Transitions among BMI States: A Test of Competing Hypotheses

Overweight/obesity and underweight among older adults remain major public health concerns in the United States. This study aims to assess cohort differences in transition among BMI (body mass index) statuses (underweight, normal weight, overweight, and obese) by various cohort and race/ethnicity–gender groups. The empirical work of this study was based on the 1992–2014 Health and Retirement Study (HRS). Multistate life tables (MSLT) were used to assess transitions among different BMI statuses. Results from multistate life tables suggested that the impact of cumulative advantage (disadvantage), persistent inequality, and aging-as-leveler on transition among BMI statuses was shaped along race/ethnicity–gender and cohort lines. Weight management and weight loss strategies should focus on ethnic minorities (i.e., Black and Hispanic populations) and White participants from recent cohorts. Programs aimed at minimizing the negative consequences associated with underweight and weight loss should focus on individuals from earlier cohorts and Black populations.

Multistate life tables using Stata

The mslt command calculates the functions of a multistate life table and plots a graph of conditional and unconditional life expectancies by time. The command provides linear and exponential solutions to estimate the number of individuals, transitions, probabilities, person-years, and years of life in a given cohort and state of occupancy. The input data are time-specific transition rates (or survivorship proportions) between nonabsorbing and at most one absorbing state. In addition to the mean age at transfer between states, mslt calculates the following summary measures: the mean age, the probability of dying, the average duration, and the proportion of life spent in a specific state.

A New Look at the Living Arrangements of Older Americans Using Multistate Life Tables

Objectives We extend existing research on the living arrangements of older Americans by focusing on geographic proximity to children, examining transitions in living arrangements across older ages, and describing differences by both race/ethnicity and educational attainment. Method We use data from the Health and Retirement Study (HRS) over a period of 10 years (2000–2010) to construct multistate life tables. These analyses allow us to describe the lives of older Americans between ages 65 and 90 in terms of the number of expected years of life in different living arrangements, reflecting both mortality and living arrangement transitions. Results Americans spend a substantial proportion of later life living near, but not with, adult children. There is a good deal of change in living arrangements at older ages and living arrangement-specific life expectancy differs markedly by race/ethnicity and educational attainment. However, overall life expectancy is not strongly related to living arrangements at age 65. Discussion Multistate life tables, constructed separately by sex, race/ethnicity, and educational attainment, provide a comprehensive description of sociodemographic differences in living arrangements across older ages in the United States. We discuss the potential implications of these differences for access to support and the exacerbation or mitigation of inequalities at older ages.

Multistate Life Tables: Movement versus Transition Perspectives

This paper attempts to present a comprehensive view of the methodological and empirical aspects involved in the construction of increment–decrement life tables, that is life tables which allow entries into (increments) as well as withdrawals from (decrements) alternative states. The first principal part of the paper, section 2, presents a theoretical exposition of such tables, paralleling that of the ordinary life table, and discusses various issues raised by the conceptualization of multistate life-table functions. The second principal part, section 3, contrasts the two alternative approaches to the applied calculation of such tables. On the one hand, the movement approach, which views interstate transfers as events (such as deaths or births), requires data in the form of occurrence/exposure rates; on the other hand, the transition approach, which regards such transfers as the results of a change in an individual's state of presence between two points in time, uses data in the form of survivorship proportions.