Demography and Retirement: The Twenty-First Century

Eileen M. Crimmins and Dominique G. Ingegneri

This paper will address the issue of recent and future trends in health among the American population middle aged and older. At the outset it is useful to acknowledge that not all researchers agree as to the direction of changes in health in the recent past and this disagreement leads to shaky ground on which to predict the future. Acknowledging this, however, we will attempt to join the theory and the data concerning health change in the past into a plausible picture which indicates that in recent years there has been no substantial improvement in self-reported health among the American population. In fact, the 1970's appear to have been years of some deterioration in health; and the first part of the 1980's appear to be years of relative stability in health with some hint of improvement in the most recent years. We have yet to experience any sustained period of improvement in reported health among the middle aged and older population.

In the first section of the paper we will describe the changing relationship between morbidity and mortality in recent years and how this has led to disagreement among researchers as to the expected direction of change in health over the past 25 years. Next we will turn to the issue of measuring change in health. In the third section of the paper we will present data on observed changes in health over a twenty year period. Finally, we will discuss the implications of the recent changes in health for the future.

Some may wonder how it is possible to question the direction of trends in health when it is obvious that remarkable strides have been made in extending life in recent years. Life expectancy at birth was 74.9 years in 1988, up from 70.2 in 1968; remarkable improvement in only twenty years. Not only has life

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