Health at Older Ages: The Causes and Consequences of Declining Disability among the Elderly

By David M. Cutler; David A. Wise | Go to book overview

6
Intensive Medical Care
and Cardiovascular Disease
Disability Reductions

David M. Cutler, Mary Beth Landrum, and Kate A. Stewart

Disability among the elderly has declined markedly in the United States in the past two decades. In 1984, 25 percent of the elderly population reported difficulty with activities associated with independent living.1 By 2004 and 2005, the share had fallen to below 20 percent, a decline of one fifth.

Although these basic facts are well known, the interpretation of these facts is not clear. Is the reduction in disability a result of improved medical care, individual behavioral changes, or environmental modifications that allow the elderly to better function by themselves? Will the trend continue, or is it time limited? What does the reduction in disability mean for years of healthy life and labor force participation? We explore these issues in this chapter.

To make progress, we focus on disability caused by a specific set of medical conditions—cardiovascular disease. Focusing on one condition is helpful because it allows us to analyze health shocks and their sequelae in some detail. Cardiovascular disease (CVD) is a natural condition to pick because it is the most common cause of death in the U.S. (and most other developed

David M. Cutler is the Otto Eckstein Professor of Applied Economics and Dean for the So-
cial Sciences at Harvard University and an affiliate of the National Bureau of Economic Re
search. Mary Beth Landrum is an associate professor of Biostatistics in the Department of
Health Care Policy at Harvard Medical School. Kate A. Stewart is a researcher at Mathe-
matica Policy Research, Inc., and was a Ph.D. candidate in Health Policy at Harvard Medical
School when this research was completed.

We are grateful to the National Institute on Aging grants P30 AG12810 and R01 AG19805,
and the Mary Woodard Lasker Charitable Trust and Michael E. DeBakey Foundation for re-
search support.

1. The data are from the National Long-Term Care Survey, a survey we describe later and
use in this chapter.

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