NCPA - National Center for Policy Analysis

Longer Lives, Less Disability

March 23, 1999

Earlier in this century, says health researcher James F. Fries, observers thought increasing average lifespans, finding cures for acute illnesses and promoting healthier habits would create a huge population of chronically ill and demented elders who would impose immense health care costs.

Fortunately, those fears were unfounded: delaying the onset of disability through disease prevention and health risk reductions results in the "compression of morbidity" to a period between an increasing average age of onset of disability and the age of death. For instance:

  • Fries' 14-year study of runners over age 50 found that exercising vigorously for an average of 280 minutes per week delayed the onset of disability by about 10 years compared with a control group.
  • Both male and female runners increased disability at a rate only one-third of that of the controls, after adjusting for various factors.
  • As the subjects moved from age 58 toward age 70, the differences in physical function between the groups increased, and the lifetime disability rate of the exercisers is only one-third to one-half that of sedentary individuals.

Another longitudinal study Fries conducted of 1,741 University of Pennsylvania students surveyed in 1962 and annually since 1986 has found that:

  • Persons with the high health risk factors of smoking, high body mass index and lack of exercise had disability rates twice that of low risk individuals -- both over their lifetimes and in the last year or two of life.
  • The low risk group postponed the onset of disability by an average of about 7.75 years.
  • And despite having increased mortality rates, high risk subjects have greatly increased disability rates during their lives.

Thus research shows a long healthy life with a relatively rapid terminal decline is an attainable ideal.

Source: James F. Fries (Stanford University Medical Center), "The Compression of Morbidity," Health Promotion Research Advocate, First Quarter 1999, Health Enhancement Research Organization (HERO), 2040 Valleydale Road, Suite 100, Birmingham, Ala. 35244, (205) 988-4417.


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