Effects of Improved Morbidity Rates on Active Life Expectancy and Eligibility for Long-Term Care Services

Abstract

This study examines effects of better health on active life expectancy and eligibility for long-term care services, using data from the 1984-1990 Longitudinal Study of Aging and microsimulation techniques. Results show that better health increases total life expectancy (TLE), the proportion of life spent unimpaired, and the amount of time spent unimpaired. Women experience larger proportional increases in active life expectancy under assumptions of better health. Better health also reduces the proportion of men and women who would be eligible for long-term care services. However, better health decreases the proportion of men eligible for long-term care services more than it decreases the eligible proportion of women. The results reinforce the importance of focusing on policies designed to promote healthy lifestyles and to reduce the prevalence of chronic conditions.

Get full access to this article

View all access options for this article.

References

Arno, P. S. , Levine, C. , & Memmott, M. (1999). The economic value of informal caregiving. Health Affairs, 18, 182-188.

Blair, S. N. , Kampert, J. B. , Kohl, H. W. , Barlow, C. E. , Macera, C. A. , Paffenbarger, R. S. , & Gibbons, L. A. , (1996). Influences of cardiorespiratory fitness and other precursors on cardiovascular disease and all-cause mortality in men and women. Journal of the American Medical Association, 276, 205-210.

Branch, L. G. , Guralnik, J. M. , Foley, D. J. , Kohout, F. J. , Wetle, T. T. , Ostfeld, A. , & Katz, S. (1991). Active life expectancy for 10,000 Caucasian men and women in three communities. Journal of Gerontology: Medical Sciences, 46, M145-M150.

Clark, D. O. , Maddox, G. L. ,& Steinhauser, K. (1993). Race, aging, and functional health. Journal of Aging and Health, 5, 536-553.

Colvez, A. , & Blanchet, M. (1981). Disability trends in the United States population 1966-76: Analysis of reported causes. American Journal of Public Health, 71, 464-471.

Crimmins, E. M. , Hayward, M. D. , & Saito, Y. (1994). Changing mortality and morbidity rates and the health status and life expectancy of the older population. Demography, 31, 159-175.

Crimmins, E. M. , Hayward, M. D. , & Saito, Y. (1996). Differentials in active life expectancy in the older population of the United States. Journal of Gerontology: Social Sciences, 51B, S111-S120.

Crimmins, E. M. , Saito, Y. , & Ingegneri, D. (1989). Changes in life expectancy and disability-free life expectancy in the United States. Population and Development Review, 15, 235-267.

Crimmins, E. M. , Saito, Y. , & Ingegneri, D. (1997). Trends in disability-free life expectancy in the United States, 1970-90. Population and Development Review, 23, 555-572.

10.

Fiatarone, M. A. , O'Neill, E. F. , Ryan, N. D. , Clements, K. M. , Solares, G. R. , Nelson, M. E. , Roberts, S. B. , Kehayis, J. J. , Lipsitz, L. A. , & Evens, W. J. (1994). Exercise training and nutritional supplementation for physical frailty in very elderly people. NewEngland Journal of Medicine, 330, 1769-1775.

11.

Freedman, V. A. ,& Martin, L. G. (1998). Understanding trends in functional limitations among older Americans. American Journal of Public Health, 88, 1457-1462.

12.

Fries, J. F. (1980). Aging, natural death, and the compression of morbidity. NewEngland Journal of Medicine, 303, 130-135.

13.

Gruenberg, E. M. (1977). The failures of success. Milbank Memorial Fund Quarterly, 55, 3-24.

14.

Hayward, M. D. , & Heron, M. (1999). Racial inequity in active life among adult Americans. Demography, 36, 77-91,

15.

Jackson, M. E. , Burwell, B. , Clark, R. F. ,& Harahan, M. (1992). Eligibility for publicly financed home care. American Journal of Public Health, 82, 853-856.

16.

Katz, S. , Ford, A. B. , Moskowitz, R. W. , Jackson, B. A. , & Jaffee, M. W. (1963). Studies of illness in the aged. The index of ADL: A standardized measure of biological and psychosocial function. Journal of the American Medical Association, 185, 914-919.

17.

Kovar, M. G. , Fitti, J. E. ,& Chyba, M. M. (1992). The Longitudinal Study of Aging: 1984-1990. In Vital health statistics(Vol. 28). Hyattsville, MD: National Center for Health Statistics.

18.

Laditka, S. B. (1998). Modeling lifetime nursing home use under assumptions of better health. Journal of Gerontology: Social Sciences, 53B, S177-S187.

19.

Laditka, S. B. ,& Wolf, D. A. (1998). Newmethods for analyzing active life expectancy. Journal of Aging and Health, 10, 214-241.

20.

Land, K. C. , Guralnik, J. M. ,& Blazer, D. G. (1994). Estimating increment-decrement life tables with multiple covariates from panel data: The case of active life expectancy. Demography, 31, 297-319.

21.

Lubitz, J. , Beebe, J. B. ,& Baker, C. (1995). Longevity and Medicare expenditures. NewEngland Journal of Medicine, 332, 999-1003.

22.

Manton, K. G. (1988). A longitudinal study of functional change and mortality in the United States. Journal of Gerontology: Social Sciences, 43, S153-S161.

23.

Manton, K. G. , Corder, L. , & Stallard, E. (1993). Estimates of change in chronic disability and institutional incidence and prevalence rates in the U.S. elderly population from the 1982, 1984, and 1989 National Long Term Care Survey. Journal of Gerontology: Social Sciences, 48, S153-S166.

24.

Manton, K. G. ,& Soldo, B. (1985). Dynamics of health changes in the oldest old: New perspectives and evidence. Milbank Quarterly, 63, 206-281.

25.

McCartney, N. , Hicks, A. L. , Martin, J. , & Webber, C. E. (1996). A longitudinal trial of weight training in the elderly: Continued improvements in year 2. Journal of Gerontology: Biological Sciences, 51A, B425-B433.

26.

Mihelic, A. H. ,& Crimmins, E. M. (1997). Loss to follow-up in a sample of Americans 70 years of age and older: The LSOA 1984-1990. Journal of Gerontology: Social Sciences, 52B, S37-S48.

27.

Reed, D. M. , Foley, D. J. , White, L. R. , Heimovitz, H. , Burchfiel, C. M. , & Masaki, K. (1998). Predictors of healthy aging in men with high life expectancies. American Journal of Public Health, 88, 1463-1468.

28.

Rogers, R. C. , Rogers, A. , & Belanger, A. (1992). Disability-free life among the elderly in the United States: Sociodemographic correlates of functional health. Journal of Aging and Health, 4, 19-42.

29.

Rowe, J. W. , & Kahn, R. L. (1998). Successful aging. New York: Pantheon.

30.

Russell, L. B. (in press). Cost-effectiveness analysis. In G. Chapman & F. Sonnenberg (Eds.), Decision making in health care: Theory, psychology, and applications. Cambridge, UK: Cambridge University Press.

31.

Soldo, B. A. ,& Freedman, V. A. (1994). Care of the elderly: Division of labor among the family, market, and state. In L. G. Martin & S. H. Preston (Eds.), Demography of aging (pp. 195-216). Washington, DC: National Academy Press.

32.

U.S. Department of Health and Human Services . (1994). Vital statistics of the United States, 1990, Vol. II: Mortality Part A. Hyattsville, MD: National Center for Health Statistics.

33.

Vaupel, J. W. , Carey, J. R. , Christensen, K. , Johnson, T. E. , Yashin, A. I. , Holm, N. V. , Iachine, I. A. , Kannisto, V. , Khazaeli, A. A. , Liedo, P. , Longo, V. D. , Zeng, Y. , Manton, K. G. ,& Curtsinger, J. W. (1998). Biodemographic trajectories of longevity. Science, 280, 855-860.

34.

Vita, A. J. , Terry, R. B. , Hubert, H. B. , & Fries, J. F. (1998). Aging, health risks, and cumulative disability. New England Journal of Medicine, 338, 1035-1041.

35.

Wiener, J. M. , Hanley, R. J. , Clark, R. , & Van Nostrand, J. F. (1990). Measuring the activities of daily living: Comparisons across national surveys. Journal of Gerontology: Social Sciences, 45, S229-S237.

36.

Wolf, D. A. , & Laditka, S. B. (1997). Stochastic modeling of active life and its expectancy (Papers in Microsimulation Series, Paper No. 4, ISSN 1084-1695). Syracuse, NY: Syracuse University, The Maxwell Center for Demography and Economics of Aging.