title: No evidence of morbidity compression in Spain: a time series study based on national hospitalization records.
abstract: OBJECTIVE
  Compression of morbidity postulates that as the populations age, the age of onset of disease is postponed. The objective of this study is to test for evidence of compression of morbidity in Spain.
  
  
  METHODS
  We calculated the age and sex-specific incidence of myocardial infarction, heart failure, cerebrovascular disease, as well as bladder, prostate, breast, lung, and colon cancer among hospital discharges covering 99.5 % of the Spanish population, approximately 40 million inhabitants for two non-overlapping periods, 1997-2000 and 2007-2010, and estimated the length of life spent with disease using the Sullivan method.
  
  
  RESULTS
  We found that expansion of morbidity due to an earlier age-specific onset of incident disease and increase in life expectancy was the norm in Spain. Notable exceptions were cardiovascular disease in women (-0.2 % time spent with disease) and lung cancer for men (-0.9 % time spent with disease) from 1997-2000 to 2007-2010.
  
  
  CONCLUSIONS
  Compression of morbidity is often cited by policy makers when discussing adjustments to the health-care system. If morbidity is measured by age at onset of disease, the burden of morbidity has increased in Spain.
authors.affiliation: Department of Epidemiology and Biostatics, University of California San Francisco, 550 16th Street, 2nd Floor, Campus Mail Box 0560, San Francisco, CA, 94158-2549, USA. swalter@psg.ucsf.edu.
authors.forename: Stefan
authors.initials: S
authors.lastname: Walter
authors.affiliation: Department of Community Health Sciences, Fielding School of Public Health, and California Center for Population Research, University of California, Los Angeles, USA.
authors.forename: Hiram
authors.initials: H
authors.lastname: Beltrán-Sánchez
authors.affiliation: Department of Preventive Medicine and Public Health, Universidad Complutense de Madrid, Madrid, Spain.
authors.forename: Enrique
authors.initials: E
authors.lastname: Regidor
authors.affiliation: Gastrointestinal Cancer and Early Clinical and Translational Research Units, Medical Oncology Division, 12 de Octubre University Hospital, Madrid, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Gomez-Martin
authors.affiliation: Area of Preventive Medicine and Public Health, Rey Juan Carlos University, Madrid, Spain.
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Del-Barrio
authors.affiliation: Area of Preventive Medicine and Public Health, Rey Juan Carlos University, Madrid, Spain.
authors.forename: Angel
authors.initials: A
authors.lastname: Gil-de-Miguel
authors.affiliation: Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, USA.
authors.forename: S V
authors.initials: SV
authors.lastname: Subramanian
authors.affiliation: Area of Preventive Medicine and Public Health, Rey Juan Carlos University, Madrid, Spain.|Department of Population Medicine, Harvard Medical School, Boston, MA, USA.
authors.forename: Ruth
authors.initials: R
authors.lastname: Gil-Prieto
mesh_terms: D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D002318:Cardiovascular Diseases / Q000453:epidemiology; D005260:Female; D006304:Health Status; D006801:Humans; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009369:Neoplasms / Q000453:epidemiology; D010351:Patient Discharge / Q000706:statistics & numerical data; D011788:Quality of Life; D017678:Sex Distribution; D013030:Spain / Q000453:epidemiology
keywords: Age of onset; Cancer; Cardiovascular disease; Compression of morbidity; Disease-free life expectancy; Spain