Rethinking Morbidity Compression: Increasing Inequality in Age at Morbidity Onset

Rosie Seaman , Max Planck Institute for Demographic Research
Andreas Höhn, MPDIR Rostock and SDU Odense
Rune Lindahl-Jacobsen, Max Planck Odense Center on the Biodemography of Aging
Pekka Martikainen, University of Helsinki
Alyson A. Van Raalte, Max Planck Institute for Demographic Research (MPIDR)
Kaare Christensen, University of Southern Denmark and Odense University Hospital

To evaluate morbidity compression, studies typically report the proportion of life expectancy spent in an unhealthy state. This overlooks variation in age at morbidity onset between individuals, a factor Fries (1980) saw as crucial for determining whether the continuation of disease postponement was possible. We use incidence of first hospitalization after age 60 to study variation in morbidity onset over a 27-year period in Denmark. Number of hospitalizations and the population at risk for each year between 1987 and 2014 were identified using nationwide registry data. Sex-specific life tables were constructed, from which the mean and the coefficient of variation in age at first admission were calculated. Mean age at first admission increased between 1987 and 2014 from 67.8 years (95% CI: 67.7 – 67.9) to 69.5 years (95% CI: 69.4 – 69.6) in men, and 69.1 (95% CI: 69.1 – 69.2) to 70.5 years (95% CI: 70.4 – 70.6) in women. In the same period, the coefficient of variation in age at first admission increased from 9.1% (95% CI: 9.0 – 9.1) to 9.9% (95% CI: 9.8 -10.0) among men and from 10.3% (95% CI: 10.2 – 10.4) to 10.6% (95% CI: 10.5 – 10.6) among women. On average, morbidity has been postponed but variation in age at onset has increased. This variation has important implications for individual life planning and population-level welfare. Pensions, social and health care services will have to adapt to an increasingly heterogeneous ageing population, a phenomenon that trends in the measurement of average morbidity onset cannot identify.

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 Presented in Session 82. Healthy Life Expectancies II