Improving Data on America's Aging Population

Summary of a Workshop

Deborah Carr, Anu Pemmarazu, Dorothy P. Rice, Editors

Committee on National Statistics

Committee on Population

Commission on Behavioral and Social Sciences and Education

National Research Council

NATIONAL ACADEMY PRESS
Washington, D.C. 1996



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Improving Data on America's Aging Population: Summary of a Workshop Improving Data on America's Aging Population Summary of a Workshop Deborah Carr, Anu Pemmarazu, Dorothy P. Rice, Editors Committee on National Statistics Committee on Population Commission on Behavioral and Social Sciences and Education National Research Council NATIONAL ACADEMY PRESS Washington, D.C. 1996

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Improving Data on America's Aging Population: Summary of a Workshop NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance. This report has been reviewed by a group other than the authors according to procedures approved by a Report Review Committee consisting of members of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Bruce M. Alberts is president of the National Academy of Sciences. The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. William A. Wulf is interim president of the National Academy of Engineering. The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Kenneth I. Shine is president of the Institute of Medicine. The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy's purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Bruce M. Alberts and Dr. William A. Wulf are chairman and interim vice chairman, respectively, of the National Research Council. This workshop was supported by funds from the National Institute on Aging through grant No. SES 9116694 by the National Science Foundation to the National Academy of Sciences for support of core activities of the Committee on National Statistics. ISBN 0-309-05633-0 Additional copies of this report are available from National Academy Press, 2101 Constitution Avenue, N.W., Lock Box 285, Washington, DC 20055 Call 1-800-624-6242 or 202-334-3313 (in the Washington metropolitan area). This report is also available on-line at http://www.nap.edu Copyright 1996 by The National Academy of Sciences. All rights reserved. Printed in the United States of America

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Improving Data on America's Aging Population: Summary of a Workshop COMMITTEE ON NATIONAL STATISTICS 1995–1996 NORMAN M. BRADBURN (Chair), National Opinion Research Center, University of Chicago JOHN E. ROLPH (Vice Chair), Department of Information and Operations Management, School of Business Administration, University of Southern California JULIE DAVANZO, RAND, Santa Monica, California WILLIAM F. EDDY, Department of Statistics, Carnegie Mellon University JOHN F. GEWEKE, Department of Economics, University of Minnesota, Minneapolis JOEL B. GREENHOUSE, Department of Statistics, Carnegie Mellon University ERIC A. HANUSHEK, W. Allen Wallis Institute of Political Economy, Department of Economics, University of Rochester NICHOLAS JEWELL, Program in Biostatistics, School of Public Health, University of California, Berkeley CHARLES F. MANSKI, Department of Economics, University of Wisconsin, Madison WILLIAM NORDHAUS, Department of Economics, Yale University JANET L. NORWOOD, The Urban Institute, Washington, D.C. EDWARD B. PERRIN, Department of Health Services, School of Public Health and Community Medicine, University of Washington KEITH F. RUST, Westat, Inc., Rockville, Maryland FRANCISCO J. SAMANIEGO, Division of Statistics, University of California, Davis MIRON L. STRAF, Director MICHELE L. CONRAD, Division Administrator

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Improving Data on America's Aging Population: Summary of a Workshop COMMITTEE ON POPULATION 1995–1996 RONALD D. LEE (Chair), Department of Demography, University of California, Berkeley CAROLINE H. BLEDSOE, Department of Anthropology, Northwestern University JOSE-LUIS BOBADILLA, World Bank, Washington, D.C. JOHN BONGAARTS, The Population Council, New York JOHN B. CASTERLINE, The Population Council, New York LINDA G. MARTIN, RAND, Santa Monica, California ROBERT A. MOFFITT, Department of Economics, Brown University MARK R. MONTGOMERY, The Population Council, New York W. HENRY MOSLEY, Department of Population Dynamics, School of Hygiene and Public Health, Johns Hopkins University ALBERTO PALLONI, Department of Sociology, University of Wisconsin, Madison JAMES P. SMITH, RAND, Santa Monica, California BETH J. SOLDO, Department of Demography, Georgetown University MARTA TIENDA, Population Research Center, University of Chicago AMY O. TSUI, Carolina Population Center, University of North Carolina, Chapel Hill JOHN HAAGA, Director

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Improving Data on America's Aging Population: Summary of a Workshop WORKSHOP ON PRIORITIES FOR DATA ON THE AGING POPULATION Participants DOROTHY RICE (Chair), Institute for Health and Aging, University of California-San Francisco RONALD ABELES, National Institute on Aging, National Institutes of Health, U.S. Department of Health and Human Services CLYDE BEHNEY, Division of Health Care Services, Institute of Medicine RICHARD BURKHAUSER, Center for Policy Research, Maxwell School, Syracuse University ROBERT CLARK, Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services STEVEN CLAUSER, Health Care Financing Administration, U.S. Department of Health and Human Services STEVEN COHEN, Agency for Health Care Policy and Research, National Institutes of Health, U.S. Department of Health and Human Services DAVID CUTLER, Department of Economics, Harvard University LILY ENGSTROM, Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services JACOB FELDMAN, National Center for Health Statistics, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services DOROTHY GILFORD, Commission on Behavioral and Social Sciences and Education, National Research Council NANCY GORDON, Demographic Programs, Bureau of the Census, U.S. Department of Commerce JONATHAN GRUBER, Department of Economics, Massachusetts Institute of Technology HOLLY HARVEY, Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services ROBERT HAUSER, Department of Sociology, University of Wisconsin, Madison RICHARD HAVLICK, National Institute on Aging, National Institutes of Health, U.S. Department of Health and Human Services SANDRA HOFFERTH, Institute for Social Research, University of Michigan MICHAEL HURD, Department of Economics, State University of New York, Stony Brook DAVID JOHNSON, Bureau of Labor Statistics, U.S. Department of Labor THOMAS JUSTER, Institute for Social Research, University of Michigan ROBERT KANE, Institute for Health Services Research, School for Public Health, University of Minnesota

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Improving Data on America's Aging Population: Summary of a Workshop ROBERT KOMINSKI, Population Division, Bureau of the Census, U.S. Department of Commerce MARION EIN LEWIN, Institute of Medicine JENNIFER MADANS, Division of Epidemiology, National Center for Health Statistics, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services KENNETH MANTON, Center for Demographic Studies, Duke University NADINE MARKS, Department of Child and Family Studies, University of Wisconsin, Madison MARY McCARTHY, Bureau of Labor Statistics, U.S. Department of Labor FAITH MITCHELL, Commission on Behavioral and Social Sciences and Education, National Research Council MARILYN MOON, The Urban Institute, Washington, D.C. ROBERT MOORE, Bureau of Data Management and Strategy, Health Care Financing Administration, U.S. Department of Health and Human Services RANDALL OLSEN, Center for Human Resources Research, Ohio State University JAN OLSON, Social Security Administration GEORGIANNE PATMIOS, National Institute on Aging, National Institutes of Health, U.S. Department of Health and Human Services DEBORAH PHILLIPS, Commission on Behavioral and Social Sciences and Education, National Research Council WILLIAM RAUB, Office of the Assistant Secretary for Planning and Evaluation, U. S. Department of Health and Human Services PHILIP RONES, Bureau of Labor Statistics, U.S. Department of Labor TIMOTHY SMEEDING, Metropolitan Studies Program and Economics Department, Syracuse University BETH SOLDO, Department of Demography, Georgetown University ROBYN STONE, Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services MICHAEL STOTO, Division of Health Promotion and Disease Prevention, Institute of Medicine RICHARD SUZMAN, Office of Demography, National Institute on Aging, National Institutes of Health, U.S. Department of Health and Human Services BARBARA BOYLE TORREY, Commission on Behavioral and Social Sciences and Education, National Research Council JOAN VAN NOSTRAND, National Center for Health Statistics, Center for Disease Control and Prevention, U.S. Department of Health and Human Services ROBERT WALLACE, Department of Preventive Medicine and Environmental Health, University of Iowa

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Improving Data on America's Aging Population: Summary of a Workshop KATHERINE WALLMAN, Office of Information and Regulatory Affairs, U.S. Office of Management and Budget ROBERT WILLIS, Institute for Social Research, University of Michigan GOOLOO WUNDERLICH, Division of Health Care Services, Institute of Medicine Staff DEBORAH CARR, Rapporteur AGNES GASKIN, Senior Project Assistant JOHN HAAGA, Director, Committee on Population ANU PEMMARAZU, Research Assistant MIRON L. STRAF, Director, Committee on National Statistics

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Improving Data on America's Aging Population: Summary of a Workshop Contents     PREFACE   xi     INTRODUCTION   1     AMERICA'S AGING POPULATION: TRENDS AND UNCERTAINTIES   5     Projecting the Elderly Population: How Many?   5     Health and Disability   6     Long-Term and Acute Care Arrangements   9     Work and Retirement Patterns in Later Life   11     Income, Wealth, and Quality of Life   12     Living Arrangements and Family   14     Residential Patterns   15     Summary   16     IMPROVING DATA SOURCES   17     Oversampling Subgroups of the Elderly   17     Cross-Agency Coordination and Data Integration   19     Ethical Challenges   21     Attention to Statistical Methodology   23     Data for State-Level and Local-Level Estimates   24     Accurate and Standard Concepts and Measures   26     CONCLUSIONS   29

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Improving Data on America's Aging Population: Summary of a Workshop     REFERENCES   33 APPENDIX A:   AGENDA, WORKSHOP ON PRIORITIES FOR DATA ON THE AGING POPULATION   39 APPENDIX B:   DATA SOURCES FOR STUDYING AGING: SURVEY CHARACTERISTICS AND LINKAGE CAPACITIES   43

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Improving Data on America's Aging Population: Summary of a Workshop Preface In March 1996 the Committee on National Statistics and the Committee on Population convened a group of experts for a two-day workshop on priorities for data on the aging population. The workshop provided a vehicle for serious brainstorming among a group of policy analysts, principal investigators for the major surveys, academic and other researchers, and others interested in aging-related statistics from many perspectives. The purposes of the workshop were to explore 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 how future data needs can be met for the purposes of research; for understanding the social, economic, and health conditions of the older population; and for informing public policy. Participants reviewed developments on statistics for the aging population since publication of the Committee on National Statistics report The Aging Population in the Twenty-First Century (Gilford, 1988) and major trends in the population at older ages, identified policy issues for which data may be needed, described current data collection efforts, and suggested changes to more effectively meet future data needs. Funding for the workshop was provided by the National Institute on Aging, and we thank its director, Richard Hodes, and Richard Suzman, director of the institute's Office of Demography, for their interest in and support of this project. A number of staff of the National Research Council contributed time and expertise to the workshop and the production of this report. Miron Straf, John Haaga, and Anu Pemmarazu organized the workshop. Agnes Gaskin was the project

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Improving Data on America's Aging Population: Summary of a Workshop assistant. In addition, Deborah Carr of the University of Wisconsin at Madison served as rapporteur. Editorial assistance was provided by Eugenia Grohman. We are especially grateful to the chair Dorothy Rice and workshop participants for their time and effort to this task. The report that follows is a summary of their presentations and discussion. Norman M. Bradburn, Chair Committee on National Statistics Ronald D. Lee, Chair Committee on Population