# Determinants of Elderly Health: The Role of Place-Based Factors

> **NIH NIH R37** · MASSACHUSETTS INSTITUTE OF TECHNOLOGY · 2024 · $469,617

## Abstract

PROJECT SUMMARY/ABSTRACT
Determinants of Elderly Health: The Role of Place-Based Factors
 The goal of the proposed research is to better understand the factors affecting the health and health
behaviors of the elderly population in the United States by moving beyond the work of the prior grant, which
aggregated analysis of elderly healthcare utilization, to look directly at health behaviors and health outcomes.
As recent work has shown, there are large disparities in life expectancy among the Medicare population by
race, income, and geography, despite access to the same universal health insurance program. By examining
two potential broad-based forces, person-specific factors (“health capital”), which can include genetic
endowments as well as prior medical care, and place-based factors (“current place effects”), which is the
environment associated with their current location, we hope to gather findings that will greatly enrich not only
our understanding of the factors that affect the elderly’s health behaviors and health, but also shed light on the
likely efficacy of alternative policies aimed at improving elderly health behaviors and health.
 To accomplish this goal, the proposal has three central Aims. In Aim 1, we focus on a specific, harmful
health behavior: opioid addiction. The elderly population uses prescription opioids at a higher rate than any
other age group, therefore suggesting that this crisis is acute among the elderly and may worsen as the near-
elderly continue to age. By analyzing person-specific factors, such as mental health status and prior
substance abuse, as well as place-specific factors, including availability of physicians willing to prescribe
opioids for what they perceive as legitimate reasons or the presence of policies such as prescription monitoring
programs intended to limit abuse, we hope to gain a better understanding of both the causes of the opioid
crisis and the likely impacts of policies designed to combat it.
 In the second part of the proposed renewal, we will extend beyond the empirical methodology
employed in Aim 1 to focus on the role of place-based factors in two specific ways. In Aim 2, we will analyze
the impact of place-based factors on elderly mortality. In Aim 3, we will analyze the role of place-based factors
in contributing to health disparities among the elderly population. It is critical to understand the relative roles of
current place effects and person-specific factors in contributing to elderly mortality and elderly mortality
disparities in order to more fully understand the factors that may lead to elderly mortality and the likely effects
of policies on elderly health. Through these aims we hope to gain a clearer understanding of how person-
specific and place-specific factors affect the health behaviors and health outcomes of the elderly population in
the United States.

## Key facts

- **NIH application ID:** 10837037
- **Project number:** 5R37AG032449-16
- **Recipient organization:** MASSACHUSETTS INSTITUTE OF TECHNOLOGY
- **Principal Investigator:** Amy N. Finkelstein
- **Activity code:** R37 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $469,617
- **Award type:** 5
- **Project period:** 2009-04-01 → 2025-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10837037

## Citation

> US National Institutes of Health, RePORTER application 10837037, Determinants of Elderly Health: The Role of Place-Based Factors (5R37AG032449-16). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10837037. Licensed CC0.

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