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

1
The Health of Older Men
in the Past

Dora L. Costa


1.1 Introduction

The population of the United States has been rapidly aging—slowly at first, more rapidly recently. In 1910, only 4 percent of the population was older than sixty-four. By 1940 the figure was 7 percent, and by 1990, 13 percent. By 2050 the figure is projected to rise to at least 20 percent (Costa 1998). If life expectancies increase faster than expected, the percentage of the population older than sixty-four in 2050 will be even greater. Vaupel (1991) has argued that children alive today may live ninety on average, or even one hundred years.

What are the consequences of mortality declines for older-age health? Gruenberg (1977) and Verbrugge (1984) have argued that rising longevity may increase both chronic disease and disability rates. Fries' (1980, 1989) theory of the aging process implies that the onset of chronic disease and disability rates can be postponed until the limit of life is reached, thus implying that both chronic disease and disability rates are decreasing. Manton (1982) has argued that even though declines in mortality may increase the prevalence of chronic disease, the rate of progression of chronic disease and therefore of disability may fall.

The empirical evidence available thus far shows that, on the whole, population aging has been accompanied by improvements in elderly chronic disease, disability, and functional limitation rates (for a review of recent

Dora L. Costa is a professor of economics at the University of California, Los Angeles, and
a research associate of the National Bureau of Economic Research.

I thank the National Institute on Aging grants P30 AG12810 and R01 AG19805, and the
Mary Woodard Lasker Charitable Trust and Michael E. DeBakey Foundation, NIH grants
AG19637 and AG10120, the Robert Wood Johnson Foundation, and the Center for Ad-
vanced Study in the Behavioral Sciences.

-21-

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