Design, Validation, and An Application of the Future Adult Model

This dissertation describes, validates, and utilizes the Future Adult Model (FAM), a dynamic microsimulation model developed for policy analysis of health and health-related outcomes. FAM is based on the Panel Study of Income Dynamics and projects health risk factors (e.g., smoking, body mass index), health outcomes (e.g., diabetes, functional limitations), and health-related economic outcomes (e.g., employment, disability benefits). The first paper describes the model, targeting the description to an audience of model consumers and users. The second paper focuses on the internal consistency and external validity of two key outcomes in FAM: body mass index and diabetes. Internal consistency is assessed by comparing a decade of projections to the host PSID data. External validity is assessed comparing to Behavioral Risk Factor Surveillance System data. The third paper utilizes FAM to assess the potential fiscal consequences of health innovation in the US over the next three decades. This analysis includes analyses of Social Security Old Age and Survivor's Insurance, Social Security Disability Insurance, Supplemental Security Income, Medicare, and Medicaid expenditures, as well as revenues from federal and state taxes. Prevention of any of the chronic diseases considered could result in fiscal savings, with the largest savings for hypertension prevention. Though the potential savings of disease prevention are large, they are no panacea for solvency issues facing entitlement programs like Medicare and Social Security.