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National Center for Chronic Disease Prevention and Health Promotion
Chronic Disease Prevention
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National Center for Chronic Disease Prevention and Health Promotion Chronic Disease Prevention Home | Contact Us |
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CENTERS FOR
DISEASE CONTROL AND PREVENTION Commentary Live Better, Live Longer James S.
Marks, MD, MPH Director
CDC’s Healthy Days measures are fairly simple questions that have real value in helping to track HRQOL outcomes. It is about time that we as a society recognize and begin to keep score of this fundamental component of health. In a recent issue of the New England Journal of Medicine, investigators found that people at age 70 who had no activity limitations lived about 3 years longer than people who had one or more limitations in a variety of activities associated with daily living.* This finding was not surprising. What was surprising to the authors was that after age 70, initially healthy people had slightly lower total lifetime health expenditures despite living 3 years longer. Although the initially healthy people did eventually become ill and incur expense, their health care expenditures per year of life were about 25% less than those of people with activity limitations. So arriving at age 70 relatively well, without limitations in health-related quality of life, was associated with not only longer life but also lower health care costs. Also, people who reached age 70 in good health spent fewer years substantially disabled than people who had activity limitations at 70. This is important because much of our total health care spending occurs in the last few years of life. Moreover, this study and others dispel notions that helping people live longer would increase total health care costs. While this is good news, it is even better news in terms of the aging baby boomer generation. Even moderate delays in disability will give us more time as a society to adjust to the health care costs that boomers will incur and more time to work out solutions to deal with these costs. Substantial delays in the onset of serious disabilities will decrease the total costs even more, meaning that a portion of projected health care costs might be avoided completely. As the number of older adults increases, many older people will need to work to maintain a good standard of living. Some will want to work because they find it fulfilling and enjoyable. Others may want to volunteer or to take care of grandchildren while the parents go to work. Regardless, they can work only if they are healthy. A critically important part of older life is not just its length, but its quality and enjoyability. We emphasize health-related quality of life so that older individuals can work if they choose, stay connected with their families and friends, and not be in pain or consider themselves a burden. The goal of public health is to increase the duration of that high-quality fulfilling life. *Lubitz J, Cai L, Kramarow E, Lentzner H. Health, life expectancy, and health care spending among the elderly. N Engl J Med 2003;349:1048-1055. |
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Privacy
Policy | Accessibility This page last reviewed August 10, 2004 United
States Department of Health and Human Services |
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In
this issue of CDNR, we look at the many ways in which state and local
health departments are beginning to use health-related quality of life (HRQOL)
measures to identify populations hurt the most by chronic diseases, to
strengthen health promotion programs, and to support environmental and
policy changes that will have lasting, broad benefits to the population.
