When Regions Are Status Categories: Does Longer Life Lead to Longer Ill Health?

Abstract

An average individual’s remaining life expectancy free of disability—referred to as healthy or active life expectancy—is a popular measure of population’s state of health. Such expectancies are often calculated to address the question whether the currently observed increases in total life expectancy are accompanied by increases in active life expectancy. Past studies used to conclude that the positive trends in the prolongation of life had not been matched by similar trends in the extension of healthy life. Typical of their assessments was the pessimistic conclusion that Americans were not living longer healthy lives. Additions to life expectancy, it was argued, were concentrated in the disabled years—primarily years of long-term disability. This chapter challenges such conclusions and demonstrates that a reliance on prevalence rather than incidence rates in the analysis leads to the pessimistic assessment.