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Understanding the Twentieth Century Decline in Chronic Conditions Among Older Men

  • Dora L. Costa

I use a sample of Union Army veterans to trace the impact of a high infant mortality rate in area of enlistment, such infectious disease as acute respiratory infections, measles, typhoid fever, tuberculosis, rheumatic fever, diarrhea, and malaria while in the army, occupation at enlistment, and occupation at older ages on chronic respiratory problems, various heart conditions, and joint and back problems at older ages. I find that between 1900 and the present the prevalence of respiratory conditions at older ages fell by 70 percent, that of arrhythmias, murmurs, and valvular heart disease by 90 percent, atherosclerosis by 60 percent, and joint and back problems by 30 percent. Occupational shifts accounted for 15 percent of the decline in joint problems, over 75 percent of the decline in back problems, and 25 percent of the decline in respiratory difficulties. Reduced exposure to infectious disease accounted for at least 10 to 25 percent of the decline in chronic conditions. I also find that the duration of chronic conditions has remained unchanged since the early 1900s but that if disability is measured by difficulty in walking, men with chronic conditions are now less disabled than they were in the past.

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Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 6859.

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Date of creation: Dec 1998
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Publication status: published as Demography, Vol. 37, no. 1 (February 2000): 53-72.
Handle: RePEc:nbr:nberwo:6859
Note: DAE AG
Contact details of provider: Postal: National Bureau of Economic Research, 1050 Massachusetts Avenue Cambridge, MA 02138, U.S.A.
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  1. Lee, Chulhee, 1997. "Socioeconomic Background, Disease, and Mortality among Union Army Recruits: Implications for Economic and Demographic History," Explorations in Economic History, Elsevier, vol. 34(1), pages 27-55, January.
  2. Timothy Waidmann & John Bound & Michael Schoenbaum, 1995. "The Illusion of Failure: Trends in the Self-Reported Health of the U.S. Elderly," NBER Working Papers 5017, National Bureau of Economic Research, Inc.
  3. Bartel, Ann & Taubman, Paul, 1979. "Health and Labor Market Success: The Role of Various Diseases," The Review of Economics and Statistics, MIT Press, vol. 61(1), pages 1-8, February.
  4. David Cutler & Mark McClellan & Joseph Newhouse, 1998. "The Costs and Benefits of Intensive Treatment for Cardiovascular Disease," NBER Working Papers 6514, National Bureau of Economic Research, Inc.
  5. Dora Costa & Richard H. Steckel, 1997. "Long-Term Trends in Health, Welfare, and Economic Growth in the United States," NBER Chapters, in: Health and Welfare during Industrialization, pages 47-90 National Bureau of Economic Research, Inc.
  6. Samuel H. Preston & Michael R. Haines, 1991. "Fatal Years: Child Mortality in Late Nineteenth-Century America," NBER Books, National Bureau of Economic Research, Inc, number pres91-1, October.
  7. Dora L. Costa, 1998. "The Evolution of Retirement: An American Economic History, 1880-1990," NBER Books, National Bureau of Economic Research, Inc, number cost98-1, October.
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