Benefits Gained, Benefits Lost: Comparing Baby Boomers to Other Generations in a Longitudinal Cohort Study of Self‐Rated Health

Abstract

Policy Points:r Despite beliefs that baby boomers are healthier than previous generations, we found no evidence that the health of baby boomers is substantially different from that of the previous or succeeding cohorts.r The effects of increased education, higher income, and lower smoking rates on improving self-rated health were nearly counterbalanced by the adverse effect of increasing body mass index (BMI).r Assumptions that baby boomers will require less health care as they age because of better education, more prosperity, and less propensity to smoke may not be realized because of increases in obesity.Context: Baby boomers are commonly believed to be healthier than the previous generation. Using self-rated health (SRH) as an indicator of health status, this study examines the effects of age, period, and birth cohort on the trajectory of health across 4 generations: World War II (born between 1935 and 1944), older baby boomers (born between 1945 and 1954), younger baby boomers (born between 1955(born between and 1964(born between ), and Generation X (born between 1965(born between and 1974 Survey 1994Survey -2010 at baseline), using multilevel growth models to estimate the age trajectory of SRH by cohort, accounting for period and incorporating the influence of changes in education, household income, smoking status, and body mass index (BMI) on SRH over time.Findings: SRH worsened with increasing age in all cohorts. Cohort differences in SRH were modest (p = 0.034), but there was a significant period effect (p = 0.002). We found marked cohort effects for increasing education, income, and BMI, and decreasing smoking from the youngest to the oldest cohorts, which were much reduced (education and smoking) or removed (income and BMI) once period was taken into account. At the population level, multivariable analysis showed the benefits of increasing education and income and declines in smoking on the trajectory of improving SRH were almost counterbalanced by the effects of increasing BMI (obesity). Conclusions:We found no evidence to support the expectation that baby boomers will age more or less healthily than previous cohorts did. We also found that increasing BMI has likely undermined improvements in health that might have otherwise occurred, with possible implications for the need for health care. Period effects had a more profound effect than birth cohort effects. This suggests that interventions to improve health, such as reducing obesity, can be targeted to the entire, or a major portion of the, population and need not single out particular birth cohorts.

More than the Affordable Care Act: Topics and Themes in Health Policy Research

“…The methods for causal inference and inferential statistics that dominate in econometrics and biostatistics continue to be popular in health policy research. For example, the prevalence of regression discontinuity analyses and instrumental variable approaches in health economics (e.g., Bauhoff, Hotchkiss, & Smith, 2011;Cawley & Meyerhoefer, 2012), and longitudinal and time series analysis in public health and biomedicine (e.g., Badley, Canizares, Perruccio, Johnson, & Gignac, 2015;Levy, Diez, Dou, Barr, & Dominici, 2012;Power, Kuh, & Morton, 2013).…”

Age Matters: Exploring Correlates of Self-Rated Health Across Four Generations of Australian Males

“…In addition, other studies that have assessed sociodemographics, health-related behaviors, and health status using longitudinal data to assess cohort and period effects in other populations and at different time periods have noted similar findings to this study, including decreasing smoking prevalence and increasing obesity prevalence over time. 12,15,42 An additional limitation of this study is the potential of this study to represent associations for a particular subset of Australian males, given that the Ten to Men cohort was found to be more socioeconomically advantaged than the Australian population of males aged 10-55 years. 7 However, given the size and scope of the Ten to Men study it is likely that a sufficient number of males of varying characteristics were included in the analysis to have reasonable confidence in the findings of this study.…”

“…11 Most research to date related to the health differences of sociologically defined generations focuses on identifying period and cohort effects that explain differences in health between the generations at the same age, 12-15 much of which focuses on understanding the health needs of Baby Boomers as they approach retirement. 12,14,16 Much less focus has been placed on the health needs of Generation X and younger generations, particularly when taking a life stage approach to look at differences between the generations at a particular point in time.…”

Smokers' BMI and perceived health: Does the order of questions matter?

“…Jylhä (2009) reports that self-rated health has been used to predict mortality in “around one hundred” separate research studies. Age is known to be associated with self-rated health, such that older people have worse self-assessments (Badley et al, 2015, Wagner and Short, 2014, Manderbacka et al, 1999). Body mass index (BMI), a common indicator of overweight and obesity, is often assessed in self-report surveys (usually by asking for self-reported weight and height).…”