1 international comparative data for research and policy on aging james p. smith

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International Comparative Data for Research and

Policy on Aging

James P. Smith

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What Will (Mostly) Determine the Future of the World?

• The Aging of the Population

– Mortality rates falling

– Birth rates falling

– Work rates falling

–The sky is not falling

3

World

606,425

1,907,249

0

500,000

1,000,000

1,500,000

2,000,000

2,500,000

2000 2050

Population Ages 60+, Total (Millions)

USA

46

104

0

20

40

60

80

100

120

2000 2050

52,219

329,102

0

100,000

200,000

300,000

400,000

2000 2050

China

4

10

162021

25

35

0

10

20

30

40

50

World US Europe

2000 2050

Percent of Population Age 60+

5

1016

20

10

23

9 11

2125

3530

42

28

37

0

10

20

30

40

50

2000 2050


6

16

10

25

30

0

10

20

30

40

50

US China

2000 2050


7

12.9

7.38.5 8.7

3.22.1 1.7

2.33.2

1.1

0

2

4

6

8

10

12

14

China S. Korea Thailand India Japan

2000

2050

Support Ratios in AsiaPeople 25–64/People 65+

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What Will (Mostly) Determine Our Future?

• What is the problem with an aging population

- Provide income and health security during old age at affordable budgets

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What Will (Mostly) Determine Our Future?

• What is the problem with an aging population

same problems in Asia

- disadvantage- aging more rapidly , at lower incomes, and with weak non-familial income and health security systems in place

- advantage- much easier to change systems than in Europe and America

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The International Landscape in Comparable Data Collection

• The USA Health and Retirement Survey - HRS

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Overview of HRS

• Nationally representative longitudinal survey of ~20,000 people age 51+ designed to produce public use data

• Funded mostly by NIA (and SSA)

• Began in 1992 with the birth cohorts of 1931-41

• Two year periodicity

• Links to administrative records—health and pension

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Core Content Areas in HRS• HealthPhysical/psychological self-report, conditions, disabilities;

Cognitive testing

Behaviors (smoking, drinking, exercise)

• Health ServicesUtilization, expenditure, insurance, out-of-pocket spending

• Labor ForceEmployment status/history, earnings, disability, retirement, type of work

• Economic StatusIncome, wealth, and consumption

Linkage to pensions, Social Security earnings/benefit histories

• Family StructureExtended family, proximity, transfers to/from of money, time, housing.

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0 2 17 41 77 102152

199255

310373

449 485

1 38

1223

37

53

66

72

81

8693

0 0 0

27

37

44

54

5959

10 1423

37

54

83

101

129

185

228

281

318

326

24

0

100

200

300

400

500

600

700

800

900

1000

1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005

Year

Cit

atio

n C

ou

nt

Journal Article Book/Book Chapter Dissertation Working Paper Forthcoming

Scientific Productivity of HRS:HRS Publications, 1993-2005:

Cumulative Count by Type

Cumulative Count: June 15, 2005 Journal Publications 510 Books and Book Chapters 83 Dissertations 59 Working Papers 326 Total 978

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• HRS

• ELSA (English Longitudinal Study of Ageing)

– Two waves completed (2002, 2004)– Third wave now in field– Similar to HRS SES and Health content and

breath – Big innovation is biomarkers

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1998 1999 2001 2002/3 2003 2004/52000

HSE(CVD)

5,053

Nurse visit

HSE(CVD)

5,053

Nurse visit

HSE(ethnic)

2,227

HSE(ethnic)

2,227HSE

(respiratory)

4,549

Nurse visit

HSE(respiratory)

4,549

Nurse visit

ELSA W1

12,100Individuals

aged 50 or over

ELSA W1

12,100Individuals

aged 50 or over

ELSA W2

c.10,800

+ Nurse Visit

ELSA W2

c.10,800

+ Nurse Visit

ELSA Design Basics

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• HRS, ELSA

• SHARE (Survey of Health, Ageing and Retirement in Europe)

– 14 countries in Europe- more on the horizon

– completed first wave 2004, approved for EU funding of second wave now in the field

– Similar instruments to HRS and ELSA

– Big innovation is very strict comparability of survey instruments across countries

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The International Landscape in Comparable HRS Data Collection-

on to Asia

• HRS, ELSA, SHARE

• South Korea- finished first wave and data are now available- KLoSA-

• Japan- internally funded and now in the field- JHRS

• Thailand- partially funded but early stages of preparation- HART

• China- large pilot next year- CHARLS

• India- Discussions in India led by team from Harvard- ???

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on to Asia

• In every single Asian country multiple preliminary visits were made by key members of the HRS-ELSA- SHARE team

– To provide all types of assistance on survey content, design, and implementation

– To provide continuing support and collaboration

– Some level of NIA funding has been critical

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Comparable Data Collection- individual sample sizes at baseline

• HRS - 12,654 -ages 50+

• ELSA- 12,100 -ages 50+

• SHARE – 22,777 in 11 countries - ages 50+

• KLoSA – about 11,000 -ages 45+

• Japan- about 10,000 individuals -ages 45-75

• China- about 10,000 individuals – ages 45+

•

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Comparable Data Collection- periodicity of surveys

All Countries have selected two year periodicity

•

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Comparable Data Collection- Content

• Aim is to have significant comparable content so that cross-national studies can be conducted

• But also allow for scientific innovation at the country level

• Content also has to reflect reality and policies of each country

• Just finished initial meeting in Chiang Mai Thailand in February to discuss issues of comparability across countries – most PIs were able to attend

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Comparable Data Collection- Health- biomarkers

• Only ELSA (venous blood) and now HRS (dry blood) are doing biomarkers now but many countries are planning to do so in future waves

• Performance tests are done by many of the surveys- grip strength, walking speed, etc

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Comparable Data Collection- links to pensions and health records

All Countries have agreed in principle to do these links

- allows one to study the impact of variation in the type of pension and health care system on

- income security during old age

- health outcomes and costs

•

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Comparable Data Collection- DATA Distribution

• All participating countries have committed to widespread and quick release of data into the public domain both within their country and to the international community

– This is a big departure in some countries and HRS model helped a great deal

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• HRS, ELSA, SHARE

• New Asian surveys -South Korea (KLoSA); Japan- (JHRS): Thailand (HART): China (CHARLS); India (???): and most likely more to come

• Latin America- two round of Mexican (MHAS) survey already exist

• Argentina and Chile have expressed interest in doing HRS style studies

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HRS Studies’ Global Coverage

Health and Retirement Study (HRS)

English Longitudinal Study of Ageing (ELSA)

Survey of Health, Ageing and Retirement in Europe (SHARE)Planned Asian HRS studies

Mexican HRS (MHAS)

??

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Conclusions

• The American HRS has quickly lead to similar types of surveys in almost thirty countries to study aging issues around the world

– Small seed investments by NIA have had a very big impact

– Gives the opportunity to study effects of health and pension systems different than your own

– Produced an international set of scholars in demography, economics, and health who are collaborating on this research

1 international comparative data for research and policy on aging james p. smith

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