WHAT ARE THE PATHWAYS TO RETIREMENT: DO HEALTH AND COHORT MATTER?

Abstract Studies about retirement often neglect ethnic identity. Yet, racial and ethnic inequality plays an important role in retirement decisions. For instance, minorities are less likely to continue working in old age beyond the normal retirement age because of some individual factors such as poor or fair health, cognitive impairment, functional limitation (Green, 2005; Ghilarducci & Moore, 2015; Mudrazija, 2010), physical limitations (Radl, 2014; Solem et al., 2016; Pienta & Hayward, 2002), retirement benefit and eligibility of pension (Radl, 2014; Honig, 1996). This research examined the influence of ethnicity on whether working for people aged above 60 in Taiwan. In addition to testing the pathways to retirement, we scrutinized how occupational sector mediates the likelihood of ethnic effect on retirement. After comparing two cohorts from the dataset “Taiwan Longitudinal Study in Aging”, we found that working in public sector, white-collar workers, being a Mainlander, being non-married, higher education, self-reported bad health and functional limitation are all associated with the higher likelihood of retirement. Finding suggested that the incentive structure of the public pension for public sector workers, who are mostly Mainlanders, could contribute to the higher likelihood of retirement. However, the magnitude of mediator is much larger for the older cohort than the younger cohort. The study not only could benefit cumulative advantage approach by analyzing East Asia data but also bring policy implication, that retirement policy makers should reduce public pension incentive for public sector workers to delay the retirement age.


UNDERSTANDING NON-MEDICAL COSTS FOR HEALTH CARE: EVIDENCE FROM INPATIENT CARE FOR OLDER PEOPLE IN CHINA
Wei Yang 1 , 1. King's College London, London, United Kingdom Non-medical costs can constitute a substantial part of total health care costs, especially for older people. Costs associated with carers, travel, food and accommodation for family members accompanying and caring for older people during their medical visits can be hefty. This study seeks to examine the effects of non-medical costs on catastrophic health payments and health payment-induced poverty among older people in rural and urban China. Using data from the China Health and Retirement Longitudinal Survey 2015, this study finds that inpatient costs account for a significant proportion of household expenditure, and non-medical costs can account for approximately 18% of total costs. That share is highest for those who belong to the lowest wealth groups. Non-medical costs increase the chances of older people incurring catastrophic health payments and suffering from health payment-induced poverty. Such effects are more concentrated among the poor than the rich. The results also show that the rural population are more likely to incur catastrophic health payments and suffer from health payment induced poverty compared to the urban population. This paper urges policy makers to consider reimbursing the non-medical costs of patient care, improving health care systems in general and for the rural populations specifically.

WEALTH PROFILES AND VARIATIONS BY GENDER AND RACE: A GROWTH-MIXTURE MULTIGROUP COMPARISON
Yu-Chih Chen, 1 and Nancy Morrow-Howell 1 , 1. Washington University in St. Louis, St. Louis, Missouri, United States Wealth is fundamentally affected by various life course characteristics. However, little is known about the role of life course factors in shaping wealth trajectories in later life. This study explored how the longitudinal profiles of wealth varied by gender and race (white and non-white populations). Data came from the 2004-2014 Health and Retirement Study with 16,189 older adults aged 51 and older. With corrections for clustered effect within household, this study used growth mixture modeling (GMM) to identify the longitudinal patterns of wealth, and how these profiles varied by these two important life course attributes. The model began with a separate GMM model for race and gender to investigate the optimal latent class model. These results were combined using multi-group approach to incrementally examine the gender and race invariance using configural (same form), structural (same trajectory mean), dispersion (same trajectory variance), and distributional (same latent class size) test. Results identified four distinct wealth profiles-Stable high, Low and increasing, Stable low, and High but decline-for each race and gender category. The multigroup GMM analyses revealed that the wealth profiles varied by gender and race, but the degrees of variation differed a great deal, with results supporting a dispersion model for gender but a configural model for race. Results indicate that race has a stronger effect in shaping wealth development compared to gender. The findings suggest that understanding wealth disparities in later life could be facilitated by examining how wealth varies by gender and race.

WHAT ARE THE PATHWAYS TO RETIREMENT: DO HEALTH AND COHORT MATTER?
Fang-Yi Huang, 1 and Min Li 2 , 1. Trinity Washington University, College Park, Maryland, United States,

University of Florida, Gainesville, Florida, United States
Studies about retirement often neglect ethnic identity. Yet, racial and ethnic inequality plays an important role in retirement decisions. For instance, minorities are less likely to continue working in old age beyond the normal retirement age because of some individual factors such as poor or fair health, cognitive impairment, functional limitation (Green, 2005;Ghilarducci & Moore, 2015;Mudrazija, 2010), physical limitations (Radl, 2014;Solem et al., 2016;Pienta & Hayward, 2002), retirement benefit and eligibility of pension (Radl, 2014;Honig, 1996). This research examined the influence of ethnicity on whether working for people aged above 60 in Taiwan. In addition to testing the pathways to retirement, we scrutinized how occupational sector mediates the likelihood of ethnic effect on retirement. After comparing two cohorts from the dataset "Taiwan Longitudinal Study in Aging", we found that working in public sector, white-collar workers, being a Mainlander, being nonmarried, higher education, self-reported bad health and functional limitation are all associated with the higher likelihood of retirement. Finding suggested that the incentive structure of the public pension for public sector workers, who are mostly Mainlanders, could contribute to the higher likelihood of retirement. However, the magnitude of mediator is much larger for the older cohort than the younger cohort. The study not only could benefit cumulative advantage approach by analyzing East Asia data but also bring policy implication, that retirement policy makers should reduce public pension incentive for public sector workers to delay the retirement age. Due to the rapid climate change in recent years, global communities have seen an increased frequency of large-scale natural and man-made disasters. Acknowledging extravagant lifestyles and wasteful consumption of natural resources as prominent factors leading to intensified stress placed on the biosphere and ecosystems, many older adults with chronic medical conditions or disabilities in Taiwan have promoted environmental sustainability through two ways: 1) participating a recycling program in their local communities by collecting, sorting, and reclaiming reusable resources that are regenerated into eco-friendly blankets for disaster survivors and 2) practicing plant-based diet to promote healthy lifestyle and mitigate climate change. These older participants of environmentally sustainable initiatives believe the interconnectedness among humanity, the environment, and sustainable lifestyles. To understand association between the recycling therapy and older adults' well-being a quasi-experimental design with 72 people age 60 and older (recycling group vs. non-recycling group) and photovoice were used to examine longitudinal effects of the recycling therapy on physical and mental health. To examine the effects of plantbased diet on dementia and health care cost ten-year data from Taiwan's National Health Insurance Database were used by two studies to compare risk of dementia and medical expenditure between vegetarian and non-vegetarian groups among older adults in Taiwan. Four presentations in the symposium will discuss positive outcomes of environmental volunteering on older adults' physical and mental wellness and longitudinal effects of a cohort with environmental-friendly diet on dementia risk and lower actual health care expenditures. To promote environmental sustainability and mitigate climate change that causes numerous families to suffer from natural disasters, a group of older residents' volunteer to recycle usable materials by setting up recycling stations in their communities and transform recycled bottles into eco-friendly blankets for disaster survivors globally. This study examined long-term effects of the peer-led Tzu Chi Recycling Program (TCRP) on older adults' compassion, psychological and physiological well-being. Using a quasi-experimental design, 1-year longitudinal data were collected from older adults at recycling stations (intervention group n = 36) and community centers (control group n = 36) in rural areas in Southern Taiwan. Findings from two-way repeated analysis of variance show that TCRP significantly improved older adults' selfcompassion, compassion for others, depression, hostility, happiness, and hypertension. Older adults built resilience through environmental volunteering in the TCRP as an environmental sustainability model for health promotion and social good High antioxidants and phytochemicals from plant foods may protect against cognitive decline, while saturated fats from animal based foods considered as risk factors have been associated with dementia. Plant-based diets with limited animal products have been shown to improve glycemic control and reduce diabetes risk. The study aims to examine the association between vegetarian diet and dementia risk in a prospective cohort study. Quantitative data collected from 12,062 participants of Tzu Chi Vegetarian Study from 2005 to 2014 in Taiwan. Data included self-administered questionnaire on demographics, medical history, life-style, and a 57-item food frequency questionnaire (FFQ), National Health Insurance Database and the National Death Registry. Findings show that compared with non-vegetarians, vegetarians had 38% lower risk of dementia (HR = 0.62, 95% CI = 0.39, 0.98) after adjusting for age, sex, education, marital status, physical activities, smoking, alcohol drinking, hypertension, diabetes, hyperlipidemia, and ischemic heart diseases.

ASSOCIATION BETWEEN ENVIRONMENTALLY FRIENDLY DIET AND LOWER HEALTH CARE EXPENDITURES
Chin-Lon Lin, 1 Tina H. Chiu, 2 Jen-Hung Huang, 3 and Ming-Nan Lin 1 , 1. Dalin Tzu Chi Hospital,Chiayi,Taiwan (Republic of China),2. Fu Jen Catholic University,Xinzhuang,New Taipei,Taiwan (Republic of China),3. Hualien Tzu Chi Hospital,Hualien,Hualien,Taiwan (Republic of China) Vegetarian diets have decreased incidence rates of chronic non-communicable diseases that have been associated with burden on medical systems worldwide. Previous studies propose a relationship between meat consumption and high medical expenditure; however, there is a dearth in