CESR Events Archive

Monday, January 26
12pm – 1pm
VPD 203

Abstract:

Background: Family care resources have profound implications for care use among those with functional limitations, especially when coupled with dementia. A better understanding of family availability among those at high risk of dementia is important to predict care transitions at the onset of dementia and subsequent years.

Methods: Using Health and Retirement Study (HRS) data, we developed a holistic measure of family care availability (FCA) for adults 55+ who will have dementia onset within the next two years and have disability. We incorporated multiple family contextual factors, considering presence, disability status, geographic proximity, and working status. We conducted cluster analysis to identify groups based on FCA measures specific to relationship type (spouse, adult child, sibling, grandchild). We then examined variation in FCA across population groups and assessed nursing facility utilization at the onset and over the course of dementia.

Results: Of the 2,119 sample persons, 54% did not have a spouse, and 6% did not have an adult child at baseline (i.e., 2 years prior to the onset of dementia). The overall FCA index ranges from 0 to 100, with a mean of 32.0 (SD = 20.6). The distribution of the FCA index was primarily shaped by the spousal and child availability. FCA is significantly lower at ages 85+ compared to 65-84 (26.0 vs. 33.4-36.7; p<0.001). Males’ FCA is substantially greater compared to females (38.9 vs. 27.2; p<0.001). Hispanics have significantly higher FCA than Non-Hispanic Whites and Blacks (37.02 vs. 30.0-31.6; p<0.001). Adults with some college education and above have a greater FCA index compared to adults with a high school education (35.7 vs. 29.4; p<0.001). Cluster analysis identified three distinctive groups: high spousal availability (N=552); high adult-child-availability (N=497); and low spouse- and low adult-child-availability  (N=1,292). Those in the high adult-child-availability group are significantly less likely to use nursing facilities than those in the low spouse- and low child-availability group at dementia onset and subsequent years.

Conclusion: The FCA index, a holistic measure of family availability to care, will help identify vulnerable populations lacking family care resources and predict care transitions at the onset and over the course of dementia.

Bio:

Dr. HwaJung Choi is an Associate Professor at Internal Medicine, School of Medicine, and Health Management and Policy, School of Public Health, University of Michigan. She is also a Faculty Associate at the Institute for Social Research (ISR), University of Michigan. She was a Fulbright scholar and received Ph.D. in Economics at the University of Michigan.

Dr. Choi is an economist and family demographer whose research focuses on family and community contextual factors and their implications for health and care use among older adults with physical and cognitive limitations. Dr. Choi also examines trends and cross-national differences in health and disability outcomes. She is awarded large research grants from the National Institute on Aging as PI, which support the following studies: to assess the impacts of Covid19 pandemic on care use among adults with dementia (R01AG075002); to examine the implications of residential location for disability and cognitive function outcomes (R01AG080491); to develop and evaluate new measures of family care availability (RF1AG083037). Dr. Choi is a Co-lead of the Research and Education Core at the Michigan Center for Contextual Factors in Alzheimer’s Disease and supports early-career scientists in advancing their research and training on contextual factors related to dementia risk and care.

Thursday, January 15
9am – 10am
Zoom (See email for Zoom link)

Abstract: Much is known about how parental resources shape the human capital of children, but far less is known about the role of parental traits and behaviors. Using unique data from the Lifelines Cohort Study linked to administrative records, we study the intergenerational effects of a random increase in parental genetic predisposition for externalizing behavior. There are three main findings. First, a stronger predisposition for externalizing behavior is a strong predictor of hostile behavior, attention deficit disorder, and substance abuse, but is less strongly related to education or income. Second, this predisposition leads to sizeable reductions in the education of the next generation. Third, these intergenerational effects cannot be explained by the genetic endowments of children. Our results thus present a unique case in which intergenerational effects on education exceed the effects on these outcomes in the first generation.

This project is joint work with Sander de Vries

Bio: Sjoerd van Alten is an economist researching the genetic and environmental determinants that shape inequalities in human capital, health, and labor market outcomes. He investigates these topics as a Postdoc Researcher at the School of Business Economics (SBE) at the Vrije Universiteit Amsterdam. Additionally, some of his work focuses on the effects of selection bias in large-scale Biobanks that are widely used in medicine, epidemiology, statistical genetics, and the social sciences.

He has authored and published various papers on these topics in outlets such as Nature Communications, Nature Genetics, and Intergenerational Journal of Epidemiology. In 2024, he completed his PhD-thesis “Genetics, Human Capital Formation and the Intergenerational Transmission of Socioeconomic Status” at Vrije Universiteit Amsterdam and Tinbergen Institute, under supervision of Titus Galama, Maarten Lindeboom, and Kevin Thom (UW-Milwaukee).