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The Rise in Life Expectancy, Health Trends among the Elderly, and the Demand for Health and Social Care

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  • Lindgren, Björn

    (Lund University, Lund, Sweden and National Bureau of Economic Research, Cambridge, MA, United States.)

Abstract

The objective of this report is to review the evidence on (a) ageing and health and (b) the demand for health and social care among the elderly. The issues discussed are: does health status of the elderly improve over time, and how do the trends in health status of the elderly affect the demand for health and social care? The review is based on some 100 published scientific papers. While it is not a complete review, it covers most recent empirical studies of health trends and the changing pattern of demand for health and social care. Health is a multidimensional concept. It includes self-assessed health, presence of disease, functional status, and disability, usually expressed as capacity to perform activities of daily living (ADL). There are certainly elderly who have no problems in any of these dimensions. But health among elderly varies, and to a much larger extent than among younger people. Many elderly have one or more chronic diseases; if the disease is well controlled, there may be no problems in other dimensions of health. If not, other health problems may follow, lowering self-assessed health, creating ADL limitations etc. When analyzing health trends, it is important to cover all four dimensions of health, since the impact on health care and social care differ, depending on which dimension shows improved health. The reviewed literature provides strong evidence that the prevalence of chronic disease among the elderly has increased over time. There is also fairly strong evidence that the consequences of disease have become less problematic due to medical progress: decreased mortality risk, milder and slower development over time, making the time with disease (and health care treatment) longer but less troublesome than before. Evidence also suggests the postponement of functional limitations and disability. Some of the reduction in disability may certainly be attributed to improvements in treatments of chronic diseases. But they are apparently also due to the increased use of assistive technology, public transport, accessibility of buildings, etc. The results, hence, indicate that the ageing individual is expected to need health care for a longer (and not necessarily postponed) period of time than previous generations but elderly care for a shorter (and certainly postponed) period of time. Thus, one might say that the development overall has been in accordance with the “dynamic equilibrium” scenario. A general conclusion of the empirical literature seems to be that expenditures will not be lower over remaining life years but they will be distributed over a longer period of time. Several authors warn against the potential negative impact of an increasing prevalence of obesity on life expectancy, health, and health and social care. The role of technological advances within medicine is highlighted by many authors and its consequences for the elderly analyzed.

Suggested Citation

  • Lindgren, Björn, 2016. "The Rise in Life Expectancy, Health Trends among the Elderly, and the Demand for Health and Social Care," Working Papers 142, National Institute of Economic Research.
    • Handle: RePEc:hhs:nierwp:0142
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    2. Leandro Prados de la Escosura, 2018. "Well-being Inequality in the Long Run," Working Papers 0131, European Historical Economics Society (EHES).
    3. Prados de la Escosura, Leandro, 2023. "Health, income, and the preston curve: A long view," Economics & Human Biology, Elsevier, vol. 48(C).
    4. María del Carmen Ramos-Herrera & Simón Sosvilla-Rivero, 2020. "Fiscal Sustainability in Aging Societies: Evidence from Euro Area Countries," Sustainability, MDPI, vol. 12(24), pages 1-20, December.
    5. Leandro Prados de la Escosura, 2023. "Inequality Beyond GDP: A Long View," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 69(3), pages 533-554, September.
    6. Harpa S. Eyjólfsdóttir & Neda Agahi & Johan Fritzell & Carin Lennartsson, 2022. "Physical functioning as a predictor of retirement: Has its importance changed over a thirty-year period in Sweden?," European Journal of Ageing, Springer, vol. 19(4), pages 1417-1428, December.
    7. Leandro Prados de la Escosura, 2021. "Augmented human development in the age of globalization," Economic History Review, Economic History Society, vol. 74(4), pages 946-975, November.
    8. Heger, Dörte & Kolodziej, Ingo W.K., 2016. "Changes in morbidity over time: Evidence from Europe," Ruhr Economic Papers 640, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    9. Isabel Correia Dias & Priscila Ferreira & Lígia Costa Pinto & Marieta Valente & Paula Veiga, 2017. "Growing old, unhealthy and unequal: an exploratory study on the health of Portuguese individuals aged 50+," NIMA Working Papers 67, Núcleo de Investigação em Microeconomia Aplicada (NIMA), Universidade do Minho, revised Jun 2018.
    10. Lassila, Jukka & Valkonen, Tarmo, 2019. "Alternative Demography-based Projection Approaches for Public Health and Long-term Care Expenditure," ETLA Working Papers 74, The Research Institute of the Finnish Economy.
    11. Keegan, Conor & Brick, Aoife & Bergin, Adele & Wren, Maev-Ann & Whyte, Richard & Henry, Edward, 2020. "Projections of expenditure for public hospitals in Ireland, 2018–2035, based on the Hippocrates Model," Research Series, Economic and Social Research Institute (ESRI), number RS117.

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    More about this item

    JEL classification:

    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I10 - Health, Education, and Welfare - - Health - - - General
    • I38 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Government Programs; Provision and Effects of Welfare Programs
    • J11 - Labor and Demographic Economics - - Demographic Economics - - - Demographic Trends, Macroeconomic Effects, and Forecasts
    • J14 - Labor and Demographic Economics - - Demographic Economics - - - Economics of the Elderly; Economics of the Handicapped; Non-Labor Market Discrimination

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