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The Rise in Life Expectancy, Health Trends among the Elderly, and the Demand for Health and Social Care


  • Lindgren, Björn

    (Lund University, Lund, Sweden and National Bureau of Economic Research, Cambridge, MA, United States.)


The objective of this report is to review the evidence on (a) ageing and health and (b) the demand for health and social care among the elderly. The issues discussed are: does health status of the elderly improve over time, and how do the trends in health status of the elderly affect the demand for health and social care? The review is based on some 100 published scientific papers. While it is not a complete review, it covers most recent empirical studies of health trends and the changing pattern of demand for health and social care. Health is a multidimensional concept. It includes self-assessed health, presence of disease, functional status, and disability, usually expressed as capacity to perform activities of daily living (ADL). There are certainly elderly who have no problems in any of these dimensions. But health among elderly varies, and to a much larger extent than among younger people. Many elderly have one or more chronic diseases; if the disease is well controlled, there may be no problems in other dimensions of health. If not, other health problems may follow, lowering self-assessed health, creating ADL limitations etc. When analyzing health trends, it is important to cover all four dimensions of health, since the impact on health care and social care differ, depending on which dimension shows improved health. The reviewed literature provides strong evidence that the prevalence of chronic disease among the elderly has increased over time. There is also fairly strong evidence that the consequences of disease have become less problematic due to medical progress: decreased mortality risk, milder and slower development over time, making the time with disease (and health care treatment) longer but less troublesome than before. Evidence also suggests the postponement of functional limitations and disability. Some of the reduction in disability may certainly be attributed to improvements in treatments of chronic diseases. But they are apparently also due to the increased use of assistive technology, public transport, accessibility of buildings, etc. The results, hence, indicate that the ageing individual is expected to need health care for a longer (and not necessarily postponed) period of time than previous generations but elderly care for a shorter (and certainly postponed) period of time. Thus, one might say that the development overall has been in accordance with the “dynamic equilibrium” scenario. A general conclusion of the empirical literature seems to be that expenditures will not be lower over remaining life years but they will be distributed over a longer period of time. Several authors warn against the potential negative impact of an increasing prevalence of obesity on life expectancy, health, and health and social care. The role of technological advances within medicine is highlighted by many authors and its consequences for the elderly analyzed.

Suggested Citation

  • Lindgren, Björn, 2016. "The Rise in Life Expectancy, Health Trends among the Elderly, and the Demand for Health and Social Care," Working Papers 142, National Institute of Economic Research.
  • Handle: RePEc:hhs:nierwp:0142

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    References listed on IDEAS

    1. 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.
    2. Eileen M. Crimmins & Hiram Beltrán-Sánchez, 2010. "Mortality and Morbidity Trends: Is There Compression of Morbidity?," Journals of Gerontology: Series B, Gerontological Society of America, vol. 66(1), pages 75-86.
    3. Felder, Stefan & Meier, Markus & Schmitt, Horst, 2000. "Health care expenditure in the last months of life," Journal of Health Economics, Elsevier, vol. 19(5), pages 679-695, September.
    4. Seshamani, Meena & Gray, Alastair M., 2004. "A longitudinal study of the effects of age and time to death on hospital costs," Journal of Health Economics, Elsevier, vol. 23(2), pages 217-235, March.
    5. Wouterse, B. & Meijboom, B.R. & Polder, J.J., 2011. "The relationship between baseline health and longitudinal costs of hospital use," Other publications TiSEM bdedc33c-9737-4bfc-beee-0, Tilburg University, School of Economics and Management.
    6. Tim Miller, 2001. "Increasing longevity and medicare expenditures," Demography, Springer;Population Association of America (PAA), vol. 38(2), pages 215-226, May.
    7. Benjamins, Maureen Reindl & Hummer, Robert A. & Eberstein, Isaac W. & Nam, Charles B., 2004. "Self-reported health and adult mortality risk: An analysis of cause-specific mortality," Social Science & Medicine, Elsevier, vol. 59(6), pages 1297-1306, September.
    8. Andreas Werblow & Stefan Felder & Peter Zweifel, 2007. "Population ageing and health care expenditure: a school of 'red herrings'?," Health Economics, John Wiley & Sons, Ltd., vol. 16(10), pages 1109-1126.
    9. repec:aph:ajpbhl:1978:68:10:954-956_2 is not listed on IDEAS
    10. Helweg-Larsen, Marie & Kjøller, Mette & Thoning, Henrik, 2003. "Do age and social relations moderate the relationship between self-rated health and mortality among adult Danes?," Social Science & Medicine, Elsevier, vol. 57(7), pages 1237-1247, October.
    11. 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.
    12. Bram Wouterse & Bert R. Meijboom & Johan J. Polder, 2011. "The relationship between baseline health and longitudinal costs of hospital use," Health Economics, John Wiley & Sons, Ltd., vol. 20(8), pages 985-1008, August.
    13. Dov Chernichovsky & Sara Markowitz, 2004. "Aging and aggregate costs of medical care: conceptual and policy issues," Health Economics, John Wiley & Sons, Ltd., vol. 13(6), pages 543-562.
    14. Carter, Lawrence R. & Lee, Ronald D., 1992. "Modeling and forecasting US sex differentials in mortality," International Journal of Forecasting, Elsevier, vol. 8(3), pages 393-411, November.
    15. Wong, Albert & Wouterse, Bram & Slobbe, Laurentius C.J. & Boshuizen, Hendriek C. & Polder, Johan J., 2012. "Medical innovation and age-specific trends in health care utilization: Findings and implications," Social Science & Medicine, Elsevier, vol. 74(2), pages 263-272.
    16. Wouterse, Bram & Huisman, Martijn & Meijboom, Bert R. & Deeg, Dorly J.H. & Polder, Johan J., 2013. "Modeling the relationship between health and health care expenditures using a latent Markov model," Journal of Health Economics, Elsevier, vol. 32(2), pages 423-439.
    17. Baoping Shang & Dana Goldman, 2008. "Does age or life expectancy better predict health care expenditures?," Health Economics, John Wiley & Sons, Ltd., vol. 17(4), pages 487-501.
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    Cited by:

    1. Isabel Correia Dias & Priscila Ferreira & Lígia Costa Pinto & Marieta Valente & Paula Veiga, 2017. "Growing old, unhealthy and unequal: an exploratory study on the health of Portuguese individuals aged 50+," NIMA Working Papers 67, Núcleo de Investigação em Microeconomia Aplicada (NIMA), Universidade do Minho, revised Jun 2018.

    More about this item

    JEL classification:

    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I10 - Health, Education, and Welfare - - Health - - - General
    • I38 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Government Programs; Provision and Effects of Welfare Programs
    • J11 - Labor and Demographic Economics - - Demographic Economics - - - Demographic Trends, Macroeconomic Effects, and Forecasts
    • J14 - Labor and Demographic Economics - - Demographic Economics - - - Economics of the Elderly; Economics of the Handicapped; Non-Labor Market Discrimination

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