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Forecasting Health Status Changes in an Aging U.S. Population: Assessment of the Current Status and Some Proposals

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Forecasting in the Social and Natural Sciences

Abstract

Much interest has been recently focused on forecasting population health changes such as population aging and life expectancy increases at advanced ages, qualitative changes in health and survival, changes in federal reimbursement systems, and the need to forecast for long-range capital investment in specialized health facilities. Recent efforts at forecasting health and morbidity changes in the population are reviewed in this paper and the recent lack of methodological innovation in health forecasting strategies is examined. Two forecasting models—stochastic compartmental systems and mixed multivariate continuous state-discrete state processes—are described. We show how these models can be applied to health forecasting using existing data, how they can be used in a complementary fashion to improve health projections made from any one type of data, and how the mixed multivariate stochastic process model can be used to evaluate assumptions made in the compartment modeling approach.

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References

  • Ahlburg, D. A.: 1987, Aggregate Economic-Demographic Models’ (this issue).

    Google Scholar 

  • Anker, R. and J. C. Knowles: 1983, Population Growth, Employment, and Economic-Demographic Interactions in Kenya: Bachue-Kenya, St. Martins Press, New York.

    Google Scholar 

  • Armitage, P. and R. Doll: 1954, ‘The Age Distribution of Cancer and a Multi-Stage Theory of Carcinogenesis’, Br. J. Cancer, 8, 1–12.

    Google Scholar 

  • Armitage, P. and R. Doll: 1961, ‘Stochastic Models for Carcinogenesis’, in J. Neyman (ed.), Proceedings of the Fourth Berkeley Symposium on Mathematical Statistics and Probability, Vol. IV, Biology and Problems of Health, University of California Press, Berkeley.

    Google Scholar 

  • Barlow, R. and G. W. Davies: 1974, ‘Policy Analysis with a Disaggregated Economic-Demographic Model’, J. Public Economics, 3, 43–70.

    Article  Google Scholar 

  • Beard, R. E.: 1963a, ‘A Theory of Mortality Based on Actuarial, Biological and Medical Considerations’, in Proceedings, International Population Conference, New York, 1961, Vol. 1, International Union for the Scientific Study of Population, London.

    Google Scholar 

  • Beard, R. E.: 1963b, ‘Actuarial Methods of Mortality Analysis: Adaptation to Changes in the Age and Cause Pattern’, in Proceedings of the Royal Society, B 159, 56.

    Google Scholar 

  • Cook, P. J., R. Doll, and S. A. Fellingham: 1969, ‘A Mathematical Model for the Age Distribution of Cancer in Man’, Int. J. Cancer, 4, 93–112.

    Article  Google Scholar 

  • Cooper, B. S. and D. Rice: 1976, ‘The Economic Costs of Illness Revisited’, Social Security Bulletin, 39, 21–36.

    Google Scholar 

  • Economos, A. C.: 1982, ‘Rate of Aging, Rate of Dying and the Mechanism of Mortality’, Arch. Gerontol. Geriatr, 1, 3–27.

    Article  Google Scholar 

  • Eggers, P.S., R. Connerton, and M. McMullan: 1983, ‘The Medicare Experience with End-Stage Renal Disease: Trends in Incidence, Prevalence, and Survival’, Working Paper.

    Google Scholar 

  • Federal Old-Age and Survivors Insurance and Disability Insurance Trust Funds, Board of Trustees: 1982, Annual Report, Presented to Congress, April 1, 1982.

    Google Scholar 

  • Feldman, J. J.: 1983, ‘Work Ability of the Aged Under Conditions of Improving Mortality’, Milbank Memorial Fund Quarterly, 61, 430–444.

    Article  Google Scholar 

  • Fix, E. and J. Neyman: 1951, ‘A Simple Stochastic Model of Recovery, Relapse, Death and Loss of Patients’, Hum. Biol., 23, September, 205–241.

    Google Scholar 

  • Freeland, M. S. and C. E. Schendler: ‘National Health Expenditures: Short-term Outlook and Long-term Projections’, HCFR, Winter, 97–137.

    Google Scholar 

  • Golini, A. and V. Egidi: 1984, ‘Effect of Morbidity Changes on Mortality and Population Size and Structure’, in J. Vallin et al, (eds.), Methodologies for the Collection and Analysis of Mortality Data, Chapter 17, IUSSP, Ordina Editions, Liège, Belgium, 405–448.

    Google Scholar 

  • Gompertz, B.: 1825, ‘On the Nature of the Function Expressive of the Law of Human Mortality’, Philosophical Trans., Royal Soc. of London, 115, 513.

    Article  Google Scholar 

  • Hartunian, N. S., C. N. Smart, and M. S. Thompson: 1981, The Incidence and Economic Costs of Major Health Impairments, D. C. Heath, Lexington, MA.

    Google Scholar 

  • Jacquez, J. A.: 1972, Compartmental Analysis in Biology and Medicine, Elsevier, Amsterdam.

    Google Scholar 

  • Katz, S., L. G. Branch, M. H. Branson, J. A. Papsidero, J. C. Beck, and D. S. Green: 1983, ‘Active Life Expectancy’, New England Journal of Medicine, 309 (20), 1218–1223.

    Article  Google Scholar 

  • Katzman, R.: 1976, ‘The Prevalence and Malignancy of Alzheimer’s Disease’, Arch. Neurol, 33, 217–218.

    Google Scholar 

  • Koizumi, A.: 1982, ‘Toward A Healthy Life in the 21st Century’, in Population Aging in Japan: Problems and Policy Issues in the 21st Century, International Symposium on an Aging Society: Strategies for 21st Century, Japan, Nihon University, Nov. 24–27, Chapter 6, 1–19.

    Google Scholar 

  • Lubitz, J. and R. Prihoda: 1983, ‘Use and Costs of Medicare Services in the Last Years of Life’, in Health, United States, DDHS Pub. No. (PHS)84–1232, Public Health Service, U.S. Government Printing Office, Washington, DC.

    Google Scholar 

  • Luce, B. R., K. Liu, and K. G. Manton: 1984, ‘Estimating the Long-term Care Population and Its Use of Services’, in Long-Term Care and Social Security, ISSA Studies and Research, No. 21, Geneva.

    Google Scholar 

  • Makeham, W. M.: 1860, ‘On the Law of Mortality and Construction of Annuity Tables’, J. Inst Actuaries, 8, 301.

    Google Scholar 

  • Manton, K. G.: 1983, ‘Forecasting Life Expectancy’, Testimony before Subcommittee on Savings, Pensions, and Investment Policy of the Committee on Finance, U.S. Senate, July 15, 1983, Washington, D.C., published in Federal Register.

    Google Scholar 

  • Manton, K. G.: 1984a, ‘An Evaluation of Strategies for Forecasting the Implications of Occupational Exposure to Asbestos’, prepared for U.S. Library of Congress, Congressional Research Service, Government Division.

    Google Scholar 

  • Manton, K. G.: 1984b, £A Review and Assessment of Models for Forecasting Health Status and Life Expectancy Changes in the Elderly Population’, Report for the National Institute on Aging.

    Google Scholar 

  • Manton, K. G., C. Holzer, E. MacKenzie, E. Spitznagel, A. Forsythe, and D. Jackson: 1985, ‘Statistical Methods for Estimating and Extrapolating Disease Prevalence and Incidence Rates from a Multisite Study’, in W. Eaton and L. Kessler (eds.) Epidemiological Field Methods in Psychiatry: The NIMH Epidemiological Catchment Area Program, Academic Press, New York, 351–371.

    Google Scholar 

  • Manton, K. G. and K. Liu: 1985, ‘Strategies for Collating Diverse Scientific Evidence in the Analysis of Population Health Characteristics: Bioactuarial Models of Chronic Disease Mortality for the Elderly’, Sociological Methods & Research, 13, 407–431.

    Article  Google Scholar 

  • Manton, K. G. and E. Stallard: 1979, ‘Maximum Likelihood Estimation of a Stochastic Compartment Model of Cancer Latency: Lung Cancer Mortality Among White Females in the U.S.’, Comput. Biomed. Res., 12, 313–325.

    Article  Google Scholar 

  • Manton, K. G. and E. Stallard: 1982, ‘A Population-based Model of Respiratory Cancer Incidence, Pregression, Diagnosis, Treatment and Mortality’, Comput. Biomed. Res., 15, 342–360.

    Article  Google Scholar 

  • Manton, K. G. and E. Stallard: 1980: ‘A Stochastic Compartment Model Representation of Chronic Disease Dependence: Techniques for Evaluating Parameters of Partially Unobserved Age Inhomogeneous Stochastic Processes’, Theor. Popul. Biol., 18 (1), 57–75.

    Article  Google Scholar 

  • Manton, K. G., E. Stallard, J. P. Creason, W. B. Riggan, and M. A. Woodbury: 1986a, ‘Compartment Model Approaches for Estimating the Parameters of a Chronic Disease Process Under Changing Risk Factor Exposures’, Comput. Biomed. Res., 19, 151–169.

    Article  Google Scholar 

  • Manton, K. G., E. Stallard, and H. D. Tolley: 1983, ‘The Economic Impact of Health Policy Interventions’, Risk Analysis, 3 (4), 265–275.

    Article  Google Scholar 

  • Manton, K. G., E. Stallard, and J. W. Vaupel: 1986, ‘Alternative Models for the Heterogeneity of Mortality Risks Among the Aged’, JASA, 81, 635–644.

    Google Scholar 

  • Manton, K. G. and M. A. Woodbury: 1985, ‘A Continuous-Time Multivariate Gaussian Stochastic Process Model of Change in Discrete and Continuous State Variables’, in N. Tuma (ed.), Sociological Methodology, Jossey-Bass, San Francisco, 277–315.

    Google Scholar 

  • Manton, K. G. and M. A. Woodbury: 1983, ‘A Mathematical Model of the Physiological Dynamics of Aging and Correlated Mortality Selection: Part II, Application to the Duke Longitudinal Study’, J. Gerontology, 38, 406–413.

    Google Scholar 

  • Myers, G. C.: 1981, ‘Future Age Projections and Society’, in A. J. J. Giimore (ed), Aging: A Challenge to Science and Social Policy, Vol. II, Oxford University Press, Oxford.

    Google Scholar 

  • Nicholson, W. J., G. Perkel, and I. J. Selikoff: 1981, ‘Cancer for Occupational Asbestos Exposure: Projections 1980–2000’, Banbury Report, 9, Cold Spring Harbor Laboratory, Cold Spring Harbor, N.Y.

    Google Scholar 

  • Nihon University: 1982, ‘Population Aging in Japan: Problems and Policy Issues in the 21st Century’, International Symposium on an Aging Society: Strategies for the 21st Century, Japan, Nov. 24–27.

    Google Scholar 

  • Ogawa, N.: 1982, ‘Economic Implications of Japan’s Aging Population’, Int. Labour Rev., 121, 17–33.

    Google Scholar 

  • Perks, W.: 1932, ‘On Some Experiments in the Graduation of Mortality Statistics’, J. Inst. Actuaries, 63, 12.

    Google Scholar 

  • Peto, J., H. Seidman, and I. J. Selikoff: 1982, ‘Mesothelioma Incidence Among Asbestos Workers: Implications for Models of Carcinogenesis and Risk Assessment Calculations’, Br. J. Cancer, 45, 124–135.

    Article  Google Scholar 

  • Rice, D. P.: 1966, Estimating the Cost of Illness, DHEW Public Health Service Pub. No. 947 - 6, U.S. Government Printing Office, Washington, DC.

    Google Scholar 

  • Rice, D. P. and J. J. Feldman: 1983, ‘Living Longer in the United States: Demographic Changes and Health Needs of the Elderly’, Milbank Memorial Fund Quarterly, 61 (3), 362–396.

    Article  Google Scholar 

  • Rice, D. P. and T. A. Hodgson: 1981, ‘Social and Economic Implications of Cancer in the United States’, DHHS Publ. No. (PHS) 81–1404, U. S. Government Printing Office, Washington, DC.

    Google Scholar 

  • Riley, M. W.: 1981, ‘Health Behavior of Older People: Toward a New Paradigm’, in D. L. Parron, F. Soloman and J. Rodin (eds.), Health, Behavior and Aging, Institute of Medicine Interim Report No. 5, National Academy Press, Washington, DC.

    Google Scholar 

  • Riley, M. W. and K. Bond: 1983, ‘Beyond Ageism: Postponing the Onset of Disability’, in M. W. Riley, B. B. Hess and K. Bond (eds.), Aging in Society: Selected Reviews of Recent Research, Lawrence Erlbaum, Hillsdale, N.J.

    Google Scholar 

  • Sacher, G. A. and E. Trucco: 1962, ‘The Stochastic Theory of Mortality’, Annals of the New York Academy of Sciences, 96, 985.

    Article  Google Scholar 

  • Schoen, R. and K. C. Land: 1979, ‘A General Algorithm for Estimating a Markov-Generated Increment-Decrement Life Table with Applications to Marital Status Patterns’, JASA, 74, 761–776.

    Google Scholar 

  • Selikoff, I. J.: 1981, ‘Disability Compensation for Asbestos-Associated Diseases in the United States’, Report to U.S. Dept. Labor, Contract No. J-9-M-0165, Environmental Sciences Laboratory, Mount Sinai School of Medicine, City University of New York, June.

    Google Scholar 

  • Selikoff, I. J., E. C. Hammond, and H. Seidman: 1980, ‘Latency of Asbestos Disease Among Insulation Workers in the United States and Canada’, Cancer, 46, 2736–2740.

    Article  Google Scholar 

  • Singer, R. B. and L. Levinson: 1976, Medical Risks: Patterns of Mortality Survival, D. C. Heath, Lexington, MA.

    Google Scholar 

  • Social Security Administration, Office of the Actuary: 1982, Life Tables for the United. States, 1900–2050, Actuarial Study No. 87, SSA Pub. No. 11–11534.

    Google Scholar 

  • Social Security Administration, Office of the Actuary: 1981, Social Security Area Population Projections, 1981, Actuarial Study No. 85, SSA Pub. No. 11–11532.

    Google Scholar 

  • Spiegelman, M.: 1969, Introduction to Demography, Harvard University Press, Cambridge, MA.

    Google Scholar 

  • Strehler, B. L. and A. S. Mild van: 1960, ‘General Theory of Mortality and Aging’, Science, 132, 14.

    Article  Google Scholar 

  • Tolley, H. D. and K. G. Manton: 1984, ‘Assessing Health Care Costs in the Elderly’, Transactions of the Society of Actuaries, 36, 579–603.

    Google Scholar 

  • Tolley, H. D., K. G. Manton, and E. Stallard: 1982, ‘Compartment Model Methods in Estimating Costs of Cancer’, Transactions of the Society of Actuaries, 34, 399–413.

    Google Scholar 

  • Vaupel, J. W., K. G. Manton, and E. Stallard: 1979, ‘The Impact of Heterogeneity in Individual Frailty on the Dynamics of Mortality’, Demography, 16 (3), 439–454.

    Article  Google Scholar 

  • Walker, A. M.: 1982, Projections of Asbestos-Related Disease 1980–2009, Final Report, Epidemiology Resources, Inc., Chestnut Hill, MA.

    Google Scholar 

  • Wilkins, R. and O. B. Adams: 1983, Healthfulness of Life, Institute for Research on Public Policy, Montreal.

    Google Scholar 

  • Woodbury, M. A. and K. G. Manton, K. G.: 1977, ‘A Random Walk Model of Human Mortality and Aging’, Theor. Popul. Biol, 11 (1), 37–48.

    Article  Google Scholar 

  • Woodbury, M. A. and K. G. Manton: 1983, ‘A Mathematical Model of the Physiological Dynamics of Aging and Correlated Mortality Selection: Part I, Theoretical Development and Critiques’, J. Gerontol., 38, 398–405.

    Google Scholar 

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Manton, K.G. (1987). Forecasting Health Status Changes in an Aging U.S. Population: Assessment of the Current Status and Some Proposals. In: Land, K.C., Schneider, S.H. (eds) Forecasting in the Social and Natural Sciences. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-4011-6_8

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  • DOI: https://doi.org/10.1007/978-94-009-4011-6_8

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-010-8279-2

  • Online ISBN: 978-94-009-4011-6

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