CDHA CAAR

“Gradual Change or Punctuated Equilibrium? Reconsidering Patterns of Health in Later-Life,” by Michal Engelman and Heide Jackson (2017-01, May 2017, .pdf format, 30p.).

Abstract:

This paper examines the curious mismatch between the supposition of gradual, continuous change embedded in common health trajectory models and a pattern of punctuated stability that is captured in the nationally-representative and widely-used Health and Retirement Study. Inspired by an insight from evolutionary biology, our analysis contrasts the conclusions drawn from mixed regression methods (growth curve models and latent class growth analysis) designed to capture trajectories in repeated-measure data with methods (multistate life tables and sequence analysis) designed to describe discrete states and transition patterns. Although a gradually increasing number of functional limitations is consistent with prevailing notions of health decline, our ndings suggest that later life functional health, as captured in survey data, is more aptly characterized as a punctuated equilibrium: long-term stability that is irregularly interrupted by changes in health status or mortality. We conclude by discussing the implications of a punctuated equilibrium model for studies of health and aging.

www.ssc.wisc.edu/cde/cdewp/2017-01.pdf

“Population Aging in India: Facts, Issues, and Questions,” by Arunika Agarwal, Alyssa Lubet, Elizabeth Mitgang, Sanjay Mohanty, and David E. Bloom (PGDA Working Paper No. 132, 2016, .pdf format, 24p.).

Abstract:

India, one of the world’s two population superpowers, is undergoing unprecedented demographic changes. Increasing longevity and falling fertility have resulted in a dramatic increase in the population of adults aged 60 and up, in both absolute and relative terms. This change presents wide-ranging and complex health, social, and economic challenges, both current and future, to which this diverse and heterogeneous country must rapidly adapt. This chapter first lays out the context, scope, and magnitude of India’s demographic changes. It then details the major challenges these shifts pose in the interconnected areas of health, especially the massive challenges of a growing burden of noncommunicable diseases; gender, particularly the needs and vulnerabilities of an increasingly female older adult population; and income security. This chapter also presents an overview of India’s recent and ongoing initiatives to adapt to population aging and provide support to older adults and their families. It concludes with policy recommendations that may serve as a productive next step forward, keeping in mind the need for urgent and timely action on the part of government, private companies, researchers, and general population.

cdn1.sph.harvard.edu/wp-content/uploads/sites/1288/2012/11/Population-Aging-in-India_PGDA-Working-Papers.pdf