Research by Author & Topic

Publications by Brenda Spillman on Elderly

This article attempts to resolve previously published inconsistencies across national surveys in trends in activity limitations among the elderly. The authors prepared estimates from five national surveys from 1982-2001, and investigated sources of the inconsistencies. The panel found consistent declines of 1%-2.5% per year for two commonly used disability measures: difficulty with, and help with daily activities. Mixed evidence was found for the use of help or equipment. The panel found that the period, definition of disability, treatment of the institutionalized population, and age standardizing of results affected results. The implications of the findings for policy, national survey efforts, and further research are discussed. (Freedman, VA, E Crimmins, RF Schoeni, B Spillman, H Aykan, K Land, J Lubitz, K Manton, L Martin, D Shinberg, T Waidmann. 2004. "Resolving Discrepancies in Old-Age Disability Trends Across National Surveys: Report From a Technical Working Group." Demography 41(3):417-441.)

This study explores the properties of an integrated income and disability annuity as an alternative framework for long-term care financing, demonstrating that pooling disability and mortality risks can reduce the need for medical underwriting, and discussing private and public implications. Specifically, a simulation indicates that pooling these competing risks can reduce the costs of both the income annuity and the disability coverage and expand the medically eligible population to 98 percent of 65-year-olds. Combining income and disability protection may be able to expand private markets for long-term care financing beyond what appears possible in the conventional long-term care insurance market, and is only one of multiple models that could be considered for long-term care financing. Public policy should foster innovation in financing mechanisms and avoid the distortion of choices created by exclusive policy focus on a conventional insurance model. (Journal of Aging and Health 15(1): 45–73, 2003.)

This article examines the implications of the positive correlation of mortality and disability for the benefits of combining an immediate income annuity with long-term care disability coverage at retirement ages. It also investigates the value of such a combined benefit to various subgroups of prospective purchasers and the implications of possible errors and moral hazard in the reporting of disability status and making claims. (The Journal of Risk and Insurance, 2001, Vol. 68, No. 2, 225-254)