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The elimination of selected chronic diseases in a population: The compression and expansion of morbidity

Author

Listed:
  • Nusselder, W.J.
  • Van Velden, K.D.
  • Van Sonsbeek, J.L.A.
  • Lenior, M.E.
  • Van Den Bos, G.A.M.

Abstract

Objectives. This study evaluates the effect of eliminating a specific disease on the mortality, long-term disability, and overall health status of a population. Primarily, it examines whether elimination leads to a compression of morbidity. Methods. The Sullivan method was used to calculate disability-free life expectancy. Cause-deleted disability prevalence was estimated with a multiple logistic regression model that used data from the Dutch National Survey of General Practice. Cause-deleted probabilities of dying were derived with the cause-elimination life-table technique, assuming independence among competing causes of death. Results. Eliminating disabling nonfatal diseases such as arthritis/back complaints results in a decline in life expectancy with disability-that is, an absolute compression of morbidity. Eliminating highly fatal diseases such as cancer leads to an increase in the number of years and the proportion of life with disability- that is, a relative expansion of morbidity. Conclusions. While eliminating fatal diseases leads to an increase in disability-free life expectancy, life expectancy with disability may increase as well. This represents an increasing burden to society. On the other hand, eliminating nonfatal disabling diseases leads to absolute compression of morbidity.

Suggested Citation

  • Nusselder, W.J. & Van Velden, K.D. & Van Sonsbeek, J.L.A. & Lenior, M.E. & Van Den Bos, G.A.M., 1996. "The elimination of selected chronic diseases in a population: The compression and expansion of morbidity," American Journal of Public Health, American Public Health Association, vol. 86(2), pages 187-194.
    • Handle: RePEc:aph:ajpbhl:1996:86:2:187-194_7
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    Cited by:

    1. Schulz, Erika & Leidl, Reiner & Konig, Hans-Helmut, 2004. "The impact of ageing on hospital care and long-term care--the example of Germany," Health Policy, Elsevier, vol. 67(1), pages 57-74, January.
    2. Kurimori, Sugako & Fukuda, Yoshiharu & Nakamura, Keiko & Watanabe, Masafumi & Takano, Takehito, 2006. "Calculation of prefectural disability-adjusted life expectancy (DALE) using long-term care prevalence and its socioeconomic correlates in Japan," Health Policy, Elsevier, vol. 76(3), pages 346-358, May.
    3. Joan Costa-Font & Raphael Wittenberg & Concepció Patxot & Adelina Comas-Herrera & Cristiano Gori & Alessandra di Maio & Linda Pickard & Alessandro Pozzi & Heinz Rothgang, 2008. "Projecting Long-Term Care Expenditure in Four European Union Member States: The Influence of Demographic Scenarios," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 86(2), pages 303-321, April.
    4. Wilma Nusselder & Caspar Looman, 2004. "Decomposition of differences in health expectancy by cause," Demography, Springer;Population Association of America (PAA), vol. 41(2), pages 315-334, May.

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