The Risk of Being Sick: Morbidity Trends in Four Countries

• Published in: Population and development review 1990-09, Vol.16 (3), p.403-432
• Main Author: Riley, James C.
• Format: Article
• Language: English
• Subjects: Chronic diseases; Comparative Study; Crosscultural Analysis; Death; Death Rate; Diabetes; Diseases; Epidemiology; Great Britain; Health Care; Health surveys; Hungary; Japan; Morbidity; Mortality; Mortality Rates; Notifiable diseases; Public health; Rates of change; Statistics; United States; United States of America
• ISSN: 0098-7921; 1728-4457
• DOI: 10.2307/1972830

Death rates have declined in developed countries for more than a century, and the risk of dying while sick has also declined. But the prevalance of sickness has increased. Health surveys in Japan, the United States, Britain, and Hungary indicate that the prevalence of sickness at each age moves in a direction opposite to the risk of death at each age. In the first three countries, where death rates have declined, the proportion of people reporting health problems and restricting ordinary activities because of health has increased. In Hungary death rates have increased and the proportion of people reporting chronic illness has decreased. Some explanations for the increase in sickness rates refer to subjective changes in the evaluation of health experience that show up as a lower threshold for distinguishing health from ill health. Other explanations--prolongation of the average course of maladies, insult substitution, and the effects of mortality decline--refer to objective factors accounting for additional time spent in ill health. The article reviews arguments offered for each explanation and stresses the role of objective factors in increasing sickness time.