Gains in health expectancy from the elimination of diseases among older people.

Abstract

This paper examines a health expectancy based approach to obtaining disease-specific measures of the contribution of health problems to loss of healthy life among older people. Health expectancies combine mortality and morbidity into a single population health measure. The objectives of this study are to evaluate the usefulness of potential gains in health expectancies as a measure of health impact of various chronic diseases and injury among older people and to examine whether elimination of specific diseases and injuries leads to a compression or expansion of morbidity. Results are presented for Australians aged 65 years and over in 1993. The results highlight the importance of the chronic non-fatal diseases such as osteoarthritis and eyesight and hearing problems as causes of disability and handicap in older people. Elimination of such diseases results in an increase in healthy years of life while total life expectancy remains unchanged, leading to an absolute compression of morbidity. At the other extreme, elimination of highly fatal diseases such as cancer can result not only in an increase in healthy years but an even larger increase in years with disability, resulting in a relative expansion of morbidity.