Article Text

Download PDFPDF

Compression, expansion, or dynamic equilibrium? The evolution of health expectancy in New Zealand
Free
  1. Patrick Graham1,
  2. Tony Blakely2,
  3. Peter Davis1,
  4. Andrew Sporle3,
  5. Neil Pearce4
  1. 1Department of Public Health and General Practice, Christchurch School of Medicine and Health Sciences, New Zealand
  2. 2Department of Public Health, Wellington School of Medicine and Health Sciences, New Zealand
  3. 3Department of Statistics, University of Auckland, New Zealand
  4. 4Centre for Public Health Research, Massey University, Wellington, New Zealand
  1. Correspondence to:
 Dr P Graham
 Department of Public Health and General Practice, Christchurch School of Medicine and Health Sciences, PO Box 4345, Christchurch, New Zealand; patrick.grahamchmeds.ac.nz

Abstract

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.

  • SIS, socioeconomic indicators survey
  • DIS, household disability survey
  • health expectancy
  • population health
  • trends
View Full Text

Statistics from Altmetric.com

Footnotes

  • Funding: this study was funded by the Health Research Council of New Zealand. The Centre for Public Health Research is supported by a Programme Grant from the Health Research Council of New Zealand.

  • Conflicts of interest: none declared.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Linked Articles