Monday, April 21
Grant Miller: Managerial Incentives in Public Service Delivery
Objectives. We addressed three questions: Have recent improvements in old-age disability been mirrored in changes in self-reported general health status? Are general health status trends similar for younger and older Americans? Have changes in general health status been uniform across demographic and socioeconomic groups?
Methods. Using logistic regression, we analyzed data from the 1982–2003 National Health Interview Surveys (n = 1,445,872 aged 18–69; n = 178,384 aged 70 and older).
Results. The proportion of people aged 70 and older reporting disability declined at 1.38% per year and the proportion 70 and older reporting poor/fair health declined at 1.85% per year. There was less of a decline in reports of poor/fair health at younger ages. Trends for the 18–69 population showed widening health disparities by income but narrowing of the race/ethnicity and education gaps. In the older population, there was no change for those aged 80–84 and 85 and older, the race/ethnicity gap persisted, and both education and income differentials widened over time.
Discussion. Declines in proportions reporting poor/fair health among the older population in recent decades mirror declines in disability. Although the younger population has not experienced such progress, its prevalence of poor/fair health is low throughout the 21-year analysis period. Of concern are the growing socioeconomic disparities in health for both younger and older populations.