Epidemiologic Observations on the Compression of Morbidity

Abstract

Data on the health experience of two cohorts of Alameda County, California adults selected in 1965 and 1974 are used to examine evidence for a compression of morbidity. These data, based on two representative cohorts that have been prospectively followed, indicate major declines in age-specific mortality rates between the two cohorts. Accompanying these declines in risk of death is an increase in the age-specific prevalence of a number of chronic conditions and symptoms and a decrease in the association between these conditions and symptoms and risk of death. This increase in morbidity is accompanied, in turn, by an increase in the amount of disability associated with specific chronic conditions and symptoms. The overall picture is one of increased survival accompanied by increased morbidity and disability. These data do not provide evidence in support of a compression of morbidity. A further consideration of the methodologic and conceptual problems that are raised by the compression of morbidity hypothesis suggests that it is not a testable hypothesis and that further efforts should concentrate, instead, on primary and secondary prevention efforts to lessen morbidity burdens and improve quality of life for older persons.