Active Life Expectancy: A Central Measure of Population Health

  • Sarah B. Laditka
  • James N. Laditka
Part of the International Handbooks of Population book series (IHOP, volume 1)

An important aspect of population health is increasingly measured by disability indicators. Active life expectancy, also often referred to as health expectancy, has emerged as a useful indicator of population health. This indicator was first proposed by the U.S. Department of Health, Education and Welfare (1969) nearly 40 years ago and has been widely adopted for use by the World Health Organization and governments throughout the world to monitor population health. Researchers commonly partition total life expectancy into two parts. One part is healthy life expectancy, also often referred to as active life expectancy or disability-free life expectancy. This component is a measure of the years an individual can expect to live free of disability. The second part measures the years a person can expect to live with disability, also commonly referred to as inactive life expectancy or disabled life expectancy. Although the phrase “active life expectancy” refers to the period of life without disability, the same phrase is often used to describe this entire research area. Thus, a researcher who studies active life expectancy is interested to estimate the periods of life spent with and without disability.


Assistive Technology Health Expectancy Healthy Life Expectancy Active Life Expectancy Total Life Expectancy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. Albert M, Brown DR, Buchner D, Laditka JN, Launer LJ, Scherr P, Thies W, Wagster MV (2007) The healthy brain and our aging population: Translating science to public health practice. Foreword. Alzheimer’s and Dementia 3:S3–S5Google Scholar
  2. Auchincloss AH, Hadden W (2002) The health effects of ruralurban residence and concentrated poverty. J Rural Health 18(2):319–336Google Scholar
  3. Auchincloss AH, Van Nostrand JF, Ronsaville D (2001) Access to health care for older persons in the United States: Personal, structural, and neighborhood characteristics. J Aging Health 13(3):329–354Google Scholar
  4. Balfour JL, Kaplan GA (2002) Neighborhood environment and loss of physical function in older adults: Evidence from the Alameda County Study. Am J Epidemiol 155(6):507–515Google Scholar
  5. Bebbington A, Bajekal M (2003) Subnational variations in health expectancy. In: Robine JM, Jagger C, Mathers CD, Crimmins EM, Suzman RM (eds) Determining health expectancies, Wiley, West Sussex, UK, pp 127–147Google Scholar
  6. Becket LA, Brock DB, Lemke JH, Mendes de Leon C, Guralnik JM, Fillenbaum GG, Branch LG, Wetle TT, Evans DA (1996) Analysis of change in selfreported physical function among older persons in four population studies. Am J Epidemiol 143:766–778Google Scholar
  7. Bélanger A, Martel L, Berthelot JM, Wilkins R (2002) Gender differences in disabilityfree life expectancy for selected risk factors and chronic conditions in Canada. J Women Aging 14:61–83Google Scholar
  8. Binder EF, Schechtman KB, Ehsani AA, Seger-May K, Brown M, Sinacore DR, Yarasheski KE, Holloszy JO (2002) Effects of exercise training on frailty in community-dwelling older adults: Results of a randomized, controlled trial. J Am Geriatr Soc 50(12):1921–1928Google Scholar
  9. Blackwell DL, Hayward MD, Crimmins EM (2001) Does childhood health affect chronic morbidity in later life? Soc Sci Med 52:1269–1284Google Scholar
  10. Blair SN, Kampert JB, Kohl HW, Barlow CE, Macera CA, Paffenbarger RS, Gibbons LW (1996) Influences of cardiorespiratory fitness and other precursors on cardiovascular disease and all-cause mortality in men and women. J Am Med Assoc 276:205–210Google Scholar
  11. Bone MR, Bebbington AC, Nicolaas G (1998) Policy applications of health expectancy. J Aging Health 10:136–153Google Scholar
  12. Branch LG, Guralnik JM, Foley DJ, Kohout FJ, Wetle TT, Ostfeld A, Katz S (1991) Active life expectancy for 10,000 Caucasian men and women in three communities. J Gerontol: Med Sci 46:M145–M150Google Scholar
  13. Brookmeyer R, Gray S, Kawas C (1998) Projections of Alzheimer’s disease in the United States and the public health impact of delaying disease onset. Am J Public Health 88:1337–1342Google Scholar
  14. Burke JP, Williams K, Gaskill SP, Hazuda HP, Haffnew SM, Stern MP (1999) Rapid rise in the incidence of type 2 diabetes from 1987 to 1996. Arch Intern Med 159(13):1450–1456Google Scholar
  15. Cambois EE (2006) The relationship between occupational status, mobility, and mortality at older ages. In: Yi Z, Crimmins E, Carrière Y, Robine JM (eds) Longer life and healthy aging, Springer, The Netherlands, pp 213–234Google Scholar
  16. Christen WG, Glynn RJ, Hennekens CH (1996) Antioxidants and agerelated eye disease. Ann Epidemiol 6:60–66Google Scholar
  17. Clarke P, George LK (2005) The role of the built environment in the disablement process. Am J Public Health 95(11):1933–1939Google Scholar
  18. Cohen ML (1991) Variance estimation of microsimulation models through sample reuse. In: Citro CF, Hanushek EA (eds) Improving information for social policy decisions: the uses of microsimulation modeling, Vol II, Technical papers, National Academy Press, Washington, DC, pp 237–254Google Scholar
  19. Colvez A, Blanchet M (1981) Disability trends in the United States population, 1966–1976. Analysis of reported causes. Am J Public Health 71:464–471Google Scholar
  20. Cornman JC, Freedman VA, Agree EM (2005) Measurement of assistive device use: Implications for estimates of device use and disability in later life. Gerontologist 45:347–358Google Scholar
  21. Crimmins EM (1996) Mixed trends in population health among older adults. J Gerontol: Soc Sci 51B:S223–S225Google Scholar
  22. Crimmins EM (2004) Trends in health of the elderly. Annu Rev Public Health 25:79–98Google Scholar
  23. Crimmins EM, Alley D, Reynolds SL, Johnston M, Karlamangla A, Seeman T (2005) Changes in biological markers of health: Older Americans in the 1990s. J Gerontol: Med Sci 60A(11):1409–1413Google Scholar
  24. Crimmins EM, Hayward MD, Saito Y (1994) Changing mortality and morbidity rates and the health status and life expectancy of the older population. Demography 31:159–175Google Scholar
  25. Crimmins EM, Hayward MD, Saito Y (1996) Differentials in active life expectancy in the older population of the United States. J Gerontol: Soc Sci 51B:S111–S120Google Scholar
  26. Crimmins EM, Johnston M, Hayward M, Seeman T (2003) Age differences in allostatic load: An index of physiological dysregulation. Exp Gerontol 38:731–734Google Scholar
  27. Crimmins EM, Kim JK, Hagedorn A (2002) Life with and without disease: Women experience more of both. J Women Aging 14:47–59Google Scholar
  28. Crimmins EM, Saito Y (2001) Trends in healthy life expectancy in the United States 1970–1999: Gender, racial, and educational differences. Soc Sci Med 52:1629–1641Google Scholar
  29. Crimmins EM, Saito Y, Ingegneri D (1989) Changes in life expectancy and disabilityfree life expectancy in the United States. Popul Dev Rev 15:235–267Google Scholar
  30. Crimmins EM, Saito Y, Ingegneri D (1997) Trends in disabilityfree life expectancy in the United States, 1970–1990. Popul Dev Rev 23:555–572Google Scholar
  31. Crimmins EM, Saito Y, Reynolds SL (1997) Further evidence on recent trends in the prevalence and incidence of disability among older Americans from two sources: The LSOA and the NHIS. J Gerontol: Soc Sci 52B:S59–S71Google Scholar
  32. Cutler DM, Landrum MB, Stewart K (2006) Intensive medical care and cardiovascular disease disability reductions. NBER Working Paper Series No. 21184, Cambridge, MAGoogle Scholar
  33. Daltroy L, Phillips C, Eaton H, Larson M, Partridge A, Logigian M, Liang MH (1995) Objectively measuring physical ability in elderly persons: The physical capacity evaluation. Am J Public Health 85(4):558–560Google Scholar
  34. Davis WB, Hayes CG, Knowles M, Riggan WB, Van Braggen J, Tyroler HA (1985) Geographic variation in declining ischemic heart disease mortality in the United States, 1968– 1978. 1. Rates and changes, whites, aged 35–74 years. Am J Epidemiol 122:657–672Google Scholar
  35. Desai M, Pratt LA, Lentzer H, Robinson KN (2001) Trends in vision and hearing among older Americans. Aging Trends 2:1–8Google Scholar
  36. Deeg DJH (2001) Sexdifferences in the evolution of life expectancy and health in old age. In: Robine JM, Kirkwood TBL, Allard M (eds) Sex and longevity: sexuality, gender, reproduction, parenthood, Springer-Verlag, New York, pp 129–140Google Scholar
  37. Deeg DJH (2005) Longitudinal characterization of course types of function limitations. Disabil Rehabil 27(5):253–261Google Scholar
  38. Doblhammer G, Kytir J (2001) Compression or expansion of morbidity? Trends in healthy-life expectancy in the elderly Austrian population between 1978 and 1998. Soc Sci Med 52:385–391Google Scholar
  39. Elo IT (2001) New African American life tables from 1935–1940 to 1985–1990. Demography 38:97–114Google Scholar
  40. Elo IT, Preston SH (1997) Racial and ethnic differences in mortality at older ages. In: Martin LG, Soldo BJ (eds) Racial and ethnic differences in the health of older Americans, National Academy Press, Washington, DC, pp 10–42Google Scholar
  41. Fiatarone MA, O’Neill EF, Ryan ND, Clements KM, Solares GR, Nelson ME, Roberts SB, Kehayis JJ, Lipsitz LA, Evens WJ (1994) Exercise training and nutritional supplementation for physical frailty in very elderly people. New Engl J Med 330:1769–1775Google Scholar
  42. Freedman VA, Agree EM, Martin LG, Cornman JC (2005) Trends in the use of assistive technology in personal care for late-life disability, 1992–2001. Gerontologist 46(1):124–127Google Scholar
  43. Freedman VA, Crimmins EM, Schoeni RF, Spillman BC, Aykan H, Kramarow E, Land K, Lubitz J, Manton K, Martin LG, Shinberg D, Waidmann T (2004) Resolving inconsistencies in old age disability trends: report from a technical group. Demography 41:417–441Google Scholar
  44. Freedman VA, Hodgson N, Lynn J, Spillman BC, Waidmann T, Wilkinson AM, Wolf DW (2006) Promoting declines in the prevalence of late-life disability: Comparisons of three potentially high-impact interventions. Milbank Q 84(3):493–520Google Scholar
  45. Freedman VA , Martin LG (1998) Understanding trends in functional limitations among older Americans. Am J Public Health 88:1457–1462Google Scholar
  46. Freedman VA, Martin LG (1999) The role of education in explaining and forecasting trends in functional limitations among older Americans. Demography 36:461–473Google Scholar
  47. Freedman VA , Martin LG (2000) Contributions of chronic conditions to aggregate changes in old-age functioning. Am J Public Health 90:1755–1760Google Scholar
  48. Freedman, VA, Martin LG, Schoeni RE (2002) Recent trends in disability and functioning among older adults in the United States: A systematic review. J Am Med Assoc 288(24):3137–3146Google Scholar
  49. Freedman VA , Soldo BJ (eds) (1994) Trends in disability at older ages: Summary of a workshop. National Academy Press, Washington, DCGoogle Scholar
  50. Fries JF (1980) Aging, natural deah, and the compression of morbidity. New Engl J Med 303:130–135Google Scholar
  51. Fries JF (1988) Aging, illness, and health policy: Implications of the compression of morbidity. Perspect Biol Med 21:407–428Google Scholar
  52. Fries JF (2002) Reducing disability in older age. [editorial] J Am Med Assoc 288(24):3164–3166Google Scholar
  53. Fuchs VR (1974) Who shall live? Basic Books, New YorkGoogle Scholar
  54. Fukuda Y, Nakamura K, Takano T (2005) Municipal health expectancy in Japan: Decreased healthy longevity of older people in socioeconomically disadvantaged areas. BMC Public Health 5:65Google Scholar
  55. George LK (2005) Socioeconomic status and health across the life course: Progress and prospects. J Gerontol: Psychol Soc Sci 60(Suppl1):135–139Google Scholar
  56. Geronimus AT, Bound J, Waidmann TA, Colen CG, Steffick D (2001) Inequity in life expectancy, functional status, and active life expectancy across selected black and white populations in the United States. Demography 38:227–251Google Scholar
  57. Gill T, Baker D, Gottschalk M, Peduzzi P, Allore H, Byers A (2002) A program to prevent functional decline in physically frail, elderly persons who live at home. New Engl J Med 347(14):1068–1074Google Scholar
  58. Gill T, Baker D, Gottschalk M, Peduzzi P, Allore H, Van Ness P (2004) A prehabilitation program for the prevention of functional decline: Effect on higher-level physical function. Arch Phys Med Rehabil 85(7):1043–1049Google Scholar
  59. Gruenberg EM (1977) The failures of success. Milbank Mem Fund Q 55:3–24Google Scholar
  60. Grundy E (2006) Gender and healthy aging. In: Yi Z, Crimmins E, Carrière YY, Robine JM (eds) Longer life and healthy aging, Springer, The Netherlands, pp 173–199Google Scholar
  61. Gu K, Cowie CC, Harris MI (1998) Mortality in adults with and without diabetes in a national cohort of the US population, 1971–1993. Diab Care 21(7):1138–1145Google Scholar
  62. Guitierrez-Fisac JL, Gispert R, Sola J (2000) Factors explaining the geographical differences in disability free life expectancy in Spain. J Epidemiol Community Health 54:451–455Google Scholar
  63. Guralnik JM, Land KC, Blazer D, Fillenbaum GG, Branch LG (1993) Educational status and active life expectancy among older blacks and whites. New Engl J Med 329(2):110–116Google Scholar
  64. Hammond C (2003) How education makes us healthy. London Rev Edu 1(1):61–78Google Scholar
  65. Hardy SE, Gill TM (2004) Recovery from disability among community-dwelling older persons. J Am Med Assoc 291:1596–1602Google Scholar
  66. Hayward MD, Crimmins EM, Miles TP, Yang Y (2000) The significance of socioeconomic status in explaining the racial gap in chronic health conditions. Am Sociol Rev 65:910–930Google Scholar
  67. Hayward MD, Crimmins EM , Saito Y (1998) Causes of death and active life expectancy in the older population of the United States. J Aging Health 10:192–213Google Scholar
  68. Hayward MD, Gorman BK (2004) The long arm of childhood: The influence of early-life social conditions on men’s mortality. Demography 41(1):87–107Google Scholar
  69. Hayward MD, Grady WR (1990) Work and retirement among a cohort of older men in the United States 1966–1983. Demography 27:337–356Google Scholar
  70. Hayward MD, Heron M (1999) Racial inequity in active life among adult Americans. Demography 36:77–91Google Scholar
  71. Helmer C, Barberger-Gateau P, Letenneur L, Dartigues JF (1999) Subjective health and mortality in French elderly women and men. J Gerontol: Soc Sci 54B:S84–S92Google Scholar
  72. Hendrie HC, Albert MS, Butters MA, Gao S, Knopman DS, Launer LJ, Yaffe K, Cuthbert BN, Edwards E, Wagster MV (2006) The NIH cognitive and emotional health project: Report of the critical evaluation study committee. Alzheimer’s and Dementia 2(1):12–32Google Scholar
  73. Jacobzone S (2000) Coping with aging: International challenges. Health Affairs 19:213–225Google Scholar
  74. Jagger C (1999) Health expectancy calculation by the Sullivan method: a practical guide. European concerted action on the harmonization of health expectancy calculations in Europe (EURO-REVES). Nihon University Population Research Institute Research Paper Series No. 68. Tokyo, JapanGoogle Scholar
  75. Jagger C, Barberger-Gateau P, Robine JM (2005) Disability in older people – indicators, process and outcomes. Disabil Rehabil 27(5):209–212Google Scholar
  76. Jagger C, Goyder E, Clarke M, Brouard N, Arthur A (2003) Active life expectancy in people with and without diabetes. J Public Health Med 25(1):42–46Google Scholar
  77. Jagger C, Matthews F (2002) Gender differences in life expectancy free of impairment at older ages. J Women Aging 14:85–97Google Scholar
  78. Jagger C, Raymond N, Morgan K (1998) Planning for the future: The effect of changing mortality, incidence, and recovery rates on life expectancy with visual disability. J Aging Health 10:154–170Google Scholar
  79. Jagger C, Spiers N, Arthur A (2005) The role of sensory and cognitive function in the onset of activity restriction in older people. Disabil Rehabil 27(5):277–283Google Scholar
  80. Jenkins CL, Laditka SB (2003) A comparative analysis of disability measures and their relation to home health care use. Home Health Care Serv Q 22(1):21–37Google Scholar
  81. Jitapnkul S. Kunanusont C, Phoolcharoen W, Suriyawongpaisal P, Ebrahim S (2003) Disability-free life expectancy of elderly people in a population undergoing demographic and epidemiologic transition. Age and Aging 32:401–405Google Scholar
  82. Kalbfleisch JD, Lawless JF (1985) The analysis of panel data under a Markov assumption. J Am Stat Assoc 80:863–871Google Scholar
  83. Kaneda T, Zimmer Z, Tang Z (2005) Socioeconomic status differentials in life and active life expectancy among older adults in Beijing. Disabil Rehabil 27(5):241–251Google Scholar
  84. King H, Aubert RE, Herman WH (1998) Global burden of diabetes, 1995–2025. Prevalence, numerical estimates, and projections. Diabetes Care 21(9):1414–1431Google Scholar
  85. Kinsella K, Gist YJ (1998) International brief: Gender and aging. Bureau of the Census, Washington, DCGoogle Scholar
  86. Kramer AF, Erickson KI, Colcombe SJ (2006) Exercise, cognition, and the aging brain. J Appl Physiol 101: 1237–1242Google Scholar
  87. Kramer M (1983) The increasing prevalence of mental disorders: A pandemic threat. Psychiatr Q 55:115–143Google Scholar
  88. Laditka JN, Laditka SB (2006) Effects of diabetes on healthy life expectancy: Shorter lives with more disability for both women and men. In: Yi Z, Crimmins E, Carrière Y, Robine JM (eds) Longer life and healthy aging, Springer, The Netherlands, pp 71–90Google Scholar
  89. Laditka JN, Laditka SB (2000) The morbidity compression debate: Risks, opportunities, and policy options for women. J Women Aging 12(1/2):23–38Google Scholar
  90. Laditka JN, Laditka SB, Olatosi B, Elder KT (2007) The health tradeoff of rural residence for impaired older adults: Longer life, more impairment. J Rural Health 23(2):124–132Google Scholar
  91. Laditka JN, Wolf DA (2006) Improving knowledge about disability transitions by adding retrospective information to panel surveys. Popul Health Metrics 4:16Google Scholar
  92. Laditka SB (ed) (2002) Health expectations for older women: International perspectives. Haworth PressGoogle Scholar
  93. Laditka SB, Hayward MD (2003) The evolution of demographic methods to calculate health expectancies. In: Robine JM, Jagger C, Mathers C, Crimmins E, Suzman R (eds) Determining health expectancies, Wiley, Baffins Lane, Chichester, Sussex, UK, pp 221–234Google Scholar
  94. Laditka SB, Jenkins CL (2001) Difficulty or dependency? Effects of measurement scales on disability prevalence among older Americans. J Health Soc Policy 13(3):1–15Google Scholar
  95. Laditka SB, Laditka JN (2001) Effects of improved morbidity rates on active life expectancy and eligibility for long-term care services. J Appl Gerontol 10:39–56Google Scholar
  96. Laditka SB, Laditka JN (2002) Recent perspectives on active life expectancy for older women. J Women Aging 14(1/2): 163–184Google Scholar
  97. Laditka SB, Mastanduno MP, Laditka JN (2001) Health care use of individuals with diabetes in an employer-based insurance population. Arch Intern Med 161(10):1301–1308Google Scholar
  98. Laditka SB, Wolf DA (1998) New methods for analyzing active life expectancy. J Aging Health 10:214–241Google Scholar
  99. Land KC, Guralnik JM, Blazer DG (1994) Estimating increment-decrement life tables with multiple covariates from panel data: The case of active life expectancy. Demography 31:297–319Google Scholar
  100. Leveille SG, Penninx BW, Melzer D, Izmirlian G, Guralnik JM (2000) Sex differences in the prevalence of mobility disability in old age: the dynamics of incidence, recovery, and mortality. J Gerontol: Soc Sci 55B:S41–S50Google Scholar
  101. Lièvre A, Brouard N, Heathcote C (2003) The estimation of health expectancies from cross-longitudinal surveys. Math Popul Stud 10:211–248Google Scholar
  102. Lin G (2000) Regional assessment of elderly disability in the U.S. Soc Sci Med 50(7–8):1015–1024Google Scholar
  103. Lubitz J, Beebe JB, Baker C (1995) Longevity and Medicare expenditures. New Engl J Med 33:999–1003Google Scholar
  104. Lubitz J, Cai L, Kramarow E, Lentzner H (2003) Health, life expectancy, and health care spending among the elderly. New Engl J Med 349 (11):1048–1055Google Scholar
  105. Mann WC, Ottenbacher K, Frass L, Tomita M, Granger CV (1999) Effectiveness of assistive technology and environmental interventions in maintaining independence and reducing home care costs for the frail elderly: A randomized trial. Arch Family Med 8:210–217Google Scholar
  106. Manton KG (1982) Changing concepts of morbidity and mortality in the elderly population. Milbank Mem Fund Q 60:183–191Google Scholar
  107. Manton KG, Corder L, Stallard E (1993) Estimates of change in chronic disability and institutional incidence and prevalence rates in the U.S. elderly population from the 1982, 1984, and 1989 National Long Term Care Survey. J Gerontol: Soc Sci 48:S153–S166Google Scholar
  108. Manton KG, Corder L, Stallard E (1997) Chronic disability trends in the U.S. elderly populations 1982 to1994. PNAS 94:2593–2598Google Scholar
  109. Manton KG, Gu X (2001) Changes in the prevalence of chronic disability in the United States black and nonblack population above age 65 from 1982 to 1999. PNAS 11:6354–6359Google Scholar
  110. Manton KG, Stallard E (1997) Health and disability differences among racial and ethnic groups. In: Martin LG, Soldo BJ (eds) Racial and ethnic differences in the health of older Americans, National Academy Press, Washington, DC, pp 43–105Google Scholar
  111. Mathers CD, Murray JL, Lopez AD, Sadana R, Salomon JA (2002) Global patterns of healthy life expectancy for older women. J Women Aging 14:99–117Google Scholar
  112. Matthews RJ, Jagger C, Hancock RM (2006) Does socio-economic advantage lead to a longer, healthier old age? Soc Sci Med 62(10):2489–2499Google Scholar
  113. Matthews KA, Kelsey SF, Meilahn EN, Kuller LH, Wing RR (1989) Educational attainment and behavioral and biologic risk factors for coronary heart disease in middle age women. Am J Epidemiol 129:1132–1144Google Scholar
  114. Matthews FE, Miller LL, Brayne C, Jagger C, the Medical Research Council Cognitive Function and Aging Study (MRC CFAS) (2006) Regional differences in multidimensional aspects of health: findings from the MRC cognitive function and ageing study. BMC Public Health 6:90Google Scholar
  115. McCartney N, Hicks AL, Martin J, Webber CE (1996) A longitudinal trial of weight training in the elderly: Continued improvements in year 2. J Gerontol: Biol Sci 51A: B425–B433Google Scholar
  116. McGovern PG, Burke GL, Spafka SX, Folsom AR, Blackburn H (1992) Trends in mortality, morbidity, and risk factor levels for stroke from 1960 through 1990: The Minnesota heart survey. J Am Med Assoc 268:753–759Google Scholar
  117. Minicuci N, Noale M (2005) Disability free life expectancy in older Italians. Disabil Rehabil 27(5):221–227Google Scholar
  118. Murtagh KN, Hubert HB (2004) Gender differences in physical disability among an elderly cohort. Am J Public Health 94 (8):1406–1411Google Scholar
  119. National Diabetes Information Clearinghouse (1999) Diabetes statistics. Bethesda, MD, National Institute of Diabetes and Digestive and Kidney Diseases, US National Institutes of Health, NIH Publication, pp. 99–3926Google Scholar
  120. National Institute of Diabetes and Digestive and Kidney Diseases (2001) Diet and exercise dramatically delay type 2 diabetes: diabetes medication Metformin also effective. Available at: September 24, 2001
  121. Olshansky SJ, Carnes BA, Rogers RA, Smith L (1997) Infectious diseases: New and ancient threats to world health. Popul Bull 52:1–58Google Scholar
  122. Olshansky SJ, Passaro DJ, Hershow RC, Layden J, Carnes BA, Brody J, Hayflick L, Butler RN, Allison DB, Ludwig DS (2005) A potential decline in life expectancy in the United States in the 21st Century. New Engl J Med 352(11):1138–1145Google Scholar
  123. Olshansky SJ, Wilkins R (1998) Introduction. J Aging Health 10:123–135Google Scholar
  124. Olsson J, Persson U, Tollin C, Nilsson S, Melander A (1994) Comparison of excess costs of care and production losses because of morbidity in diabetic patients. Diabetes Care 17(11):1257–1263Google Scholar
  125. Panapasa SV (2002) Disability among older women and men in Fiji: Concerns for the future. J Women Aging 14:149–162Google Scholar
  126. Penninx BW, Messier SP, Rejeski WJ, Williamson JD, DiBari M, Cavazzini C, Applegate WB, Pahor M (2001) Physical exercise and the prevention of disability in activities of daily living in older persons with osteoarthritis. Arch Intern Med 161(19):2309–2316Google Scholar
  127. Peres K, Verret C, Alioum A, Barberger-Gateau P (2005) The disablement process: Factors associated with progression of disability and recovery in French elderly people. Disabil Rehabil 27(5):263–276Google Scholar
  128. Pope AM, Tarlov A (eds) (1991) Disability in America: Toward a national agenda for Prevention. National Academy Press, Washington, DCGoogle Scholar
  129. Porell FW, Miltiades HB (2002) Regional differences in functional status among the aged. Soc Sci Med 54(8):1181–1198Google Scholar
  130. Preston SH (2005) Deadweight? – The influence of obesity on longevity [editorial]. New Engl J Med 352(1):1135–1137Google Scholar
  131. Preston SH, Elo I, Rosenwaike I, Hill M (1996) African American mortality at older ages: Results from a matching study. Demography 33:193–209Google Scholar
  132. Preston SH, Taubman P (1994) Socioeconomic differences in adult mortality and health status. In: Martin LG, Preston SH (eds) Demography of aging, National Academy Press, Washington, DC, pp 279–318Google Scholar
  133. Réseau Espérance de Vie en Santé (International Network on Health Expectancy and the Disability Process). Available at: October 20 2006
  134. Reed DM, Foley DJ, White LR, Heimovitz H, Burchfiel CM, Masaki K (1998) Predictors of healthy aging in men with high life expectancies. Am J Public Health 88:1463–1468Google Scholar
  135. Reyes-Beaman S, Jagger C, Garcia-Pena C, Munoz O, Beaman PE, Stafford B,the National Group of Research on Ageing (2005) Active life expectancy of older people in Mexico. Disabil Rehabil 27(5):213–219Google Scholar
  136. Reynolds SL, Saito Y, Crimmins EM (2005) The impact of obesity on active life expectancy in older American men and women. Gerontologist 45(4):438–444Google Scholar
  137. Robine JM, Jagger C, Cambois E (2002) European perspectives on healthy aging in women. J Women Aging 14:119–133Google Scholar
  138. Robine JM, Jagger C, Mathers C, Crimmins EM, Suzman R (eds) (2003) Determining health expectancies. Wiley, Baffins Lane, Chichester, Sussex, UKGoogle Scholar
  139. Robine JM, Mormiche P, Sermet C (1998) Examination of the causes and mechanisms for the increase in disability-free life expectancy. J Aging Health 10:171–191Google Scholar
  140. Robine JM, Ritchie K (1991) Healthy life expectancy: Evaluation of a global indicator of change in population health. Br Med J 302:457–460Google Scholar
  141. Robine JM, Romieu I, Cambois E (1997) Health expectancies and current research. Rev Clin Gerontol 7:73–81Google Scholar
  142. Ross CE, Wu CL (1995) The links between education and health. Am Sociol Rev 60:719–745Google Scholar
  143. Rowe JW, Kahn RL (1998) Successful aging. Pantheon, New YorkGoogle Scholar
  144. Rydwik E, Frandin K, Akner G (2004) Effects of physical training on physical performance in institutionalized elderly patients (70+) with multiple diagnoses. Age Aging 33(1):13–23Google Scholar
  145. Sabates R, Feinstein L (2006) The role of education in the uptake of preventive health care: The case of cervical screening in Britain. Soc Sci Med 62(12):2998–3010Google Scholar
  146. Sauvaget C, Tsuji I, Aonuma T, Hisamichi S (1999) Health-life expectancy according to various functional levels. J Am Geriatr Soc 47:1326–1331Google Scholar
  147. Schoen R (1975) Constructing increment-decrement life tables. Demography 12:313–324Google Scholar
  148. Schoen R (1988) Modeling multigroup populations. Plenum, New YorkGoogle Scholar
  149. Schoen R, Woodrow K (1980) Labor force status life tables for the United States 1972. Demography 17:297–322Google Scholar
  150. Schoeni RF, Freedman VA , Wallace RB (2001) Persistent, consistent, widespread, and robust? Another look at recent trends in old-age disability. J Gerontol: Soc Sci 56B:S206–S281Google Scholar
  151. Schoeni RF, Martin LG, Andreski PM, Freedman VA (2005) Persistent and growing socioeconomic disparities in disability among the elderly, 1982–2002. Am J Public Health 95(11): 2065–2070Google Scholar
  152. Songer TJ (2001) Disability in diabetes. Diabetes in America, 2nd edn. National Institutes of Health, Bethesda, MD,pp. 259–282. on August 27 2001
  153. Spiers N, Jagger C, Clarke M (1996) Physical function and perceived health: Cohort differences and interrelationships in older people. J Gerontol: Soc Sci 51B:S226–S233Google Scholar
  154. Sullivan DF (1971) A single index of mortality and morbidity. HSMHA Health Rep 86:347–354Google Scholar
  155. Tsuji I, Sauvaget C, Hisamichi S (2002) Health expectancies in Japan: Gender differences and policy implications for women. J Women Aging 14:135–148Google Scholar
  156. United States Census Bureau (2000) International Database. Available at: Accessed on July 3 2001
  157. U.S. Department of Health, Education, Welfare (HEW) (1969) Towards a social report. Government Printing Office, Washington, DCGoogle Scholar
  158. van Baal PHM, Hoogenveen RT, de Wit GA, Boshuizen HC (2006) Estimating health-adjusted life expectancy conditional on risk factors: Results for smoking and obesity. Popul Health Metrics 4:1–14Google Scholar
  159. Vaupel JW, Carey JR, Christensen K, Johnson TE, Yashin AI, Holm NV, Iachine IA, Kannisto V, Khazaeli AA, Liedo P, Longo VD, Zeng Y, Manton KG, Curtsinger JW (1998) Biodemographic trajectories of longevity. Science 280:855–860Google Scholar
  160. Verbrugge LM (1984) Longer life but worsening health? Trends in health and mortality of middle-aged and older persons. Milbank Q 63:475–519Google Scholar
  161. Vita AJ, Terry RB, Hubert HB, Fries JF (1998) Aging, health risks, and cumulative disability. New Engl J Med 338:1035–1041Google Scholar
  162. Waidmann TA, Liu K (2000) Disability trends among elderly persons and implications for the future. J Gerontol: Soc Sci 55B:S298–S307Google Scholar
  163. Wen M, Browning CR, Cagney KA (2003) Poverty, affluence and income inequality: Neighborhood economic structure and its implications for health. Soc Sci Med 57:843–860Google Scholar
  164. Wister AV (1996) Effects of socioeconomic status on exercise and smoking: Age-related differences. J Aging Health 8: 467–488Google Scholar
  165. Wolf DA (2001) The role of microsimulation in longitudinal data analysis. Canadian Studies in Population: special issue on Longitudinal Methodology 28(2):313–339Google Scholar
  166. Wolf DA, Laditka SB, Laditka JN (2002) Patterns of active life among older women: Differences within and between groups. J Women Aging 14(1/2):9–26Google Scholar
  167. Yi Z, Crimmins E, Carrière Y, Robine JM (eds) (2006) Longer life and healthy aging. Springer,The NetherlandsGoogle Scholar
  168. Yi Z, Yuzhi L, George LG (2006) Female disadvantages among the elderly in China. In: Yi Z, Crimmins E, Carrière Y, Robine JM (eds) Longer life and healthy aging, Springer, The Netherlands, pp 201–211Google Scholar

Copyright information

© Springer Science+Business Media B.V. 2009

Authors and Affiliations

  • Sarah B. Laditka
    • 1
  • James N. Laditka
    • 2
  1. 1.Department of Public Health SciencesUniversity of North Carolina at CharlotteCharlotte, NCUSA
  2. 2.University of North Carolina – CharlotteCharlotte, NCUSA

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