Heath and Aging

Growing Older in America: The Health and Retirement Study

Appendix A

HRS EXPERIMENTAL MODULES

Every wave of the Health and Retirement Study (HRS) contains a set of experimental modules that are administered to a random subsample of respondents. The intent of the modules is to allow HRS investigators, as well as other researchers on aging, to suggest questions that test out new and untried content, have a methodological purpose, or that, in combination with the rest of the HRS data, would permit new research questions to be investigated. For a more detailed inventory of these modules and their use by researchers, visit the HRS website at: http://hrsonline.isr.umich.edu/meta/sho_meta.php?hfyle=modules.

OVERVIEW OF EXPERIMENTAL MODULES

HRS 2002 (Wave 6) Modules
Self-assessed health utilities; willingness to pay for disease prevention; restless leg syndrome, night leg cramps, and neck and shoulder pain; risk aversion; Internet use; loneliness, stress, and social support/social burden; ELSA health questions; numeracy; positive well-being; later life education; subjective uncertainty about stock market returns.

HRS 2000 (Wave 5) Modules
Medicare knowledge; alternative medicine; planning and expectations for retirement; social and economic altruism; benevolence and obligation; health plan booklet; health utilities index; risk tolerance; alcohol consumption and instrumental activities of daily living (IADL) measures; proxy validation; social altruism; valuing health.

HRS 1998 (Wave 4) Modules
There were limited modules in HRS 1998, due to the addition of two new cohorts and the merger of the original HRS and AHEAD cohorts. The 1998 modules were targeted primarily toward AHEAD sample members who were asked activity of daily living (ADL) and cognition questions corresponding to similar modules in previous waves.

HRS 1996 (Wave 3) Modules
Consumption and anchoring; health during childhood; health pedigree; personality inventory; Medicare attitudes and preferences; volunteerism and time use; preference parameters for consumption, saving, and labor supply; advance directives; attitudes toward inter-familial transfers; retirement planning; saving for retirement.

AHEAD 1995 (Wave 2) Modules
Unfolding brackets with different entry points; Wave 1 ADL questions; Longitudinal Study of Aging 2 (LSOA2) ADL questions; security and safety; sleep; living wills; in-depth ADLs.

HRS 1994 (Wave 2) Modules
CES-D depression scale; crystallized intelligence; functional health; long-run income elasticity of labor supply; risk aversion; social support; parent-child transfers; ADLs; activities and time allocation; nutrition.

AHEAD 1993 (Wave 1) Modules
Resilience; time use; alternative ADLs; WAIS Similarities; quality of life; in-depth ADLs; financial pressure.

HRS 1992 (Wave 1) Modules
Physiological health measures; ADL measures from NLTCS and NHIS; meta-memory; process benefits; employment alternatives; parental wealth; occupational injuries; health risks; substitution elasticity of consumption.

BRIEF DESCRIPTIONS OF EXPERIMENTAL MODULES

HRS 2002 (Wave 6) Modules

  • Module 1: Self-assessed health utilities. Asks for a self-rating of health between 0 (death) and 100 (perfect health for your age/a 20-year-old), and then uses bracket-like techniques to assess willingness to trade years of life for perfect health, based on comparing two fictional persons with health similar to the respondent.
  • Module 2: Willingness to pay for disease prevention. Assesses willingness to pay (dollars) for prevention of cancer or Alzheimer's disease.
  • Module 3: Restless leg syndrome, night leg cramps, and neck and shoulder pain. Measures symptoms of restless leg syndrome (associated with sleep problems and health consequences of sleep problems), night leg cramps, and neck and shoulder pain.
  • Module 4: Risk aversion. Repeats previous module questions about large risk aversion to be paired with questions about small risk aversion asked in the main survey.
  • Module 5: Internet use. Asks about computer and Internet access and use at work and at home.
  • Module 6: Loneliness, stress, and social support/social burden. Assesses negative well-being in three of its dimensions. This module has twice the sample size of other modules, and hence also takes the place of Module 7. It is part of an analytic project under an NIA-funded program at the University of Chicago, developed in consultation with the HRS.
  • Module 8: ELSA health questions. Provides a cross-reference between health items asked in the English Longitudinal Study of Ageing (ELSA) and the HRS.
  • Module 9: Numeracy. Tests additional numeracy items and uses a six-way design to test for context effects across four types of mathematical skills. Each math item is couched in three contexts-health, economic/market, and context-free-and respondents are assigned to pre-designated combinations so that they receive each math problem only once. It also overlaps with an ELSA proposal to develop numeracy measures for large surveys.
  • Module 10: Positive well-being. Builds on the work of Powell Lawton and others to assess the extent of positive feelings about life and health.
  • Module 11: Later life education. Asks about educational activities in later life.
  • Module 12: Subjective uncertainty about stock market returns. Assesses the respondent's full distribution of expectations of one-year stock market returns by asking for probabilities that the return would be above or below specified levels.

HRS 2000 (Wave 5) Modules

  • Module 1: Medicare knowledge. Asks questions and presents hypothetical situations to ascertain respondents' knowledge about health maintenance organization (HMO) and non-HMO Medicare and about sources of their information about Medicare.
  • Module 2: Alternative medicine. Covers recent and past use of herbal or other dietary supplements and medications, treatments by chiropractors, massage therapists, or acupuncturists, and spiritual practices that may be related to health.
  • Module 3: Planning and expectations for retirement. Asks about activities undertaken by respondents to plan for retirement; the questions are slightly different for those who are already fully retired than for those still anticipating full retirement. A subset of questions is designed to get at the propensity to plan ahead.
  • Module 4: Economic altruism. Ascertains willingness to give regular financial assistance to relatives and friends at varying levels of need, as well as to charities.
  • Module 5: Benevolence and obligation. Asks about the respondent's self-perception as a giver to others, and his or her reasons for giving, especially as they relate to family members.
  • Module 6: Request for health plan booklet. Requests the respondent's health plan booklet to help assess the possibility of using this method to obtain details of health insurance coverage.
  • Module 7: Health utilities index. Implements the Mark III version of the Health Utilities Index to assess problems with vision, hearing, mobility, hand and arm use, mental functioning, general discomfort, and outlook on life. Domain scores and overall utility preference scores can be computed. Index to assess problems with vision, hearing, mobility, hand and arm use, mental functioning, general discomfort, and outlook on life. Domain scores and overall utility preference scores can be computed.
  • Module 8: Tolerance for large and small risks. Addresses the respondent's willingness to take financial risks by posing a set of hypothetical situations and asks what he or she would do in those situations.
  • Module 9: Alcohol consumption and HRS 1992 IADL measures. A very short module with a few questions about difficulties of everyday activities and alcohol consumption.
  • Module 10: Proxy validation. Repeats selected questions asked in the general survey about health and daily activities, but asks the respondent to answer these questions about his or her spouse/partner. The intention is to look at the agreement between respondent and spouse reports of health problems.
  • Module 11: Social altruism. Asks about connectedness to other people and the emotional support available from the respondent's spouse/partner, adult children, parents and parents-in-law, and friends.
  • Module 12: Valuing health. Asks respondents to compare their present state of health to perfect health using a standard time-tradeoff question valuing health in terms of years of life, and a similar willingness-to-pay question valuing health in terms of money.

HRS 1998 (Wave 4) Modules

  • Module 1: AHEAD 1993 ADL questions. Contains questions about difficulty and the use of equipment and help in activities of daily living. Most respondents who were asked to do this module in 1998 were asked to do the same module in AHEAD 1995.
  • Module 3: ADL measures used for the Longitudinal Studies of Aging. Contains the ADL questions used in AHEAD 1993 and AHEAD 1995, which were in turn based on those proposed for (and subsequently used in) the second LSOA. Most respondents who were asked to do this module in 1998 were asked to do the same module in both AHEAD 1993 and AHEAD 1995.
  • Module 4: ADL measures used for the National Long-Term Care Study (NLTCS). Most respondents who were asked to do this module in 1998 were asked to do the same module in AHEAD 1993.
  • Module 5: 1990 Census ADL questions. Slightly less than half of the respondents who were asked to do this module in 1998 were asked to do the same module in AHEAD 1993.
  • Module 10: Cognitive section for proxy interviewed sample members. Also included in the module section, although not actually a module, is a section of the interview that is administered to sample persons for whom proxy interviews were done, but who are willing and able to do this section themselves.

HRS 1996 (Wave 3) Modules

  • Module All: Consumption and anchoring. Contains questions on food consumption, as well as questions designed to assess the degree to which the responses to unfolding brackets are affected by the level of the entry point (i.e., the "anchoring effect"). To yield adequate sample sizes, these questions were asked of all respondents.
  • Module 1: Health during childhood. Contains questions on the individual's health when growing up (from birth to age 16), on parental family composition, and on the parental family's economic status.
  • Module 2: Health pedigree. Asks about the individual's health pedigree-whether the individual's parents are still living, the cause of death if deceased, health status if living, and cause and age of death of any deceased siblings.
  • Module 3: Personality. Provides a brief personality inventory based on the respondent's rating of how closely each of 12 descriptive words fits the respondent.
  • Module 4: Medicare attitudes and preferences. Attempts to measure respondents' attitudes and preferences toward Medicare. Includes questions on whether the respondent would prefer various cash equivalent dollar payments to Medicare insurance, and is thus a form of contingent valuation.
  • Module 5: Volunteerism and time use. Asks how many hours the respondent spent in the past year on 10 types of volunteer activities ranging from helping religious organizations to helping neighbors. Hours spent in 11 time-use activities ranging from television watching to reading are also obtained.
  • Module 6: Preference parameters for consumption, saving, and labor supply. Attempts to understand the respondents' preferences toward consumption, saving, and labor supply by asking about their behavior if they won a hypothetical sweepstakes that would pay an amount equal to their current family income for life.
  • Module 7: Advance directives. Contains questions on advance directives and respondent preferences toward a hypothetical cancer treatment under a variety of costs and treatment success-rate assumptions.
  • Module 8: Attitudes toward inter-familial transfers. Examines respondents' willingness to give financial help to parents and/or siblings under a variety of hypothetical situations. These data, in conjunction with those from HRS 1994 Module 7, are designed to develop a better understanding of altruism.
  • Module 9: Retirement planning. Asks about retirement planning and saving for retirement, and contains a question intended to measure the extent to which the respondent understands compound interest. It asks about the extent to which the respondent relies or plans to rely on Social Security, employer-provided pension plans, individual retirement accounts, 401(k) or Keogh plans, and private savings. Also asks retirees questions about the adequacy of their savings.
  • Module 10: Saving for retirement. Contains questions on the current level of savings for retirement and on the reliance or expected reliance on public, private, and personal sources of income in retirement.

AHEAD 1995 (Wave 2) Modules

Each of the AHEAD 1995 modules includes questions designed to assess the importance of anchoring effects in unfolding questions about dollar amounts. In each case, respondents were asked about the amount of money they had in savings accounts and total household consumption in the past month.

  • Modules 1 and 2: AHEAD 1993 ADL questions. Questions about difficulty and the use of equipment and help in activities of daily living that were asked in AHEAD 1993 were modified in 1995. To assist analysts who wish to take account of these wording changes when examining changes in responses across waves, a random subsample (double the size of the other modules) was asked the 1993 version of the ADL questions (in addition to the revised ADL questions that were asked in the main interview).
  • Module 3: LSOA2 ADL questions. Asks the same questions as Module 3 in AHEAD 1993, and were asked of the same respondents in both waves.
  • Module 4: Security and safety. Poses questions about the subjective probability of being the victim of a crime, and steps taken out of concern about crime.
  • Module 5: Sleep. Includes questions about trouble falling asleep and staying asleep through the night, problems of falling asleep during the day, and the use of medications to aid sleep. It also includes two questions about the sense of personal control.
  • Module 6: Living wills. Inquires about end-of-life directives, and whether or not the respondent has named anyone to make health care decisions for them if they are unable to do so themselves. Respondents were also presented with two scenarios about someone with a life-threatening illness who is presented with the choice of taking an experimental treatment with randomly varied cost and probability of success.
  • Module 7: In-depth ADLs. Asks the same questions as Module 7 in AHEAD 1993, of the same respondents in both waves.

HRS 1994 (Wave 2) Modules

  • Module 1: Center for Epidemiologic Studies Depression (CES-D) Scale. Assesses the degree to which the HRS 1994 scale loses information compared with the original HRS 1992 scale. The version of the CES-D Depression Scale included in the HRS 1994 instrument is a substantially truncated version of the scale used in 1992.
  • Module 2: Crystallized intelligence. It was decided to eliminate the similarities test (a test of crystallized intelligence) in the main survey, on the grounds that crystallized IQ is not expected to change with any rapidity in the HRS age range and is expected to change more slowly than memory. The similarities test in this module is the same test contained in the HRS 1992.
  • Module 3: Functional health. A methodological test of the HRS 1994 functional health scale compared with the HRS 1992 scale. The HRS 1992 scale was a four-point scale associated with level of difficulty in performing various activities. Telephone interview considerations in HRS 1994 led to the development and use of a two-point scale to be followed by a second two-point scale in the event of a "some difficulty" response. This module uses the original four-point scale designed for a personal interview environment.
  • Module 4: Long-run income elasticity of labor supply. Sets up a hypothetical set of circumstances to yield pure estimates of income elasticity. The hypothetical illustration concerns the effect of a windfall gain on labor hours, along with measures that will generate an assessment of the strength of an altruism parameter.
  • Module 5: Risk aversion. HRS 1992 contained a measure of risk aversion based on responses to a hypothetical situation involving alternate jobs and respondents' willingness to take jobs with various risky characteristics. This module is an attempt to refine the risk aversion measure by observing the distribution of risk aversion at the extremes of the distribution, where the 1992 data suggest most of the sample actually resides.
  • Module 6: Social support. Asks questions about respondents' sources of social support, including spouses, friends, and co-workers.
  • Module 7: Transfers. Examines motivations for transfers from parents to children. It is intended to aid in the analysis of preference parameters, specifically altruism.
  • Module 8: Activities of daily living. Gathers baseline data on the incidence of ADL deficiencies in the sample, and to find out who the ADL helpers are. Part of the module asks about future needs for ADL help, as well as whether or not respondents perceive themselves to be at risk of helping someone else with ADLs.
  • Module 9: Activities and time allocation. Seeks to assess the strength of some of the pull toward retirement that can be attributed to the desire to reallocate time to non-market time issues.
  • Module 10: Nutrition. Asks respondents how often they eat foods from the various major food groups. The list of food types is fairly detailed, e.g., distinguishing red meats from other meat and from fish.

AHEAD 1993 (Wave 1) Modules

  • Module 1: Resilience. Asks an innovative sequence of questions designed to measure the concept of resilience, defined as the individual's ability to recover quickly and completely from any misfortune or challenge.
  • Module 2: Time use. Contains a set of questions on unpaid but economically productive activities: home maintenance, volunteer work, and informal help to others. Together with core-study questions on paid employment, these questions permit a balanced assessment of the productive contributions of older adults.
  • Modules 3 and 4: Alternative ADLs. Contains the ADL questions proposed for (and subsequently used in) the second LSOA (Module 3) and replicates the ADL function items on the NLTCS screen (Module 4).
  • Module 5: WAIS Similarities. Applies the WAIS Similarities, a widely used measure of abstract reasoning that was used in the main HRS 1992 interview; also includes two ADL questions that are asked on the 1990 U.S. Census long form.
  • Module 6: Quality of life. Asks questions focusing on the essential quality of life issue-whether or not life is still worth living.
  • Module 7: In-depth ADLs. Probes various detailed adaptive strategies for bathing to explore whether or not adaptive mechanisms account for a lack of reported difficulty with bathing despite obvious physical or cognitive impairments.
  • Module 9: Financial pressure. Asks respondents if they find it difficult to pay their bills or if they cut back on nonmedical expenses, such as eating out or traveling. Also asks about the perceived fairness of policy alternatives for making long-term care in nursing homes more accessible to older people.

HRS 1992 (Wave 1) Modules

  • Module A: Physiological measurements of health and functioning status. Measures vital capacity using Peak Expiratory Flow Rate (PEFR) and assesses grip strength to provide a means of validating self-reports.
  • Modules B and C: ADL measures used in the National Long-Term Care Survey and in the National Health Interview Survey. Collects data to provide researchers with a cross-walk that would allow the HRS ADL measures to be recalibrated to better correspond to the ADL measures in these other studies.
  • Module D: Meta-memory. Asks a battery of questions to assess meta-memory, along with the Census Bureau screen question used for the presence of ADL limitations.
  • Module E: Process benefits. Uses a set of 10-point scales to ascertain respondents' intrinsic satisfaction from work, housework, and various types of leisure.
  • Module F: Employment alternatives. Asks a series of questions on 10-point probability scales asking respondents about the likelihood that they can find jobs like their present jobs but with specified differences in characteristics, such as different amounts of pay, greater amounts of flexibility in hours per week, weeks per year, and hours per day.
  • Module G: Parental wealth. Asks a set of questions about the asset holdings of respondents' parents, and then requests permission to talk to the parents.
  • Module H: Occupational injuries. Inquires about various characteristics of work that relate to the likelihood of on-the-job injuries.
  • Module J: Health risks. Asks a set of questions about the likelihood that respondents or spouses will need long-term care in a nursing home, longevity estimates relating to the spouse of the respondent, expectations about having medical care insurance at age 65 provided by an employer, and questions about the coverage of Medicare and the coverage that could be available from other types of insurance. Also asks about Medicaid coverage and respondents' perceptions about their eligibility for Medicaid.
  • Module K: Substitution elasticity of consumption. A highly experimental measure of the intertemporal elasticity of substitution in consumption, a concept that plays a key role in economic models of life-cycle saving behavior.

Publication Date:
Page Last Updated: April 1, 2014