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Exploring the Retirement Consumption Puzzle

July 14, 2014 Comments off

Exploring the Retirement Consumption Puzzle
Source: Journal of Financial Planning

Executive Summary

  • Empirical research on retiree spending has noted a “retirement consumption puzzle,” where retiree expenditures tend to decrease both upon and during retirement. This decrease in spending is inconsistent with general economic theories on consumption, which suggest individuals seek to maintain constant consumption over their lifetimes.
  • Government data on consumption was analyzed in this study to understand how retiree consumption actually changes over time.
  • The results of the analysis suggest that although the retiree consumption basket is likely to increase at a rate that is faster than general inflation, actual retiree spending tends to decline in retirement in real terms. This decrease in real consumption averages approximately 1 percent per year during retirement.
  • A “retirement spending smile” effect is noted. This finding has important implications when estimating retirement withdrawal rates and determining optimal spending strategies.
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Vulnerability of Social Institutions

July 11, 2014 Comments off

Vulnerability of Social Institutions
Source: OECD

Future generations will pay a high price if we fail to reform pension, health care and unemployment schemes. Social institutions will be tested in the coming years by ageing and slowing growth that threaten their sustainability and the adequacy of their deliveries, undermining the risk sharing that social institutions provide. In the face of these challenges, social institutions need to be reformed and adjusted regularly to adapt to trend changes and to shocks with-long lasting effects.

America’s Young Adults — Special Issue 2014

July 11, 2014 Comments off

America’s Young Adults — Special Issue 2014
Source: Federal Interagency Forum on Child and Family Statistics

The well-being of young adults in the United States today remains an area of key interest to the public and policy-makers alike. This age group faces the well-known challenges of achieving financial and social independence while forming their own households at a time of greater economic uncertainty than in the past. Better understanding of the achievements and needs of these young adults will inform approaches to best support this exciting and challenging transition to adulthood.

Over the 20 years since it held its first organizational meetings, the Federal Interagency Forum on Child and Family Statistics (the Forum) has established a tradition of cooperation and commitment to understanding the challenges and opportunities facing children and families today. This year, in a Special Issue on America’s Young Adults, the Forum extends that commitment to describing the well-being of youth as they transition into adulthood. Next year, the Forum will issue its customary full report, America’s Children: Key National Indicators of Well-Being.

HHS — Elder Justice Roadmap Project Report

July 10, 2014 Comments off

Elder Justice Roadmap Project Report (PDF)
Source: U.S. Department of Health and Human Services (National Center on Elder Abuse)

The Top Five Priorities critical to understanding and reducing elder abuse and to promoting health, independence, and justice for older adults, are:
1. Awareness: Increase public awareness of elder abuse, a multi-faceted problem that requires a holistic, well-coordinated response in services, education, policy, and research.
2. Brain health: Conduct research and enhance focus on cognitive (in)capacity and mental health – critical factors both for victims and perpetrators.
3. Caregiving: Provide better support and training for the tens of millions of paid and unpaid caregivers who play a critical role in preventing elder abuse.
4. Economics: Quantify the costs of elder abuse, which is often entwined with financial incentives and comes with huge fiscal costs to victims, families and society.
5. Resources: Strategically invest more resources in services, education, research, and expanding knowledge to reduce elder abuse.

Hat tip: PW

Prevalence of Incontinence Among Older Americans

July 9, 2014 Comments off

Prevalence of Incontinence Among Older Americans (PDF)
Source: National Center for Health Statistics

Objective
This report presents national estimates of incontinence prevalence in the United States using data source-specific definitions of incontinence among persons aged 65 and over by sociodemographic characteristics during 2007–2010.

Methods
Data are from the 2007–2010 National Health and Nutrition Examination Survey (NHANES), the 2010 National Survey of Residential Care Facilities (NSRCF), the 2007 National Home and Hospice Care Survey (NHHCS), and the 2009 Long Term Care Minimum Data Set (MDS). Findings are based on in-home interviews with 2,625 noninstitutionalized respondents (NHANES) and reports provided by designated facility or agency staff members for 6,856 residential care facility (RCF) residents (NSRCF), 3,226 current home health care patients (NHHCS), 3,918 hospice discharges (NHHCS), and 2,416,705 nursing home residents (MDS). Response rates for incontinence questions were 84% among noninstitutionalized persons (NHANES), 98% among RCF residents and home health and hospice care patients (NSRCF and NHHCS), and 99% for nursing home residents (MDS).

Results
This is the first report presenting national estimates on incontinence for subpopulations of older persons sampled in the Centers for Disease Control and Prevention’s National Center for Health Statistics surveys and the Centers for Medicare & Medicaid Services’ Long Term Care Minimum Data Set. Because a different definition of incontinence is used by each data collection system, it is not possible to make data comparisons between them or to summarize results across all surveys. Accordingly, only survey-specific results are presented. Including recent data from all of these data collection systems facilitates a multidimensional picture of incontinence, while underscoring the need for a standardized definition.

The Great Society, Reagan’s revolution, and generations of presidential voting

July 9, 2014 Comments off

The Great Society, Reagan’s revolution, and generations of presidential voting (PDF)
Source: Columbia University (Ghitza and Gelman)

We build a generational model of presidential voting, in which long-term partisan presidential voting preferences are formed, in large part, through a weighted “running tally” of retrospective presidential evaluations, where weights are determined by the age in which the evaluation was made. Under the model, the Gallup Presidential Approval Rating time series is shown to be a good approximation to the political events that inform retrospective presidential evaluations. The political events of a voter’s teenage and early adult years, centered around the age of 18, are enormously important in the formation of these longterm partisan preferences. The model is shown to be powerful, explaining a substantial amount of the macro-level voting trends of the last half century, especially for white voters and non-Southern whites in particular. We use a narrative of presidential political events from the 1940s to the present day to describe the model, illustrating the formation of five main generations of presidential voters.

Young First-Time Mothers Less Likely to be Married, Census Bureau Reports

July 8, 2014 Comments off

Young First-Time Mothers Less Likely to be Married, Census Bureau Reports
Source: U.S. Census Bureau

The percentage of young first-time mothers who are married is dropping, according to Fertility of Women in the United States: 2012, a report released today by the U.S. Census Bureau.

In the early 1990s, at least half of all first births to mothers younger than age 23 occurred in marriage. Since 2005, more young mothers were cohabiting (38 percent) than were married (24 percent) at the time of their first birth. However, the majority of all women continue to have their first child within marriage.

Fertility of Women in the United States: 2012 uses data from the 2012 American Community Survey and the 2012 Current Population Survey. The report examines women’s marital status at the time of their first births, the completed fertility of women up to age 50 and the fertility patterns of young women. Fertility patterns are shown by race, ethnicity, age, citizenship and employment status, as well as state of residence.

The State of the Nation’s Housing 2014

July 7, 2014 Comments off

The State of the Nation’s Housing 2014
Source: Joint Center for Housing Studies of Harvard University
From press release:

The U.S. housing recovery should regain its footing, but also faces a number of challenges, concludes The State of the Nation’s Housing report released today by the Joint Center for Housing Studies of Harvard University. Tight credit, still elevated unemployment, and mounting student loan debt among young Americans are moderating growth and keeping millennials and other first-time homebuyers out of the market.

Although the housing industry saw notable increases in construction, home prices, and sales in 2013, household growth has yet to fully recover from the effects of the recession. Young Americans, saddled with higher-than-ever student loan debt and falling incomes, continue to live with their parents. Indeed, some 2.1 million more adults in their 20s lived with their parents last year, and student loan balances increased by $114 billion.

Still, given the sheer volume of young adults coming of age, the number of households in their 30s should increase by 2.7 million over the coming decade, which should boost demand for new housing.

Overview of Emergency Department Visits in the United States, 2011

July 4, 2014 Comments off

Overview of Emergency Department Visits in the United States, 2011
Source: Agency for Healthcare Research and Quality

Emergency departments (EDs) provide a significant source of medical care in the United States, with over 131 million total ED visits occurring in 2011. Over the past decade, the increase in ED utilization has outpaced growth of the general population, despite a national decline in the total number of ED facilities. In 2009, approximately half of all hospital inpatient admissions originated in the ED. In particular, EDs were the primary portal of entry for hospital admission for uninsured and publicly insured patients (privately insured patients were more likely to be directly admitted to the hospital from a doctor’s office or clinic).

ED utilization reflects the greater health needs of the surrounding community and may provide the only readily available care for individuals who cannot obtain care elsewhere. Many ED visits are “resource sensitive” and potentially preventable, meaning that access to high-quality, community-based health care can prevent the need for a portion of ED visits.

This HCUP Statistical Brief presents data on ED visits in the United States in 2011. Patient and hospital characteristics for two types of ED visits are provided: ED visits with admission to the same hospital and ED visits resulting in discharge, which includes patients who were stabilized in the ED and then discharged home, transferred to another hospital, or any other disposition. The most frequent conditions treated by patient age group also are presented for both types of ED visits. All differences between estimates noted in the text are statistically significant at the .0005 level or better.

Sexting and Sexual Behavior Among Middle School Students

July 3, 2014 Comments off

Sexting and Sexual Behavior Among Middle School Students
Source: Pediatrics

OBJECTIVE:
It is unknown if “sexting” (ie, sending/receiving sexually explicit cell phone text or picture messages) is associated with sexual activity and sexual risk behavior among early adolescents, as has been found for high school students. To date, no published data have examined these relationships exclusively among a probability sample of middle school students.

METHODS:
A probability sample of 1285 students was collected alongside the 2012 Youth Risk Behavior Survey in Los Angeles middle schools. Logistic regressions assessed the correlates of sexting behavior and associations between sexting and sexual activity and risk behavior (ie, unprotected sex).

RESULTS:
Twenty percent of students with text-capable cell phone access reported receiving a sext and 5% reported sending a sext. Students who text at least 100 times per day were more likely to report both receiving (odds ratio [OR]: 2.4) and sending (OR: 4.5) sexts and to be sexually active (OR: 4.1). Students who sent sexts (OR: 3.2) and students who received sexts (OR: 7.0) were more likely to report sexual activity. Compared with not being sexually active, excessive texting and receiving sexts were associated with both unprotected sex (ORs: 4.7 and 12.1, respectively) and with condom use (ORs: 3.7 and 5.5, respectively).

CONCLUSIONS:
Because early sexual debut is correlated with higher rates of sexually transmitted infections and teen pregnancies, pediatricians should discuss sexting with young adolescents because this may facilitate conversations about sexually transmitted infection and pregnancy prevention. Sexting and associated risks should be considered for inclusion in middle school sex education curricula.

Dating Violence Among Male and Female Youth Seeking Emergency Department Care

July 3, 2014 Comments off

Dating Violence Among Male and Female Youth Seeking Emergency Department Care
Source: Annals of Emergency Medicine

Study objective
We determine prevalence and correlates of dating violence, dating victimization, and dating aggression among male and female patients aged 14 to 20 years seeking emergency department (ED) care.

Methods
This was a systematic sampling of subjects aged 14 to 20 years seeking care at a single large academic ED between September 2010 and March 2013. Participants completed a computerized, self-administered, cross-sectional survey of demographics, dating violence from physical abuse measures of the Conflict in Adolescent Dating Relationships Inventory, associated behaviors, and ED health service use. Separate analyses were conducted for male and female patients.

Results
Four thousand three hundred eighty-nine youths (86.1% participation rate) were screened, and 4,089 (mean age 17.5 years; 58% female patients) were eligible for analysis. Almost 1 in 5 female patients (n=215; 18.4%) and 1 in 8 male patients (n=212; 12.5%) reported past-year dating violence. Of female patients, 10.6% reported dating victimization and 14.6% dating aggression, whereas of male patients, 11.7% reported dating victimization and 4.9% reported dating aggression. Multivariate analyses showed that variables associated with any male dating violence were black race (adjusted odds ratio [AOR] 2.26; 95% CI 1.54 to 3.32), alcohol misuse (AOR 1.03; 95% CI 1.00 to 1.06), illicit drug use (AOR 2.38; 95% CI 1.68 to 3.38), and depression (AOR 2.13; 95% CI 1.46 to 3.10); any female dating violence was associated with black race (AOR 1.68; 95% CI 1.25 to 2.25), public assistance (AOR 1.64; 95% CI 1.28 to 2.09), grades D and below (AOR 1.62; 95% CI 1.07 to 2.43), alcohol misuse (AOR 1.04; 95% CI 1.02 to 1.07), illicit drug use (AOR 2.85; 95% CI 2.22 to 3.66), depression (AOR 1.86; 95% CI 1.42 to 2.44), and any past year ED visit for intentional injury (AOR 2.64; 95% CI 1.30 to 5.40).

Conclusion
Nearly 1 of 6 male and female patients aged 14 to 20 years and seeking ED care report recent dating violence, and health disparities remain among this population. Dating violence was strongly associated with alcohol, illicit drug use, and depression and correlated with previous ED service use among female youths. ED interventions should consider addressing these associated health conditions, as well as improving screening protocols to address dating violence among male and female youths.

Eight in Ten Millennials Say Great Recession Taught Them to Save “Now,” Wells Fargo Survey Finds

July 3, 2014 Comments off

Eight in Ten Millennials Say Great Recession Taught Them to Save “Now,” Wells Fargo Survey Finds
Source: Wells Fargo

As millennial Americans have experienced the effects of the Great Recession of 2008, a strong majority (80%) say it has taught them they have to save “now” to “survive” economic problems down the road. Despite this generation’s reported lesson, 45 percent are not saving for retirement, while slightly more than half (55%) are saving. The savings picture varies by gender with 61 percent of men and 50 percent of women reporting that they are saving. This difference in saving rates may hinge on the fact that the median annual household income reported by millennial men is $77,000 versus $56,000 for women. For college-educated millennials, median annual household income is reported to be $83,000 for men and $63,000 for women. About half of all millennials report they are “satisfied” with their savings at this point in their lives, but the gender discrepancy is pronounced, with 58 percent of men feeling satisfied, versus 41 percent of women. These findings are part of the 2014 Wells Fargo Millennial Study, conducted online by Harris Poll on behalf of Wells Fargo, released today at a Women’s Institute For A Secure Retirement (WISER®) forum in Washington, DC. The survey was conducted among over 1,600 U.S. adults aged 22-33 (“millennials”), and among over 1,500 U.S. adults aged 49-59 (“baby boomers”).

“The silver lining of the recession that started over five years ago is that a majority of millennials get that saving is a necessity and even equate it with ‘surviving’ tough times. But millennial women are starting out their working lives making far less than men and, as a consequence, are saving less and feeling less contentment at the start of their working lives,” said Karen Wimbish, director of Retail Retirement at Wells Fargo.

The Pressure of Debt
Millennials are struggling under the pressure of debt, with 42 percent saying “it is their biggest financial concern currently.” Four in ten say their debt is “overwhelming” versus 23 percent of baby boomers. Forty-five percent of millennial women feel “overwhelmed” by debt, versus 33 percent of millennial men. Perhaps due to big debt obligations, over half of the millennials (56%) say they are “living paycheck to paycheck,” regardless of gender.

What Kind of Debt?
When asked to rank their number one financial concern after paying day-to-day bills, millennials cite paying off student loans (29%) as their top concern, whereas boomers cite saving for retirement (44%). When asked to estimate certain categories of debt as a percentage of monthly pay, millennials report their debt breaks down, on average, as follows: credit card debt, 16 percent; mortgage debt, 15 percent; student loan debt, 12 percent; auto debt, 9 percent; and medical debt, 5 percent. Among all millennials, 47 percent are allocating 50 percent or more of their paychecks to these types of debt.
“People have to closely examine what they are spending their money on and figure out the best way to comfortably manage debt and savings levels,” said Wimbish.

From Living Arrangements to Labor Force Participation, New Analysis Looks at State of the Nation’s 65-and-Older Population

July 2, 2014 Comments off

From Living Arrangements to Labor Force Participation, New Analysis Looks at State of the Nation’s 65-and-Older Population
Source: U.S. Census Bureau

A new report released today by the U.S. Census Bureau provides the latest, comprehensive look at the nation’s population aged 65 and older, comprising 40.3 million in 2010.

The 65+ in the United States: 2010 report contains many findings about the 65-and-older population on topics such as socio-economic characteristics, size and growth, geographic distribution, and longevity and health. For example, Americans 65 and older living in a nursing home fell 20 percent between 2000 and 2010, from 1.6 million to 1.3 million. Meanwhile, the share in other care settings has been growing.

In the report, a number of trends and characteristics are separated by age, sex, race and Hispanic origin for the older population. The report incorporates research and findings from many recent studies that draw heavily from the 2010 Census and nationally representative surveys, such as the Current Population Survey, American Community Survey and National Health Interview Survey.

Boomers & Vacation Plans: An AARP Bulletin Survey

July 1, 2014 Comments off

Boomers & Vacation Plans: An AARP Bulletin Survey
Source: AARP

Key Findings:

  • About six-in-ten (57%) American Boomers say they are planning to take an overnight vacation within the next 12 months.
  • Among those Boomers who have planned to take an overnight vacation in the next 12 months, about seven-in-ten (68%) report they are planning to take more than one overnight vacation, while three-in-ten (29%) report they are planning to make only one overnight vacation.
  • About half (47%) of Boomers who have an overnight vacation planned in the next 12 months, say they are planning for one to two weeks away on vacation, while one-third (34%) say they are planning for more than two weeks away on vacation.
  • Half (49%) of Boomers who have an overnight vacation planned in the next 12 months say they are planning to spend $1,000 to less than $5,000 for their overnight vacations. However, one-third (34%) say they are planning to spend less than $1,000 while eight-in-ten (13%) say they are planning to spend $5,000 or more for their overnight vacations.
  • The high majority (56%) of Boomers who have an overnight vacation planned in the next 12 months say their spouse or partner will be going with them, and one-in-seven (15%) say their child/children will be going with them, while one-in-six (17%) Boomers say they are planning on going self/alone for their vacation.
  • Two-thirds (64%) of Boomers say they will be going to another state within the U.S. and one-in-five (20%) report they will be vacationing within their own state. But, one-in-five (19%) Boomers report going out of the country for their vacation in the next 12 months.
  • The highest proportion of Boomers, who are planning for an out of country vacation, are planning on going to Europe (38%), followed by Latin or South America (21%), Caribbean (13%), and Canada (10%).

While asking about the motive for their overnight vacation within the next 12 months, most of Boomers say the main reason is either “To see, connect, or spend time with family and/or friends” (45%), or “For a pure fun, or relaxation” (38%).

As the Nation Ages, Seven States Become Younger, Census Bureau Reports

June 30, 2014 Comments off

As the Nation Ages, Seven States Become Younger, Census Bureau Reports
Source: U.S. Census Bureau

The median age declined in seven states between 2012 and 2013, including five in the Great Plains, according to U.S. Census Bureau estimates released today. In contrast, the median age for the U.S. as a whole ticked up from 37.5 years to 37.6 years. These estimates examine population changes among groups by age, sex, race and Hispanic origin nationally, as well as all states and counties, between April 1, 2010, and July 1, 2013.

“We’re seeing the demographic impact of two booms,” Census Bureau Director John Thompson said. “The population in the Great Plains energy boom states is becoming younger and more male as workers move in seeking employment in the oil and gas industry, while the U.S. as a whole continues to age as the youngest of the baby boom generation enters their 50s.”

The largest decline in the nation was in North Dakota, with a decline of 0.6 years between 2012 and 2013. The median age in four other Great Plains states — Montana, Wyoming, South Dakota and Oklahoma — also dropped. Alaska and Hawaii also saw a decline in median age. (See Table 1.) In addition, the median age fell in 403 of the nation’s 3,143 counties, many of which were in the Great Plains. Williams, N.D., the center of the Bakken shale energy boom, led the nation with a decline of 1.6 years. Next to Alaska, North Dakota had a heavier concentration of males (51.1 percent of the total population) than any other state.

The nation as a whole grew older as the oldest baby boomers became seniors. The nation’s 65-and-older population surged to 44.7 million in 2013, up 3.6 percent from 2012. By comparison, the population younger than 65 grew by only 0.3 percent.

These statistics released today also include population estimates for Puerto Rico and its municipios by age and sex.

Our nation is a study in contrasts when it comes to local age structure. There was a more than 42-year difference in the median ages of the county with the highest median age — Sumter, Fla., at 65.5 — and the county with the youngest median age — Madison, Idaho, at 23.1.

New Older Driver Data Trends in Upward Direction

June 27, 2014 Comments off

New Older Driver Data Trends in Upward Direction
Source: AAA Foundation for Traffic Safety

According to a new report from the AAA Foundation for Traffic Safety, older Americans are extending their time behind the wheel compared to previous generations. For example, 84 percent of Americans 65 and older held a driver’s license in 2010 compared to barely half in the early 1970s. Today, one in six drivers on U.S. roads are ages 65 and older and this new research shows an increased automobility of older drivers with travel patterns indicating about a 20 percent increase in trips and a 33 percent increase in miles travelled between 1990 and 2009.

While upward trends indicate greater mobility for the silver tsunami, the Understanding Older Drivers: An Examination of Medical Conditions, Medication Use and Travel Behaviors report reveals that 90 percent of older drivers also use prescription medications with two-thirds taking multiple medications. Previous Foundation research has shown that combinations of medications, both prescription and over- the-counter, can result in an impairment in safe driving ability.

The report also reveals gender differences when it comes to medication-use behind the wheel. Older women that use medications are more likely to regulate their driving compared to men and, even without a medical condition, female drivers drive less than their male counterparts with a medical condition.

Interactive Metro Map: Baby Boomers Gaining Jobs, Millennials Standing Pat

June 26, 2014 Comments off

Interactive Metro Map: Baby Boomers Gaining Jobs, Millennials Standing Pat
Source: EMSI

Call it the great job stagnation for millennials, and the late-career proliferation of baby boomers.

The number of young workers aged 22-34 nationwide is basically unchanged since 2007, while the number of jobs for boomers (55-64) — fueled by mega population growth — has climbed 9% over that time, according to a new analysis from EMSI and CareerBuilder.

The stark contrast between millennials and baby boomers in the workforce is clearly portrayed in an accompanying interactive map from Tableau Software. Many of the the 175 most populous metros have seen a drawback in millennial jobs (losses represented by the huge number of red bubbles). Toggle to the baby boomer section of the map, however, and you’ll see a sea of green (representing job gains). Only six of the top 175 metros have fewer boomer jobs than in 2007, and the declines are small by comparison.

Home Hours in the United States and Europe

June 26, 2014 Comments off

Home Hours in the United States and Europe
Source: Federal Reserve Bank of Atlanta

Using data from the Multinational Time Use Study, this paper documents the trends and levels of time allocation, with a focus on home hours, for a relatively large set of industrialized countries during the past 50 years. Three patterns emerge. First, home hours have decreased in both the United States and European countries. Second, female time allocation contributes more to the cross-country difference in both the trends and the levels of market hours and home hours per person. Third, time allocations between the United States and Europe are more similar for the prime-age group than for the young and old groups.

School mental health services: signpost for out-of-school service utilization in adolescents with mental disorders? A nationally representative United States cohort

June 25, 2014 Comments off

School mental health services: signpost for out-of-school service utilization in adolescents with mental disorders? A nationally representative United States cohort
Source: PLoS ONE

Background
School mental health services are important contact points for children and adolescents with mental disorders, but their ability to provide comprehensive treatment is limited. The main objective was to estimate in mentally disordered adolescents of a nationally representative United States cohort the role of school mental health services as guide to mental health care in different out-of-school service sectors.

Methods
Analyses are based on weighted data (N = 6483) from the United States National Comorbidity Survey Replication Adolescent Supplement (participants’ age: 13–18 years). Lifetime DSM-IV mental disorders were assessed using the fully structured WHO CIDI interview, complemented by parent report. Adolescents and parents provided information on mental health service use across multiple sectors, based on the Service Assessment for Children and Adolescents.

Results
School mental health service use predicted subsequent out-of-school service utilization for mental disorders i) in the medical specialty sector, in adolescents with affective (hazard ratio (HR) = 3.01, confidence interval (CI) = 1.77–5.12), anxiety (HR = 3.87, CI = 1.97–7.64), behavior (HR = 2.49, CI = 1.62–3.82), substance use (HR = 4.12, CI = 1.87–9.04), and eating (HR = 10.72, CI = 2.31–49.70) disorders, and any mental disorder (HR = 2.97, CI = 1.94–4.54), and ii) in other service sectors, in adolescents with anxiety (HR = 3.15, CI = 2.17–4.56), behavior (HR = 1.99, CI = 1.29–3.06), and substance use (HR = 2.48, CI = 1.57–3.94) disorders, and any mental disorder (HR = 2.33, CI = 1.54–3.53), but iii) not in the mental health specialty sector.

Conclusions
Our findings indicate that in the United States, school mental health services may serve as guide to out-of-school service utilization for mental disorders especially in the medical specialty sector across various mental disorders, thereby highlighting the relevance of school mental health services in the trajectory of mental care. In light of the missing link between school mental health services and mental health specialty services, the promotion of a stronger collaboration between these sectors should be considered regarding the potential to improve and guarantee adequate mental care at early life stages.

Improving Dementia Long-Term Care: A Policy Blueprint

June 25, 2014 Comments off

Improving Dementia Long-Term Care: A Policy Blueprint
Source: RAND Corporation

In 2010, 15 percent of Americans older than age 70 had dementia, and the number of new dementia cases among those 65 and older is expected to double by the year 2050. As the baby boomer generation ages, many older adults will require dementia-related long-term services and supports (LTSS). This blueprint is the only national document to date that engages local, state, and national stakeholders to specifically focus on policy options at the intersection of dementia and LTSS.

The authors undertook five major tasks that resulted in a prioritized list of policy options and research directions to help decisionmakers improve the dementia LTSS delivery system, workforce, and financing. These were to (1) identify weaknesses in the LTSS system that may be particularly severe for persons with dementia; (2) review national and state strategies addressing dementia or LTSS policy; (3) identify policy options from the perspective of a diverse group of stakeholders; (4) evaluate the policy options; and (5) prioritize policy options by impact and feasibility.

Stakeholders identified 38 policy options. RAND researchers independently evaluated these options against prespecified criteria, settling on 25 priority options. These policy options can be summarized into five objectives for the dementia LTSS system: (1) increase public awareness of dementia to reduce stigma and promote earlier detection; (2) improve access to and use of LTSS; (3) promote high-quality, person- and caregiver-centered care; (4) provide better support for family caregivers of people with dementia; and (5) reduce the burden of dementia LTSS costs on individuals and families.

This policy blueprint provides a foundation upon which to build consensus among a larger set of stakeholders to set priorities and the sequencing of policy recommendations.

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