Recent demographic trends in the Latin American and Caribbean (LAC) region will shape the growth and age composition of its populations for decades to come. The rapid mortality decline that began during the 1950s, and the more recent and even sharper reduction in fertility, will produce unusually high rates of growth of the older population, a large change in overall population age composition, and significant increases in the ratio of older to younger population. According to the 2013 United Nations projections, the number of people aged 60 and over in LAC is expected to increase from 59 million in 2010 to 196 million in 2050, and the number of people aged 80 and over will increase from 8.6 million to more than 44 million during the same period. To explore the process of rapid aging in the LAC, a workshop took place at the National Academy of Medicine in May 2015. Participants of the workshop presented scientific research emphasizing what is unique about aging in LAC and what is similar to other processes around the world, highlighted the main areas where knowledge of the aging process in LAC is insufficient and new research is required, and proposed data collection that will produce information for policymaking while being responsive to the needs of the research community for harmonized, highly comparable information. The workshop afforded participants an opportunity to consider strategies for articulating data collection and research in the region so that country-based teams can reap the benefits from being part of a larger enterprise while simultaneously maintaining their own individuality and responding to the particular needs of each country. Strengthening the Scientific Foundation for Policymaking to Meet the Challenges of Aging in Latin America and the Caribbean summarizes the presentations and discussions of the workshop. Table of Contents Front Matter 1 Introduction 2 Aging in Latin America and the Caribbean in Global Perspective 3 Health Status, Disability, and Mortality 4 Health Care Systems, Access, and Quality 5 Labor Market Participation/Retirement 6 Family and Social Transfers 7 Resilience and Aspects of Well-Being in Older Age 8 Opportunities to Generate Evidence on Older Adults and Move the Research Agenda Forward References Appendix A WORKSHOP AGENDA

Population surveys traditionally collect information from respondents about their circumstances, behaviors, attitudes, and other characteristics. In recent years, many surveys have been collecting not only questionnaire answers, but also biologic specimens such as blood samples, saliva, and buccal swabs, from which a respondent's DNA can be ascertained along with other biomarkers (e.g., the level of a certain protein in the blood). The National Health and Nutrition Examination Survey (NHANES), sponsored by the National Center for Health Statistics (NCHS), has been collecting and storing genetic specimens since 1991, and other surveys, such as the Health and Retirement Study (HRS) funded by the National Institute on Aging, have followed suit. In order to give their informed consent to participate in a survey, respondents need to know the disposition and use of their data. Will their data be used for one research project and then destroyed, or will they be archived for secondary use? Sponsors of repeated cross-sectional surveys, such as NHANES, and of longitudinal surveys that follow panels of individuals over time, such as HRS, generally want to retain data for a wide range of secondary uses, many of which are not explicitly foreseen at the time of data collection. They typically inform respondents that their data will be stored in a secure manner and may be provided to researchers with suitable protections against individual identification. The addition of biologic specimens to a survey adds complications for storing, protecting, and providing access to such data and measurements made from them. There are also questions of whether, when, and for which biologic measurements the results should be reported back to individual respondents. Recently, the cost of full genomic sequencing has plummeted, and research findings are beginning to accumulate that bear up under replication and that potentially have clinical implications for a respondent. For example, knowing that one possesses a certain gene or gene sequence might suggest that one should seek a certain kind of treatment or genetic counseling or inform one's blood relatives. Biomedical research studies, in which participants are asked to donate tissues for genetic studies and are usually told that they will not be contacted with any results, are increasingly confronting the issue of when and which DNA results to return to participants. Issues in Returning Individual Results from Genome Research Using Population-Based Banked Specimens, with a Focus on the National Health and Nutrition Examination Survey is the summary of a workshop convened in February 2013 by the Committee on National Statistics in the Division of Behavioral and Social Sciences and Education of the National Research Council. This report considers how population surveys, in particular NHANES, should implement the reporting of results from genomic research using stored specimens and address informed consent for future data collection as well as for the use of banked specimens covered by prior informed consent agreements. The report will be of interest to survey organizations that include or contemplate including the collection of biologic specimens in population surveys for storing for genetic research. The issues involved are important for advancing social, behavioral, and biomedical knowledge while appropriately respecting and protecting individual survey respondents.

Among the poorest and least developed regions in the world, sub-Saharan Africa has long faced a heavy burden of disease, with malaria, tuberculosis, and, more recently, HIV being among the most prominent contributors to that burden. Yet in most parts of Africa-and especially in those areas with the greatest health care needs-the data available to health planners to better understand and address these problems are extremely limited. The vast majority of Africans are born and will die without being recorded in any document or spearing in official statistics. With few exceptions, African countries have no civil registration systems in place and hence are unable to continuously generate vital statistics or to provide systematic information on patterns of cause of death, relying instead on periodic household-level surveys or intense and continuous monitoring of small demographic surveillance sites to provide a partial epidemiological and demographic profile of the population. In 1991 the Committee on Population of the National Academy of Sciences organized a workshop on the epidemiological transition in developing countries. The workshop brought together medical experts, epidemiologists, demographers, and other social scientists involved in research on the epidemiological transition in developing countries to discuss the nature of the ongoing transition, identify the most important contributors to the overall burden of disease, and discuss how such information could be used to assist policy makers in those countries to establish priorities with respect to the prevention and management of the main causes of ill health. This report summarizes the presentations and discussions from a workshop convened in October 2011 that featured invited speakers on the topic of epidemiological transition in sub-Saharan Africa. The workshop was organized by a National Research Council panel of experts in various aspects of the study of epidemiological transition and of sub-Saharan data sources. The Continuing Epidemiological Transition in Sub-Saharan Africa serves as a factual summary of what occurred at the workshop in October 2011. Table of Contents Front Matter 1 Introduction 2 The Changing Context of the Transition in sub-Saharan Africa 3 Mortality and Causes of Death 4 Risk Factor Transitions: Exposures and Comparative Risk Assessment 5 The Role of Migration 6 Health Financing in sub-Saharan Africa 7 Data Collection and Validation in Resource-Poor Settings 8 The Epidemiological Transition in Africa: Are There Lessons from Asia? 9 Future Research Directions References Appendix A Workshop Agenda Appendix B Participant List Appendix C Biographical Sketches of Steering Committee Members and Presenters