Are we living longer and healthier lives? Recent trends in mortality and morbidity in Spain, 2001-2009

Evidence on trends in prevalence of disease and disability can clarify whether countries are experiencing a compression or expansion of morbidity. The prevalence of chronic diseases and risk factors appears to have been increasing in both Europe and other developed countries indicating an expansion of morbidity as indicated by disease. It is likely that better treatment, preventive measures (such as cancer screening and treatment of cardiovascular risk factors) and increases in education levels have contributed to the declines in mortality and increases in life expectancy. It should be noted that, the increases in presence of disease appear to be less associated with disability. This paper examines whether there has been an expansion or compression of morbidity in Spain. It uses trends in mortality and morbidity from major causes of death and links of these with mortality to provide estimates of life expectancy with and without diseases and loss of functioning. The analysis uses a repeated cross-sectional Spanish health survey in 2001 and 2009 for measues of morbidity, the Spanish National Health Survey, mortality information comes from the National Statistics Institute database. Increasing survival among people with diseases can lead to a higher prevalence of diseases in the older population.