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Disability and Morbidity among US Birth Cohorts, 1998-2018: A Multidimensional Test of Dynamic Equilibrium Theory

Ageing data

Tianyu Shen and Collin Payne

Abstract: A substantial body of prior research has explored patterns of disability-free and morbidity-free life expectancy (LE) among older populations. However, these distinct facets of later-life health are almost always studied in isolation, even though they are very likely to interact with each other. Using data from the US Health and Retirement Study (HRS) and a multistate life table approach, this paper explores the interactions between disability, morbidity, and mortality among four successive US birth cohorts, born from 1914-1923 to 1944-1953. These 10-year cohorts are compared in the periods 1998-2008 and 2008-2018. The LE and health expectancies (HEs) are calculated via demographic microsimulation, and are modelled separately by sex, educational attainment and race/ethnicity. We find little compression of disability but a substantial expansion of morbidity across cohorts in each of the three age ranges. Investigating interactions between morbidity and disability, we find that disability-free life expectancy (DFLE) among those living with chronic morbidities has increased, but that at the population level DFLE is largely unchanged across successive cohorts. Investigating patterns in population sub-groups, we find that less advantaged populations (low educated and non- white groups) live substantially fewer years free of disabilities or chronic morbidities. Broadly, these patterns suggest that the link between chronic morbidities and disability has weakened over time in the US population. However, at the population level, successive cohorts are spending fewer years of life free of both chronic morbidities and disability.

This paper has been published in SSM-Population Health. For the peer-reviewed paper, please refer to https://doi.org/10.1016/j.ssmph.2023.101528


Suggested citation (APA): Shen, T., & Payne, C. F. (2023). Disability and morbidity among US birth cohorts, 1998–2018: A multidimensional test of dynamic equilibrium theory. SSM - Population Health, 101528. https://doi.org/https://doi.org/10.1016/j.ssmph.2023.101528


KeywordsMorbidity, Disability, Aging, Dynamic equilibrium, Health expectancy


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