The Avalanche Hypothesis and Compression of Morbidity: Testing Assumptions through Cohort-Sequential Analysis

Area of Science:

• Gerontology
• Public Health
• Health Economics

Background:

• The compression of morbidity model suggests a health breakpoint in adulthood.
• This model's assumption of a health breakpoint has not been empirically tested.
• This study investigates the existence and timing of such a health breakpoint.

Purpose of the Study:

• To test the assumption of a morbidity tipping point.
• To identify the age at which health status begins to significantly deteriorate.
• To investigate an analogous tipping point for healthcare costs.

Main Methods:

• Retrospective analysis of morbidity and healthcare costs data from 55,550 adults.
• Utilized cohort-sequential and hockey stick regression models.
• Data collected in Pittsburgh, PA (2006-2009); analyses conducted in 2012-2013.

Main Results:

• Morbidity increased exponentially with age (P<.001).
• A significant morbidity tipping point was identified at 45.5 years.
• Healthcare costs also exhibited exponential growth with a tipping point at 39.5 years.

Conclusions:

• The findings support the existence of a morbidity tipping point, confirming a key assumption.
• The identified morbidity tipping point (45.5 years) may occur earlier than commonly assumed.
• Healthcare costs began to rise significantly about 6 years before the morbidity tipping point, indicating an "avalanche of morbidity" and costs.