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32 The Demography of Population Health

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Handbook of Population

Part of the book series: Handbooks of Sociology and Social Research ((HSSR))

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Abstract

This chapter provides a conceptual overview of the healthy life expectancy framework used to examine the linkages between mortality, morbidity, and disability. Because changes in these individual-level processes sometimes combine in complex ways to generate changes in population health, the healthy life expectancy framework provides a means for summarizing these complexities that allows the development of policies targeted at improving the quality of life rather than simply improvements in the overall length of life. A general description of the measures and methods used in modeling the linkages between mortality, morbidity, and disability, and thus population health, is offered. Major gaps in current knowledge are discussed, with current and potential complementarities across key lines of research identified. Demographic models of healthy life expectancy are powerful tools in understanding population health and such models might inform individual-level analyses of health disparities within a population.

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Notes

  1. 1.

    A number of recent reviews are available elsewhere that provide in-depth summaries of health expectancy research findings (e.g., Crimmins et al. 2016; Freedman et al. 2013; He et al. 2016; Olshansky et al. 2012; Santosa et al. 2016; Solé-Auró et al. 2015) and methods (e.g., Robine et al. 2003; Saito et al. 2014; World Health Organization 2014).

  2. 2.

    The individual analog of a prevalence rate is whether a person has a health condition. Associations between the presence of a health condition and a predictor variable, by definition, summarize the historical relationship between some predictor variable (e.g., socioeconomic status) and the presence of a health condition prior to the time of observation.

  3. 3.

    In 2001 the World Health Organization introduced the International Classification of Functioning, Disability, and Health (ICF). The ICF’s changes in terminology make it difficult to explicitly compare to Nagi’s scheme and Verbrugge and Jette’s disablement process, although the ICF’s conceptual framework embraces Verbrugge and Jette’s ideas of how extra- and intra-individual factors influence environmental demands and individuals’ capabilities. The ICF uses two umbrella terms, functioning and disability. Functioning encompasses body functions, activities executed by the individual, and participation in a life situation. Disability refers to the impairment of physiological functions, organ systems, activity limitation, and participation restriction. Because demographers have relied almost exclusively on the earlier classification schemes, our discussion focuses on these health concepts.

  4. 4.

    European demographers use a slightly different classification scheme, but the terminology is similar.

  5. 5.

    Studies that define disability in terms of IADLs and ADLs often refer to disability-free life expectancy as active life expectancy (e.g., Chan et al. 2016; Crimmins et al. 1996; Freedman and Spillman 2016; Hayward et al. 1998). Some researchers reserve the term disability-free life expectancy for health problems that curtail activities in major social roles such as work and school.

  6. 6.

    More information about the REVES International network on health expectancies and the disablement process can be found at https://reves.site.ined.fr/en/

  7. 7.

    More information about the Washington Group on Disability Statistics, including the most recent developments in short question set and the various extended question sets, can be found at http://www.washingtongroup-disability.com/

  8. 8.

    This has led to the use of multistate life table methods in calculating healthy life expectancy, because this approach explicitly allows for age-related declines and improvements in health (Laditka and Hayward 2003).

  9. 9.

    More information about the he Interdisciplinary Association for Population Health Science (IAPHS) can be found at https://iaphs.org/

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Authors and Affiliations

  1. University of Nebraksa-Lincoln, Lincoln, NE, USA

    David F. Warner

  2. University of Texas at Austin, Austin, TX, USA

    Mark D. Hayward

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  1. David F. Warner
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  2. Mark D. Hayward
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Correspondence to David F. Warner .

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  1. Department Sociology, Texas A&M University, College Station, TX, USA

    Dudley L. Poston Jr.

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Warner, D.F., Hayward, M.D. (2019). 32 The Demography of Population Health. In: Poston, D.L. (eds) Handbook of Population. Handbooks of Sociology and Social Research. Springer, Cham. https://doi.org/10.1007/978-3-030-10910-3_33

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