Generational Trends in Physical Health and Disability in the United States and Europe

Laura Gimeno , UCL University College London
Alice Goisis, University College London
Jennifer Dowd, University of Oxford
George Ploubidis, UCL Centre for Longitudinal Studies

Declines in mortality have typically been associated with improvements in physical health across successive generations. While life expectancy in most high-income countries continues to increase, there is evidence that younger generations, particularly in the United States (US), are less healthy than previous generations at the same age. We compared generational trends in physical health in the US, England, and continental Europe to explore whether other regions have experienced a similar “generational health drift.” Using data from nationally representative studies of adults aged >=50 years from the US (Health and Retirement Study), England (English Longitudinal Study of Ageing) and 11 continental European countries (Survey of Health, Ageing and Retirement in Europe), we estimated differences in the age-adjusted risk of self-reported chronic disease and disability and observer-measured health indicators across pseudo-birth cohorts (born <1925, 1925-1935, 1936-1945, 1946-1954, and 1955-1959). Age-adjusted risk of doctor-diagnosed chronic disease increased across cohorts in all regions. Trends in disability risk were more regionally varied. Still, in both the US and Europe, we observed a structural break in disability trends, with declines observed in pre-war cohorts slowing, stalling, or reversing for cohorts born since 1945. We found evidence for a generational health drift in all regions, particularly for cohorts born since 1945. While more chronic disease in younger cohorts need not translate to worse quality of life or higher rates of functional limitation if conditions are well managed, there is some suggestion that worsening chronic disease morbidity may be spilling over into worsening disability.

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 Presented in Session 64. Wellbeing in Older Age