Living longer but not necessarily healthier: The joint progress of health and mortality in the working-age population of England

Abstract

Despite improvements in life expectancy, there is uncertainty on whether the increase in years of healthy life expectancy has kept pace. In this paper we explore whether there is empirical support for the expansion of morbidity hypothesis in the population aged 25-64 living in England. Nationally representative cohorts born between 1945 and 1980 are constructed from repeated annual cross-sections of the Health Survey for England, 1991-2014. Later-born cohorts at a given age have the same or higher prevalence of self-reported bad general health and long-term illness, self-reported high blood pressure (in men), self-reported and objectively-measured diabetes, circulatory illnesses, clinical hypertension, and overweight BMI. We also find that healthy life expectancies (in the sense of absence of each of these problems) at age 25 have increased at a slower pace than life expectancy between 1993 and 2013. Our findings lend support to the expansion of morbidity hypothesis and point to increased future demand for specific healthcare services at younger ages.

Keywords: Health Survey for England; Sullivan method; compression of morbidity; expansion of morbidity; healthy life expectancy; population health.