Compression or Expansion of Morbidity: Evaluating Life Expectancy with and without Chronic Conditions in Denmark

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

Over the past two centuries, populations across the globe have witnessed a remarkable surge in life expectancy. Nevertheless, living longer does not guarantee living healthier, sparking a long-standing debate on the relationship between mortality and morbidity. Building on a multidimensional approach recently introduced, we construct a period life table providing joint information on accumulated years lived in both good and poor health. We assume an illness-death model with no recovery, as we aim at modelling the onset of major chronic diseases, which are among the leading causes of disability and death in most low-mortality countries. In the framework we operate, length of life (x) is broken down into a sum of years spent healthy (h), and years spent unhealthy (u), such that x=h+u. Instead of calculating rates, probabilities, and other metrics for each specific age x, we compute them for different combinations of h and u. We apply the method to examine mortality and chronic morbidity in Denmark from 1995 to 2019. Our preliminary findings suggest that morbidity from chronic diseases may be compressing, as fewer individuals die having received a chronic condition diagnosis and those who do are dying at older ages, but with less years spent unhealthy.

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

See paper.