Saving and consumption patterns of the elderly

The paper provides an empirical analysis of saving and consumption choices of the elderly in Germany, based on the German income and expenditure surveys 1978 and 1983. Main feature of these data is the large sample size making it possible to analyze saving and consumption patterns of the very old (aged 75 and above).The observed age-consumption profiles are very different from those predicted by the pure life-cycle theory. Although wealth is declining between age 60 and 70, it increases again after 70, such that the very old have the highest savings rates among all age groups and accumulate wealth rather than decumulate it. These profiles are not confounded by cohort effects and mortality differences. The corresponding expenditure data suggest the following explanation: due to the generous German pension system and the almost complete coverage of health expenses by the mandatory health insurance in Germany, the declining consumption n very old age cannot exhaust the annuity income of the elderly such that wealth is being accumulated in old age.Research in this paper was supported by the National Institute on Aging, grant no. 3 PO1 AG05842-01. I appreciate the helpful comments by Doug Bernheim, Angus Deaton, Daniel McFadden, Jonathan Skinner, Konrad 'Stahl and David Wise, and two anonymous referees. I am indebted to Hermann Buslei and Johannes Velling who provided most valuable and able assistance.     

Problems in measuring role strains and social functioning in relation to psychological symptoms

The problems that people experience in social roles can be regarded as either causes or consequences of psychological symptoms. To reflect one of these possibilities, Pearlin et al. (1981) developed measures of "role strains" which are considered sources of psychopathology. To reflect the other position, Dohrenwend et al. (1981) constructed measures of "role functioning" which are seen as consequences of psychopathology. We show that the measures developed by these two teams of investigators are similar in content and show substantial empirical overlap despite the different meanings attributed to them. In an effort to understand whether these highly correlated measures assess, "role strain" or "role functioning," we conduct an exploratory analysis of marital and housework role problems, using a small panel sample of New York City residents. Specifically, we use instrumental variables to identify reciprocal effects between psychological distress and each role area. We find that the relationship between housework role problems and distress is more consistent with Pearlin et al.'s interpretation, whereas the relationship between marital problems and distress is more consistent with that of Dohrenwend et al. Investigators interested in measuring either role strain or role functioning must bear in mind the strong possibility of contamination from the other construct.     

Medicine and the question of suffering

Doctors are not health care providers, and medicine is not a commodity. To practice medicine well, the doctor must attend to each patient as a whole person and be faithful in giving care when cure is not possible.     

Recent trends in the process of stratification

Using the 14 annual cross-sections from the General Social Survey, we specify a "basic model" of attainment and describe the year-by-year fluctuations in its parameters. The results are partially consistent with theories describing the gradual growth of universalistic patterns of stratification and mobility. Under a linear model of educational achievement, we find that the direct effects of race are weakening and the returns to class-based advantages are declining in tandem. The contours of the socioeconomic "gender gap" are also changing in important ways, with the male intercept declining at a rapid pace and the female term registering small and insignificant year-by-year gains. At the same time, the returns to experience and schooling are increasing for men, whereas the corresponding returns for women have remained stable over the 15-year period. This pattern of interaction effects implies that the size of the gender gap varies over time and across different population groups.     

An analysis of indirect mortality estimation

Abstract In this paper the robustness of Brass's child-survivorship indirect mortality estimation technique is investigated. An analytical method is developed for studying the error or bias caused in indirect mortality estimates by poor data, badly chosen model functions, and specific demographic assumptions that are often violated in practice. The resulting analytical expressions give insight into the rationale of indirect methods, the conditions under which they are robust, and the magnitude of errors that occur when specific assumptions are violated.     

Assessment of patient satisfaction: development and refinement of a service evaluation questionnaire

A series of seven studies was conducted by the authors and their colleagues to produce an efficient measure of service satisfaction that can easily be related to symptom level, demographic characteristics, and type and extent of service utilization. The resulting measure, the Service Evaluation Questionnaire (SEQ) is a brief, global index that has excellent internal consistency and solid psychometric properties. Data from an extensive SEQ field study can be used as a comparison base for future applications of the two SEQ component scales, the CSQ-8 and the SCL-10. A new hypothesis has emerged from this series of studies that will guide future research: Service recipients may find if difficult to formally express dissatisfaction in the face of significant caring--however ineffectual--when the technical capacity to offer definitive treatment is not yet fully developed and when criteria for evaluating the efficacy of treatment are not yet crystal clear.