The impact of engineered communities in quality of living (QoL) for retirees in
progressive care programs
Summer Research
Paul Luzuriaga
DBA Program, Florida International University
Cohort 4.5
MAN 7910: Advanced Management Research
Dr. Alfred Castillo
July 31, 2022
2
Content
1
Abstract ......................................................................................................... 4
2
Introduction ................................................................................................... 6
3
Literature review ........................................................................................... 9
4
3.1
Daily practices...................................................................................... 10
3.2
Financial Preparedness ....................................................................... 10
3.3
Medical care status ............................................................................. 11
3.4
Engineered communities .................................................................... 12
3.5
Quality of Living .................................................................................... 14
Research model and hypothesis .............................................................. 16
4.1
Daily practices...................................................................................... 16
4.2
Financial preparedness ....................................................................... 17
4.3
Medical care status ............................................................................. 17
4.4
Engineered Communities .................................................................... 18
4.5
Quality of living in older ages ............................................................. 19
5
Methodology .............................................................................................. 19
6
Data processing ......................................................................................... 22
3
6.1
Database .............................................................................................. 22
6.2
Sample size ........................................................................................... 24
6.3
Questionnaire ....................................................................................... 25
7
Discussion .................................................................................................... 31
8
Conclusions ................................................................................................. 34
9
References .................................................................................................. 36
4
1
Abstract
The proportion of older people in the general population is rapidly
increasing and will be more noticeable in further decades as new generations
tend to have less kids, tend to focus on preventing health complications, and
medicine has more breakthroughs in healing diseases, all leading to higher life
expectancy. It is also noted that the expectancy for a healthy longevity has not
improved at the same pace as life expectancy, and only in recent years it has
started to draw some attention from scholars but not enough to create a trend
among business community. It has been noted that adopting a preventive care
model as the core of longevity research, has the potential to reduce overall
expenses in medical care. Then is the need for a better understanding of how to
provide good health and income security during older ages at sustainable
public and private budgets.
Traditionally, most of the older population prefers to live in their own
housing arrangements or with family members but keeping independence. But,
as life expectancy is growing, more elders are becoming more interested in
entering early to active living and progressive care programs. As the demand
for housing programs for elders grows, new revenue models have been
incorporated to prevent lack of funding in later years with shocking impacts for
elder precisely when care is needed the most.
5
This research will use secondary data from the health and retirement
longitudinal surveys available in the USA from the National Institute of Aging to
validate constructs analyzing the factors impacting Quality of Living among
retirees, and the impact of engineered communities and access to longevity
research in modifying those relationships.
A Life Plan Community, also known as a continuing care retirement
community, is a hybrid of an active adult community and other types of senior
housing, where customers pay a large deposit upfront and small fixed monthly
payments that will cover their expenses until death without unexpected
increases even when entering mental care or nursing home stages. The financial
burden is in the caring company then, and the need to adopt early preventive
measures to reduce expenses in the long term.
6
2
Introduction
During the next ten years, the number of people aged 60 years or over
globally is projected to grow by 38 per cent, from 1 billion to 1.4 billion,
outnumbering youth (Ghebreyesus, 2021). The impact of COVID19 has shed light
on the deficiencies of the health care systems but more specially in older
populations. An important number of assisted living facilities had to close either
because of the important number of deaths among their residents or because
of lack of workforce to take care of the remaining residents. This would have
probably forced people getting closer to retirement to start worrying about
adjusting or making retirement arrangements, their wellbeing in that stage of life,
and their overall longevity once retired. In fact, comparisons from health &
retirements surveys (HRS), longitudinal studies carried in different countries now
covering more than 70% of the population 60 years and older, clearly show that
improving health for older people must start at a much younger age (Smith,
2021) not only to improve life expectancy in the USA but mostly to get a better
aging process and reduce the economic burden in later years.
The traditional health care model for elders has been to accept patients
in assisted living facilities and just let them spend the last years of their lives,
procuring some assistance when symptoms of health issues are present. An
implicit acknowledgement that the end is coming and there is nothing to do
there. Not focusing on preventing health deterioration or in preserving
7
independence and healthy aging. This model seems to exacerbate the
depression issues among residents thus increasing alcohol problems and
accelerating health deterioration, with very limited improvements incorporated
in the last decade. It is just recently that the senior care industry is starting to look
to adopt a hospitality model (Johs-Artisensi et al., 2021) although still in an
incipient form of competitor differentiation in the market. The lack of broader
adoption of that model seems to be derived from the conception that seniors
would not be able to cope with hospitality costs, considering that in the previous
decade, only 10% of the older population held retirement insurance policies,
while another 10% had enough wealth to cover their elder care costs, leaving
around 80% of the population either applying for coverage through federal or
state programs, or depending on the support of family and friends (Ameriks et
al., 2019).
Lately, there is a new development in retirement programs, focused
mainly on reducing the burden of uncertainty of health care costs increases as
people get older and need more assistance. They are called Progressive Care
or Lifetime Programs, and basically operate as prepaid care. This model will
clearly demand better preventive care at early stages of aging rather than
reactive spending when issues get complicated.
8
The potential for commercial developments in the Aging Industry seems
exciting, accounting for around the 20% of the GDP, but is very dependent on
people maintaining good health into older age (Woods & Crampin, 2020).
There seems to be a limited offer of retirement products integrated and
tailored to maximize healthy longevity among retirees but only isolated vendors
selling independent solutions for every stage of retirement, either active living,
independent living, assisted living, and nursing homes. Then real estate
promoters focus only on developing residential units or communities for retirees,
some medical companies establish near those communities, and specific
functionality services might be offered on an individual basis. Then, retired
people do not have real control on their quality of ageing and might be forced
to accept those limited resources without considering if their spending is cost
efficient or not.
On the other hand, it is still to be validated if living in built environments or
engineered communities for retirees makes a difference for a healthy longevity
rather than living alone or with other family members after retirement. And even
further, the impact of relocating for retirement would have on the emotional
wellbeing of the older adults thus in their healthy longevity.
9
This research will find answers for the question: What are the impacts of
engineered communities in the factors driving the quality of living among
retirees?
3
Literature review
The appraisal approach to define preparedness for retirement becomes
helpful as most people who plan for their retirement face four main postures: a
new beginning, a continuation of pre-retirement life, an imposed disruption, a
transition to old age (Hopkins et al., 2006) then those styles having impact on
consumption patterns for and after retirement. Seems like people who start
planning early for their retirement tend retire one or two years before retirement
age (Zappalà et al., 2008). It is still to see if that early retirement is later
correlated with better longevity.
Health and retirement conditions and expectations information has been
collected since 1992 in the USA with the Health & Retirement Survey or HRS
(Fisher & Ryan, 2018) followed by other countries. Continental Europe has
compiled the SHARE survey, similar to the HRS (Börsch-Supan et al., 2005). Those
are frequently used as the base for several studies in older people or retirement
factors. This research will use this information as the main secondary source for
independent variables.
10
3.1
Daily practices
Physical activity decreases with aging either because of the appearance
of body mobility limitations or medical issues preventing people to perform
regular activities or daily routines. The individual response seems to be different
when limitations are congenital, born related or acquired at before adulthood
than when start developing at ages closer to retirement (Slingerland et al.,
2007). The impacts on mental health issues, mostly depression, are more evident
when aging related limitations becomes evident after the age of 50, when most
people would start thinking about retirement (Reitzes et al., 1996).
In the last ten years, there have been some studies focused on
understanding the impacts of leisure centered activities to prevent mental
health deterioration (Kekäläinen et al., 2020) then reducing the burden on
companion services for later ages. It is still to be measured that impact in a
preventive care model.
As population gets older, the impact of daily activities to balance the
three aspects of wellbeing, prevent body decay, stimulate the mind and
spiritual comfort becomes more relevant (Yen et al., 2022).
3.2
Financial Preparedness
The National Institute of Aging, NIA, has been leading several research
initiatives in the impact of financial health at later stages of the workforce, and
11
its impact on retiring early or delaying retirement. Most of the work force seems
to get closer to retirement without securing enough savings or investments to
secure their own increasing expenses during retirement, or did not have
considered the incremental characteristic of medical expenses as aging occurs
(Ameriks et al., 2019). This study will not include the analysis of last resource risky
investments occurred when some people try to force gains in short-term risky
transactions to make up the apparent lost time in building a savings portfolio.
3.3
Medical care status
The importance of studying the interaction between health treatments
becomes more important when dealing with older patients. Underlaying or preexisting conditions and preventive care when studied the whole individual are
easily identified as drivers for Future Elderly Model instead of studying impacts of
isolated medical conditions or diseases, as the traditional research model has
done for years. In recent years, it is more evident the relationship between
physical health care and mental care prompting to more focused research for
slowing the aging process (Goldman et al., 2013).
The FEM model allows to measure the impact of different health factors in
elder population and is based on the Health & Retirement Survey in the US,
already considering several cohorts to measure trends in health care.
12
The hospitality approach considering retirees as customers and not
patients requires different attributes to be considered: the relationship between
residents and staff, the social practices of the business, the knowledge of the
residents likes and dislikes, and the experience during arrival or departure (JohsArtisensi et al., 2021). Most of the programs for retirees’ lack of understanding the
likes and dislikes among program residents or customers but are only based on
general perceptions of the “retired cluster”. Only recently some cities in Europe
with larger retired populations have started changing their offer of services,
tailoring for that specific group rather than the general population.
Some Asian programs for retirees focused on attracting mostly European
and Japanese retirees are built around strong antiaging therapies, showing
strong financial results (Yonei, 2017), and the customer acquisition has been
better that similar programs without those attributes, especially considering that
some of the therapies offered there are not available in most developed
countries. It is still needed to validate the actual benefit from those therapies for
a healthy longevity, but this study is focusing on perception from the consumers.
3.4
Engineered communities
Engineered communities are defined as housing units designed and
configured to facilitate specific purposes. For this study, an engineered
community for retirees would have particular features to facilitate daily activities
13
of adults as they get older. They include active living units, independent living
units, and assisted living units. Nursing homes and memory care units are left out
as they present services more related to health care or palliative care than to
day-to-day activities.
Some researchers have focused either in the quality of facilities
developed for senior living programs (Rodiek, 2008) or in the adoption of
different spatial distribution either to facilitate physical activity or connection to
most commonly used services.
Of interest for this research is the differentiation among communities or
facilities conceived for different stages of independence during the natural
aging process: active living, independent living, assisted living, and nursing
homes. Those would present different requirements in terms of spaces,
connections, and equipment. Most recently, developers have started to plan for
communities with a progression of services based on care needs, starting with
independent
living,
and
ending
with
nursing
homes.
Most
of
those
developments are evolutions from previous living by design research (Bors et al.,
2009).
An additional complexity is added when considering international
community projects, as quality of services and community interactions might be
relevant for people considering relocate for retirement (Wong & Musa, 2015),
14
Mostly considering two trend: the international mobility from people trying
to test from different environments, cultures, emotions, and even love life to
reducing tax exposure and be exposed to longevity treatments not available at
their country of origin (Ashton et al., 2019). Then is the migration trends occurring
within the country of origin, regularly to face better climate conditions or
because specific destinations have been appointed as retirement destinations,
attracting large groups of friends retiring together, or people expecting to find
groups with similar interests there (Gustafson, 2001).
No interaction models have been found while performing this literature
research either with the satisfaction of general retirement life expectations or
with the modification of behavior for the retirement decision making process.
3.5
Quality of Living
Retirement industry refers to business operations related to the relocation
of retirees who seek affordable social care and alternative retirement life.
Factors considered for well-being indexes have been considered for the
general population (Pinquart & Sörensen, 2001; Reitzes et al., 1996; Sawyer &
James, 2018), but only limited factors for the aging population (Bianchi &
Drennan, Judy, 2021; Ruggeri et al., 2020).
Hawes & Phillips studied the links between models and goals of assisted
living trying to identify quality indicators and identified clear breaches between
15
the declared objectives in programs and the actual outcomes in the quality of
service delivered to their customers (Hawes & Phillips, 2007). Analysis for older
age showed clear differences as focus turns mostly towards health and
emotional wellbeing (Bowling & Gabriel, 2007).
In their study, Bowling & Gabriel have defined a short set of 7 questions
relevant for the construct, including:
-
Availability of support from family and friends
-
Health status self-evaluation
-
Activities of daily living score
-
Perception of safety / security
-
Enjoyment in living in the area
-
Financial peace of mind (income/expenses ratio)
16
4
Research model and hypothesis
The structural model is shown in the following picture, with five constructs
and six hypotheses.
Factors and hypotheses for each construct are developed below:
4.1 Daily practices
Defined here as the intentional adoption of recurrent activities to exercise
the body, exercise the mind, and comfort the spirit. Including outdoor activities,
group activities, directed exercises, activities with family and friends, faith, or
cultural activities.
17
The hypotheses considered in this construct is:
H1 (+): As the daily practices to balance body, mind and spiritual
wellbeing increases, the quality of living in older ages will improve as well.
4.2
Financial preparedness
Defined here as the conscious financial planning for savings, cashable
investments, and long-term insurance, or any combination of the three to secure
enough funding for retirement needs in later years.
The hypotheses considered in this construct is:
H2 (+): As the financial preparedness score increases, the quality of living
in older ages will improve as well.
4.3
Medical care status
Defined here as the access to traditional medical care and appropriate
mental care, including family doctor, specialist inter-consults, medication,
diagnostics, and therapies as needed in a timely manner. Also included the
access to innovative or alternative to anti-aging therapies that might or might
not be included in standard health care plans.
The factors and hypotheses considered in this construct are the following:
H3 (+): As the access to comprehensive medical care improves, the
quality of living in older ages will improve as well.
18
4.4
Engineered Communities
Defined here as built environments with the retirement population in mind
that includes multiple living units with own leisure space and some directed
activities.
The factors considered for this construct are the following:
a. Level of independence considered in the environment design,
classifying communities for level of assistance to daily activities of
customers.
b. Connectivity of facilities to satisfy the needs of retired customers, either
basic needs as grocery, pharmacy, medical services, or leisure and
entertainment activities.
c. Comfort level of the designed facilities, including area of units, easiness
to circulate to different areas, interconnection with external and
common areas.
d. Activities considered inside the community facilities, including walking
areas, pools, gym, meeting rooms, both in terms of space distribution
and equipment allocation.
And the following hypotheses should be tested:
H6: The inclusion of better engineered communities should modify the
impact of financial preparedness in quality of living in older ages.
19
H7: The inclusion of engineered communities should modify the impact of
daily practices in quality of living in older ages.
4.5
Quality of living in older ages
Defined here as the self-evaluated comprehensive health status including
physical, mental and emotional well-being.
This dependent variable is constructed based on self-evaluations on daily
activities score, health status, availability to request help from friends and family,
and the enjoyment of living.
5
Methodology
This research is based on secondary data obtained from the Health &
Retirement Survey (HRS) collected in the USA, a cooperative agreement
between the National Institute on Aging (NIA) and the University of Michigan,
with supplemental funding from the U.S. Social Security Administration (SSA).
The University of Michigan Health and Retirement Study (HRS) is a
longitudinal panel study that surveys a representative sample of approximately
20,000 people in America, supported by the National Institute on Aging (NIA)
and the Social Security Administration. The first wave or cohort was designed in
1990, and data collected in 1992. Since then, a new wave of data is collected
20
every 2 years. The last data wave was collected in 2018, but a supplemental
survey was collected in 2019 to capture the main effects of the COVID 19
pandemic.
The main psychosocial domains assessed in the questionnaire are listed
below (Fischer, 2017):
General Topics
Life Satisfaction
Self Perceptions of Aging / Subjective
Age
Satisfaction with Life Domains
Compassion and Self-image Goals
Big 5 Personality Traits
Self-Control / Impulsiveness
Sub-Facets of Trait Conscientiousness
Need for Cognition
Positive & Negative Affect
Psychological Well-being (Purpose in
Life)
Social Participation / Engagement
Experienced Well-being
Retrospective Social Participation
Risk Attitudes
Composition of Social Network
Stressful Life Events
# Close Social Relationships
Lifetime Traumas
Contact with Social Network
Financial Strain
Perceived Social Support
Change in Control over Financial
21
General Topics
Situation
Family and Friends in Neighborhood
Experience of Chronic Stress
Partner Division of Labor
Everyday Discrimination
Cynical Hostility
Attributions of Everday Discrimination
Optimism/Pessimism
Major Experiences of Lifetime
Discrimination
Hopelessness
Unusual Living Circumstances
Loneliness
Neighborhood Disorder / Social
Cohesion
Personal Sense of Control (Agency)
Quality of Relationship with Parents in
Early Life
Domain Specific Control
Anxiety
Social Effort / Reward Balance
Anger
Religiosity / Sprituality
Subjective Social Status (Cantril Ladder)
Prayer Frequency
Day Reconstruction Measure
Work-specific Topics
Work Status
Work Environment Characteristics
Job Satisfaction
Work Ability
Job Stressors
Job Lock
Coworker Support
Work/Family Priorities
22
General Topics
Supervisor Support
Work/Nonwork Interference &
Enhancement
6
6.1
Data processing
Database
The 2018 wave of the NHR survey has over 7,800 variables including
reloaded identification tags, observation notes from interviewer, and verification
& totalization variables for analysis, with a total of 17,146 respondents that
completed the survey. Some sections might be not applicable for some
respondents though, then showing several empty fields in the database.
The database is structured by sections, with all variables grouped in those
sections, as respondents might take a break before completing the whole
survey.

Section PR: Preload (Household)

Section PR: Preload (Respondent)

Section PR: Preload (Jobs)

Section PR: Preload (Pension)

Section PR: Preload (Siblings)
23

Section PR: Preload (HH Member Child)

Section A: Cover screen (Household)

Section A: Coverscreen (Respondent)

Section B: Demographics (Respondent)

Section C: Physical Health (Respondent)

Section D: Cognition (Respondent)

Section E: Family Structure (Children) (Household)

Section E: Family Structure (Children) (HH Member Child)

Section E: Family Structure (Children) and Transfers (To Child)

Section E: Family Structure (Children) and Transfers (From Child)

Section F: Parents, Siblings and Transfers (Respondent)

Section F: Parents, Siblings and Transfers (Siblings)

Section G: Functional Limitations and Helpers (Respondent)

Section G: Functional Limitations and Helpers (Helper)

Section H: Housing (Household)

Section I: Physical Measures (Respondent)

Section J: Employment (Respondent)

Section J2: Pension (Pension)

Section J3: Retirement (Respondent)

Section M1: Disability for Reinterviews (Respondent)

Section M2: Disability for Non-Reinterviews (Respondent)
24

Section N: Health Services and Insurance (Respondent)

Section P: Expectations (Respondent)

Section Q: Assets and Income (Household)

Section R: Asset Change (Household)

Section S: Widowhood and Divorce (Respondent)

Section T: Wills and Life Insurance (Respondent)

Section U: Asset Reconciliation (Household)

Section V: Modules (Respondent)

Section
W:
Event
History,
Internet
Use
and Social
Security
(Respondent)
6.2

Section TN: Thumbnails (Respondent)

Section IO: Interviewer Observations (Respondent)

Section IO: Interviewer Observations-Housing (Household)

Section LB: Leave-Behind Questionnaires (Respondent)

Section Y: Time Calculations (Respondent)
Sample size
The NHR survey 2018 wave showed 17,146 respondents. As this analysis is
performed to test hypotheses affected by active living communities, those
respondents with some cognitive impairment or those already residing in assisted
25
living facilities were discarded, according to responses in questions Q011 and
Q028 of the survey. Then, 15,965 subjects remained for the analysis.
6.3
Questionnaire
Out of the more than 7,000 questions (variables) included in the NHR
survey, the following questions were selected for the initial Exploratory Factor
Analysis.
General and control data:
Code
Group
Tag
Household ID
HHIDPN Gen00 plus PN
(Numeric)
ELAPSED
MONTHS FROM
QA063 Gen00
NOW TO TWO
YRS AGO
R CURRENT AGE
QA019 Gen00
CALCULATION
Type
MARITAL STATUS
ASSIGNED
7
scale
QB063
Gen00
Question
Preloaded
Preloaded
Preloaded
B063 is assigned using values from the
following variables: X065, A007, A023,
A026, A034, A231, B061, and B058
Construct: Daily Practices
Code
Group
QA106
DP1
QA113
DP1
QB082
DP1
Tag
COUNT OF CONTACT
KIDS
COUNT OF CHILD
CHILDLAW AND
GRANDCHILD
HOW OFTEN ATTEND
RELIGIOUS SERV
Type
integer
Question
Number of children in
contact
integer
Number of children and
children in law in contact
5 scale
About how often have you
attended religious services
during the past year?
26
Code
Group
Tag
Type
QC065
DP1
EMOTIONAL/PSYCHIAT
RIC PROBLEMS
4 scale
QC080
QC223
QC224
DP1
DP1
DP1
NUMBER TIMES FALLEN
HOW OFTEN
VIGOROUS ACTIVITY
HOW OFTEN
MODERATE ACTIVITY
Question
Have you ever had or has a
doctor ever told you that you
have any emotional, nervous,
or psychiatric problems?
integer
How many times have you
fallen since [Prev Wave IW
Month]/in the last two
years]]]?
5 scale
We would like to know the
type and amount of physical
activity involved in your daily
life. How often do you take
part in sports or activities that
are vigorous, such as running
or jogging, swimming,
cycling, aerobics or gym
workout, tennis, or digging
with a spade or shovel?
5 scale
And how often do you take
part in sports or activities that
are moderately energetic,
such as gardening, cleaning
the car, walking at a
moderate pace, dancing,
floor or stretching exercises?
And how often do you take
part in sports or activities that
are mildly energetic, such as
vacuuming, laundry, home
repairs?
During the last 12 months, was
there ever a time when you
felt sad, blue, or depressed
for two weeks or more in a
row?
QC225
DP1
HOW OFTEN MILD
ACTIVITY
5 scale
QC150
DP1
FELT DEPRESSED IN PAST
YR
3 scale
QG013
DP1
CHKPNT: COUNT OF
G001 THROUGH G012
integer
Sum of items respondent has
difficulty with
QG037
DP1
R ABILITY TO DRIVE
4
options
Are you able to drive?
27
Code
Group
Tag
Type
QLB001B
DP1
Q01B. DO ACTIVITIES
W/GRANDCHILDREN
7 scale
QLB001
C
DP1
Q01C. VOLUNTEER
YOUTH
7 scale
Question
HOW OFTEN YOU DO EACH
ACTIVITY. Do activities with
grandchildren,
nieces/nephews, or
neighborhood children?
Do volunteer work with
children or young people?
Construct: Financial Preparedness
Code
Group
Tag
Type
Question
QJ963
FP2
WORKED FOR PAY IN LAST
12 MONTHS
y/n
Have you worked for pay in
the last 12 months?
QJ547
FP2
A LOT OF STRESS
4
scale
QJ548
FP2
PREFERENCE TO YOUNG
FOR PROMOTION
4
scale
QJ549
FP2
PRESSURE TO RETIRE
4
scale
GRADUALLY REDUCE HRS
4
scale
As I get older, I would prefer
to gradually reduce the hours
I work on this job, keeping my
pay per hour the same
11
scale
Using a 0 to 10 scale where 0
means "no control at all" and
10 means "very much
control," how would you rate
the amount of control you
have over your financial
situation these days?
QJ550
FP2
QLB025 FP2
Q25. CONTROL OVER
FINANCIAL SITUATION
My job involves a lot of stress
In decisions about promotion,
my employer gives younger
people preference over older
people
My co-workers make older
workers feel that they ought
to retire before age 65
28
Code
Group
QP166
QP007
FP2
FP2
Tag
Type
Question
0-100
On the same scale from 0 to
100, what do you think is the
percent chance that by next
year at this time your home
will be worth [more/less] than
it is today?
0-100
what are the chances that
you [and your
[husband/wife/partner]] will
leave any inheritance?
Type
Question
RATE HAND STRENGTH
4
scale
How would you rate your
hand strength? Would you
say it is very strong, somewhat
strong, somewhat weak, or
very weak?
SHORT OF BREATH
4
scale
How often do you become
short of breath while awake?
Would you say often,
sometimes, rarely, or never?
CHANCE HOME VALUE UP
NEXT YEAR
WILL R LEAVE ANY
INHERITANCE
Construct: Medical care status
Code
QG208
QG209
Group
MC3
MC3
Tag
QG210
MC3
DIFFICULTY WITH BALANCE
4
scale
QLB023
MC3
Q23. CONTROL OVER
HEALTH
11
scale
HEALTH INSURANCE PLAN
SATISFACTION -1
5
scale
QN284_1 MC3
How often do you have
difficulty with balance?
Would you say often,
sometimes, rarely, or never?
Using a 0 to 10 scale where 0
means "no control at all" and
10 means "very much
control," how would you rate
the amount of control you
have over your health these
days?
Overall, how satisfied are you
with this health plan?
29
Code
Group
Tag
Type
QN071
MC3
LTC INSURANCE
y/n
MC3
HOW SATISFIED W/ HEALTH
CARE
5
scale
Thinking about the quality,
cost, and convenience of
your health care, how
satisfied are you overall?
5
scale
Thinking about your
experiences with the health
care system over the past
year, how often were your
wishes for care taken into
account?
QN235
QN295
MC3
HOW SATISFIED W/ HEALTH
CARE
Question
Not including government
programs, do you now have
any long-term care insurance
which specifically covers
nursing home care for a year
or more or any part of
personal or medical care in
your home?
Construct: Type of Housing
Code
Group
Tag
Type
Question
QA099
TH4
NUMBER OF RESIDENT
CHILDREN
integer
Number of resident children in
house
11
scale
Are you generally a person
who tries to avoid taking risks
or one who is fully prepared
to take risks? Please rate
yourself from 0 to 10, where 0
means "not at all willing to
take risks" and 10 means "very
willing to take risks."
TH4
WHAT PER CENT TAKE
RISKS
QLB013
TH4
Q13. NUM FAM MEM
CLOSE RELATIONSHIP
QLB015B
TH4
Q15B. RELY ON FRIENDS IF
PROBLEM
QB132
How many of these family
members would you say you
integer
have a close relationship
with?
How much can you rely on
4 scale them if you have a serious
problem?
30
Code
Group
Tag
Type
Q16A. MEET UP WITH
FRIENDS
On average, how often do
you do each of the following
6 scale with any of your friends, not
counting any who live with
you?
QLB018M TH4
Q18M. NO ONE CARES
MUCH WHAT HAPPENS TO
YOU
6 scale
QLB018B
TH4
Q18B. OPTIMISTIC ABOUT
OWN FUTURE
QLB020D
TH4
Q20D. AFRAID WALK
ALONE AFTER DARK
QLB016A
QLB020G
TH4
TH4
Q20G. PEOPLE HELP YOU
IF IN TROUBLE
Question
No one cares much what
happens to you.
6 scale I'm always optimistic about
my future
People feel safe walking
alone in this area after
dark/People would be afraid
7 scale
to
walk alone in this area
after dark
If you were in trouble, there
are lots of people in this area
7 scale who would help you/If you
were in trouble, there is
nobody in this area who
would help you
Construct: Quality of Life (Dependent Variable)
Code
Group
Tag
Type
QB000
QL5
LIFE SATISFACTION
5
scale
QC001
QL5
RATE HEALTH
5
scale
QC002
QL5
COMPARE HEALTH TO
PREVIOUS WAVE
3
scale
Question
Now, please think about your
life-as-a-whole. How satisfied
are you with it?
Would you say your health is
excellent, very good, good,
fair, or poor?
Compared with your health
when we last asked you in
[Prev Wave IW], would you
say that your health is better
now, about the same, or
worse?
31
Code
Group
Tag
Type
QD101
QL5
RATE MEMORY
5
scale
QL5
RATE MEMORY PAST
3
scale
QL5
NUM TIMES GET TOGETHER
WITH PEOPLE- PER
7
scale
Q02E. CHANGE NONE IF
LIVED LIFE OVER
7
scale
QD102
QF177
QLB002E QL5
QLB024
QP185
7
Question
Part of this study is concerned
with people's memory, and
ability to think about things.
First, how would you rate your
memory at the present time?
Compared to [Last IW], would
you say your memory is better
now, about the same, or
worse now than it was then?
How often do you get
together with people in or
near the facility just to chat or
for a social visit?
Please say how much you
agree or disagree with the
following statements. If I
could live my life again, I
would change almost
nothing.
QL5
Q24. CONTROL OVER
SOCIAL LIFE
11
scale
Using a 0 to 10 scale where 0
means "no control at all" and
10 means "very much
control," how would you rate
the amount of control you
have over your social life
these days?
QL5
TEN YRS FROM NOW
STANDARD LIVING RATING
5
scale
10 years from now, do you
think your own standard of
living will be higher, lower or
the same as now?
Discussion
An Exploratory Factor Analysis was performed on the selected variables to
define the quality of the sample. The analysis was impossible to run with the
32
original dataset as too many variables were heavily correlated or showed no
variance.
After removing the variables that showed no variance within their own
data or strong correlation among them, a set of 31 variables that could be
analyzed was established. The determinant for that matrix was .123, indicative of
low multicollinearity.
After performing the Exploratory Factor Analysis, too many factors were
automatically determined, based on Eigenvalues. Then, forcing to select the 5
expected factors, only 20% of the variance could be explained. A dispersion
that is corroborated by the KMO value obtained of .653.
Reviewing the Rotated Factor Matrix, either too many variables showed
interference with 2 or more factors, or no significant weight on a factor at all,
causing that only 3 factors were possibly extracted, with one construct getting
representative scores for 3 questions, and the other 2, not enough variables to
establish a construct.
33
Figure 1 - Initial Factor Matrix before iterations
34
Figure 2 - Final Factor Matrix after 12 iterations
8
Conclusions
The data samples extracted from the Health & Retirement Survey wave
2018 (HRSw2018) did not provide enough support for the constructs nor
hypotheses established at the beginning of this research.
Most of the data found in the HRSw2018 dealt with demographic data
and existing conditions of the respondents. Either behavioral questions in a
35
dedicated survey or preliminary interpretation of the secondary data collected
would be needed to conduct the proposed research.
The data obtained from the HRSw2018 and the Rand file containing the
longitudinal data starting in wave 2010, was enough to analyze the variance in
only one factor over time, but not for future behavior or decision making
forecasting, as most variables showed multicollinearity in either analysis.
36
9
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10 Appendix A: Data processing documentation