An, Y., Chin, S. & Miller, R. Growing Old in Rural America: Measuring Late Life Health and Economic Well-being. The Journal of the Economics of Ageing, 100565.
Abstract: We estimate well-being among older rural Americans with an expected utility framework and simulations using longitudinal data spanning nearly 30 years from the Health and Retirement Study. At age sixty, we find mean rural consumption expenditures of $24,105, a retirement probability of 53%, and a remaining life expectancy of 20.3 years for the cohort born 1931-36. When adjusting life expectancy for living in poor health, we obtain an age sixty quality adjusted life expectancy (QALE) of only 15.4 years. Our welfare metric suggests well-being among rural residents who report loneliness is only about half that of the non-lonely rural residents—largely driven by substantial consumption and QALE gaps. We also document substantial regional variation in rural well-being. Moreover, we find that older rural Americans are generally falling further behind older urban Americans across birth cohorts. Most of this widening gap is driven by declining relative consumption and wealth as opposed to health.
Abstract: We estimate well-being among older rural Americans with an expected utility framework and simulations using longitudinal data spanning nearly 30 years from the Health and Retirement Study. At age sixty, we find mean rural consumption expenditures of $24,105, a retirement probability of 53%, and a remaining life expectancy of 20.3 years for the cohort born 1931-36. When adjusting life expectancy for living in poor health, we obtain an age sixty quality adjusted life expectancy (QALE) of only 15.4 years. Our welfare metric suggests well-being among rural residents who report loneliness is only about half that of the non-lonely rural residents—largely driven by substantial consumption and QALE gaps. We also document substantial regional variation in rural well-being. Moreover, we find that older rural Americans are generally falling further behind older urban Americans across birth cohorts. Most of this widening gap is driven by declining relative consumption and wealth as opposed to health.
Working Papers
An, Y., Komarek, T. & Miller, R. (2025). Population Aging, Regional Integration, and Economic Growth Across U.S. Counties.
Abstract: This paper examines how population aging has impacted economic growth across U.S. counties from 2000 to 2020, with a focus on spatial variation between metropolitan and non-metropolitan areas. Using an instrumental variables approach that leverages lagged age structure to address endogeneity concerns, we find that aging significantly reduces per capita GDP growth in non-metro counties but has smaller and often statistically insignificant effects in metro counties. Decomposing by industry reveals that aging tends to depress output in agriculture, construction, mining, manufacturing, and public-sector employment—particularly in rural areas—while raising output in sectors like healthcare and professional services. Importantly, we also find that the negative growth effects of aging are mitigated in counties with greater economic openness, measured by commuting inflows from surrounding areas. These results suggest that the local consequences of demographic aging depend not only on industrial structure, but also on regional integration and labor market connectivity. Our results underscore the need for targeted strategies to support sectoral adaptation and mitigate economic decline in aging rural regions.
Abstract: This paper examines how population aging has impacted economic growth across U.S. counties from 2000 to 2020, with a focus on spatial variation between metropolitan and non-metropolitan areas. Using an instrumental variables approach that leverages lagged age structure to address endogeneity concerns, we find that aging significantly reduces per capita GDP growth in non-metro counties but has smaller and often statistically insignificant effects in metro counties. Decomposing by industry reveals that aging tends to depress output in agriculture, construction, mining, manufacturing, and public-sector employment—particularly in rural areas—while raising output in sectors like healthcare and professional services. Importantly, we also find that the negative growth effects of aging are mitigated in counties with greater economic openness, measured by commuting inflows from surrounding areas. These results suggest that the local consequences of demographic aging depend not only on industrial structure, but also on regional integration and labor market connectivity. Our results underscore the need for targeted strategies to support sectoral adaptation and mitigate economic decline in aging rural regions.
Selected Works in Progress
Emotional Shocks and Complications in the Workplace, with Sayorn Chin and Sammy Zahran.
Lead Exposure and Maternal Health, with Sayorn Chin and Sammy Zahran.
Urban Heat Island and Health Outcomes.