Trends Over 4 Decades in Disability-Free Life Expectancy in the United States

Abstract

Objectives: To examine changes over 40 years (1970-2010) in life expectancy, life expectancy with disability, and disability-free life expectancy for American men and women of all ages.

Methods: We used mortality rates from US Vital Statistics and data on disability prevalence in the community-dwelling population from the National Health Interview Survey; for the institutional population, we computed disability prevalence from the US Census. We used the Sullivan method to estimate disabled and disability-free life expectancy for 1970, 1980, 1990, 2000, and 2010.

Results: Over the 40 years, there was a steady increase in both disability-free life expectancy and disabled life expectancy. At birth, increases in disabled life and nondisabled life were equal for men (4.5 years); for women, at birth the increase in life with disability (3.6 years) exceeded the increase in life free of disability (2.7 years). At age 65 years, the increase in disability-free life was greater than the increase in disabled life.

Conclusions: Across the life cycle, there was no compression of morbidity, but at age 65 years some compression occurred.

FIGURE 1—

Age-Specific Prevalence of Institutionalization for Health Reasons at 5 Dates for (a) Males and (b) Females: United States, 1970–2010 Note. Details on sources of data are given in the online appendixes, available as supplements to the online version of this article at http://www.ajph.org.