• January 24, 2013

    Reubin Andres

    Dr. Reubin Andres, an early leader in the field of aging research and the first clinical director of NIA, died on September 23, 2012. “I was saddened to hear the news of Dr. Andres’s passing. His legacy will most certainly be his dedication and vision in research on aging. Dr. Reubin was a true pioneer, a valued mentor and colleague and a marvelous human being,” said NIA Director Dr. Richard J. Hodes.

    Dr. Andres joined the Gerontology Research Center (the precursor to NIA) in 1962, where he was assistant chief and head of the GRC’s metabolism section. He was later named the first clinical director of NIA, serving in this position from 1977 until 1998.

    Dr. Andres was named an NIH scientist emeritus at the time of his retirement in 2003. He was cited for his productive research career that included the invention of the glucose insulin clamp technique, a method that remains the gold standard in the study of glucose and insulin homeostasis in man; his original and fundamental observations on the hormonal abnormalities in diabetes mellitus; and his recognition that mortality follows a U-shaped curve as a function of body mass index with the minimal mortality/maximal longevity associated with higher body mass index than prior work suggested.

    Among his many achievements, Dr. Andres played a critical role in the development of the Baltimore Longitudinal Study of Aging, now in its 54th year. “With the passing of Dr. Andres, we’ve lost a great man and an extraordinarily talented and generous scientist. I’m sure that his name will continue to inspire generations of researchers in aging for years to come,” said NIA Scientific Director Dr. Luigi Ferrucci.

  • January 31, 2013

    Luigi Ferrucci lecture

    “Of Uncertainty and Hope, a Lesson from My Patients” was the title of the Joseph T. Freeman Lecture delivered by Dr. Luigi Ferrucci at the Gerontological Society of America (GSA) meeting in November 2012. The annual Freeman lecture in geriatrics is presented by the previous year’s winner of the Joseph T. Freeman Award, which GSA gives to a prominent physician in the field of aging—both in research and practice—who is a member of the Society's Health Sciences section.

    Dr. Jack Guralnik, former chief of NIA’s Laboratory of Epidemiology, Demography, and Biometry, introduced Dr. Ferrucci, noting his work as principal investigator of the InChianti project in Italy, director of the Baltimore Longitudinal Study of Aging, editor of the Journal of Gerontology, and, most recently, scientific director of the NIA.

    In his lecture, Dr. Ferrucci described the “interconnectedness” of geriatrics. He noted that changes associated with aging—such as body composition, imbalance in energy production and utilization, homeostatic dysregulation, and neurodegeneration—can lead to geriatric syndromes of physical and cognitive frailty, resulting in a number of health problems ranging from falls and disability to sleep disorders and cognitive impairment. He concluded, “A geriatrician needs to be a fantastic doctor and then realize that this is not enough.”

  • January 31, 2013

    Go4Life WheelGo4Life, NIA’s national exercise and physical activity campaign for older adults had a very productive first year. Launched in October, 2011, the campaign encourages Americans 50+ to fit exercise and physical activity into daily life. Go4Life offers exercises, motivational tips, safety information, and free resources for health professionals and the public. Go4Life has added:

    In the coming year, we hope you will help us expand and enhance the Go4Life campaign. If you have suggestions or feedback about Go4Life, email us at

  • March 15, 2013
    Dr. Robert Butler
    Dr. Robert Butler, former NIA Director

    Please join us as Dr. Ronald C. Petersen, a leading expert in the field of Alzheimer’s disease research, presents Neuroimaging and Biomarkers: How Early Can We Diagnose Alzheimer’s? at the Robert N. Butler Memorial Lecture May 8. The special lecture, part of the prestigious NIH Director’s Wednesday Afternoon Lecture Series, honors NIA’s founding director, who was among the first to warn about the impact that Alzheimer’s disease would have on our aging population.

    The lecture takes place Wednesday, May 8, 2013, at 3 p.m., in the NIH Clinical Center’s Masur Auditorium (PDF, 824K) on the campus in Bethesda, MD.

    Dr. Petersen directs the Mayo Alzheimer’s Disease Research Center and the Mayo Clinic Study of Aging and chairs the U.S. Advisory Council on Alzheimer’s Research, Care, and Services established under the National Alzheimer’s Project Act. His interests include clinical research involving aging, mild cognitive impairment, dementia, Alzheimer’s disease, and neuroimaging.

    Dr. Butler served as the founding NIA director from 1976 – 1982. He coined the phrase “ageism” to describe the discrimination experienced by older people. A prominent gerontologist and psychiatrist at the time of his NIA appointment, Dr. Butler received the 1976 Pulitzer Prize for General Non-Fiction for his book Why Survive? Being Old in America. The book describes the problems faced by older Americans, along with Dr. Butler’s prescription for change.

    At NIA, Dr. Butler set in place a visionary research endeavor, building a broad program of basic, biomedical, social, and behavioral research that remains at the core of NIA’s efforts today. During his tenure, he wrote and lectured regularly about the everyday problems faced by older adults.

    In 1982, he left NIA to accept the position of chairman of a newly formed geriatrics department at Mount Sinai School of Medicine in New York City. He continued his advocacy for older people when, in 1990, he founded the International Longevity Center U.S.A., a nonprofit research, policy, and education center of longevity and aging with branches in nine other countries.

    More information about Dr. Butler.

    For more information about the lecture, contact Anne Decker at

    What: Neuroimaging and Biomarkers: How Early Can We Diagnose Alzheimer’s?
    Robert N. Butler Memorial Lecture, part of the NIH Director’s Wednesday Afternoon Lecture Series
    Presented by Dr. Ronald C. Petersen
    When: Wednesday, May 8, 2013 at 3:00 p.m.
    Where:  Masur Auditorium (PDF, 824K), NIH Clinical Center, Bldg. 10, Bethesda, Maryland


  • February 5, 2013

    Dr. Toren Finkel to speak at the Geroscience Interest Group (GSIG)

    What: Seminar with Toren Finkel, Ph.D.

    When: Thursday, March 28, 2013, 12:00 PM – 1:00 PM

    Where: Lipsett Amphitheater, Building 10, NIH

    Title: "Molecular Mechanisms Regulating Mammalian Aging"

    The Geroscience Interest Group (GSIG) cordially invites you to the seminar listed above. Dr. Finkel is Chief of the Center for Molecular Medicine in the Division of Intramural Research at the National Heart, Lung, and Blood Institute. Dr. Finkel’s lab investigates the role of cellular metabolism and oxidative stress in aging and age-related diseases. His research has included studies on oxidative homeostasis in stem cell biology, cellular senescence as a model for aging, the role of autophagy in age-related diseases, and interrogating pathways in model organisms to understand their role in mammalian aging. Dr. Finkel is Editor-in-Chief of Drug Discovery Today-Disease Mechanisms and Associate Editor of Circulation Research.

    Publications relevant to his seminar:

    • Narayan N, Lee IH, Borenstein R, Sun J, Wong R, Tong G, Fergusson MM, Liu J, Rovira II, Cheng H-L, Wang G, Gucek M, Lombard D, Alt FW, Sack, MN, Murphy E, Cao L, and Finkel T. (2012). The NAD-dependent deacetylase SIRT2 is required for programmed necrosis. Nature, 492: 199-204.
    • Finkel T, Deng C, and Mostoslavasky. (2009) Recent progress in the biology and physiology of sirtuins. Nature, 460: 587-591.

    The Geroscience Interest Group (GSIG) is a newly formed trans-NIH group aimed at enhancing opportunities for discussion of the intersection between the biology of aging and the biology of diseases and conditions that are of interest across ICs. It is focused on basic biology, but with a longer view towards translation. If you are interested in learning more, please visit the GSIG website.

    The seminar will be videocast and archived in the GSIG website. Sign Language Interpreters will be provided. Individuals with disabilities who need reasonable accommodation to participate in this event should contact Dr. Ron Johnson at or at 301.496.1953 or Dr. Ron Kohanski at or at 301.496.6402.

  • March 11, 2013

    Applications are now closed to participate in the National Institute on Aging (NIA) 2013 Summer Institute on Aging Research. This 6-day workshop for investigators new to the field is focused on current issues, research methodologies, and funding opportunities. The Summer Institute, one of the premier short-term training opportunities for new investigators, is scheduled to be held July 14-19, 2013 in Bethesda, Maryland, on the campus of the National Institutes of Health. Support is available for travel and living expenses. Applications deadline was March 22, 2013.

    Video: NIA's Summer Institute on Aging Research

    Read more and view additional videos of 2012 Summer Institute participants

    Offered through the NIA Office of Special Populations, investigators focusing on health disparities research are encouraged to apply. As with all NIH programs, investigators of diverse backgrounds are also encouraged to apply. Applicants must be U.S. citizens, non-citizen nationals or permanent residents. For additional information, contact Andrea Griffin-Mann at


    Deadline: March 22, 2013

  • January 25, 2013

    The Winter 2013 issue of LINKS: Minority Research and Training is now available! This issue has some exciting new features. Get to know six participants from the 2012 NIA Summer Institute on Aging Research through videos in the article, Reflections from the Summer Institute on Aging Research. Or, have ideas about ways to increase diversity in clinical research? Share them in the comments section at the end of the article, Minority Recruitment: Translating General Principles Into Specific Strategies. Let the conversation begin!

    The Winter 2013 issue also includes:

    New to Links? The twice-yearly newsletter is part of NIA’s initiative to address health disparities and support scientists representing underserved populations. Subscribing is easy. We also invite you to visit NIA’s Minority Aging and Health Disparities web page, where you’ll find information about the Health Disparities Research Persons Network, training opportunities, and more.

  • January 17, 2013

    A team of researchers, led by scientists at the University of North Carolina, Chapel Hill, with support from the National Institute on Aging at the NIH, has developed an innovative approach to study aging cells in living mice. The approach is described in the January 17, 2013, issue of Cell.

    The researchers designed a strain of mice whose p16 gene is tagged with a luminescent gene derived from the firefly. As a result, the p16 gene glows in areas of the body where the gene is active—the more cells expressing the gene, the more intense the glowing effect.

    The p16 gene is best known as a tumor suppressor and is primarily active in senescent cells. Cell senescence, a state in which cells stop dividing but maintain a limited function in the body, may protect against cancer. In cancer, cells divide and proliferate without control. However, research suggests that cell senescence may also contribute to some of the negative effects of aging.

    Researchers found an exponential increase of p16 as mice aged, supporting the relationship between senescence and aging. But the p16 levels were varied, suggesting factors beyond genetics, diet and lifestyle may play a part in determining how well mammals age. The expression of p16 did not predict cancer or aging-related death, leading researchers to suspect that an accumulation of senescent cells is not the main cause of mortality.

    Researchers conclude that findings from this work support p16 as a potential indicator of aging and this new strain of mice may be helpful in determining the effects of compounds on aging cells.

    Reference: Burd, Christin E., et al. Monitoring Tumorigenesis and Senescence In Vivo with a p16INK4a-Luciferase Model. Cell. 2013 Jan 17; 152(1-2):340-351. Epub 2013 Jan 17.

  • January 14, 2013

    A new online report from the National Institutes of Health (NIH) highlights recent progress in NIH-supported Alzheimer’s disease research.

    Prepared annually by the National Institute on Aging (NIA) at NIH, the latest report -- 2011-2012 Alzheimer’s Disease Progress Report: Intensifying the Research Effort -- describes new investments and summarizes research in several areas:

    • prevalence of Alzheimer’s disease
    • biology of Alzheimer’s and the aging brain
    • genes that may play a role in the disease
    • risk factors for cognitive decline and dementia
    • neuroimaging and biomarkers that detect and track the disease
    • translational research to identify and test new drugs
    • potential new therapies to treat, delay, or prevent Alzheimer’s
    • caregiving
    • gender and racial differences in the impact of Alzheimer’s

    Other features include a primer on Alzheimer’s disease and the brain, tables listing NIA-funded clinical trials, and videos that further explain critical areas of study.

    Read online or download the free report: 2011-2012 Alzheimer’s Disease Progress Report: Intensifying the Research Effort

  • December 20, 2012

    Grants Funded from RFA-AG-11-004, “Regional and International Differences in Health and Longevity at Older Ages (RFA-AG-11-004)”

    NIA published an RFA entitled “Regional and International Differences in Health and Longevity at Older Ages” on June 22, 2010 which solicited R01 applications to advance knowledge on the reasons behind the divergent trends that have been observed in health and longevity at older ages, both across industrialized/high life expectancy nations and across geographical areas in the U.S.

    NIA funded seven R01 applications from the RFA during the summer of 2011. Four grants are studying the underlying reasons for the large American health disadvantage at older ages compared to their Western European counterparts. These grants are focusing on issues including obesity, social policies addressing work-family strain, physiological dysregulation due to work stress, early life conditions such as childhood health, the impact of the recent financial crisis, and cancer screening rates.

    1. Lisa Berkman, Social protection, work and family strain: cumulative disadvantage effects in the US and Europe (R01 AG040248)
    2. Pierre-Carl Michaud, Working Lives, Physiological Dysregulation and International Health Differences (R01 AG040176)
    3. Samuel Preston, The Contribution of Obesity to International Differences in Longevity (R01 AG040212)
    4. James Patrick Smith, International Differences in Health, Longevity, and SES (R01 AG040165)

    Two grants focus on the U.S. The first is developing a new publicly-available database of historical mortality data by state which will be invaluable for future study of the driving forces behind US mortality trends. The second project is studying how US health disparities among different birth cohorts are related to US geographic region.

    1. Scott Lynch, Understanding US regional health & mortality disparities: A Life Course Approach (R01 AG040199)
    2. John Wilmoth, Variability of mortality levels and trends by state in the United States (R01 AG040245)

    Finally, NIA funded a one-year project studying the remarkable increase in life expectancy experienced by East Germans after the 1989-1990 unification of West and East Germany; the aim of this project is to understand the relative impact on increased life expectancy between the increased affluence experienced by East Germans vs. the improved health care system available to East German elderly post-unification.

    1. James Vaupel, Theory-Based Comparative Demography of Mortality at Older Ages (one-year project only on East-West Germany, R01 AG040050)

    (See below for the grant abstracts. Also, for more information on the above grants,
    go to the NIH RePORTER site at ).

    RFA-AG-11-004 was influenced by a National Academy of Sciences panel which determined, based on available evidence, that past smoking rates are a major reason for shorter lifespans in the US compared to other high-income countries, and that obesity rates in the US also appear to be a significant factor (see ). The summary report from the National Research Council, which also identified research gaps, is entitled Explaining Divergent Levels of Longevity in High Income Countries (NRC, 2011) and is available at . A volume of background scientific papers is entitled International Differences in Mortality at Older Ages (NRC, 2011) and is available at .


    Theory-Based Comparative Demography of Mortality at Older Ages

    DESCRIPTION (provided by applicant): Theory is important in guiding research to penetrate the bewildering surface of myriad age, sex, time and population-specific statistics about mortality at older ages. The goal of the proposed research is to advance theory and thereby empirical knowledge of mortality comparisons by using data from the "natural experiment" of East-West German unification and the resulting rapid convergence of E. German death rates to W. German levels to quantify the relative causal importance of two factors suggested by theory: "prosperity" vs. "healthcare".

    International Differences in Health, Longevity, and SES

    DESCRIPTION (provided by applicant): Our first objective examines impacts of early life conditions and childhood health across a set of European countries and the US on salient later life adult outcomes including adult health and socioeconomic status (SES). Differences in early life conditions are potentially an important source of international differences in adult health. Second, we will study dual pathways between SES and health with an emphasis on England and America. Pathways from SES to health are explored by examining whether future onsets of new chronic conditions using self-reports and biomarkers of disease are related to key SES markers- income, wealth, and education. We will examine whether ""innovations"" in economic status affect health-especially during the recent financial crisis. Health feedbacks to labor supply, income, and wealth may be quantitatively important. Health outcomes include physical and mental health, including depression, psycho-social health, overall well-being, and life satisfaction. Our third specific aim examines the relationship between alternative measures of SES and subsequent all cause and cause-specific incident mortality in England and the US. Access to financial resources may be essential in dealing with consequences of health problems after they occur. The final specific aim will examine whether differential cancer screening rates can account for significant parts of country differences in cancer rates, especially those to the disfavor of the United States. Screening is known to vary across types of cancer and is believed to be more aggressive for breast, colon, and prostate cancer in the US than the UK and low for respiratory cancer.

    PUBLIC HEALTH RELEVANCE: The research is important since it deals with the level of well-being of older people in the United States compared to the rest of the Industrialized Western World. By using comparative analysis of the United States, England, and other countries, we can assess how and why over-all well-being is related to health and socioeconomic status at older ages in these countries.

    Working Lives, Physiological Dysregulation and International Health Differences

    DESCRIPTION (provided by applicant): The U.S. appears to have worse health than people in a number of European countries. Because health reflects an accumulation of processes over a lifetime, we will study how stressful events during the working years may affect pre-retirement health and ultimately longevity. The broad aims of this application are to find whether in panel data the health gap between the U.S. and Europe increases during the working years, but not during the post-retirement years, and to explain these broad facts by differences in the stress induced in the labor market and by differences in the ameliorating effects of economic and social policy (including health insurance). Our analysis will use data on 15 countries, which provides a wealth of variation in institutions in time as well as in space. The principal outcomes will be fourfold. First, this study will clarify at what point in the life-cycle health differences emerge and chart their path thereafter. Second, this study will propose a formal economic and biological model linking indicators of physiological functioning to other health and economic outcomes clarifying some of the concepts measured in the literature and guide empirical work on the topic. Third, this study will provide micro as well as cross-country empirical evidence on the relationship between economic stressful events and physiological dysregulation using biomarkers but also reported health measures. Fourth, because of its cross-country design, this study will exploit differences in social policy across countries and over time to see estimate how these policies contribute to the international differences in health through the effect of physiological dysregulation on health.

    PUBLIC HEALTH RELEVANCE: The U.S. has fallen behind in terms of life expectancy in the pre-retirement years and large differences in health have emerged between the U.S. and Europe. This project aims to test the hypothesis that differences in physiological dysregulation due to a more stressful working life in the U.S. are responsible for those differences. This project will use a large array of longitudinal datasets in 15 countries to link health outcomes in the pre-retirement years to life histories and exploit differences in social policy across countries.

    Understanding US regional health & mortality disparities: A Life Course Approach

    DESCRIPTION (provided by applicant): Regional disparities in health and mortality in the U.S. have been observed repeatedly, but little attempt has been made to explain them. At best, anecdotal explanations are usually offered. For example, poorer health among southerners is often attributed to diet without any empirical support. Extant literature suffers from several additional shortcomings. First, many studies focus on a single health outcome, like stroke mortality, thereby underestimating the full extent of regional variation in health. Second, many studies measure region coarsely. Often, only one region is contrasted against all others. This approach also leads to underestimation of the full range of regional variation in health and hinders our ability to understand the precise mechanisms that account for it, because within-region cultural and structural heterogeneity is extensive. Third, studies of regional disparities have generally failed to take a life course perspective, instead treating them as existing in a temporal vacuum. The proposed research will address these shortcomings, first by adopting a life course perspective. The life course perspective recognizes that neither region of residence, nor health, nor the relationship between them, is static at the individual level across age. Furthermore, regional characteristics and the distribution of health outcomes also vary across sociohistoric time, implying that the relationship between region and health may differ across birth cohorts. The life course perspective therefore provides a more comprehensive and detailed lens through which to begin to explain regional differences in health. Given this perspective, the proposed research will establish the full extent of regional disparities in health using a variety of longitudinal statistical methods applied to at least three nationally-representative, large sample data sets: the General Social Survey, the Health and Retirement Study, and the National Health Epidemiologic Follow-up Surveys. These data will be augmented via the collection of region-year contextual variables like physician density, climate, etc. Collectively, these surveys contain a wide variety of health measures, including self-rated health, physical functioning, depressive symptoms, mortality, and diabetes, as well as refined measures of region (i.e., the nine-category Census measure). Importantly, these three surveys also contain at least one measure of region of residence in early life (birth and adolescence), which, from a life course perspective, is useful in helping differentiate the role of early life socialization into regional culture from the role of structural characteristics of an individual's current region of residence in influencing health. In addition, this early life region measure, as well as the use of longitudinal methods, will enable the investigation of the extent to which health influences regional mobility, an issue (i.e., endogeneity) commonly ignored in research. Basic descriptive methods, typical regression models, multistate life table methods for both panel and cross-sectional data, and hierarchical growth models, including autoregressive latent trajectory models, will be used to flesh out the extent of regional differences in health as well as the mechanisms that account for them.

    PUBLIC HEALTH RELEVANCE: Regional differences in health and mortality in the US have been observed in numerous studies but have been left largely unexplained. Understanding the mechanisms that account for regional differences is important for determining how health disparities can be reduced. Our proposed project aims to determine the full extent of regional differences in health and to explain them (1) by using more refined measures of region and a broader array of health outcomes than used in previous research, and (2) by employing a life course perspective and methods to differentiate with greater precision and accuracy the pathways via which region may affect health. 

    The Contribution of Obesity to International Differences in Longevity

    DESCRIPTION (provided by applicant): The primary objective of this research is to identify the contribution of obesity to international differences in longevity. Adults in the United States have a higher prevalence of obesity than adults in any other country in Europe, North America, or East Asia. At the same time, life expectancy in the United States has fallen below that of most other OECD countries and ranked 32nd in the world in 2008. One of the prime candidates to account for the US disadvantage in health and longevity is its high level of obesity. A key input to evaluating the contribution of obesity to international differences in longevity is the set of individual-level mortality risks associated with different levels of obesity. This project will identify the set of mortality risks associated with obesity that should be used in international and intertemporal comparisons. We do so by explicitly introducing two other factors on which the mortality risks associated with current obesity depend: an individual's history of obesity and his or her smoking status. The omission of obesity histories from earlier studies has led to biased estimates of the effects of current obesity. Non-smokers show a higher mortality risk from obesity than smokers, so that countries that smoke heavily should be expected to have lower risks from obesity. We will apply these sets of obesity risks to calculate population attributable risks and obesity's implications for survivorship and longevity. An important product of our work will be an explanation of the large declines that have been observed in the estimated effect of obesity on mortality. In addition, we will develop a new indirect approach to estimating the contribution of obesity to international differences in longevity by building on previous methods developed to estimate smoking-attributable mortality. Epidemiologic and demographic studies of obesity would benefit greatly from a clarification of the mortality risks associated with obesity. Such a clarification would also contribute to improved projections of mortality in the US and elsewhere. Uncertainty about future of mortality is the single factor to which fiscal balances in the Social Security Trust Fund are most sensitive. The contribution of this project to improved projections is enhanced by its explicit incorporation of obesity histories into the risk analysis, since these histories are revealed well in advance of actual mortality conditions.

    PUBLIC HEALTH RELEVANCE: The United States has the highest prevalence of obesity and one of the lowest life expectancies among developed nations. The objective of this research is to identify the contribution of obesity to international differences in longevity. Results will lead to improved mortality projections and a clearer understanding of how obesity is influencing national mortality profiles.

    Variability of mortality levels and trends by state in the United States

    DESCRIPTION (provided by applicant): The purpose of the project is to promote research on historical trends and, in particular, interstate variations in the mortality of the United States since the 1930s. To this end, we will construct a publicly-accessible collection of mortality data series by state, designed to meet the research needs of team members and collaborators as well as those of the greater academic community. The new data series will include indicators of both total (i.e., all causes of death) and cause-specific mortality. We will create state-level estimates of all-cause mortality by age, sex, and year for the period from 1933 to 2007. We will also create annual state-specific estimates of mortality by age, sex, and cause of death for 1959-2007 (possibly, 1950-1958 as well). All data series will have the same format used for country estimates in the Human Mortality Database (HMD,, helping to facilitate comparative research both within the United States and on an international level. This work will draw on data from various sources, including the vital registration system, the decennial census, and the beneficiary records of Social Security and Medicare. It will require the development of new methodologies for combining such information into coherent and comparable series of mortality estimates, including complete life tables. Our knowledge of the data sources, including their defects and limitations, will be clearly documented and distributed alongside the data within the HMD. The project is intended to catalyze research on mortality patterns and trends by state within the U.S. State-specific mortality data are intrinsically useful for the analysis of health disparities, since geographic differences are an important component of overall inequality in the face of death. The products of the work proposed here will facilitate more detailed analyses of regional mortality differentials by cause within the U.S., which could offer new insights and evidence about the driving forces behind the country's mortality trends in recent decades - in particular the slow pace of decline compared to other high-income nations, especially for women.

    PUBLIC HEALTH RELEVANCE: The purpose of the project is to construct a publicly-accessible collection of mortality data series by state since the earliest time available until now (1933-2008). Improved information about mortality patterns by sex, age groups and causes of death contributing to the ongoing disparities in life expectancy across U.S. states will help researchers to identify the underlying conditions and processes that have produced these patterns. A better understanding of geographic differences in U.S. mortality will be a useful tool for guiding future policy efforts to improve the health and longevity of the population and to investigate the historical impact of public health interventions.

    Social protection, work and family strain: disadvantage effects in US and Europe

    DESCRIPTION (provided by applicant): The United States is losing ground in health: our ranking in life expectancy is near the bottom of European countries and comparisons of major chronic conditions in the US and 13 European countries showed the US to have higher disease prevalence than any comparison country. The diverging life expectancy (LE) trends have been most distinct for American women, but the US also fares poorly with regard to male life expectancy and infant mortality. The health gap is largest among socioeconomically disadvantaged groups, but even well- educated Americans have worse health than many of Europeans. We hypothesize that the explanations for the American health disadvantage have roots in the challenging social context faced by families, and in particular women, in post-WWII America. Since WWII, American society has been marked by: high fertility; high female labor market participation; weak labor laws and family protection policies; and family instability, and increased single parenthood. The combination or convergence of these factors created a ""perfect storm"" that threatened vulnerable families and imposed extreme stresses even on the relatively advantaged. Such social conditions might work via influencing health behaviors or through more direct physiological mechanisms. We have developed a theoretical framework for this confluence of conditions that builds on the job strain models incorporating dimensions of demand, control and support but adds an important dimension related to family that extends the strain model beyond work to family life. Over time Americans, especially women, have experienced high demands in terms of full time work often with high family demands, coupled with low formal support ( social protection policies) or informal support from other family members. This combination especially among workers with low job control leads to a cumulative disadvantage taking its toll in health over time. In order to understand whether these social conditions account for cross area variations in risk we must understand whether either the distribution and/or the toxicity of the ""risk"" vary across areas. We draw from ongoing studies including HRS, SHARE and ELSA, mortality data at a country level (using the human mortality files) and data on public policies, collected from the CPS,SIPP and SHARELIFE and OECD. We propose 4 specific aims: Aim 1: Describe the distribution of work-family strain for females born 1920-1960, across the US and EU. Aim 2: Assess the differential toxicity of work-family strain on CVD risk behaviors and biomarkers, incidence of stroke and heart disease, CVD mortality, and life expectancy in the US and Europe. Aim 3: Assess whether distributions or the toxicity of work-family strain explain geographic and temporal variations in CVD and life expectancy. Aim 4: Assess impacts of trends in work-family strain on socioeconomic inequalities in mortality in the US and Europe.

    PUBLIC HEALTH RELEVANCE: With the vast majority of women in the labor force who also have young children and with the aging of societies virtually across the globe, there is an urgent public health need to provide both formal (policy) and informal (family) support to women and their families. Evidence suggests that work family strain has an adverse impact on health outcomes for low wage employees and young children and perhaps other groups. Countries in which a number of work family policies have been implemented seem to fewer adverse population health outcomes. This situation is particularly severe in the US where fertility and labor force participation among women is high and where state and federal policies promoting the health of families is very limited.

    Prepared December 2012