Disparities by sex, race/ethnicity, and education in trends in the disability burden in the United States, 1996-2018.

Abstract

Research remains inconclusive on whether increased longevity is resulting in disability compression. Using the Health and Retirement Study and multistate models, this study is the first to examine trends (between 1996-2006 and 2008-18) across multiple key aspects of disability burden: namely, lifetime risk and age at onset of disability; recovery and mortality of the disabled; and disability-free life expectancy (DFLE) at age 50 in the United States' older population. Furthermore, we differentiate these trends by key socio-demographic factors: sex, race/ethnicity, and educational attainment. The analysis shows that over four-fifths of the total life expectancy increase at age 50 was in DFLE. This was accompanied by a one-year postponement in disability onset and insignificant recovery from disability. However, lifetime risk of disability remained unchanged between periods. Disability trends improved more for women than men. Latinx and the lowest-educated adults experienced no improvement in disability onset. The lowest-educated Whites exhibited substantial health deterioration.