Soldo, Beth J
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Publication Cross-Cohort Differences in Health on the Verge of Retirement(2006-09-01) Soldo, Beth J; Mitchell, Olivia; Tfaily, Rania; McCabe, JohnBaby Boomers have left a unique imprint on US culture and society in the last 60 years, and it might be anticipated that they will also put their own stamp on retirement, the last phase of the life cycle. Yet because Boomers have not all fully retired, we cannot yet judge how they will fare as retirees. Instead, we focus on how this group compares with prior groups on the verge of retirement, that is, at ages 51-56. Accordingly, this chapter evaluates the stock of health which Early Boomers bring to retirement and compare these to the circumstances of two prior cohorts at the same point in their life cycles. Using three sets of responses from the Health and Retirement Study, we find some interesting patterns. Overall, the raw evidence indicates that Boomers on the verge of retirement are in poorer health their counterparts 12 years ago. Using a summary health index designed for this study, we find that those born 1948 to 1953 share health risks with the War Baby cohort. This suggests that most of the health decline instead began before the late 1940’s. A more complex set of health conclusions emerges from the specific self-reported health measures. Boomers indicate they have relatively more difficulty with a range of everyday physical tasks, but they also report having more pain, more chronic conditions, more drinking and psychiatric problems, than their HRS earlier counterparts. This trend portends poorly for the future health of Boomers as they age and incur increasing costs associated with health care and medications. Using our health index, only those at the 75th percentile or higher are likely to be characterized as having good or better health.Publication Cross-Cohort Differences in Health on the Verge of Retirement(2006-09-01) Soldo, Beth J; Mitchell, Olivia S; Tfaily, Rania; McCabe, John FBaby Boomers have left a unique imprint on US culture and society in the last 60 years, and it might be anticipated that they will also put their own stamp on retirement, the last phase of the life cycle. Yet because Boomers have not all fully retired, we cannot yet judge how they will fare as retirees. Instead, we focus on how this group compares with prior groups on the verge of retirement, that is, at ages 51-56. Accordingly, this chapter evaluates the stock of health which Early Boomers bring to retirement and compare these to the circumstances of two prior cohorts at the same point in their life cycles. Using three sets of responses from the Health and Retirement Study, we find some interesting patterns. Overall, the raw evidence indicates that Boomers on the verge of retirement are in poorer health their counterparts 12 years ago. Using a summary health index designed for this study, we find that those born 1948 to 1953 share health risks with the War Baby cohort. This suggests that most of the health decline instead began before the late 1940’s. A more complex set of health conclusions emerges from the specific self-reported health measures. Boomers indicate they have relatively more difficulty with a range of everyday physical tasks, but they also report having more pain, more chronic conditions, more drinking and psychiatric problems, than their HRS earlier counterparts. This trend portends poorly for the future health of Boomers as they age and incur increasing costs associated with health care and medications. Using our health index, only those at the 75th percentile or higher are likely to be characterized as having good or better health.Publication Childhood Predictors of Late-Life Diabetes: The Case of Mexico(2005-09-01) Kohler, Iliana V; Soldo, Beth JWe investigated the interplay between characteristics of early childhood circumstances and current socioeconomic conditions and health, focusing specifically on diabetes in mid and late life in Mexico. The analysis used data from the 2001 Mexican Health and Aging Study (MHAS), a large nationally representative study of Mexicans born before 1950. We analyzed the extent to which childhood conditions, such as exposure to infectious diseases, a poor socioeconomic environment, and parental education, affect the risk of diabetes in later life. Our results indicate that individuals age 50 and older who experienced serious health problems before age 10 have a higher risk of having late-life diabetes. There is a significant inverse relationship between maternal education and diabetes in late life of adult offspring. Individuals with better educated mothers have a lower risk of being diabetic after age 50. This relationship remains after controlling for other childhood and adult risk factors.Publication Evaluating Health and Disease in Sub-Saharan Africa: Minimally Invasive Collection of Plasma in the Malawi Longitudinal Study of Families and Health (MLSFH)(2012-07-30) Kohler, Iliana V.; Anglewicz, Philip; Kohler, Hans-Peter; McCabe, John F.; Chilima, Ben; Soldo, Beth J.Background: The collection of biomarker-based indicators of adult health and fitness is an important addition to socioeconomic surveys since these indicators provide valuable insights into the biological functions, and the complex causal pathways between socioeconomic environments and health of adult individuals. Other than select Demographic and Health Surveys (DHS), there are almost no population-based sources of biomarker-based indicators of adult health in sub-Saharan Africa (SSA), where most population-based biologic data are focused on HIV, other STDs, malaria, or nutritional status. While infectious diseases---such as HIV and malaria---attract the majority of research and NGOs attention in sub-Saharan Africa, there is an important need to understand the general determinants of adult health in SSA since the region will rapidly age in the next decades in ways that are significantly different from the aging patterns in other developing regions due to the AIDS epidemic, and chronic diseases will increasingly become relevant for understanding the health of sub-Saharan populations. Methods and Design: We document our protocol for the collection of biomarker-based health indicators as a pilot project within the Malawi Longitudinal Study of Families and Health (MLSFH), and we provide basic descriptive information about the study population and the collected biomarker-based indicators of adult health obtained from respondents in rural Malawi. LabAnywhere kits were used to obtain blood plasma from 980 adult men and women living in Balaka, the southern-most region in rural Malawi. The procedure allows for the non-invasive collection of blood plasma, but has not been been previously used in the context of a developing country. We collected biomarkers for inflammation and immunity, lipids, organ function, and metabolic processes. We specifically collected wide-range CRP, total cholesterol, LDL, HDL, total protein, urea, albumin, blood urea nitrogen, creatinine, random blood glucose and HbA1c assays. Overall, the mean values of the biomarkers are below the lower limits of clinical guidelines for adult populations in the U.S. and other developed countries, and only small proportions of the sample are above the upper limits of the normal clinical ranges as defined by U.S. standards. The correlationional patterns of the collected biomarkers are consistent with observations from developed countries, and the comparison with other low-income populations such as the Tsimane in Bolivia or the Yakuts in Siberia show remarkably similar age-specific patterns of the biomarkers despite differences in the mode of blood sampling. Discussion: The MLSFH biomarker sample makes a potentially important contribution to understanding the health of the adult populations in low income environments. The present study confirms that the collection of such biomarkers using the LabAnywhere system is feasible in rural sub-Saharan contexts: the refusal rate was very low in the MLSFH and following the procedures described above, only a small fraction of the biomarker samples could not be analyzed by LabAnywhere. The system therefore provides an attractive alternative to the collection of dried blood spots (DBS) and venous blood samples, providing a broader range of potential biomarkers than DBS and being logistically easier than the collection of venous blood.Publication Using Anthropometric Indicators for Mexicans in the United States and Mexico to Understand the Selection of Migrants and the "Hispanic Paradox"(2005-09-01) Soldo, Beth J; Crimmins, Eileen M; Alley, Dawn; Kim, Jung KiAnthropometric measures including height provide an indication of childhood health that allows exploration of relationships between early life circumstances and adult health. Height can also be used to provide some indication of how early life health is related to selection of migrants and the Hispanic paradox in the United States. This article joins information on persons of Mexican nativity ages 50 and older in the United States collected in the National Health and Nutrition Examination Survey IV (NHANES IV 1999-2002) with a national sample of persons of the same age living in Mexico from the Mexican Health and Aging Survey (MHAS 2001) to examine relationships between height, education, migration, and late-life health. Mexican immigrants to the United States are selected for greater height and a high school, rather than higher or lower, education. Return migrants from the United States to Mexico are shorter than those who stay. Height is related to a number of indicators of adult health. Results support a role for selection in the Hispanic paradox and demonstrate the importance of education and childhood health as determinants of late-life health in both Mexico and the United States.