factors among subpopulations for whom the index is low (e.g., the very old and minorities).

Opportunities for behavioral research include the following:

  • study of the psychological concomitants of illness and how these affect self-care and response to formal care;

  • study of the comparative effectiveness of different modalities in the treatment of chronic mental disorders; and

  • examination of the effect of behavioral and social intervention on the outcome of long-term illness.

Resource Recommendations

Despite increases in the federal commitment to health research, the social and behavioral sciences have lost ground relative to other areas of investigation. Support for behavioral and social research on aging in 1989 was estimated at $80–$100 million from the federal government and $10–$15 million from nonfederal sources such as foundations (Behavioral and Social Research Program, NIA). Estimates of resources for the research agenda primarily involve investigator-originated studies and are to be phased in over a 5-year period.

Behavioral and social research will require substantial added funds during the first 5 years of the new research agenda, especially to raise funding for approved NIH research proposals on aging from one in four to one in two. Because much of the support for behavioral and social studies in aging comes from agencies outside the NIH (e.g., the Health Care Financing Administration and the Alcohol, Drug Abuse, and Mental Health Administration), support for research on aging by non-NIH agencies should be increased by at least 50 percent.

Other support includes training for 200 more behavioral and social scientists per year, one-time costs for construction of additional centers for multidisciplinary research (see the recommendations for funding section), and a share in funds for infrastructure utilized by all areas of research on aging.

Health Services Delivery Research

The growth of the older population, particularly those 85 and over, the chaotic state of today's health care system, rising health care costs, and mounting public concern about value received for the health care dollar lend urgency to the need for a new impetus in health services delivery research. Research in health services delivery expands knowledge about the organization, financing, and deliv-



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