Working Paper: NBER ID: w22306
Authors: Michael Chernew; David M. Cutler; Kaushik Ghosh; Mary Beth Landrum
Abstract: Understanding how healthy lifespans are changing is essential for public policy. This paper explores changes in healthy lifespan in the U.S. over time and considers reasons for the changes. We reach three fundamental conclusions. First, we show that healthy life increased measurably in the US between 1992 and 2008. Years of healthy life expectancy at age 65 increased by 1.8 years over that time period, while disabled life expectancy fell by 0.5 years. Second, we identify the medical conditions that contribute the most to changes in healthy life expectancy. The largest improvements in healthy life expectancy come from reduced incidence and improved functioning for those with cardiovascular disease and vision problems. Together, these conditions account for 63 percent of the improvement in disability-free life expectancy. Third and more speculatively, we explore the role of medical treatments in the improvements for these two conditions. We estimate that improved medical care is likely responsible for a significant part of the cardiovascular and vision-related extension of healthy life.
Keywords: disability-free life expectancy; elderly population; medical advancements; public policy
JEL Codes: I1; I3
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| improvements in healthy life expectancy (I14) | reduced incidence of medical conditions (I12) |
| improvements in healthy life expectancy (I14) | improved functioning of medical conditions (I12) |
| reduced incidence of cardiovascular disease (I12) | increased healthy life expectancy (I14) |
| improved functioning related to cardiovascular disease (I12) | increased healthy life expectancy (I14) |
| increased use of effective treatments (cholesterol-lowering agents, antihypertensive medications) (I12) | improved health outcomes (I14) |
| cataract surgery (Y60) | reduced vision problems (I14) |
| cataract surgery (Y60) | reduced associated disability (I12) |
| improved medical care (I14) | increased healthy life expectancy (I14) |