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Improving Data on America's Aging Population: Summary of a Workshop Introduction The Committee on National Statistics (CNSTAT) has had a continued interest in the adequacy of statistical information and methodology for studying the aging population. In the report of CNSTAT's Panel on Statistics for an Aging Population, the adequacy of current statistical information and methodology was examined, particularly in the area of health and medical care, for an aging population. The panel's report, The Aging Population in the Twenty-First Century: Statistics for Health Policy (Gilford, 1988), focused on the data required during the next decade for policy development and research on health care for the elderly. Recommendations emphasized modifications to existing national statistical programs and surveys in light of the budgetary constraints faced by the federal agencies at that time. A systematic review of administrative and survey data sets led to a large number of recommendations to improve existing surveys and to make better use of administrative records required for health policy analysis in the next decade. In the 8 years since the report was issued, many of its recommendations have been enacted. The most substantial progress has been made in three main areas: federal data collection, data linkages, and mechanisms for data dissemination. Several new data sets, including the longitudinal Health and Retirement Survey (HRS), the Assets and Health Dynamics Among the Oldest-Old (AHEAD) survey, and the Medicare Current Beneficiary Survey, address the report's call for data that describe health and functional transitions of old Americans. Several data linkage and integration projects have also been completed or are now in progress. One milestone is a tracking system by the U.S. Department of
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Improving Data on America's Aging Population: Summary of a Workshop Health and Human Services (HHS), in which all National Center for Health Statistics surveys will be linked to the National Death Index and data from the Health Care Financing Administration. New data dissemination mechanisms have also been established. The Federal Interagency Forum on Aging-Related Statistics—a congressionally mandated organization—was established in 1986 to encourage cooperation among federal agencies in the development, collection, analysis and dissemination of data on the older population. One of the forum's projects is the biannual publication of Data Base News in Aging, which highlights the content of government-sponsored surveys and products containing information about the older population. In addition, most federal statistical agencies have developed—or are currently developing—procedures for researchers to access their data bases through the Internet, particularly, the World Wide Web. Despite these strides, the National Institute on Aging (NIA) believes it is important to continually reassess the current data collection environment and to develop general guidelines for the collection of additional data on aging. In the coming decades, the nation's decision makers will be challenged by changing demands for social and health services due to the anticipated rapid rate of growth of the elderly (65 years or older) and especially of the oldest old (85 years or older). At the same time, national policy makers are contemplating a major shift in responsibility for many social programs from the federal to state government level. Such a shift would place even greater demands on the capacity of statistical systems to track and publish up-to-date information about the number, health status, economic well-being, employment behavior, living arrangements, and service utilization patterns of the elderly. It is in this context that the Committee on National Statistics and the Committee on Population, at the request of the NIA, convened a workshop in March 1996 to discuss data on the aging population that address the emerging and important social, economic, and health conditions of the older population. The purposes of the workshop were to identify how the population at older ages in the next few decades will differ from the older population today, to understand the underlying causes of those changes, to anticipate future problems and policy issues, and to suggest future needs for data for research in these areas. The scope of the workshop was broader than that of the 1988 CNSTAT report, including not only data on health and long-term care, but also actuarial, economic, demographic, housing, and epidemiological data needs for informing public policy. Workshop participants included members of the two committees, investigators for the major NIA-funded surveys on the aging population, officials of relevant federal agencies, and other experts on economics, biodemography, public policy, and the social aspects of aging. The workshop format was informal in order to facilitate discussion; see agenda, Appendix A. The workshop began with a brief review of the findings and recommendations of the 1988 CNSTAT report, but the purpose was not to assess systemati-
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Improving Data on America's Aging Population: Summary of a Workshop cally the degree to which each of the 1988 recommendations had been implemented. Rather, participants discussed and identified issues pertaining to trends in the population at older ages: consequences of baby boomers facing retirement; health, disability and functional status of the older population; trends in long-term care; health care delivery, organization, and financing; and longevity and quality of life. They also focused on identifying important data needed to understand these issues and to inform public policies. Specifically, participants assessed how current and future data collection activities might meet some of these needs. Important data gaps were identified, and the likely future environment of data collection was considered. This report is a summary of the workshop proceedings and discussions. As such, it does not provide a comprehensive review of data collection efforts or empirical research focusing on the old population. Rather, it reflects the concerns and areas of expertise of the workshop participants. The discussions focused primarily on the economic, social, and health trends affecting the aging population. A variety of related topics, important in their own right, were not covered in detail: such topics include the effects of macroeconomic trends on health, health policy evaluation, and disease diagnoses, as well as health informatics (the combination of computer science, information science, and medical science; Connick, 1994). The first section of this report reviews the information presented at the workshop regarding economic, social, and health trends affecting the aging population. The second section highlights the common themes that emerged at the workshop. Finally, broad guidelines for assessing the merits of relevant data sources are provided, and suggestions for future projects are described.
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