title: The elimination of selected chronic diseases in a population: the compression and expansion of morbidity.
abstract: OBJECTIVE
  This study evaluates the effect of eliminating a specific disease on the mortality, long-term disability, and overall health status of a population. Primarily, it examines whether elimination leads to a compression of morbidity.
  
  
  METHODS
  The Sullivan method was used to calculate disability-free life expectancy. Cause-deleted disability prevalence was estimated with a multiple logistic regression model that used data from the Dutch National Survey of General Practice. Cause-deleted probabilities of dying were derived with the cause-elimination life-table technique, assuming independence among competing causes of death.
  
  
  RESULTS
  Eliminating disabling nonfatal diseases such as arthritis/back complaints results in a decline in life expectancy with disability--that is, an absolute compression of morbidity. Eliminating highly fatal diseases such as cancer leads to an increase in the number of years and the proportion of life with disability--that is, a relative expansion of morbidity.
  
  
  CONCLUSIONS
  While eliminating fatal diseases leads to an increase in disability-free life expectancy, life expectancy with disability may increase as well. This represents an increasing burden to society. On the other hand, eliminating nonfatal disabling diseases leads to absolute compression of morbidity.
authors.affiliation: Netherlands Institute for Primary Health Care, Utrecht, The Netherlands.
authors.forename: W J
authors.initials: WJ
authors.lastname: Nusselder
authors.forename: K
authors.initials: K
authors.lastname: van der Velden
authors.forename: J L
authors.initials: JL
authors.lastname: van Sonsbeek
authors.forename: M E
authors.initials: ME
authors.lastname: Lenior
authors.forename: G A
authors.initials: GA
authors.lastname: van den Bos
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease / Q000453:epidemiology / Q000401:mortality; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities; D005260:Female; D006306:Health Surveys; D006801:Humans; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D012494:Sampling Studies