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Understanding the Improvement in Disability-Free Life Expectancy in the US Elderly Population

In: Insights in the Economics of Aging

Author

Listed:
  • Michael Chernew
  • David M. Cutler
  • Kaushik Ghosh
  • Mary Beth Landrum

Abstract

Understanding how healthy lifespans are changing is essential for public policy. This paper explores changes in healthy lifespan in the U.S. over time and considers reasons for the changes. We reach three fundamental conclusions. First, we show that healthy life increased measurably in the US between 1992 and 2008. Years of healthy life expectancy at age 65 increased by 1.8 years over that time period, while disabled life expectancy fell by 0.5 years. Second, we identify the medical conditions that contribute the most to changes in healthy life expectancy. The largest improvements in healthy life expectancy come from reduced incidence and improved functioning for those with cardiovascular disease and vision problems. Together, these conditions account for 63 percent of the improvement in disability-free life expectancy. Third and more speculatively, we explore the role of medical treatments in the improvements for these two conditions. We estimate that improved medical care is likely responsible for a significant part of the cardiovascular and vision-related extension of healthy life.
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Suggested Citation

  • Michael Chernew & David M. Cutler & Kaushik Ghosh & Mary Beth Landrum, 2016. "Understanding the Improvement in Disability-Free Life Expectancy in the US Elderly Population," NBER Chapters, in: Insights in the Economics of Aging, pages 161-201, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberch:13631
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    References listed on IDEAS

    as
    1. Robert F. Schoeni & Vicki A. Freedman & Robert B. Wallace, 2001. "Persistent, Consistent, Widespread, and Robust? Another Look at Recent Trends in Old-Age Disability," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 56(4), pages 206-218.
    2. Vicki Freedman & Brenda Spillman & Patti Andreski & Jennifer Cornman & Eileen Crimmins & Ellen Kramarow & James Lubitz & Linda Martin & Sharon Merkin & Robert Schoeni & Teresa Seeman & Timothy Waidman, 2013. "Trends in Late-Life Activity Limitations in the United States: An Update From Five National Surveys," Demography, Springer;Population Association of America (PAA), vol. 50(2), pages 661-671, April.
    3. David A. Wise, 2014. "Discoveries in the Economics of Aging," NBER Books, National Bureau of Economic Research, Inc, number wise13-1, March.
    4. David M. Cutler, 2008. "Are We Finally Winning the War on Cancer?," Journal of Economic Perspectives, American Economic Association, vol. 22(4), pages 3-26, Fall.
    5. Vicki Freedman & Robert Schoeni & Linda Martin & Jennifer Cornman, 2007. "Chronic conditions and the decline in late-life disability," Demography, Springer;Population Association of America (PAA), vol. 44(3), pages 459-477, August.
    6. Schoeni, R.F. & Martin, L.G. & Andreski, P.M. & Freedman, V.A., 2005. "Persistent and growing socioeconomic disparities in disability among the elderly: 1982-2002," American Journal of Public Health, American Public Health Association, vol. 95(11), pages 2065-2070.
    7. David M. Cutler & David A. Wise, 2009. "Health at Older Ages: The Causes and Consequences of Declining Disability among the Elderly," NBER Books, National Bureau of Economic Research, Inc, number cutl08-1, March.
    8. Mary Beth Landrum & Kate A. Stewart & David M. Cutler, 2009. "Clinical Pathways to Disability," NBER Chapters, in: Health at Older Ages: The Causes and Consequences of Declining Disability among the Elderly, pages 151-187, National Bureau of Economic Research, Inc.
    9. David M. Cutler & Mary Beth Landrum & Kate A. Stewart, 2009. "Intensive Medical Care and Cardiovascular Disease Disability Reductions," NBER Chapters, in: Health at Older Ages: The Causes and Consequences of Declining Disability among the Elderly, pages 191-222, National Bureau of Economic Research, Inc.
    10. Vicki Freedman & Eileen Crimmins & Robert Schoeni & Brenda Spillman & Hakan Aykan & Ellen Kramarow & Kenneth Land & James Lubitz & Kenneth Manton & Linda Martin & Diane Shinberg & Timothy Waidmann, 2004. "Resolving inconsistencies in trends in old-age disability: Report from a technical working group," Demography, Springer;Population Association of America (PAA), vol. 41(3), pages 417-441, August.
    11. Eileen Crimmins & Mark Hayward & Aaron Hagedorn & Yasuhiko Saito & Nicolas Brouard, 2009. "Change in disability-free life expectancy for Americans 70 years old and older," Demography, Springer;Population Association of America (PAA), vol. 46(3), pages 627-646, August.
    12. David M. Cutler, 2005. "Intensive Medical Technology and the Reduction in Disability," NBER Chapters, in: Analyses in the Economics of Aging, pages 161-184, National Bureau of Economic Research, Inc.
    13. Office of Health Economics, 2007. "The Economics of Health Care," For School 001490, Office of Health Economics.
    14. Linda Martin & Robert Schoeni & Patricia Andreski, 2010. "Trends in health of older adults in the United States: Past, present, future," Demography, Springer;Population Association of America (PAA), vol. 47(1), pages 17-40, March.
    15. Freedman, V.A. & Martin, L.G., 1998. "Understanding trends in functional limitations among older Americans," American Journal of Public Health, American Public Health Association, vol. 88(10), pages 1457-1462.
    16. Anne Case & Angua Deaton, 2015. "Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century," Working Papers 15078.full.pdf, Princeton University, Woodrow Wilson School of Public and International Affairs, Research Program in Development Studies..
    17. Rosen, Allison B. & Stewart, Susan T. & Cutler, David M., 2009. "Forecasting the Effects of Obesity and Smoking on U.S. Life Expectancy," Scholarly Articles 5344184, Harvard University Department of Economics.
    18. Crimmins, Eileen M. & Saito, Yasuhiko, 2001. "Trends in healthy life expectancy in the United States, 1970-1990: gender, racial, and educational differences," Social Science & Medicine, Elsevier, vol. 52(11), pages 1629-1641, June.
    19. David M. Cutler & Adriana Lleras-Muney, 2010. "The Education Gradient in Old Age Disability," NBER Chapters, in: Research Findings in the Economics of Aging, pages 101-120, National Bureau of Economic Research, Inc.
    20. Liming Cai & James Lubitz, 2007. "Was there compression of disability for older Americans from 1992 to 2003?," Demography, Springer;Population Association of America (PAA), vol. 44(3), pages 479-495, August.
    21. David A. Wise, 2010. "Research Findings in the Economics of Aging," NBER Books, National Bureau of Economic Research, Inc, number wise08-1, March.
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    Blog mentions

    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. Erik Tollefson’s journal round-up for 13th June 2016
      by Erik Tollefson in The Academic Health Economists' Blog on 2016-06-13 16:00:03

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    9. Courtney Coile & Kevin S. Milligan & David A. Wise, 2018. "Social Security Programs and Retirement Around the World: Working Longer – Introduction and Summary," NBER Working Papers 24584, National Bureau of Economic Research, Inc.
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    More about this item

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • I31 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - General Welfare, Well-Being

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