Tag: "life expectancy"
Goldman and his colleagues estimate that delayed aging could increase life expectancy by an additional 2.2 years and generate more than $5 trillion in social value. When aging is delayed, say the authors, all fatal and disabling disease risks are also lowered. Although delayed aging would also greatly increase entitlement outlays, the researchers demonstrate that these costs can be managed through modest policy changes, such as indexing the eligibility ages for Social Security and Medicare.
A great deal of medical care is wasteful, we are told, because doctors do too much, patients want too much, and death comes anyway.
Yet, even if medical spending does not prolong life it may nevertheless do a lot to reduce the years that people spend disabled. Many people would consider money spent reducing disability money well spent.
Evidence for Significant Compression of Morbidity in the Elderly is a new NBER Working Paper by David M. Cutler, Kaushik Ghosh, and Mary Beth Landrum. Its authors report that although Americans over 65 have more diseases than they used to, disability “has been compressed into the period just before death.” Their results show that although life expectancy increased .7 years (from 17.5 to 18.2) between 1992 and 2005, disability free life expectancy increased 1.6 years (from 8.8 to 10.4).
Throughout the sample period, they find that the prevalence of major disease in the elderly was relatively constant. About 80 percent of the elderly had at least one major condition in the year before death. Many suffered from more than one. Heart disease afflicted about 38 percent of the elderly 12 months before death. Cancer, Alzheimer’s disease, pulmonary disease, heart attacks, and stroke each afflicted about 25 percent. Hip fracture rates afflicted about 9 percent, and Parkinson’s rates about 4 percent.
The increase in disability free life expectancy occurred despite the fact that the prevalence of chronic disabling conditions like Alzheimer’s and pulmonary disease increased. Though medicine may be able to alleviate the suffering of those with these conditions, the increase in disability free life expectancy may have resulted from progress in preventing heart disease, strokes, and hip fracture. The proportion of the elderly population affected by those acute conditions fell from about 40 percent of the population in 1991 to 30 percent in 2009.
The authors are agnostic about whether medical care has caused the improvement, noting that other unnamed “social and environmental factors” might be also be responsible for at least part of the trend.
A recent Bloomberg article ranked the U.S. health care system 46 out of 48 in efficiency based in part on life expectancy statistics. But Matthew Yglesias at Slate explains that life expectancy is a poor measure of a health care system’s performance:
If we raised the taxes on alcohol and gasoline and then spent all the revenue on a pointless bridge in Alaska, American life expectancy would go up. Not because our health care system would become more efficient, but because fewer people would die in car wrecks and murders. And as it happens, raising those taxes would be a good idea. Fewer people would die in car wrecks and murders!
A new Health Policy Brief from Health Affairs and the Robert Wood Johnson Foundation examines research on health disparities in the United States:
In [another] study, the country was divided into race-county units, and the researchers found that the life expectancy of one subgroup of black males, which the authors identified as high-risk urban black males, was more than 20 years shorter than Asian females’ life expectancy.
The brief then asks:
What are the policy implications? The brief discusses what policies can be put in place to ameliorate preventable disparities…
But this runs counter to the normal approach that has dominated health policy research for some time, which is also the economic approach: That is to ask how many additional years of life are produced by spending a dollar on various policy alternatives. The economist’s answer is: we should spend money on various programs until the extra years of life gained per dollar spent are the same across all policy options. When that happens, we are maximizing the years of life gained for a given budget. Alternatively we are minimizing the cost of the extra life expectancy we produce.
If we maximize years of life saved per dollar of expenditure, we may not get more equality. We may get more inequality. I think I can say with some confidence that we definitely would not get absolute equality.
This is Peter Orszag:
Our common perception is that retirement is a time when we can relax and take better care of ourselves after stressful careers. But what if work itself is beneficial to our health, as several recent studies suggest?
The evidence is mixed, but:
Examining the growing educational gradient in life expectancy from 1997 to 2006, Montez and Zajacova focused on white women ages 45 to 84. In addition to differential trends in smoking by education, they concluded that among these women “employment was, in and of itself, an important contributor.” The life expectancy of less-educated women was being shortened by their lower employment rates compared with those of highly educated women.
Health Care Expenditures in the Last Two Years of Life
As this graph shows, the total cost of nursing home care during a person’s last two years is extremely sensitive to that person’s longevity and rises steadily as that persons attained age increases. But the cost of that patient to Medicare during those final two years actually decreases. As the article concluded, “longevity after the age of 65 has a larger effect on the costs of nursing home care […] than on the costs of services covered by Medicare.” Thus, the increasing number of persons eligible for Medicare in the future will certainly increase that program’s costs, but their increasing longevity is itself a benign factor. Or as Harvard economist David Cutler concluded, “longer life in itself will not add to Medicare costs.”
Richard Kaplan at the Health Care Blog.
As early as the 1970s, researchers found that immigrants lived several years longer than American-born whites even though they tended to have less education and lower income, factors usually associated with worse health. That gap has grown since 1980…Evidence is mounting that the second generation does worse. Exploratory estimates based on data from 2007 to 2009…show that Hispanic immigrants live 2.9 years longer than American-born Hispanics.
[One study] found that immigrants had at least a 20 percent lower overall cancer mortality rate than their American-born counterparts.
Mortality rates from heart disease were about 16 percent lower, for kidney disease 18 percent lower, and for liver cirrhosis 24 percent lower.
This is from The NYT.
“The best childhood personality predictor of longevity was conscientiousness — the qualities of a prudent, persistent, well-organized person,” according to the two professors…
“It was not cheerfulness and it was not having a sociable personality that predicted long life across the many ensuing decades,” she and Friedman wrote in their book. “Certain other factors were also relevant, but the prudent, dependable children lived the longest. The strength of this finding was unexpected, but it proved to be a very important and enduring one.”