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Assessing morbidity compression in two cohorts from the Health and Retirement Study
Hiram Beltrán-Sánchez1, Marcia P Jiménez2, S V Subramanian3
1Department of Community Health Sciences, Fielding School of Public Health and California Center for Population Research, University of California, Los Angeles, Los Angeles, California, USA.
Background:
Increases in life expectancy are hypothesised to be associated with shorter proportional time spent with morbidity (compression of morbidity). We assessed whether this has occurred among older adults in the USA during the 1990s and 2000s.
Methods:
We used data from the Health and Retirement Study to estimate a morbidity score based on eight chronic conditions and compare it (1) prospectively between two age-matched cohorts in 1992 and 2004 over a 6-year follow-up, and (2) retrospectively in the three waves prior to death among respondents who die in (1998-2004) and (2004-2010).
Results:
Prospective assessment shows significantly higher prevalence in 6 of eight chronic conditions in the 2000s, with 37% higher diabetes prevalence. A retrospective evaluation shows significantly higher prevalence in 7 of eight chronic conditions in the three waves prior to death for (2004-2010) versus (1998-2004), with 41% higher prevalence of arthritis. Importantly, the farther away from time of death, the higher the average number of chronic conditions in (2004-2010).
Conclusions:
Using the largest longitudinal ageing study in the USA, we found no clear evidence of compression of morbidity as measured by self-reported chronic disease. Older adults in the USA may be experiencing greater disease burden in recent times.