Are we living longer but less healthy? Trends in mortality and morbidity in Catalonia (Spain), 1994–2011

Abstract

Evidence on trends in prevalence of disease and disability can clarify whether countries are experiencing a compression or expansion of morbidity. An expansion of morbidity, as indicated by disease, has appeared in Europe and other developed regions. It is likely that better treatment, preventive measures, and increases in education levels have contributed to the declines in mortality and increments in life expectancy. This paper examines whether there has been an expansion of morbidity in Catalonia (Spain). It uses trends in mortality and morbidity and links these with survival to provide estimates of life expectancy with and without diseases and mobility limitations. We use a repeated cross-sectional health survey carried out in 1994 and 2011 for measures of morbidity, and information from the Spanish National Statistics Institute for mortality. Our findings show that at age 65 the percentage of life with disease increased from 52 to 70 % for men, and from 56 to 72 % for women; the expectation of life with mobility limitations increased from 24 to 30 % for men and from 40 to 47 % for women between 1994 and 2011. These changes were attributable to increases in the prevalence of diseases and moderate mobility limitation. Overall, we find an expansion of morbidity along the period. Increasing survival among people with diseases can lead to a higher prevalence of diseases in the older population. Higher prevalence of health problems can lead to greater pressure on the health care system and a growing burden of disease for individuals.

Complex health problems among the oldest old in Sweden: increased prevalence rates between 1992 and 2002 and stable rates thereafter

“…This study investigates changes between 1992, 2002, and 2011 in the prevalence of complex health problems, i.e., the simultaneous presence of diseases/symptoms, cognitive, and physical functional limitations, in three national representative samples of the Swedish population aged 77 and over. Speculation about the compression or expansion of morbidity in the population has led to numerous trend studies using population survey data (Chatterji et al 2015;Robine and Michel 2004;Sole-Auro and Alaniz 2014). Results have revealed diverging trends depending on countries, time points, methodology and on which health indicator has been used (Crimmins and Beltrán-Sánchez 2011;Parker and Thorslund 2007).…”

Risk of dependence associated with health, social support, and lifestyle

“…However, the number of individuals suffering from chronic diseases, disabilities, and functional limitations, resulting in dependence, has increased in absolute terms in recent decades. 1 , 18 In addition, an increase in life expectancy 22 significantly impacts the planning of health services and contributes to socioeconomic costs, because of the need of long-term care. 9 , 19 An in-depth analysis of the situation may reveal the trends that present a highly complex phenomenon such as aging and its relationship with the health.…”

Has working-age morbidity been declining? Changes over time in survey measures of general health, chronic diseases, symptoms and biomarkers in England 1994–2014

“…Again, not all measures show deteriorations, and not all studies come to identical conclusions,18 but there is little sign of any improvement in morbidity among working-age Americans—despite a 23% fall in working-age mortality 1993–2013 (online supplementary appendix 1). Outside of the USA, there is a paucity of evidence, but from the limited evidence that exists, there is again little sign of improving morbidity 19–22…”