEAD codebook can be found at:


II. Reports and articles:

2. GAO REPORT: "Medicare Demonstration PPOs: Financial and Other Advantages for Plans, Few Advantages for Beneficiaries," (US Government Accountability Office, GAO-04-960, September 27, 2004, .pdf format, 58p.).

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

3. DHHS OIG REPORT: "Variation in State Medicaid Drug Prices," (US Department of Health and Human Services, Office of Inspector General, OEI-05-02-00681, September 2004, .pdf format, 39p.).

From the Summary:

This inspection report assessed the extent to which States vary in their Medicaid pharmacy reimbursement for the same drugs. The Medicaid program could benefit from substantial savings if all States reimbursed pharmacies at prices closer to the drug reimbursement prices paid by the lowest paying States. The OIG analyzed Fiscal Year 2001 prescription drug reimbursement data for 28 drugs from 42 States. We found that the highest paying State's unit reimbursement price ranged from 12 to 4,073 percent more per drug than the lowest paying State for the 28 drugs. On average, the highest paying State paid almost $200 more per package than the lowest paying State for these drugs. Medicaid could have saved $86.7 million in FY 2001 if all States had reimbursed at the same price as the lowest paying State for each of the 28 drugs. Multiple factors contribute to the differences in drug prices across States. Even States with the same formula for estimating pharmacy acquisition costs demonstrated variation in their average annual reimbursement prices. This report recommended that CMS: (1) share average manufacturer price data with States, (2) conduct further research on the factors that affect States' drug prices, and (3) annually review States' reimbursement data to target technical assistance to higher paying States.


A. "Ambulatory Care Visits to Physician Offices, Hospital Outpatient Departments, and Emergency Departments: United States, 1999-2000," by Catharine W. Burt and Susan M. Schappert (US National Center for Health Statistics, Vital and Health Statistics, Series 13, No. 157, September 2004,.pdf format, 70p.).

B. "Early Release of Selected Estimates Based on Data From the January-March 2004 National Health Interview Survey," (US National Center for Health Statistics, September 2004, .pdf format, 93p.).

C. "Health Insurance Coverage: Estimates from the National Health Interview Survey, January-March 2004," by Robin A. Cohen, Cathy Hao, and Zakia Coriaty-Nelson (US National Center for Health Statistics, September 2004, .pdf format, 13p.).

5. SSA OP COMPENDIUM: "Social Security Programs Throughout the World: Europe, 2004," (US Social Security Administration, Office of Policy, September 2004, HTML and .pdf format). "This publication provides a cross-national comparison of the social security systems in 172 countries. It summarizes the five main social insurance programs in those countries: old-age, disability, and survivors; sickness and maternity; work injury; unemployment; and family allowances. Beginning in September 2002, it will be published in four regional volumes (Europe, Asia and the Pacific, Africa, and the Americas), one every 6 months."


A. "Medicare Appoints Advisory Panel for New Durable Medical Equipment Competitive Bidding Process," (September 24, 2004).

B. "Draft Medicare Plan to Cover Implantable Defibrillators Expected to Save Thousands of Lives; Public Comments Sought," (September 28, 2004).

C. "Draft Decision Memo for Implantable Defibrillators (CAG-00157R2)," (September 28, 2004).

7. NIA NEWS RELEASE: "Health, Retirement Needs Challenge an Aging America," (US National Institution on Aging, Sep. 28, 2004).

8. KFF HEALTHCAST: "Kaiser Conversations on Health with CMS Administrator Mark McClellan," (Kaiser Family Foundation, September 29, 2004, RealPlayer or Windows Media player format, running time 1:03:00).

9. _PNAS_ ARTICLE ABSTRACT: "Characterization of the ER{beta}-/-mouse heart," by Carola Förster, Silke Kietz, Kjell Hultenby, Margaret Warner, and Jan-Åke Gustafsson (_Proceedings of the National Academy of Sciences_, Vol. 101, No. 39, September 28, 2004, .pdf and HTML format, p. 14234-14239).

10. _NEJM_ PERSPECTIVE: "Election 2004: Prescription-Drug Prices," by Richard G. Frank (_New England Journal of Medicine_, Vol. 351, No. 14, September 30, 2004, .pdf and HTML format, p. 1375-1377). Note: _NEJM_ is providing free electronic access to the full-text of this article.

11. MEDSCAPE UPDATE: Note: Medscape requires free registration before providing articles. Medscape's Palliative Care Resource Center (Collections of Medscape's key clinical content) has recently been updated.


A. "Will Hedge Funds Take a Dive?" by Daniel Kadlec (_Time_, Vol. 164, No. 14, October 4, 2004).,9171,1101041004-702152,00.html

B. "Prostate Priorities," by Sanjay Gupta (_Time_, Vol. 164, No. 14, October 4, 2004).,9171,1101041004-702137,00.html

13. AARP PRIME TIME RADIO: The following AARP _Prime Time Radio_ show, for Sep. 7 - Sep. 21, 2004, is now available (RealPlayer plug-in or helper application required, audio transcripts run between 24 and 30 minutes).

Sep. 21, 2004--Interview with John Kerry


III. Working Papers:

14. NBER:

A. "Explaining Diversities in Age-Specific Life Expectancies and Values of Life Saving: A Numerical Analysis," by Isaac Ehrlich and Yong Yin (National Bureau of Economic Research w10759, September 2004, .pdf format, 49p.).


Little attempt has been made so far to quantify the extent to which individual willingness to spend on life protection may account for the observed trends and diversities in age-specific life expectancies across individuals and over time. We address these issues via calibrated simulations of a dynamic, life-cycle model of life protection in which life's end is a stochastic event, age-specific mortality risks are endogenous variables, and spending on life protection is set jointly with related insurance options: life insurance as well as annuities. A unique feature of our model is that it links age-specific mortality risks and implicit private values-of-life-saving (VLS) as "dual variables", and estimates them jointly. It also offers new insights about the concept and measurement of VLS. Life protection is estimated to have a non-negligible impact on age-specific life expectancies. It can account for significant portions of observed inequalities in life expectancies across population groups and over time, as well as for a wide range of empirical estimates of VLS produced via the conventional "willingness to pay" approach.

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

B. "Subjective Mortality Risk and Bequests," by Li Gan, Guan Gong, Michael Hurd, and Daniel McFadden (National Bureau of Economic Research w10789, September 2004, .pdf format, 29p.).


This paper investigates whether subjective expectations about future mortality affect consumption and bequests motives. We estimate a dynamic life-cycle model based on subjective survival rates and wealth from the panel dataset Asset and Health Dynamics among Oldest Old. We find that bequest motives are small on average, which indicates that most bequests are involuntary or accidental. Moreover, parameter estimates using subjective mortality risk perform better in predicting out-of-sample wealth levels than estimates using life table mortality risks, suggesting that decisions about consumption and saving are influenced more strongly by individual-level beliefs about mortality risk than by group level mortality risk.

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

C. "Supply or Demand: Why is the Market for Long-Term Care Insurance So Small?" by Jeffrey R. Brown and Amy Finkelstein (National Bureau of Economic Research w10782, September 2004, .pdf format, 38p.).


Long-term care represents one of the largest uninsured financial risks facing the elderly in the United States. Whether the small size of this market is driven primarily by supply side market imperfections or by limitations to demand, however, is unresolved, largely due to the paucity of data about the structure of the private market. We provide what is to our knowledge the first empirical evidence on the pricing and benefit structure of long-term care insurance policies. We estimate that the typical policy purchased by a 65-year old has an average pricing load of about 18 percent and has a very limited benefit structure, covering only one-third of the expected present discounted value of long-term care expenditures. These findings are consistent with the presence of supply side market imperfections. However, we also find enormous gender differences in pricing -- typical loads are 44 cents on the dollar for men but better than actuarially fair for women -- that do not translate into differences in coverage. And, although purchased policies provide limited benefits, we demonstrate that more comprehensive policies are widely-available at similar loads, but are rarely purchased. These findings suggest that while supply-side market imperfections exist, they are not the primary cause of the small size of the private long-term care insurance market.

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

15. PENN STATE UNIVERSITY POPULATION RESEARCH INSTITUTE: "A Population with Continually Declining Mortality," by Robert Schoen, Stefan Hrafn Jonsson and Paula Tufis (WP 04-07, September 2004, .pdf format, 29p.).


In recent years, many countries have experienced sustained declines in death rates. Here we present a new dynamic population model that provides a framework for analyzing continuing mortality declines. Every year there is one birth in the model. Mortality increases exponentially over age at rate b while decreasing exponentially over time at rate c. The model population is strikingly linear in its behavior over time, with many measures changing at a rate that closely approximates a simple function of b and c. The size of the population is virtually the same as the average age at death, and both increase annually by c/b. Period life expectancy at birth also increases linearly by c/b, while the average age of the population increases linearly by c/(2b). Preserving a constant ratio of persons in the economically active ages to those in the retirement ages implies an increase in the "normal" age of retirement of about 6.8c years per year. The interpretability of parameters b and c, the ability to accommodate varying rates of decline, and the linear nature of demographic changes enhance the model's potential for analyzing steadily increasing longevity.

16. PRINCETON UNIVERSITY OFFICE OF POPULATION RESEARCH: "Perceived Stress and Physiological Dysregulation," by Noreen Goldman Dana A. Glei, Christopher L. Seplaki, I-Wen Liu, and Maxine Weinstein (Office of Population Research WP 2004-05, 2004, .pdf format, 26p.).


We use a population-based representative sample of older Taiwanese to investigate links between perceived stress and a broad set of biological measures. These bio markers were collected at a single time (2000) and reflect SNS-activity, HPA-activity, immune function, cardiovascular response, and metabolic pathways. We model the relationship between measures of perceived stress and (1) both high and low values for each of 16 individual biological indicators; and (2) a measure of cumulative physiological dysregulation based on the full set of biomarkers. We consider two measures of perceived stress, one derived from the 2000 interview and a second based on data from three interviews (1996-2000). Age and sex-adjusted models reveal significant associations between measures of perceived stress and extreme values of cortisol, triglycerides, IL-6, DHEAS and fasting glucose. Numerous bio markers examined here, including those pertaining to blood pressure and obesity, are not significantly related to perceived stress. On the other hand, the measure of cumulative physiological dysregulation is associated with both the level of perceived stress at a given time and to a longitudinal measure of perceived stress. Some results suggest that the relationship between level of perceived stress and physiological response is stronger for women than men.

17. IIASA [Laxenburg Austria]: "Putting Oeppen and Vaupel to Work: On the Road to New Stochastic Mortality Forecasts," by Warren Sanderson and Segei Scherbov (International Institute for Applied Systems Analysis Interim Report IR-04-049, September 2004, .pdf and PostScript format, 16p.).


Oeppen and Vauppel (2002) revolutionized the field of Human mortality forecasting by showing that best-practice life expectancy has risen almost linearly from the mid-nineteenth century to the present. In this paper, we present a methodology that makes use of that finding. We show that a set of 14 low mortality countries, the distribution of life expectancies in the last 40 years has had almost perfectly linear mean and median values. We use this observation to estimate the parameters of models that include both trend error and idiosyncratic error. We compare the outcomes of the new procedure with the United Nations (2003) forecasts for Germany, Japan, and the U.S., where only mortality rates differ. The projections are most similar for Japan and most different for the U.S.

Click on PDF or PS icon for full text.


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

18. Aging and Mental Health (Vol. 8, No. 5, September 2004).

19. American Journal of Epidemiology (Vol. 160, No. 7, October 1, 2004).

20. American Journal of Public Health (Vol. 94, No. 10, October 2004). Note: Full electronic text of this journal is available in the ProQuest Research Library and the EBSCO Host Academic Search Elite Database. Check your library for the availability of these databases and this issue.

21. Journal of Aging and Health (Vol. 16, No. 5, November 2004). Note: Full electronic text of this journal is available in the ProQuest Research Library database. Check your library for the availability of this database and this issue.

22. Journal of Aging Studies (Vol. 18, No. 4, November 2004).

Click on link to "Tables of Contents & Abstracts" in the top right box.

23. Journal of Family Issues (Vol. 25, No. 8, November 2004).

24. 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 September 29, 2004:

B. Alzheimer's Disease: Literature for the week of September 29, 2004:

C. Parkinson's Disease: Literature for the week of September 29, 2004:

D. Prostate Cancer: Literature for the week of September 29, 2004:

AMADEO Literature Guide:


V. Books:

25. National Academies Press: _Critical Perspectives on Racial and Ethnic Differences in Health in Late Life_, edited by Norman B. Anderson, Randy A. Bulatao, and Barney Cohen (Panel on Race, Ethnicity, and Health in Later Life, National Research Council, 2004, OpenBook format, 752p.). Note: Print copy ordering information is available at the site.

26. OECD: _Ageing and Employment Policies--United Kingdom_, (Organisation for Economic Co-operation and Development, 2004, 150p.). Note: From the ordering page you can browse the report electronically, but you will not be allowed to download or print the report. You can purchase an electronic version of the report, but the print version is forthcoming.,2340,en_2649_37435_33740324_1_1_1_37435,00.html

Click on "online bookshop." Then scroll to the bottom of the page, and click on "E-book (PDF Format) ".


VI. Funding Opportunities:

27. NIH:

A. "Ancillary Studies to the AD Neuroimaging Initiative," (US National Institutes of Health, National Institute on Aging in conjunction with other agencies, PA-04-158, September 20, 2004).

B. "Bioengineering Approaches to Energy Balance and Obesity," (US National Institutes of Health, National Institute on Aging in conjunction with other agencies, RFA-HL-04-022, September 20, 2004).

C. "Addendum to PAR-03-118," (US National Institutes of Health, National Institute on Aging in conjunction with other agencies, NOT-TW-04-003, September 23, 2004).

28. AMERICAN GERIATRICS SOCIETY: "2005 Dennis W. Jahnigen Career Development Scholars Awards." "The Jahnigen Scholars program offers two-year career development awards to support junior faculty in the specialties of anesthesiology, emergency medicine, general surgery, gynecology, ophthalmology, orthopaedic surgery, otolaryngology, physical medicine and rehabilitation, thoracic surgery, and urology. The award is intended to allow individuals to initiate and ultimately sustain a career in research and education in the geriatrics aspects of their discipline." The deadline for receipt of applications is December 7, 2004. For more information about the award go to:


VII. Legislation Information Updates:

29. US SENATE SPECIAL COMMITTEE ON AGING HEARING TESTIMONY: "Combating The Flu: Keeping Seniors Alive," a hearing held September 28, 2004.

To view the testimony (.pdf format), go to:


A. "A Prescription for Safety: The Need for H.R. 3880, the Internet Pharmacy Consumer Protection Act," a hearing held March 18, 2004 (Serial No. 108-169, ASCII text and .pdf format, 133p.).

Scroll down to or "find in page" "108-169" (without the quotes).

B. "Oversight of the Federal Employees Health Benefits Program and the Federal Long-Term Care Insurance Program," a hearing held March 24, 2004 (Serial No. 108-170, ASCII text and .pdf format, 123p.).

Scroll down to or "find in page" "108-170" (without the quotes).

31. US SENATE COMMITTEE ON GOVERNMENTAL AFFAIRS HEARING TRANSCRIPT: "Oversight of the Thrift Savings Plan: Ensuring the Integrity of Federal Employee Retirement Savings," a hearing held March 1, 2004 (S.Hrg. 108-554, ASCII text and .pdf format, 125p.).

Scroll down to or "find in page" "108-554" (without the quotes).




Charlie Fiss
Information Manager
Center for Demography and Ecology and
Center for Demography of Health and Aging
Rm. 4470A Social Science Bldg
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Phone: (608) 265-9240
Fax: (608) 262-8400