Demography

, Volume 37, Issue 1, pp 53–72

Understanding the twentieth-century decline in chronic conditions among older men

Article

Abstract

I argue that the shift from manual to white-collar jobs and reduced exposure to infectious disease were important determinants of declines in chronic disease rates among older men from the early 1900s to the 1970s and 1980s. The average decline in chronic respiratory problems, valvular heart disease, arteriosclerosis, and joint and back problems was about 66%. Occupational shifts accounted for 29% of the decline; the decreased prevalence of infectious disease accounted for 18%; the remainder are unexplained. The duration of chronic conditions has remained unchanged since the early 1900s, but when disability is measured by difficulty in walking, men with chronic conditions are less disabled now than they were in the past.

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References

  1. Barker, D.J.P. 1992. Fetal and Infant Origins of Adult Disease. London: British Medical Journal Publishing Group.Google Scholar
  2. — 1994. Mothers, Babies, and Disease in Later Life. London: British Medical Journal Publishing Group.Google Scholar
  3. Bollet, A.J. 1991. “Rheumatic Diseases Among Civil War Troops.” Arthritis and Rheumatism 34:1197–203.CrossRefGoogle Scholar
  4. Buck, C. and H. Simpson. 1982. “Infant Diarrhoea and Subsequent Mortality From Heart Disease and Cancer.” Journal of Epidemiology and Community Health 36(1):27–30.CrossRefGoogle Scholar
  5. Chirikos, T.N. 1986. “Accounting for the Historical Rise in Work-Disability Prevalence.” Milbank Quarterly 64:271–301.CrossRefGoogle Scholar
  6. Cliff, A., P. Haggett, and M. Smallman-Raynor. 1993. Measles: An Historical Geography of a Major Human Viral Disease From Global Expansion to Local Retreat, 1840–1990. Oxford: Basil Blackwell.Google Scholar
  7. Collins, S.D. [1937] 1944. “Frequency of Immunizing and Related Procedures in Nine Thousand Surveyed Families in Eighteen States.” In The Incidence of Illness and the Volume of Medical Services Among 9,000 Canvassed Families, edited by S.D. Collins. Washington, DC: U.S. Government Printing Office.Google Scholar
  8. Colvez, A. and M. Blanchet. 1981. “Disability Trends in the United States Population 1966-76: Analysis of Reported Causes.” American Journal of Public Health 71:464–71.CrossRefGoogle Scholar
  9. Crimmins, E. 1990. “Are Americans Healthier as Well as Longer-Lived?” Journal of Insurance Medicine 22:89–92.Google Scholar
  10. Costa, D.L. 1998. The Evolution of Retirement: An American Economic History, 1880–1990. Chicago: University of Chicago Press.Google Scholar
  11. Costa, D.L. and R.H. Steckel. 1997. “Long-Term Trends in Health, Welfare, and Economic Growth.” Pp. 47–89 in Health and Welfare During Industrialization, edited by R.H. Steckel and R. Floud. Chicago: University of Chicago Press.Google Scholar
  12. Cutler, D.M., M. McClellan, and J.P. Newhouse. 1999. “The Costs and Benefits of Intensive Treatment for Cardiovascular Disease.” Pp.34–711 in Measuring the Price of Medical Treatments, edited by J.E. Triplett. Washington, DC: Brookings Institute.Google Scholar
  13. Cutler, D.M. and E. Richardson. 1997. “Measuring the Health of the United States Population.” Brookings Papers on Economic Activity, Microeconomics 217–71.Google Scholar
  14. Elo, I.T. and S.H. Preston. 1992. “Effects of Early-Life Conditions on Adult Mortality: A Review.” Population Index 58:186–212.CrossRefGoogle Scholar
  15. Fogel, R.W. and D.L. Costa. 1997. “A Theory of Technophysio Evolution, With Some Implications for Forecasting Population, Health Care Costs, and Pension Costs.” Demography 34:49–66.CrossRefGoogle Scholar
  16. Fries, J.F. 1980. “Aging, Natural Death, and the Compression of Morbidity.” New England Journal of Medicine 303:130–36.CrossRefGoogle Scholar
  17. — 1989. “The Compression of Morbidity: Near or Far?” Milbank Quarterly 67:208–32.CrossRefGoogle Scholar
  18. Jean, R., M.R. Benoist, P. Rufin, B. Meyer, P. Scheinmann, and J. Paupe. 1981. “Sequelles respiratoires de la rougeole.” Revue Française des Maladies Respiratoires 9(1):45–53.Google Scholar
  19. Katz, W.A., ed. 1977. Rheumatic Diseases: Diagnosis and Management. Philadelphia: Lippincott.Google Scholar
  20. Khosla, S.N. 1981. “The Heart in Enteric (Typhoid) Fever.” Journal of Tropical Medicine and Hygiene 84(3):125–31.Google Scholar
  21. Kiple, K.F., ed. 1993. The Cambridge World History of Human Disease Cambridge, UK: Cambridge University Press.Google Scholar
  22. Larsen, C.S., J. Craig, L.E. Sering, M.J. Schoeninger, K.F. Russell, D.L. Hutchinson, and M.A. Williamson. 1995. “Cross Homestead: Life and Death on the Midwestern Frontier.” Pp. 139–59 in Bodies of Evidence: Reconstructing History Through Skeletal Analysis, edited by A.L. Grauer. New York: Wiley.Google Scholar
  23. Lee, C. 1997. “Socioeconomic Background, Disease, and Mortality Among Union Army Recruits: Implications for Economic and Demographic History.” Explorations in Economic History 34(1):27–55.CrossRefGoogle Scholar
  24. Lindholt, J.S., H. Fasting, E.W. Henneberg, and L. Ostergaard. 1999. “A Review of Chlamydia Pneumoniae and Atherosclerosis.” European Journal of Vascular and Endovascular Surgery 17:283–89.CrossRefGoogle Scholar
  25. Manton, K.G., L. Corder, and E. Stallard. 1997. “Chronic Disability Trends in Elderly United States Populations: 1982-1994.” Proceedings of the National Academy of Sciences 94:2593–98.CrossRefGoogle Scholar
  26. Manton, K.G., E. Stallard, and H.D. Tolley. 1991. “Limits to Life Expectancy: Evidence, Prospects, and Implications.” Population and Development Review 17:603–37.CrossRefGoogle Scholar
  27. Markowitz, L.E. and P. Nieburg. 1991. “The Burden of Acute Respiratory Infection Due to Measles in Developing Countries and the Potential Impact of Measles Vaccine.” Review of Infectious Diseases 13(Suppl. 6):S555–61.Google Scholar
  28. McGue, M., J.W. Vaupel, and N. Holm. 1993. “Longevity Is Moderately Heritable in a Sample of Danish Twins Born 1870–1880.” Journal of Gerontology 48:273–44.Google Scholar
  29. Muirden, K.D. 1995. “Tropical Rheumatology, Epidemiology and Community Studies: Asia/Pacific Region.” Bailliere’s Clinical Rheumatology 9(1):11–20.CrossRefGoogle Scholar
  30. New York State. 1857. Census of the State of New York for 1855. Albany: Charles Van Benthuysen.Google Scholar
  31. NygÅrd, C-H., T. Luopajärvi, and J. Illmarinen. 1988. “Musculoskeletal Capacity of Middle-Aged Women and Men in Physical, Mental and Mixed Occupations.” European Journal of Applied Physiology 57(2):181–88.CrossRefGoogle Scholar
  32. Olowu, A.O. and O. Taiwo. 1990. “Electrocardiographic Changes After Recovery From Measles.” Tropical Doctor 20(3):123–26.Google Scholar
  33. Omran, A.R. 1971. “The Epidemiological Transition: A Theory of the Epidemiology of Population Change.” Milbank Memorial Quarterly 49:509–38.CrossRefGoogle Scholar
  34. Paneth, N. and M. Susser. 1995. “Early Origin of Coronary Heart Disease (the ‘Barker Hypothesis’).” British Journal of Medicine 310(6977):411–12.Google Scholar
  35. Poterba, J.M. and L.H. Summers. 1987. “Public Policy Implications of Declining Old-Age Mortality.” Pp. 19–51 in Work, Health, and Income Among the Elderly, edited by G. Burtless. Washington, DC: Brookings Institute.Google Scholar
  36. Preston, S.H. 1993. “Demographic Change in the United States.” Pp. 51–78 in Forecasting the Health of Elderly Populations, edited by K.G. Manton, B.H. Singer, and R.M. Suzman. Berlin: Springer-Verlag.Google Scholar
  37. Preston, S.H. and M.R. Haines. 1991. Fatal Years: Child Mortality in Late Nineteenth Century America. Princeton: Princeton University Press.Google Scholar
  38. Riley, J.C. 1989. Sickness, Recovery, and Death: A History and Forecast of Ill Health. Houndsmill, UK: Macmillan.Google Scholar
  39. Stein, J., ed. 1990. Internal Medicine. Boston: Little, Brown.Google Scholar
  40. Valtonen, V.V. 1991. “Infection as a Risk Factor for Infarction and Atherosclerosis.” Annals of Medicine 23:539–43.CrossRefGoogle Scholar
  41. Verbrugge, L.M. 1984. “Longer Life but Worsening Health?: Trends in Health and Mortality of Middle-Aged and Older Persons.” Milbank Quarterly 62:475–519.Google Scholar
  42. Von Hartmann, M.G. 1974. “Arthritiden bei Infektionskrankheiten.” Verhandlung der Deutschen Gesellschaft für Rheumatologie 3:59–66.Google Scholar
  43. Waidmann, T., J. Bound, and M. Schoenbaum. 1995. “The Illusion of Failure: Trends in the Self-Reported Health of the U.S. Elderly.” Milbank Quarterly 73:253–87.CrossRefGoogle Scholar
  44. Wesley, A.G. 1991. “Prolonged After-Effects of Pneumonia in Children.” South African Medical Journal 79(2):73–76.Google Scholar
  45. Wilmoth, J.R. and H. Lundström. 1996. “Extreme Longevity in Five Countries: Presentation of Trends With Special Attention to Issues of Data Quality.” European Journal of Population 12(1):63–93.CrossRefGoogle Scholar
  46. Wilson, S.E., R. Mittendorf, L.L. Nguyen, and M. Rudberg. 1998. “The Evolving Natural History of Congestive Heart Failure: Lessons From the Past.” Unpublished manuscript, Brigham Young University.Google Scholar
  47. Wong, Y.K., P.J. Gallagher, and M.E. Ward. 1999. “Chlamydia Pneumoniae and Atherosclerosis.” Heart 81(3):232–38.Google Scholar

Copyright information

© Population Association of America 2000

Authors and Affiliations

  1. 1.Department of EconomicsCosta, Massachusetts Institute of TechnologyCambridge
  2. 2.National Bureau of Economic ResearchUSA

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