فشرده سازی و یا گسترش عوارض؟ موضوعات داغ در امید به زندگی در جمعیت سالمندان سالم اتریش بین سال های 1978 و 1998

The aim of our study is to test the theories of compression or expansion of morbidity on the basis of data on the elderly population of Austria. Our data come from four microcensus surveys for the years 1978, 1983, 1991, and 1998. We use self-perceived health ratings to calculate healthy-life expectancy for the elderly population aged 60–89. Because our data are based on four cross-sectional surveys, we devote the first part of the paper to the consequences of possible sampling and non-sampling errors in our analysis of time trends. We come to the conclusion that, although the absolute number of years lived in good health may be overestimated, the time trend in healthy-life expectancy over the 20 years most probably is unbiased. The second part of the paper describes trends in healthy-life expectancy for the Austrian population. Our results suggest that both healthy-life expectancy and the ratio of healthy years to life expectancy increased between 1978 and 1998. Thus, in Austria ill health seems to be more and more compressed into the later years of life. Contrary to Fries’s hypothesis, however, life expectancy does not seem to be approaching a maximum average life span in Austria, as mortality rates at older ages have been continuously decreasing over the last 20 years.

As in most economically advanced countries, life expectancy in Austria has increased steadily over the last several decades. Compared with the early 1970s, life expectancy at birth has been extended by 8.1 years for men and 7.5 years for women. It reached 74.6 years for men and 80.9 years for women in 1998. Because of the already low levels of mortality for children and younger adults these gains in life expectancy are primarily the result of reductions in the mortality of the elderly. Between 1980 and 1998 the standardized mortality rate was reduced by 30% for men and 33% for women aged 60 years or older. There is no evidence that this trend will stop or be reversed in the future. Together with the ageing of populations in absolute and relative terms this is considered to be one of the major challenges facing social welfare systems.