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Expected Years of Life Free of Chronic Condition–Induced Activity Limitations — United States, 1999–2008

	Supplement Volume 62, Supplement, No. 3 November 22, 2013 PDF of this issue

Expected Years of Life Free of Chronic Condition–Induced Activity Limitations — United States, 1999–2008

Supplements

November 22, 2013 / 62(03);87-92

Michael T. Molla, PhD

National Center for Health Statistics, CDC

Corresponding author: Michael T. Molla, National Center for Health Statistics, CDC. Telephone: 301-458-4379; E-mail: MMolla@cdc.gov.

Introduction

Over the 20th century, the U.S. population has witnessed major changes in fatal and nonfatal health outcomes. Mortality has declined, and life expectancy has increased continuously; chronic conditions have replaced acute diseases as leading causes of both illness and death (1). During 1900–2008, average life expectancy at birth for the total U.S. population increased from 47.3 years in 1900 to 78.1 years in 2008 (2), a gain of 30.8 years. In addition, an increasing proportion of the U.S. population is aged >65 years. According to the U.S. Census Bureau estimates, at the beginning of the 20th century, the U.S. population aged >65 years constituted only 4.1 percent of the total population; by 2008, the percentage of the total U.S. population aged >65 years was 12.8% (3,4). However, declines in mortality are not necessarily associated with declines in morbidity or the consequences of chronic conditions on life activities. The possibility that longer life might be accompanied by poor health makes it essential to develop measures that account for both mortality and morbidity at the same time. Hence, over the past 40 years, a new set of health measures (e.g., "healthy life expectancies") have been developed that account for both mortality and life spent free of the consequences of ill health. One of these newly developed set of measures (called "active life expectancy") is the average number of years expected to be lived without activity limitations.
In general, being "active" entails the continuing participation of a person in social, economic, cultural, spiritual, and civic affairs (5). In health studies, the context in which "being active" has been used has varied depending on the population group under study (6–9). In this report, "active" is used to differentiate between a person with limitations in social roles and one without such limitations. This analysis focuses on activity limitations caused by chronic conditions. Active life expectancy or active life at any age is defined as the remaining years of life free of activity limitations (YFAL) caused by chronic conditions.
This report is part of the second CDC Health Disparities and Inequalities Report (CHDIR). The 2011 CHDIR (10) was the first CDC report to assess disparities across a wide range of diseases, behavior risk factors, environmental exposures, social determinants, and health-care access. The topic presented in this report is based on criteria that are described in the 2013 CHDIR Introduction (11). This report provides information on disparities in YFAL as a result of chronic conditions, a topic that was not discussed in the 2011 CHDIR. The purposes of this report are to discuss and raise awareness of differences in the characteristics of persons who experience chronic condition–induced physical activity limitations and to prompt actions to reduce these disparities.