Effects of Health Shocks at Older Age on Older Adults and their Families: New Evidence from Large-Scale Administrative Data

About This Grant

PROJECT SUMMARY Family plays a central role in shaping the experiences of aging. Any health shock not only affects the patient but also reverberates throughout the family unit, taking a physical, emotional, and financial toll on family members. The effect on families is likely to be particularly pronounced for health shocks that lead to a pronounced decline in independence, as, for example, happens with the progression of Alzheimer’s Disease and Related Dementias (ADRD). The ways families manage sharp changes in health can have profound effects on both the patient’s well-being and that of their caregivers. Despite the intricate relationship between family dynamics and health outcomes at older ages, public policies and much of the existing research in the U.S. have predominantly focused on individual patients rather than the broader family context. The dearth of evidence relates not to the lack of interest, but to the absence of datasets that could allow studying the effects of health shocks on families. In this project, we propose to start closing this gap in knowledge by leveraging the new extensive U.S. Census Bureau infrastructure for linking administrative data. We will construct and analyze a novel individual-level database that links the health trajectories of older adults to the physical, mental, and economic well-being of their family members across multiple generations, covering twenty-five years from 1999 to 2024. Using this new database, we will comprehensively examine the interdependencies between the mental, physical, and economic well-being of older adults and their families in the United States. First, we will describe the variation in family circumstances of older adults at the time of different health shocks. We will consider variation across demographic groups, local geographies, and socio- economic circumstances. Second, we will use state of the art econometric techniques for causal inference to quantify how much deaths and major but non-fatal health shocks affect the health and economic well-being of family members, including spouses and adult children.