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Healthy life expectancy, mortality, and age prevalence of morbidity

Author

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  • Timothy Riffe

    (Max Planck Institute for Demographic Research, Rostock, Germany)

  • Alyson A. van Raalte

    (Max Planck Institute for Demographic Research, Rostock, Germany)

  • Maarten J. Bijlsma

    (Max Planck Institute for Demographic Research, Rostock, Germany)

Abstract

In calculating period healthy life expectancy, the use of age-specific morbidity prevalence patterns assumes that age captures the important time-variation in the given health condition, i.e. that the disabling process is related to how long an individual has lived. However, many morbidity patterns are better classified by time-to-death. At advanced ages the conflation of an increasing chronological-age mortality pattern and a time-to-death morbidity pattern produces an apparent morbidity pattern that increases with advancing age. Differences in period healthy life expectancy over time or between populations cannot easily be partitioned into morbidity and mortality components because the period morbidity pattern may depend on an unknown future time-to-death process not captured by period mortality. We illustrate these concepts formally and empirically, using morbidity data from the U.S. Health and Retirement Study. While holding the time-to-death morbidity pattern fixed, we show that mortality reduction alone reduces the total life years with disability. We estimate the magnitude of this bias for different realistic morbidity patterns. This has implications for any between- or within-population comparisons of period healthy life expectancy conditioned on different age patterns of mortality.

Suggested Citation

  • Timothy Riffe & Alyson A. van Raalte & Maarten J. Bijlsma, 2017. "Healthy life expectancy, mortality, and age prevalence of morbidity," MPIDR Working Papers WP-2017-015, Max Planck Institute for Demographic Research, Rostock, Germany.
  • Handle: RePEc:dem:wpaper:wp-2017-015
    DOI: 10.4054/MPIDR-WP-2017-015
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    References listed on IDEAS

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    1. Claudia Geue & Andrew Briggs & James Lewsey & Paula Lorgelly, 2014. "Population ageing and healthcare expenditure projections: new evidence from a time to death approach," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(8), pages 885-896, November.
    2. Evgeny M. Andreev & Vladimir Shkolnikov & Alexander Begun, 2002. "Algorithm for decomposition of differences between aggregate demographic measures and its application to life expectancies, healthy life expectancies, parity-progression ratios and total fertility rat," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 7(14), pages 499-522.
    3. Kenneth Manton & Kenneth Land, 2000. "Active life expectancy estimates for the U.S. elderly population: A multidimensional continuous-mixture model of functional change applied to completed Cohorts, 1982–1996," Demography, Springer;Population Association of America (PAA), vol. 37(3), pages 253-265, August.
    4. Peter Zweifel & Stefan Felder & Markus Meiers, 1999. "Ageing of population and health care expenditure: a red herring?," Health Economics, John Wiley & Sons, Ltd., vol. 8(6), pages 485-496, September.
    5. Scott M. Lynch, 2015. "Editor's choice Commentary on "Disability Trajectories at the End of Life: A Countdown Model" The Problems With Time-to-Death as a Predictor of Disability," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 70(5), pages 753-756.
    6. Evgeny M. Andreev & Vladimir M. Shkolnikov & Alexander Z. Begun, 2002. "Algorithm for decomposition of differences between aggregate demographic measures and its application to life expectancies, Gini coefficients, health expectancies, parity-progression ratios and total ," MPIDR Working Papers WP-2002-035, Max Planck Institute for Demographic Research, Rostock, Germany.
    7. 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.
    8. Timothy Riffe & Pil H. Chung & Jeroen J. A. Spijker & John MacInnes, 2015. "Time-to-death patterns in markers of age and dependency," MPIDR Working Papers WP-2015-003, Max Planck Institute for Demographic Research, Rostock, Germany.
    9. Imai, Kosuke & Soneji, Samir, 2007. "On the Estimation of Disability-Free Life Expectancy: Sullivan's Method and Its Extension," Journal of the American Statistical Association, American Statistical Association, vol. 102, pages 1199-1211, December.
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    JEL classification:

    • J1 - Labor and Demographic Economics - - Demographic Economics
    • Z0 - Other Special Topics - - General

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