Revue de la littérature sur l’évolution future de l’espérance de vie et de l’espérance de vie en santé

Like many industrialized countries, Canada is experiencing significant population aging and this phenomenon, inherited from the demographic transition, will intensify in the coming years. Mortality changes, especially at older ages, will contribute greatly to this phenomenon, hence the importance to be aware of the latest and forthcoming developments. It is also imperative to uncover recent and future health trends in the elderly population, and to investigate whether extra years of life gained through increased longevity will be spent in good or bad health. Thus, through this literature review, we first outline the academic debate on the future of mortality, and more specifically of life expectancy at birth. Since the debate essentially crystallized around two main competing views, one that supports sustained mortality gains in the future and one that expect instead these gains to peak, the arguments of each group and the main criticisms they face are exposed. We then provide a detailed account of a concomitant debate on the quality rather than the quantity of years lived. The three competing theories on the future of morbidity - compression of morbidity, expansion of morbidity and dynamic equilibrium - are presented and their relevance is discussed on the basis of empirical data. The difficulties inherent in defining the concepts of health and illness, and to obtain comparable indicators over time and space are highlighted.