Compression, expansion, or dynamic equilibrium? The evolution of health expectancy in New Zealand
Open accessAbstract
Study objective: To evaluate the New Zealand evidence for three theories of population health change: compression of morbidity, expansion of morbidity, and dynamic equilibrium. Design: Using the Sullivan method, repeated cross sectional survey information on functional limitation prevalence was combined with population mortality data and census information on the utilisation of institutional care to produce health expectancy indices for 1981 and 1996. Setting: The adult population of New Zealand in 1981 and 1996. Participants: 6891 respondents to the 1981 social indicators survey; 8262 respondents to the 1996 household disability survey. Main results: As a proportion of overall life expectancy at age 15 the expectation of non-institutionalised mobility limitations increased from 3.5% to 6% for men, and from 4.5% to 8% for women; the expectation of agility limitation increased from 3% to 7.5% for men and from 4.5% to 8.5% for women, and the expectation of self care limitations increased from 2.0% to 4.5% for men and from 3.0% to 6.0% for women. These changes were primarily attributable to increases in the expectation of moderate functional limitation. Conclusion: The dynamic equilibrium scenario provides the best fit to current New Zealand evidence on changes in population health. Although an aging population is likely to lead to an increase in demand for disability support services, the fiscal impact of this increase may be partially offset by a shift from major to moderate limitations, with a consequential reduction in the average levels of support required.
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Disability hazards are lower for later born cohorts.
“empirical evidence indicates that disability hazards are indeed lower for later born cohorts”
From Cohort differences in cognitive aging and terminal decline in the Seattle Longitudinal Study. (2011) · cites this paper as Graham, Blakely, Davis, Sporle, & Pearce, 2004
The Statistical methods section models mortality hazards but functional limitation prevalence, not disability hazards. The Changes between 1981 and 1996 section compares prevalence across survey years; it does not compare disability hazards by birth cohort. Searches for cohort-specific disability incidence and hazards found no such result in our copy. (LLM, conf=0.76)
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Salomon, J. A., Wang, H., Freeman, M. K., Vos, T., Flaxman, A. D., Lopez, A. D., & Murray, C. J. (2012) · The Lancet · doi:10.1016/s0140-6736(12)61690-0 · Cited by 1,116 · see citing works
Cohort differences in cognitive aging and terminal decline in the Seattle Longitudinal Study.
Gerstorf, D., Ram, N., Hoppmann, C., Willis, S. L., & Schaie, K. W. (2011) · Developmental Psychology · doi:10.1037/a0023426 · Cited by 154 · see citing works
- Authors
- Graham, P., Blakely, T., Davis, P., Sporle, A., & Pearce, N.
- Affiliations
- University of Otago (NZ)
- University of Auckland (NZ)
- Massey University (NZ)
- Corresponding author
- Graham, Patrick
- Venue
- Journal of Epidemiology and Community Health
- Publisher
- BMJ
- Published
- 2004-07-13
- Volume
- 58
- Issue
- 8
- Pages
- 659-666
- ISSN
- 0141-7681 (ISSN-L)
- 0143-005X
- 1470-2738
- PMC
- PMC1732857
- OpenAlex
- W1976095108
- Cited by
- 88
- References
- 0
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 1 · 2023: 2 · 2021: 6 · 2020: 2 · 2019: 2 · 2018: 5 · 2017: 5 · 2016: 4 · 2015: 5 · 2014: 10 · 2013: 4 · 2012: 6
- FWCI
- 3.86
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Epidemiology & Community Health (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- ResearchSpace (University of Auckland) (submittedVersion)
- Funders
- Health Research Council of New Zealand
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Social Sciences › Demography › Insurance, Mortality, Demography, Risk Management
- Social Sciences › Health › Health disparities and outcomes
- Keywords
- health expectancy, compression of morbidity, expansion of morbidity, dynamic equilibrium, functional limitations, mobility limitations, self-care limitations, disability services, population aging, New Zealand
- MeSH terms
- Adolescent, Adult, Aged, Cross-Sectional Studies, Female, Health Status Indicators, Health Surveys, Humans, Institutionalization, Life Expectancy, Male, Middle Aged, Morbidity, Mortality, New Zealand, Sex Factors, Life Tables
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