Changing Mortality and Morbidity Rates and the Health Status and Life Expectancy of the Older Population

Citation: Crimmins, Hayward, Saito (1994) Changing Mortality and Morbidity Rates and the Health Status and Life Expectancy of the Older Population. Demography (RSS)
Internet Archive Scholar (search for fulltext): Changing Mortality and Morbidity Rates and the Health Status and Life Expectancy of the Older Population
Tagged: uw-madison (RSS), wisconsin (RSS), sociology (RSS), demography (RSS), prelim (RSS), qual (RSS), WisconsinDemographyPrelimAugust2009 (RSS)

Summary

This paper demonstrates the consequences of changes in mortality and health transition rates for changes in both health status life expectancy and the prevalence of health problems in the older population. From the Longitudinal Study of Aging (LSOA), the authors compose a 5-state multistate life tables for the mid-1980s detailing health status information. They operationalize health status using indicators of functioning ability, which are divided into a set of states defined according to independence and the ability to provide self-fare. The dependent states are (1) being unable to independently provide personal care and (2) being able to provide personal care but not able to manage life in the home independently. The independent states are (3) being able to provide both personal care and independent living but having some difficulty in performing these tasks or in getting about outside the home and (4) having no functioning difficulties. The final state (0) is being dead. Transitions to high-numbered states are regarded as improvements in functioning; transitions to lower-numbered states as deterioration in functioning. Status differences between the beginning and the end of intervals are used to determine transitions in health status. Results show that change in mortality creates the greatest changes in levels of life expectancy at the oldest ages. Improving mortality alone implies increases in both the years and the proportion of dependent life; improving morbidity along reduces both the years and the proportion of dependent life. If mortality and morbidity change together, the relative length of dependent life remains virtually unchanged. The prevalence of disability also is affected by changes in both mortality and morbidity. Again, improving mortality alone leads to a higher prevalence of dependent individuals in the life table population; improving morbidity alone leads to a lower percentage of individuals with problems in functioning. The authors' simulations demonstrate that a population certainly can experience longer expected life but worsening health. In fact, it is probably reasonable to assume that this is the situation in the early stages of declining death rates from chronic diseases. As progress is made, the progression of these diseases may be arrested at earlier stages.