Aging and Non-communicable Disease

  • Suchit Arora
Part of the International Perspectives on Aging book series (Int. Perspect. Aging, volume 12)


Aging and the non-communicable diseases that accompany it are widely believed to play a vital role in healthcare spending. This chapter outlines how their historical relationship can be studied. It argues that since the nineteenth century, a key facet of modern aging has been that of change across generations: instead of all generations tracking a static universal age-profile of non-communicable diseases, different generations have traced their own unique profiles as they had aged. This happened partly because the generations had faced distinct economic, epidemiologic, and political milieus in their childhood years, whose influence had likely endured long afterwards. The long reach of the childhood years, in turn, suggests that cost containment in healthcare can be socially optimal if it boosts the life-course aspect of aging; and, can succeed over the long term, by improving the childhood-linked aspects of it.


Aging Non-communicable disease Gompertz Generations Healthcare spending Cost containment Compression of deaths Childhood development Life-course effects 


  1. Abel-Smith, B., & Titmuss, R. M. (1956). The cost of the National Health Service in England and Wales. London: Cambridge University Press.Google Scholar
  2. Acemoglu, D., & Robinson, J. (2000). Why did the West extend the franchise? Democracy, inequality and growth in historical perspective. The Quarterly Journal of Economics, 115(4), 1167–1199.CrossRefGoogle Scholar
  3. Acemoglu, D., & Robinson, J. (2001). A theory of political transitions. American Economic Review, 91, 938–963.CrossRefGoogle Scholar
  4. Acemoglu, D., & Robinson, J. (2008). Persistence of power, elites and institutions. American Economic Review, 98(1), 267–293.CrossRefGoogle Scholar
  5. Allen, R. (2009). Engels’ pause: Technical change, capital accumulation, and inequality in the British industrial revolution. Explorations in Economic History, 46(4), 418–435.CrossRefGoogle Scholar
  6. Atkinson, A. B., & Piketty, T. (2007). Top incomes over the twentieth century: A contrast between continental-European and English-speaking countries. Oxford: Oxford University Press.Google Scholar
  7. Atkinson, A. B., & Piketty, T. (2010). Top incomes: A global perspective. Oxford: Oxford University Press.Google Scholar
  8. Barker, D. J. P. (1992). Fetal and infant origins of adult disease. London: British Medical Journal.Google Scholar
  9. Barker, D. J. P. (1994). Mothers, babies and disease in later life. London: British Medical Journal.Google Scholar
  10. Barker, D. J. P. (1998). Mothers, babies and health in later life. Edinburgh: Churchill Livingstone.Google Scholar
  11. Barker, D. J. P. (2004). The developmental origins of well-being. Philosophical Transactions of the Royal Society: Biological Science, 359(1449), 1359–1366.CrossRefGoogle Scholar
  12. Barker, D. J. P., & Lackland, D. T. (2003). Prenatal influences on stroke mortality in England and Wales. Stroke, 34(7), 1598–1602.CrossRefGoogle Scholar
  13. Barker, D. J. P., & Osmond, C. (1986a). Infant mortality, childhood nutrition and ischemic heart disease in England and Wales. Lancet, 1(8489), 1077–1081.CrossRefGoogle Scholar
  14. Barker, D. J. P., & Osmond, C. (1986b). Childhood respiratory infections and adult chronic bronchitis in England and Wales. British Medical Journal, 293(6557), 1271–1275.CrossRefGoogle Scholar
  15. Barker, D. J. P., Godfrey, K. M., Fall, C., Osmond, C., Winter, F. D., & Shaheen, S. O. (1991). Relation of birth weight and childhood respiratory infection to adult lung function and death from chronic obstructive airways disease. British Medical Journal, 303(6804), 671–675.CrossRefGoogle Scholar
  16. Baumol, W. J. (1967). Macroeconomics of unbalanced growth: The anatomy of urban crisis. American Economic Review, 57, 415–426.Google Scholar
  17. Baumol, W. J. (1988, Fall). Containing medical costs: Why price controls won’t work. The Public Interest, 93, 37–53.Google Scholar
  18. Bengtsson, T., & Lundstrom, M. (2003). Airborne infectious diseases during infancy and mortality in later life in Southern Sweden, 1799–1894. International Journal of Epidemiology, 32(2), 286–294.CrossRefGoogle Scholar
  19. Ben-Shlomo, Y., & Davey Smith, G. (1991). Deprivation in infancy or in adult life: Which is more important for mortality risk? Lancet, 337(8740), 530–534.CrossRefGoogle Scholar
  20. Ben-Shlomo, Y., & Kuh, D. (2002). A life course approach to chronic disease epidemiology: Conceptual models, empirical challenges and disciplinary perspectives. International Journal of Epidemiology, 31(2), 285–293.CrossRefGoogle Scholar
  21. Bleakley, H. (2007). Disease and development: Evidence from hookworm eradication in the American South. The Quarterly Journal of Economics, 122(1), 73–117.CrossRefGoogle Scholar
  22. Breyer, F., Felder, S., & Costa-Font J. (2011). Does aging really affect health expenditures? If so, why? Accessed 14 May 2011.
  23. Costa, D. L. (2002). Changing chronic disease rates and the long-term declines in functional limitations among older men. Demography, 39(1), 119–137.CrossRefGoogle Scholar
  24. Costa, D. L. (2003). Understanding the mid-life and older-age mortality declines: Evidence from the Union Army Veterans. Journal of Econometrics, 112(1), 175–192.CrossRefGoogle Scholar
  25. Crimmins, E. M., & Finch, C. E. (2006). Infection, inflammation, height and longevity. Proceedings of the National Academy of Sciences, 103(2), 498–503.CrossRefGoogle Scholar
  26. Culyer, A. J. (1989). Cost containment in Europe. In Healthcare systems in transition. Paris: OECD.Google Scholar
  27. Dasgupta, P. (1993). An inquiry into well-being and destitution. Oxford: Clarendon Press.Google Scholar
  28. Davey Smith, G., Hart, C., Upton, M., et al. (2000). Height and risk of death among men women: Aetiological implications for association with cardiorespiratory disease and cancer mortality. Journal of Epidemiology and Community Health, 54, 97–103.CrossRefGoogle Scholar
  29. Davey Smith, G., Gunnel, D., & Ben-Shlomo, Y. (2001). Life-course approaches to socio-economic differentials in cause-specific adult mortality. In D. Leon & G. Walt (Eds.), Poverty, inequality and health: An international perspective (pp. 88–124). Oxford: Oxford University Press.Google Scholar
  30. Deaton, A. (2013). The great escape. Princeton: Princeton University Press.Google Scholar
  31. Elo, I. T., & Preston, S. H. (1992). Effects of early life conditions on adult mortality: A review. Population Index, 58(2), 186–212.CrossRefGoogle Scholar
  32. Financial Times. (2014, October 6). Britain’s health service needs honest treatment, Editorial.
  33. Finch, C. E., & Crimmins, E. M. (2004). Inflammatory exposure and the historical changes in human lifespans. Science, 305, 1736–1739.CrossRefGoogle Scholar
  34. Floud, R., Wachter, K., & Gregory, A. (1990). Height, health, and history: Nutritional status in the United Kingdom, 1750–1980. Cambridge: Cambridge University Press.CrossRefGoogle Scholar
  35. Floud, R., Fogel, R. W., Harris, B., & Hong, S. C. (2011). The changing body, health nutrition and human development in the Western World since 1700 (NBER). New York: Cambridge University Press.CrossRefGoogle Scholar
  36. Fogel, R. W. (1993). Economic growth, population theory and physiology: The bearing of long-term processes on the making of economic policy. American Economic Review, 84(3), 369–395.Google Scholar
  37. Fogel, R. W., & Costa, D. L. (1997). The theory of technophysio evolution with some implications for forecasting population, health care costs, and pension costs. Demography, 34(1), 49–66.CrossRefGoogle Scholar
  38. Fries, J. F. (1980). Aging, natural death and compression of morbidity. New England Journal of Medicine, 303(3), 130–135.CrossRefGoogle Scholar
  39. Fries, J. F. (1989). The compression of morbidity: Near or far? Milbank Memorial Quarterly, 67(2), 208–232.CrossRefGoogle Scholar
  40. Fries, J. F. (2005). The compression of morbidity. Milbank Quarterly, 83(4), 801–823.CrossRefGoogle Scholar
  41. Fuchs, V. R. (1990). The health sector’s share of the Gross National Product. Science, 247, 534–538.CrossRefGoogle Scholar
  42. Gompertz, B. (1825). On the nature of the function expressive of the law of human mortality, and on the mode of determining the value of life contingencies. Philosophical Transactions of the Royal Society, 115, 513–585.CrossRefGoogle Scholar
  43. Gompertz, B. (1872). On the uniform law of mortality from birth to extreme old age, and on the law of sickness. Journal of the Institute of Actuaries, 16, 329–344.Google Scholar
  44. Grossman, M. (1972). On the concept of health capital and the demand for health. Journal of Political Economy, 80(2), 223–255.CrossRefGoogle Scholar
  45. Harris, B. (2001). “The child is the father to man” the relationship between child health and adult mortality in the 19th and 20th centuries. International Journal of Epidemiology, 30, 688–696.CrossRefGoogle Scholar
  46. Harris, B., & Floud, R. (1997). Health, height, and welfare: Britain, 1700–1980. In R. H. Steckel & R. Floud (Eds.), Health, welfare and industrialization. Chicago: University of Chicago Press.Google Scholar
  47. Johansson, S. (1991). The health transition: The cultural inflation of morbidity during the decline of mortality. Health Transition Review, 1, 39–65.Google Scholar
  48. Jousilahti, P., Tuomilehto, J., Vartiainen, E., Eriksson, J., & Puska, P. (2000). Relation of adult height to cause-specific and total mortality: A prospective follow-up study of 31,199 middle-aged men and women in Finland. American Journal of Epidemiology, 151(11), 1112–1120.CrossRefGoogle Scholar
  49. Komlos, J. (1993a). Further thoughts on the nutritional status of the British population. Economic History Review, 46(3), 363–366.CrossRefGoogle Scholar
  50. Komlos, J. (1993b). A Malthusian episode revisited: The height of British and Irish servants in Colonial America. Economic History Review, 46(2), 768–782.CrossRefGoogle Scholar
  51. Komlos, J. (2008). On English pygmies and giants: The physical stature of English youth in the late 18th century and early 19th centuries. Research in Economic History, 25(2), 149–168.Google Scholar
  52. Kuh, D., & Davey Smith, G. (2004). A life-course and adult chronic disease: An historical perspective with particular reference to coronary heart disease. In D. Kuh & Y. Ben Shlomo (Eds.), A life-course approach to chronic disease epidemiology. Oxford: Oxford University Press.CrossRefGoogle Scholar
  53. Kuh, D., Hardy, R., Lagenberg, C., Richards, M., & Wadsworth, M. E. J. (2002). Mortality in adults aged 26–54 years related to socioeconomic conditions in childhood: Post-war birth cohort study. British Medical Journal, 325(Nov.), 1076–1080.CrossRefGoogle Scholar
  54. Leon, D. A., Koupilova, I., Lithell, H. O., Berguland, L., et al. (1996). Failure to realize growth potential in utero and adult obesity in relation to blood pressure in 50-year old Swedish men. British Medical Journal, 312(7028), 401–406.CrossRefGoogle Scholar
  55. Leon, D. A., Lithell, H. O., Vagero, D., et al. (1998). Reduced fetal growth rate and increased risk of death from ischaemic heart disease: Cohort study of 15000 Swedish men and women born 1915–25. British Medical Journal, 317(7153), 241–245.CrossRefGoogle Scholar
  56. Lindert, P. (2000). Three centuries of inequality in Britain and America. In A. B. Atkinson & F. Bourguinon (Eds.), Handbook of income distribution (Vol. 1, pp. 176–316). Amsterdam: Elsevier Science.Google Scholar
  57. Makeham, W. M. (1867). On the law of mortality. Journal of the Institute of Actuaries, 13, 325–358.Google Scholar
  58. Newhouse, J. P. (1992, Summer). Medical care cost: How much welfare lost? Journal of Economic Perspectives, 6(3), 3–21.Google Scholar
  59. OECD. (2013). Public spending on health and long-term care: A new set of projections (OECD economic policy papers, no. 6). Paris: OECD.Google Scholar
  60. Oliveira Martins, J., & de la Maisonneuve, C. (2006). The drivers of public health expenditure on health and long-term care: An integrated approach. OECD Economic Studies No. 43, 2006/2.Google Scholar
  61. Olshansky, J., & Ault, A. B. (1986). The fourth stage of the epidemiologic transition: The age of delayed degenerative diseases. Milbank Memorial Fund Quarterly, 64(3), 355–391.Google Scholar
  62. Olshansky, J., & Carnes, B. A. (1997). Ever since Gompertz. Demography, 34(1), 1–15.CrossRefGoogle Scholar
  63. Omran, A. R. (1971). The epidemiologic transition: A theory of epidemiology of population change. The Milbank Quarterly, 49(4), 509–538.CrossRefGoogle Scholar
  64. Omran, A. R. (1982). Epidemiologic transition. In J. A. Ross (Ed.), International encyclopedia of population (pp. 172–183). London: The Free Press.Google Scholar
  65. Osmani, S., & Sen, A. K. (2003). The hidden penalties of gender inequality: Fetal origins of ill-health. Economics and Human Biology, 1(1), 105–121.CrossRefGoogle Scholar
  66. Paneth, N., & Susser, M. (1995). Early origins of coronary heart disease (the Barker Hypothesis). British Journal of Medicine, 310(6977), 411–412.CrossRefGoogle Scholar
  67. Piketty, T. (2014). Capital in the twenty-first century. Cambridge, MA: The Belknap Press of Harvard University Press.Google Scholar
  68. Reinhardt, U. E. (2003). Does the aging of the population really drive the demand for health care? Health Affairs, 22(6), 27–39.CrossRefGoogle Scholar
  69. Schultz, T. W. (1962). Investment in human beings. Chicago: University of Chicago Press.Google Scholar
  70. Schwartz, W. B. (1987, January). The inevitable failure of cost containment strategies: Why they can provide only temporary relief. Journal of American Medical Association, 257, 220–224Google Scholar
  71. Sen, A. K. (1984). The living standard. Oxford Economic Papers, 36, U.K.Google Scholar
  72. Sen, A. K. (1999). Commodities and capabilities. Oxford: Oxford University Press.Google Scholar
  73. Solow, R. M. (1956). A contribution to the theory of economic growth. The Quarterly Journal of Economics, 70(1), 65–94.CrossRefGoogle Scholar
  74. Steckel, R. H. (1979). Slave height profiles from coastwise manifests. Explorations in Economic History, 16(4), 363–380.CrossRefGoogle Scholar
  75. Steckel, R. H. (1995). Stature and the standard of living. Journal of Economic Literature, 33(4), 1903–1940.Google Scholar
  76. Steckel, R. H., & Costa, D. L. (1997). Long-term trends in health, welfare and economic growth in the United States. In R. H. Steckel & R. Floud (Eds.), Health, welfare and industrialization. Chicago: University of Chicago Press.CrossRefGoogle Scholar
  77. Steckel, R. H., & Floud, R. (1997). Health, welfare and industrialization. Chicago: University of Chicago Press.CrossRefGoogle Scholar
  78. Szreter, S. (1997). Economic growth, disruption, deprivation, disease, and death: On the importance of politics of public health for development. Population and Development Review, 23(4), 693–728.CrossRefGoogle Scholar
  79. Szreter, S. (2005). Health and wealth: Studies in history and policy. Rochester: University of Rochester Press.Google Scholar
  80. Troesken, W. (2004). Water, race and disease. Cambridge: MIT Press.Google Scholar
  81. United Nations Organization. (2012). Political declaration of the high-level meeting of the general assembly on the prevention and control of non-communicable diseases., document A/66/L.1.
  82. Vaupel, J. W. (2010). Biodemography of aging. Nature, 464, 536–542.CrossRefGoogle Scholar
  83. Waaler, H. T. (1984). Height, weight and mortality: The Norwegian experience. Acta Medica Scandinavia, Supplement, 679, 1–51.Google Scholar
  84. Weisbrod, B. A. (1991, June). The healthcare quadrilemma: An essay on technological change, insurance, quality of care, and cost containment. Journal of Economic Literature, 29, 523–552.Google Scholar
  85. Werblow, A., Felder, S., & Zweifel, P. (2007). Population ageing and health care expenditure: A school of ‘red herrings’? Health Economics, 16, 1109–1126.CrossRefGoogle Scholar
  86. World Health Organization. (2014). Non-communicable diseases country profiles. Geneva: WHO Press.
  87. Zweifel, P., Felder, S., & Meiers, M. (1999). Ageing of population and health care expenditure: A red herring? Health Economics, 8, 485–496.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  • Suchit Arora
    • 1
  1. 1.State Teachers Retirement System of OhioColumbusUSA

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