Decline in mortality has been observed in the human population. The 20th century has witnessed an increase in length of days of people. According to Beaumont between 1930 -2010 the UK life expectancy at birth has increased by around a third, now 78.2 years and 82.3 years for men and women respectively.
The term 'Compression of mortality' has been used to imply concentrated number of deaths in the ages period closer to the end of limit of biological life span (Schnieder 2004, p. 435-487), this does not imply any age or age group but usually excludes infant & childhood mortality, the idea is basically life experience and its consequences, but includes decline in infant mortality to older age mortality. Since the 1900's a rise in expectancy of life has been observed from the pre-modern level of 35 years to 75 years in the now developed countries (Ediev n.d., p. 4). A recent study by Kannisto (2000, p. 11) argues that humans postponement of death in conducive situations is still limited by age; this compresses mortality at ages by larger number of events. There is reduced influenza epidemic and communicable diseases in the population, but observable higher deaths in the older age group due to illnesses including cancer, Alzheimer's, cardiovascular diseases and diabetes among others. Summarily, compression occurs if onset of morbidity (chronic irreversible illness) is further delayed than is life expectancy (Cai and Lubitz 2007, p.1).
Critically present the evidence that morbidity in adults is not being compressed in the same way.
Individual lifestyle factor, social and community network and socioeconomic, cultural and environmental conditions have direct impacts on health; hence the period of illness is determined to be either acute or chronic "Compressed morbidity". Smoking, unhealthy eating, lack of exercise, working and living conditions, water and sanitation, education inclusive are health determinants which contribute to favorable or unfavorable health (Goldblatt 2000, p.18).
According to Fries (2000 p.1584) "Compression of morbidity paradigm envisions reduction in cumulative lifetime morbidity through primary prevention by postponing the age of onset of morbidity to a greater amount than life expectancy is increased, largely by reducing the lifestyle health risks which cause morbidity and disability". Morbidity has not been observed to be in parallel with ongoing 'compression of mortality', the period of onset of diseases/disability is not at the end closer period of end of biological life.
Statistics show that there has not been a parallel decline in morbidity, increasing prevalence of Coronary heart diseases (CHD) above the age of 45. There is more than a doubled effect for men in Britain 65-74 age group (184 per thousand population) as against 55-64 age group (84 per thousand population) same applies for the older age group of women with rates of 124 and 56 (Bajekal 2006, p.92).
Diseases and illness which leads to disability in adults/old age population remains managed not cured within and has not declined with increased life expectancy . As noted by Fries (2000, p.1584) human aging is increasingly represented by frailty, with declining reserve function of many organ systems, including the immune system". People live longer but do so in bad health, modern medicine increases chances of survival with controlled diseases or disability, as stated by (explaining divergent levels of longevity in HIC countries) "longer-lived group may not necessarily be "healthier" than a group with a shorter life expectancy" there would in this case be a large population with ailments but alive. With the higher life expectancy doesn't come healthier years. With the onset of ageing comes a linear decline in function ability of human organs at a rate of 1.5% per year after age 30 (Fries 2000, p.1584-1585).
Prevalence of Cancer among the adults, an increase in occurrence is forecasted to triple to 2 billion by 2050 ("Demographic Facts for the World Population." : Cancer Research UK. N.p., n.d. Web. 09 Dec. 2012). In 2010, more than 60% of newly diagnosed cases were for age bracket 65 and over, the report shows that this rate is higher in the 70-74 years over age group when compared with 65-69 years age group (between males and females of both age bracket) (ONS 2000 Office for National Statistics | Jen Beaumont and Jennifer Thomas, Measuring National Well-Being: Health, Office for National Statistics cite nd ref). A similar trend was observed in 1998 data on cancer, "Subsequently, the overall rates rose more rapidly for males and were broadly similar to those for females in the 60-64 age groups. After this, the rates rose much more rapidly for males- they were almost 50% higher than those for females in the 65-69 age group and almost double in those aged 80-84" (ONS 1998, p.13)
Obesity has been associated with a lot of morbidity including diabetes. According to ONS (Focus on Health 2006, p.59) predominance of obesity is on the increase in all age and sex groups. This is further shown in the graph of diabetes prevalence (Great Britain) by age and sex, 2003, ONS (Focus on Health 2006, p.93), observably higher in the older age group 55 and over in both gender. According to Centers for disease control and prevention (2011: http://www.cdc.gov/diabetes/statistics/cvdhosp/cvd/fig4.html) there is a similar trend in the United States of America, between 1988 to 2006, rates of cardiovascular disease get higher with increasing age with rates per thousand of 63.3, 107.9 and 159.6 for age groups 45-74 years, 65-74 years and 75 older respectively.
Similarly, increase in obesity rates is observable in America, referred to as an epidemic in which people age 51 above representing 15 million of obese population. Obesity not being a chronic condition on its own is a risk factor for coronary heart disease, diabetes, stroke, diabetes (type II) and cancer being causes of death over time. The inability to carry out daily living activities (ADLs) such as eating, bathing, dressing is seen as a disability, since such people tend to receive help from professional care givers ("Center on an Aging Society." Center on an Aging Society. N.p., n.d. Web. 09 Dec. 2012.). http://ihcrp.georgetown.edu/agingsociety/pubhtml/obesity2/obesity2.html. Depression and chronic conditions are also associated with obesity within age group 51 and older hence a general ill-health lasting for a longer time.
Morbidity as seen is not being compressed so far in the last years from the summary shown above. HIV/AIDS, stroke, depression, diabetes, cancer, obesity are not being compressed into the later last few years before the end of life. Morbidity has been observed to result from education attainment (which affects knowledge about risky health attitudes), reward from occupation (which may in turn determines material and non-material rewards thus may protect from exposure to a wide range of risk factors for morbidity). Personal income and also employment status all have diverse contributions to latent period of diseases.
Discuss how in high-income countries this is likely to lead to greater disability lasting for longer periods than in the past
Countries with high-income are experiencing more of non-infectious diseases (obesity, cancer, diabetes, and stroke) symptoms are magnified as adulthood is being reached. Proportion of the population who do little or physical exercise, unhealthy living (smoking, excessive alcohol and bad diet) and are susceptible to longer period of morbidity is on the increase. With the increase in life expectancy in high income countries, inability to perform daily tasks such as doing light work, getting in or off bed, using the toilet is spread out over a longer period of time. With the issue of cancer, it is observed according to Focus on Health (2006 p.114) early diagnosed cancer cases at young age have higher survival chances (postponement of mortality, but not cure of morbidity). What Improve healthcare in high-income countries has done is to help with postponement of age of death.
By the year 2020, 10 percent of people aged 65 older in the EU countries will need long term care or regular support (Aileen Robertson et al. in Marmot 2003, p.185). This will be as a result of inability to carry out daily life activities due to morbidity of one form or another. With average life expectancy of high income countries between 75.0-82.7 in Ecuador and Japan respectively (male and female) (http://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy), delayed age of death has been observed but not delay in commencement of diseases/illness, thus old-age disability and morbidity will be extended due to the acute diseases being converted into chronic diseases, diseases of ageing are managed rather than cured (Carnes 2007, p.371).
In the past, infectious diseases usually last short period of time before the end of biological life, there were less medical treatment methods to battle diseases, with medical improvements in Countries with high, infectious diseases are managed and treated easily, although rarely cured in adults, and they could be concealed by other chronic conditions in the elderly. The immune system weakens with age, bacteria and viruses are then able to attack, and disability from respiratory infections, urinary tract infections thus leads to hospitalization. Morbidity is yet to be modified along with observed mortality, the start of the period of diseases and illness has not shifted from early adulthood, even though age at death is being postponed, age at start of diseases hence inability to perform daily life activities has not been postponed.
Even though ageing is being postponed and research comes up on how to postpone ageing, cultural and social factors, life style behavior, and biological factors have a role to play in experience of adulthood.
Ediev (n.d, p4) identifies that deterioration with age has not been slowed down in developed countries.
Observably, people living in poverty have poorer health, tendency of smoking, excessive alcohol consumption, poor exercise and diet which all have a negative effect on social relationships. According to Shaw et al. material conditions are underlying roots of ill health which includes lack of opportunities to participate in society (Mary Shaw et al. cited in Marmot 2003, p.215-216). Health is affected by poverty and such adverse socio-economic conditions in early life results in lasting cases of morbidity including respiratory diseases in adulthood
There is evidence that as adult mortality falls further and life expectancy is extended, differentials in health and survivorship in rich countries are widening. Using examples, explain why general improvements in health and survival are not equally distributed in the population.
Health inequalities across cities and regions at large are a function of socioeconomic factors as well as demographic factors. Disparity in health and survival are seen in all Countries, but more pronounced in high income Countries due to the level of medical development, accessibility/affordability and margin of health risks between social groups (Thesis Gronigen Chap 2 p.18). Countries have peculiar situations, not all countries have equal morbidity exposure or experience (risk factors associated with mortality). There are socioeconomic differences as well as cultural between Countries, leading to different health and survival experience, which is not limited to between Countries but even occurs within Countries.
Health condition is also determined for a population according to macroeconomic conditions, Gross Domestic product, political institution (democratic or Military), and Socio cultural factors (Religion, healthcare and ecological climate) (Thesis Gronigen Chap 2 p.19).
Causes of death are mostly due to morbidity, survival of illness depends according to (explaining divergent of levels of Longevity in HIC, 2011 p.117) "social status creates social inequality in health". Levels of education, income, employment grade, occupation, ethnicity, religion among other socioeconomic indicators impact mortality. This is asserted further by Brunner and Marmot, STUDIES SHOW THAT THERE IS AN INCREASING POSITIVE RELATIONSHIP BTW CIVIL SERVANTS EMPLOYMENT GRADE AND CAUSES OF HEART DISEASE SUCH AS DISTRESSING LIFE EVENTS, DIFFICULTY IN PAYING BILLS, ABDOMI NAL FAT ASSOCIATED WITH CORONARY RISK WERE OBSERVED WITHIN LOWER GRADE STAFF THIS HEALTH RISK FACTORS ARE IN RESPONSE TO ADVERSE PSHYCOSOCIAL CIRCUMSTANCES IN the WHITEHALL STUDY II, 1985-1988 (Eric Brunner and Michael Marmot cited in Marmot and Wilkinson 2003, P.32-33).
Wadsworth gives association between education and health behavior, "Low levels of education are associated with poor health related behavior" (Michael Wadsworth in Marmot and Wilkinson 2003, p.52). The difference in education attainment within population determines exposure and awareness of health related disadvantages and advantages, and also information and access to new medical care. The relationship between education and income cannot be further stressed. Income determines affordability of better medical care and stress reducing behaviors could be affordable by the higher income group, explained by (Crimmins et al. 2011, p. 118), it is explained that with higher inequality comes lower life expectancy among the lower income group/socioeconomic class.
There is differential in occupation type, differential in working conditions and type of work engaged in explains susceptibility of different kind of occupational hazards, hence mortality due to occupation. On attributing occupation with social standards and behavior (Spiker JJA 2004, p. 26) has shown that mortality is unequally distributed, a lower standard socially is directly proportional to higher mortality, citing the example of farmers-manual workers, lower mortality was observed due to causation but higher mortality in farmers-white collar occupation. Spiker JJA (2004, p. 27) concludes that hazards on the job are different uniquely for job types, miners are liable to have a higher mortality due to respiratory diseases, as shown in the England& Wales survey in 1970-1972. Observably, different occupation creates different exposure to risk antecedents in health, even though there is uniform improvement in health and survival in a population, the exposure at work is different at each occupational level.
On personal income, the reward for labor is wages. This in turn determine health, amount affordable on the basic necessities of life is dictated and this in turn affects health and standard of living. A Statistics Netherlands saw that cerebrovascular diseases, heart diseases and lung cancer were found to be associated as causes of mortality in men of low income against the high-income earners 1990, trend observed in mortality by income among women was found to be highest rate in middle-income earners and high income earners still having the lowest mortality rate in the group (Spiker JJA 2004, p. 28).
Unfavorable social environments in early life on adulthood
As there are cultural differences in every society, which creates unequal distribution of resources, the culture of a people has been linked to the access they have to health services which determines their health status and life expectancy, it has been noted that the fight for provision of health services and education boosts life expectancy and creates less mortality; this was experienced in a poor rural area of Northeast Brazil (Caldwell 1991, p. 5). Religion plays a critical role in care and of offspring's, as it determines behavior of parent in child care and care of illegitimate children. Illegitimate children are rarely well cared for, they are breastfeed for a shorter period of time and mostly end up in foster homes, and level of care given to children also plays a fundamental role in health. If children are seen as important in the culture and society as a whole, effort will be given to keep them alive and healthy, thus improvement in health and survival is further guaranteed (Caldwell & Caldwell p. 6).
Because population experience different life experience, as a group or as individuals, Life style based on present condition determines survival period. Period of difficulty at a time when working conditions are hazardous, housing and feeding is unfavorable, these conditions are grounds for diseases such as depression and stroke, survival of this condition(s) could be due to earlier period in life where living standard in life is good with regular balance diet. (Spiker JJA 2004, p. 21).
Observably, inequalities in health are due to distribution of behavioral factors and material factors in adulthood for different strata in the population (Spiker JJA 2004, p. 25). Survival chances are largely due association to social class and material possession.
Mortality experience as mentioned earlier is unequal among groups and geographical Region, hence differential in heath distribution. This could be as a result of behavioral factors such as smoking and alcohol, and/or also biological factors among other things. As gender is different so is smoking disposition between them.
Education and HIV/AIDS
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Limig Cai, James Lubiz Was there compression of disability for Older Americans from 1992 to 2003,
