Demography and Retirement: The Twenty-First Century

By Anna M. Rappaport; Sylvester J. Schieber | Go to book overview

Discussions

Eric R. Kingson


COMMENTS

Professor Eileen Crimmins' and Dominique Ingegneri's paper does an excellent job of summarizing perspectives and literature about whether current and projected declines in age-specific mortality rates are and will be accompanied by improvements or decrements in the health of middle-aged and older persons. It also presents informative findings from their research on this topic.

As a discussant for this paper I will first summarize some of what we learn from their interesting paper. Then I will identify several questions and issues that I believe need to be addressed.


WHAT WE LEARN FROM THE PAPER

First, from their analysis and review of the literature we learn that in spite of large increases in life expectancy at birth and at older ages from 1968 through 1988, the health of middle-aged and older Americans, on average, does not appear to have improved. We also learn that this trend is consistent with trends in Canada, Great Britain, Japan, and Australia. The discussion and analysis suggests that recent declines in mortality rates which have been driven primarily by reductions in death rates from chronic illnesses have "resulted in people with health limitation living longer" through these people may not "be very severely impaired" ( Crimmins and Ingegnen, 1991). Ironically, They point out, it is "the very factors which have produced the remarkable declines in mortality since the mid-1960's which call into question whether people in 1990 are healthier...as well as longer lived" ( Crimmins and Ingegneri, 1991).

Second, we learn of the complexity surrounding the relationship between morbidity and mortality trends. The authors note that to the extent that age- specific mortality rates decline as a result of decreases in infectious disease (as Was the case in the first half of the century), then the health of the population should also improve. However, potential health outcomes for the surviving population are more ambiguous when improvements in life expectancy result from reductions in death rates from chronic diseases (as has been the case since the mid-1960's). This is because mortality reductions could be associated with, for example, reductions in the prevalence of chronic diseases or with lengthened periods of survivorship after the onset of such diseases. Morever, the relationship between morbidity and mortality is more difficult to disentangle for two other reasons. As mortality declines, the surviving population tends "to be a frailer group" who is more susceptible to a whole host of diseases." Also, much of the health and disability problems of older persons are a function on non-lethal chronic diseases such as arthritis as opposed to "killer" chronic diseases such as cancer. Thus, reductions in case fatalities from prevention or treatment of killer

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Demography and Retirement: The Twenty-First Century
Table of contents

Table of contents

  • Title Page iii
  • MEMBERS OF THE PENSION RESEARCH COUNCIL v
  • Purpose of the Council vii
  • Contents ix
  • 1: Overview 1
  • Introduction 1
  • 2: Demographic Change in the United States, 1970-2050 19
  • ENDNOTES 47
  • Stephen C. Goss 53
  • Barry Edmonston 57
  • Introduction 57
  • 3: Expected Changes in the Workforce and Implications for Labor Markets 73
  • Introduction 73
  • Joseph F. Quinn 105
  • 4: Can Our Social Insurance Systems Survive the Demographic Shifts of the Twenty-First Century? 111
  • Introduction 112
  • ENDNOTES 148
  • 5: The Impact of the Demographic Transition on Capital Formation 163
  • Introduction 163
  • ENDNOTES 180
  • Alicia H. Munnell 183
  • 6: Implications of Demographic Change for Design of Retirement Programs 189
  • 7: Trends in Health Among the American Population 225
  • Introduction 225
  • ENDNOTES 242
  • Discussions 243
  • 8: Population Aging and Retirement Policy: An International Perspective 255
  • Introduction 255
  • ENDNOTES 284
  • Robert J. Myers 293
  • Bibliography 297
  • Index 315
  • Contributors 323
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