The illusion of failure: trends in the self-reported health of the U.S. elderly.

Examined trends in mortality and several self-reported health measures in older adults from the 1970s through the 1980s to test the "failure of success" hypothesis--that recent mortality declines among older adults have been associated with increased frailty and worsening health. Data from the National Health Interview Survey for 1969-1991 were used to chart population trends in three types of self-reported health measures most related to chronic illness: activity limitations, general health status, and the presence of chronic conditions. Reported activity limitation among adults aged 45-64, as well as those aged 65-69, increased during the early 1970s and stayed flat or decreased in the late 1970s and 1980s. Trends for those aged 70 and over showed no clear pattern. Reported general health status for all age groups remained relatively constant during the 1970s and fell significantly during the 1980s. Overall, prevalence of self-reported chronic conditions increased sharply in the 1970s but decreased slightly in the 1980s. Mortality declines affected a much larger fraction of respondents aged 65 and over than other age groups, with the largest improvements in the 1970s. These trends are not consistent with the failure of success hypothesis. An alternative explanation emphasizes two forces: a changing social and economic environment brought about by the expansion of income maintenance programs for individuals in poor health and the earlier diagnosis of preexisting conditions. (AgeLine Database, copyright 1995 AARP, all rights reserved)