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Gradual Change, Homeostasis, and Punctuated Equilibrium: Reconsidering Patterns of Health in Later Life

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Demography

Abstract

Longitudinal methods aggregate individual health histories to produce inferences about aging populations, but to what extent do these summaries reflect the experiences of older adults? We describe the assumption of gradual change built into several influential statistical models and draw on widely used, nationally representative survey data to empirically compare the conclusions drawn from mixed-regression methods (growth curve models and latent class growth analysis) designed to capture trajectories with key descriptive statistics and methods (multistate life tables and sequence analysis) that depict discrete states and transitions. We show that individual-level data record stasis irregularly punctuated by relatively sudden change in health status or mortality. Although change is prevalent in the sample, for individuals it occurs rarely, at irregular times and intervals, and in a nonlinear and multidirectional fashion. We conclude by discussing the implications of this punctuated equilibrium pattern for understanding health changes in individuals and the dynamics of inequality in aging populations.

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Acknowledgments

This research was supported by the Steven H. Sandell Grant Program for Junior Scholars in Retirement Research, the Network on Life Course Health Dynamics and Disparities in 21st Century America (NIA R24AG045061), the Center for Demography of Health and Aging (NIA P30 AG17266) at the University of Wisconsin–Madison, and the Epidemiology and Biostatistics of Aging Training Grant (NIA T32AG000247) at the Johns Hopkins Center on Aging and Health. An earlier version of the manuscript was presented at the 2017 annual meeting of the Population Association of America. We thank Joshua Garoon, Douglas Wolf, and two anonymous reviewers for thought-provoking comments that strengthened this article.

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  1. Department of Sociology, Center for Demography of Health and Aging, and Center for Demography and Ecology, University of Wisconsin–Madison, Madison, WI, 53706, USA

    Michal Engelman & Heide Jackson

  2. Maryland Population Research Center, University of Maryland, College Park, MD, 20742, USA

    Heide Jackson

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  1. Michal Engelman
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Correspondence to Michal Engelman.

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Engelman, M., Jackson, H. Gradual Change, Homeostasis, and Punctuated Equilibrium: Reconsidering Patterns of Health in Later Life. Demography 56, 2323–2347 (2019). https://doi.org/10.1007/s13524-019-00826-x

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