Life with and without heart disease among women and men over 50

This article uses a demographic approach and data from the Health and Retirement Survey, a nationally representative sample of the U.S. population, to investigate sex differences in the length of life lived with heart disease and after a heart attack for persons in the United States age 50 and older. On average, women live longer than men with heart disease. At age 50 women can expect to live 7.9 years and men 6.7 years with heart disease. The average woman experiences heart disease onset three years older and heart attacks 4.4 years older than men.     

Change in disability-free life expectancy for Americans 70 years old and older*

In this article, we examine changes in life expectancy free of disability using longitudinal data collected from 1984 through 2000 from two cohorts who composed the Longitudinal Studies of Aging I and II. Life expectancies with and without ADL and/or IADL disability are calculated using a Markov-based multistate life table approach. At age 70, disability-free life expectancy increased over a 10-year period by 0.6 of a year in the later cohort, which was the same as the increase in total life expectancy, both increases marginally statistically significant. The average length of expected life with IADL and ADL disability did not change. Changes in disability-free life expectancy resulted from decreases in disability incidence and increases in the incidence of recovery from disability across the two survey cohorts. Age-specific mortality among the ADL disabled declined significantly in the later cohort after age 80. Mortality for the IADL disabled and the nondisabled did not change significantly. Those with ADL disability at age 70 experienced substantial increases in both total life expectancy and disability-free life expectancy. These results indicate the importance of efforts both to prevent and delay disability and to promote recovery from disability for increasing life expectancy without disability. Results also indicate that while reductions in incidence and increases in recovery work to decrease population prevalence of disability, declining mortality among the disabled has been a force toward increasing disability prevalence.     

Changing mortality and morbidity rates and the health status and life expectancy of the older population

This paper demonstrates the consequences of changes in mortality and health transition rates for changes in both health status life expectancy and the prevalence of health problems in the older population. A five-state multistate life table for the mid-1980s provides the baseline for estimating the effect of differing mortality and morbidity schedules. Results show that improving mortality alone implies increases in both the years and the proportion of dependent life; improving morbidity alone reduces both the years and the proportion of dependent life. Improving mortality alone leads to a higher prevalence of dependent individuals in the life table population; improving morbidity alone leads to a lower percentage of individuals with problems in functioning.     

Indonesia’s social capacity for population health: the educational gap in active life expectancy

In this paper, we lay the initial groundwork for anticipating Indonesia’s future burden of disease by developing a demographic model of population health. We develop this model within the analytic framework of a Markov-based multistate life table model to calculate an important indicator of the burden of disease, the expected years of active life of elderly Indonesians. The magnitude of the gap points to the potential consequences of improvements in the nation’s educational level for the future burden of disease. The results show that having some education increases life expectancy but it also expands the expected years with a major functional problem. Overall educational attainment levels, however, are very low, indicating that Indonesia’s elderly are at the leading edge of improvements in the nation’s social capacity for health. The life tables suggest that at the early stages of development, longer life is accompanied by an expansion of morbidity.