Multistate Distributions and Morbidity Compression: Advancing the Debate on Ageing and Health

Chiara Micheletti, Max Planck Institute for Demographic Research (MPIDR)
Iñaki Permanyer, Centre d'Estudis Demogràfics
Cosmo Strozza, Interdisciplinary Centre on Population Dynamics

Traditional approaches to assess whether morbidity is compressing or expanding over time typically compare life expectancy (LE) and health-adjusted life expectancy (HLE). Changes in the HLE/LE ratio are used to support hypotheses of morbidity compression or expansion. The aim of this paper is to revisit the long-standing ‘compression vs expansion of morbidity’ debate taking advantage of recently illustrated multistate modelling techniques. Such methods allow deriving distributions estimating the number of years individuals have accumulated in good and in less-than-good health throughout their lives. Building on this approach, we propose the ‘healthy year curves’, a new tool measuring the average number of years lived in good health among those who died at a certain age. We provide an empirical application using Danish registry data showing results for women and men separately for 2008 and 2018.

Keywords: Mathematical demography , Mortality and Longevity, Health and Morbidity

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  Presented in Session 42. Patterns and Inequalities in Healthy Longevity