Not only has Americans' life expectancy increased in recent decades, they also are healthier later in life, a new study shows.
"Effectively, the period of time in which we're in poor health is being compressed until just before the end of life," Cutler said. "Where we used to see people who are very, very sick for the final six or seven years of their life, that's now far less common. People are living to older ages and we are adding healthy years, not debilitated ones."
In this study, Cutler and his colleagues analyzed health data collected from nearly 90,000 Medicare beneficiaries between 1991 and 2009. They compared this data with survey responses on how well the people were able to care for themselves -- whether they were able to cook, clean, bathe, dress, walk and manage money -- to determine how healthy the people were in relation to how close they were to dying.
Increased access to and improvements in health care are among the reasons people are healthier later in life, but further research is needed to identify all the factors.
"There seems to be a clear relationship between some conditions that are no longer as debilitating as they once were and areas of improvement in medicine," Cutler said.
"The most obvious is cardiovascular disease -- there are many fewer heart attacks today than there used to be, because people are now taking cholesterol-lowering drugs, and recovery is much better from heart attacks and strokes than it used to be," he said. "A person who suffered a stroke used to be totally disabled, but now many will survive and live reasonable lives. People also rebound quite well from heart attacks."
People's knowledge of how to live healthier lives also has improved.
"People are much better educated about their health now," Cutler said. "People are taking steps to help prevent long-term cognitive decline. We don't have any way yet to slow down something like Alzheimer's or Parkinson's, but there is a lot we can do for other health problems."
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