Abstract

Functional limitation (difficulty walking, difficulty bending, paralysis, blindness in at least one eye, or deafness in at least one ear) in the United States fell at an average annual rate of 0.6% among men aged 50 to 74 from the early twentieth century to the early 1990s. Twenty-four percent of this decline is attributable to reductions in the debilitating effects of chronic conditions, 37% is attributable to reduced rates of chronic diseases, and the remainder is unexplained. The findings have implications for theories of the impact of declining mortality rates on the health of elderly people.

The text of this article is only available as a PDF.

References

Barker, D.J.P. (
1992
).
Fetal and Infant Origins of Adult Disease
.
London
:
British Medical Journal Publishing Group
.
Barker, D.J.P. (
1994
).
Mothers, Babies, and Disease in Later Life
.
London
:
British Medical Journal Publishing Group
.
Chirikos, T.N. (
1986
).
Accounting for the Historical Rise in Work-Disability Prevalence
.
Milbank Quarterly
,
64
,
271
301
. 10.2307/3349973
Colvez, A., & Blanchet, M. (
1981
).
Disability Trends in the United States Population 1966–76: Analysis of Reported Causes
.
American Journal of Public Health
,
71
,
464
71
. 10.2105/AJPH.71.5.464
Costa, D.L. (
1998
).
The Evolution of Retirement: An American Economic History, 1880–1990
.
Chicago
:
University of Chicago Press
.
Costa, D.L. 2000a. “Long-Term Declines in Disability Among Older Men: Medical Care, Public Health, and Occupational Change.” National Bureau of Economic Research (NBER) Working Paper No. 7605, March 2000 (http://www.nber.org).
Costa, D.L. (
2000
).
Understanding the Decline in Chronic Conditions Among Older Men
.
Demography
,
37
,
53
72
. 10.2307/2648096
Crimmins, E.M. (
1990
).
Are Americans Healthier as Well as Longer-Lived?
.
Journal of Insurance Medicine
,
22
,
89
92
.
Crimmins, E.M., Saito, Y., & Reynolds, S.L. (
1997
).
Further Evidence on Trends in the Prevalence and Incidence of Disability Among Older Americans From Two Sources: The LSOA and the NHIS
.
Journals of Gerontology, Series B, Psychological Sciences and Social Sciences
,
52
(
2
),
59
71
.
Cutler, D.M., & Richardson, E. (
1997
).
Measuring the Health of the United States Population
Brookings Papers on Economic Activity, Microeconomics
(pp.
217
71
).
Washington, DC
:
Brookings Institution
.
Cutler, D.M. and L. Sheiner. Forthcoming. “Demographic Change and Medicare Cost: Standard and Non-Standard Effect.” In Demographic Change and Fiscal Policy, edited by A. Auerbach. Cambridge, MA: MIT Press.
Elo, I.T., & Preston, S.H. (
1992
).
Effects of Early-Life Conditions on Adult Mortality: A Review
.
Population Index
,
58
,
186
212
. 10.2307/3644718
Fogel, R.W., & Costa, D.L. (
1997
).
A Theory of Technophysio Evolution, With Some Implications for Forecasting Population, Health Care Costs, and Pension Costs
.
Demography
,
34
,
49
66
. 10.2307/2061659
Freedman, V.A., & Martin, L.G. (
1998
).
Understanding Trends in Functional Limitations Among Older Americans
.
American Journal of Public Health
,
88
,
1457
62
. 10.2105/AJPH.88.10.1457
Freedman, V.A., & Martin, L.G. (
1999
).
The Role of Education in Explaining and Forecasting Trends in Functional Limitations Among Older Americans
.
Demography
,
36
,
461
73
. 10.2307/2648084
Freedman, V.A., & Martin, L.G. (
2000
).
The Contribution of Chronic Conditions to Aggregate Changes in Old-Age Functioning
.
American Journal of Public Health
,
90
,
1755
61
. 10.2105/AJPH.90.11.1755
Fries, J.F. (
1980
).
Aging, Natural Death, and the Compression of Morbidity
.
New England Journal of Medicine
,
303
,
130
36
. 10.1056/NEJM198007173030304
Fries, J.F. (
1989
).
he Compression of Morbidity: Near or Far?
.
Milbank Quarterly
,
67
,
208
32
. 10.2307/3350138
Fries, J.F., Williams, C.A., Morfeld, D., Singh, G., & Sibley, J. (
1996
).
Reduction in Long-Term Disability in Patients With Rheumatoid Arthritis by Disease-Modifying Antirheumatic Drug-Based Treatment Strategies
.
Arthritis and Rheumatism
,
39
(
4
),
616
22
. 10.1002/art.1780390412
Gruenberg, E.M. (
1977
).
The Failures of Success
.
Milbank Memorial Fund Quarterly
,
Winter
,
3
24
.
Larsen, C.S., Craig, J., Sering, L.E., Schoeninger, M.J., Russell, K.F., Hutchinson, D.L., & Williamson, M.A. (
1995
).
Cross Homestead: Life and Death on the Midwestern Frontier
. In A.L. Grauer (Ed.),
Bodies of Evidence: Reconstructing History Through Skeletal Analysis
(pp.
139
59
).
New York
:
John Wiley and Sons
.
Lee, C. (
1997
).
Socioeconomic Background, Disease, and Mortality Among Union Army Recruits: Implications for Economic and Demographic History
.
Explorations in Economic History
,
34
,
27
55
. 10.1006/exeh.1996.0661
Manton, K.G. (
1982
).
Changing Concepts of Morbidity and Mortality in the Elderly Population
.
Milbank Memorial Fund Quarterly
,
60
,
183
244
. 10.2307/3349767
Manton, K.G., Corder, L., & Stallard, E. (
1997
).
Changes in the Age Dependence of Mortality and Disability: Cohort and Other Determinants
.
Demography
,
34
,
135
57
. 10.2307/2061664
Manton, K.G., Corder, L., & Stallard, E. (
1997
).
Chronic Disability Trends in Elderly United States Populations: 1982–1994
.
Proceedings of the National Academy of Sciences
,
94
,
2593
98
. 10.1073/pnas.94.6.2593
Poterba, J.M., & Summers, L.H. (
1987
).
Public Policy Implications of Declining Old-Age Mortality
. In G. Burtless (Ed.),
Work, Health, and Income Among the Elderly
(pp.
19
51
).
Washington, DC
:
Brookings Institution
.
Riley, J.C. (
1989
).
Sickness, Recovery, and Death: A History and Forecast of Ill Health
.
Houndsmill, England
:
Macmillan
.
Verbrugge, L.M. (
1984
).
Longer Life but Worsening Health? Trends in Health and Mortality of Middle Aged and Older Persons
.
Milbank Quarterly
,
62
,
475
519
.
Waidmann, T., Bound, J., & Schoenbaum, M. (
1995
).
The Illusion of Failure: Trends in the Self-Reported Health of the U.S. Elderly
.
Milbank Quarterly
,
73
,
253
87
. 10.2307/3350259