Advertisement

Population Research and Policy Review

, Volume 34, Issue 1, pp 1–18 | Cite as

Are Differences in Disability-Free Life Expectancy by Gender, Race, and Education Widening at Older Ages?

  • Aïda Solé-AuróEmail author
  • Hiram Beltrán-Sánchez
  • Eileen M. Crimmins
Article

Abstract

To examine change from 1991 to 2001 in disability-free life expectancy in the age range 60–90 by gender, race, and education in the United States. Mortality is estimated over two 10-year follow-up periods for persons in the National Health Interview Surveys of 1986/1987 and 1996/1997. Vital status is ascertained through the National Death Index. Disability prevalence is estimated from the National Health and Nutrition Examination Surveys of 1988–1994 and 1999–2002. Disability is defined as ability to perform four activities of daily living without difficulty. Disability-free life expectancy increased only among white men. Disabled life expectancy increased for all groups—black and white men and women. Racial differences in disability-free life expectancy widened among men; gender differences were reduced among whites. Expansion of socioeconomic differentials in disability-free life at older ages occurred among white men and women and black women. The 1990s was a period where the increased years of life between ages 60 and 90 were concentrated in disabled years for most population groups.

Keywords

Disability-free life expectancy Disabled life expectancy Socio-economic differences United States 

Notes

Acknowledgments

The authors gratefully acknowledge the funding provided from the Spanish Ministry of Science and Innovation (ECO2010-21787-C03-01); the Beatriu de Pinós grant 2010–2012; the U.S. National Institute on Aging (P30AG017265; T32AG000037); the David E. Bell Fellowship (Center for Population & Development Studies, Harvard University) and the Center for Demography of Health and Aging at the University of Wisconsin-Madison.

Supplementary material

11113_2014_9337_MOESM1_ESM.docx (33 kb)
Supplementary material 1 (DOCX 33 kb)

References

  1. Alley, D. E., & Chang, V. W. (2007). The changing relationship of obesity and disability, 1988–2004. The Journal of the American Medical Association, 298(17), 2020–2027.CrossRefGoogle Scholar
  2. Bird, C. E., & Rieker, P. P. (2008). Gender and health: The effects of constrained choices and social policies. New York: Cambridge University Press.CrossRefGoogle Scholar
  3. Boyle, C. A., & Decouflé, P. (1990). National sources of vital status information: Extent of coverage and possible selectivity in reporting. American Journal of Epidemiology, 131(1), 160–168.Google Scholar
  4. Cai, L., & Lubitz, J. (2007). Was there compression of disability for older Americans from 1992 to 2003? Demography, 44(3), 479–495.CrossRefGoogle Scholar
  5. Crimmins, E. M., & Cambois, E. (2003). Social inequalities in health expectancy. In J. M. Robine, C. Jagger, C. Mathers, et al. (Eds.), Determing health expectancies (pp. 111–126). Chichester: Wiley.Google Scholar
  6. Crimmins, E.M., Garcia, K., & Kim, J. K. (2010). Are international differences in health similar to international differences in life-expectancy? In E.M. Crimmins, S.H. Preston, and B. Cohen (Eds.), International differences in mortality at older ages: Dimensions and sources; panel on understanding divergent trends in longevity in high-income countries (pp. 66–101). National Research Council.Google Scholar
  7. Crimmins, E. M., Hayward, M. D., Hagedorn, A., Saito, H., & Brouard, N. (2009). Americans 70 years old and older. Demography, 46(3), 627–646.CrossRefGoogle Scholar
  8. Crimmins, E. M., Hayward, M. D., & Saito, Y. (1994). Changing mortality and morbidity rates and the health status and life expectancy of the older U.S. population. Demography, 31(1), 159–175.CrossRefGoogle Scholar
  9. Crimmins, E. M., Hayward, M. D., & Saito, Y. (1996). Differentials in active life expectancy in the older population of the United States. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 51(3), 111–120.CrossRefGoogle Scholar
  10. Crimmins, E. M., Preston, S. H., & Cohen, B. (2011). Explaining divergent levels of longevity in high-income countries. Washington, D.C: National Academies Press.Google Scholar
  11. Crimmins, E. M., & Saito, Y. (2001). Trends in healthy life expectancy in the United States, 1970–1990: gender, racial, and educational differences. Social Science and Medicine, 52(11), 1629–1641.CrossRefGoogle Scholar
  12. Crimmins, E. M., Saito, Y., & Ingegneri, D. (1997). Trends in disability-free life expectancy in the United States, 1970–1990. Population and Development Review, 23(3), 555–572.CrossRefGoogle Scholar
  13. Cutler, D.M., Lange, F., Meara, E., Richards, S., & Ruhm, C.J. (2010). Explaining the rise in educational gradients in mortality. NBER Working Paper No. 15678.Google Scholar
  14. Dupre, M. E. (2007). Educational differences in age-related patterns of disease: Reconsidering the cumulative disadvantage and age-as-leveler hypotheses. Journal of Health and Social Behavior, 48(1), 1–15.CrossRefGoogle Scholar
  15. Freedman, V. A., Spillman, B. C., Andreski, P. M., Cornman, J. C., Crimmins, E. M., Kramarow, E., et al. (2013). Trends in late-life activity limitations in the United States: An update from five national surveys. Demography, 50(2), 661–671.CrossRefGoogle Scholar
  16. Fries, J. F. (1980). Aging, natural death, and the compression of morbidity. The New England Journal of Medicine, 303(23), 1369–1370.CrossRefGoogle Scholar
  17. Geruso, M. (2012). Black-white disparities in life expectancy: How much can the standard SES variables explain? Demography, 49(2), 553–574.CrossRefGoogle Scholar
  18. Goldman, D. P., & Smith, J. P. (2002). Can patient self-management help explain the SES health gradient? Proceedings of the National Academy of Sciences of the United States of America, 99(16), 10929–10934.CrossRefGoogle Scholar
  19. Gruenberg, E. M. (1977). The failures of success. The Milbank Memorial Fund Quarterly, 55(1), 3–24.CrossRefGoogle Scholar
  20. Haas, S., & Rohlfsen, L. (2010). Life course determinants of racial and ethnic disparities in functional health trajectories. Social Science and Medicine, 70(2), 240–250.CrossRefGoogle Scholar
  21. Harper, S., Lynch, J., Burris, S., & Smith, G. D. (2007). Trends in the black-white life expectancy gap in the United States, 1983–2003. Journal American Medical Association, 297(11), 1224–1232.CrossRefGoogle Scholar
  22. Harper, S., Rushani, D., & Kaufman, J. S. (2012). Trends in the black-white life expectancy gap, 2003–2008. The Journal of the American Medical Association, 307(21), 2257–2259.CrossRefGoogle Scholar
  23. Hayward, M., & Heron, M. (1999). Racial inequality in active life among adult Americans. Demography, 36(1), 77–91.CrossRefGoogle Scholar
  24. Jagger, C. (1999). Health expectancy calculation by the Sullivan method a practical guide. Tokyo: Nihon University, Population Research Institute.Google Scholar
  25. Jemal, A., Thun, M. J., Ward, E. E., Henley, S. J., Cokkinides, V. E., & Murray, T. E. (2008). Mortality from leading causes by education and race in the United States, 2001. American Journal of Preventive Medicine, 34(1), 1–8.CrossRefGoogle Scholar
  26. Kindig, D. A., & Cheng, E. R. (2013). Even as mortality fell in most U.S. counties, female mortality nonetheless rose in 42.8 percent of counties from 1992 to 2006. Health Affairs, 32(3), 451–458.CrossRefGoogle Scholar
  27. Kraut, A., Chan, E., & Landrigan, P. J. (1992). The costs of searching for deaths: National Death Index vs Social Security Administration. American Journal of Public Health, 82(5), 760–761.CrossRefGoogle Scholar
  28. Lantz, P. M., House, J. S., Lepkowski, J. M., David, R., Williams, D. R., Richard, P., et al. (1998). Socioeconomic factors, health behaviors, and mortality: Results from a Nationally Representative Prospective Study of US Adults. Journal American Medical Association, 279(21), 1703–1708.CrossRefGoogle Scholar
  29. Lievre, A., Alley, D., & Crimmins, E. M. (2008). Educational differentials in life expectancy with cognitive impairment among the elderly in the United States. Journal of Aging and Health, 20(4), 456–477.CrossRefGoogle Scholar
  30. Manton, K. G. (1982). Changing concepts of morbidity and mortality in the elderly population. The Milbank Memorial Fund Quarterly, 60(2), 183–244.CrossRefGoogle Scholar
  31. Manton, K. G., Gu, X., & Lowrimore, G. R. (2008). Cohort changes in active life expectancy in the U.S. elderly population: Experience from the 1982–2004 national long-term care survey. Journal of Gerontology, 63B, S269–S281.CrossRefGoogle Scholar
  32. Meara, E. R., Richards, S., & Cutler, D. M. (2008). The gap gets bigger: Changes in mortality and life expectancy, by education, 1981–2000. Health Affairs, 27(2), 350–360.CrossRefGoogle Scholar
  33. Miech, R., Pampel, F., Kim, J., & Rogers, R. G. (2011). The enduring association between education and mortality: The role of widening and narrowing disparities. American Sociological Review, 76, 913–934.CrossRefGoogle Scholar
  34. Montez, J. K., Hummer, R. A., Hayward, M. D., Woo, H., & Rogers, R. G. (2011). Trends in the educational gradient of the U.S. adult mortality from 1986 to 2006 by race, gender, and age group. Research on Aging, 33(2), 145–171.CrossRefGoogle Scholar
  35. Olshansky, S. J., Antonucci, T., Berkman, L., Binstock, R. H., Boersch-Supan, A., Cacioppo, J. T., et al. (2012). Differences in life expectancy due to race and educational differences are widening, and many may not catch up. Health Affairs, 31(8), 1803–1813.CrossRefGoogle Scholar
  36. Pampel, F. C. (2002). Cigarette use and the narrowing sex differential in mortality. Population and Development Review, 28(1), 77–104.CrossRefGoogle Scholar
  37. Phelan, C. J., Link, B. G., & Tehranifar, P. (2010). Social conditions as fundamental causes of health inequalities: Theory, evidence, and policy implications. Journal of Health and Social Behavior, 51, S28–S40.CrossRefGoogle Scholar
  38. Preston, S. H., Heuveline, P., & Guillot, M. (2001). Demography: measuring and modeling population processes. Malden: Blackwell Publishers.Google Scholar
  39. Read, J. G., & Gorman, B. K. (2010). Gender and health inequality. Annual Review of Sociology, 36, 371–386.CrossRefGoogle Scholar
  40. Rogers, R. G., Hummer, R. A., & Nam, C. B. (2000). Living and dying in the U.S.A: Behavioral, health, and social differentials of adult mortality. New York: Academic Press.Google Scholar
  41. Ross, C. E., & Wu, C. (1995). The links between education and health. American Sociological Review, 60(5), 719–745.CrossRefGoogle Scholar
  42. Schenker, N., Parsons, V. L., Lochner, K. A., Wheatcroft, G., & Pamuk, E. R. (2011). Estimating standard errors for life expectancies based on complex survey data with mortality follow-up: A case study using the National Health Interview Survey Linked Mortality Files. Statistics in Medicine, 30(11), 1302–1311.CrossRefGoogle Scholar
  43. Schoeni, R. F., Freedman, V. A., & Martin, L. G. (2008). Why is late-life disability declining? Milbank Quarterly, 86(1), 47–89.CrossRefGoogle Scholar
  44. Schoeni, R. F., Freedman, V. A., & Martin, L. G. (2009). Socioeconomic and demographic disparties in trends in old-age disability. In D. M. Cutler & D. A. Wise (Eds.), Health at older ages: The causes and consequences of declining disability among the elderly (pp. 75–102). Chicago: The University of Chicago Press.CrossRefGoogle Scholar
  45. Seeman, T. E., Merkin, S. S., Crimmins, E. M., & Karlamangla, A. S. (2010). Disability trends among older americans: National Health and Nutrition Examination Surveys, 1988–1994 and 1999–2004. American Journal of Public Health, 100(1), 100–107.CrossRefGoogle Scholar
  46. Sullivan, D. F. (1971). A single index of mortality and morbidity. Rockville: Health Services and Mental Health Administration.Google Scholar
  47. The Patient Protection and Affordable Care Act, P.L. 111–148 (2010).Google Scholar
  48. Verbrugge, L. M. (1984). Longer life but worsening health? Trends in health and mortality of middle-aged and older persons. The Milbank Memorial Fund Quarterly, 62(3), 475–519.CrossRefGoogle Scholar
  49. Wagener, D. K., Molla, M. T., Crimmins, E. M., Pamuk, E., & Madans, J. H. (2001). Summary measures of population health: Addressing the first goal of healthy people 2010, improving health expectancy. Healthy People 2010 Statistical Notes, 22, 1–13.Google Scholar
  50. Williams, D. R., & Collins, C. (1995). US socioeconomic and racial differences in health: Patterns and explanations. Annual Review of Sociology, 21, 349–386.CrossRefGoogle Scholar
  51. Williams, D. R., & Mohammed, S. A. (2009). Discrimination and racial disparities in health: Evidence and needed research. Journal of Behavioral Medicine, 32(1), 20–47.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2014

Authors and Affiliations

  • Aïda Solé-Auró
    • 1
    Email author
  • Hiram Beltrán-Sánchez
    • 2
  • Eileen M. Crimmins
    • 3
  1. 1.Ined- Institut National d’Études DémographiquesParis cedex 20France
  2. 2.Center for Demography of Health and AgingUniversity of Wisconsin-MadisonMadisonUSA
  3. 3.Ethel Percy Andrus Gerontology CenterUniversity of Southern CaliforniaLos AngelesUSA

Personalised recommendations