The Transitions of Aging

239 Pages·2015·3.93 MB·English

by  Suchit Arora (auth.)

International Perspectives on Aging 12
Series Editors: Jason L. Powell, Sheying Chen
Suchit Arora
The
Transitions
of Aging
International Perspectives on Aging
Volume 12
Series Editors
Jason L. Powell
University of Lancashire, Manchester, United Kingdom
Sheying Chen
Pace University, New York, New York, USA
Thestudyofagingiscontinuingtoincreaserapidlyacrossmultipledisciplines.This
wide-ranging series on International Perspectives on Aging provides readers with
much-needed comprehensive texts and critical perspectives on the latest research,
policy, and practical developments. Both aging and globalization have become a
realityofourtimes,yetasystematiceffortofaglobalmagnitudetoaddressagingis
yettobeseen.Theseriesbridgesthegapsintheliteratureandprovidescutting-edge
debate on new and traditional areas of comparative aging, all from an international
perspective.Morespecifically,thisbookseriesonInternationalPerspectivesonAging
puts the spotlight on international and comparative studies of aging
More information about this series at http://www.springer.com/series/8818
Suchit Arora
The Transitions of Aging
SuchitArora
StateTeachersRetirementSystemofOhio
Columbus,OH,USA
Name oforiginal seriescover designer(key designer):eStudioCalamar, Berlin/Figueres
ISSN2197-5841 ISSN2197-585X (electronic)
InternationalPerspectivesonAging
ISBN978-3-319-14402-3 ISBN978-3-319-14403-0 (eBook)
DOI10.1007/978-3-319-14403-0
LibraryofCongressControlNumber:2015936331
SpringerChamHeidelbergNewYorkDordrechtLondon
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To Sonia and Sage

Preface
TheTransitionsstudiesagingbyanalyzingtheratesofnon-communicablediseases
across generations since the nineteenth century. It then examines the extent to
which economic, epidemiologic, and political conditions in the childhood years
ofthegenerationshadinfluencedtheprogressofaging.Inrecentdecades,thisissue
oftheroleofchildhooddevelopmenthascometotheforeasavitaloneforgrasping
the sources of long-term wellbeing. The book, however, harnesses it mainly for
examining another longstanding matter: what type of role does aging play in the
long-termgrowthofpercapitahealthcarespending?
Examining the matter entails weaving together strands of research from
biodemography, gerontology, health economics, economic history, epidemiology,
macroeconomics, public health history, and from the modern debate on the pros-
pectsofaging.Myhopeisthatscholarsineachofthedisciplineswillbenefitfrom
the inter-weavingof ideas as much as Ihave benefitted from their work.I am not
embarrassedtosaythatthebookleavessomelooseendsandunansweredquestions.
However,itishardtoimaginetheywillstaythatwayforlongbecausetheissuehas
become pressing in advanced economies, and is also criticalto emerging ones, as
theirpopulationsagemoreintheyearsahead.
WithoutthesupportandguidancefromRichardSteckel,PeterHowitt,andPaul
Evans,advisorstomydoctoralresearchmorethanadecadeago,thebookmaynot
havebeenpossible.Basedpartlyontheresearch,Iwasabletopublishtworelated
articles (Arora 2005, 2013), whose contents have been revised and reused in the
book. It was apparent while writing the articles that the connections between the
different topics involved would be clearer if they were presented together, in
somewhat more detail, but doing so would also make the content book-length
instead of article-length. And so it is to my wife, Sonia, and our son, Sage,
Ithankthemostfortheirpatienceastheprojectballooned.
Overtheyears,segmentsofthebookwerepresentedtovariousseminarsatthe
Pan American Health Organization, where I benefited from comments by the
participants, especially by Sir George Alleyne who encouraged the research very
vii
viii Preface
early on. As the project inched forward, I gained from discussions with Bernard
Harris, Rick Steckel, Peter Lindert, John Komlos, Simon Szreter, John Murray,
Werner Troesken, Hoyt Bleakley, Claude Diebolt, Oded Galor, Shankha
Chakraborty, Geoff Bump, and Paul Sharp. It has benefitted from suggestions by
the participants of the Beta Workshop at the University of Strasbourg, of the
conference on health and economic policy at the CES/ifo Institute, and of the
seminar at the University of Oregon’s economics department. I am grateful to
David Blau, chairman of the economics department of the Ohio State University,
for arranging access to the University Libraries. Thank you, Peter Lindert, for
sharing the data on wealth and income inequality during the nineteenth century.
BernardHarris,thankyouforansweringmymanyquestionsandforguidingmeto
key sources of information and research. The Changing Body, by Sir Roderick
Floud, Robert Fogel, Bernard Harris, and Sok Chul Hong (2011), has been an
inspirationandaninvaluableresource.
To the series editors, Jason Powell and Sheying Chen, to Evelien Bakker and
BernadetteDeelen-MansatSpringerInternational,thankyoufortheenthusiasmfor
themanuscript,andforallthesupportandpatiencetoseeitthroughinprint.Many
thanks to Nagarajan Paramasivam and to Rathika Ramkumar at SPi Global for
meticulously typesetting a manuscript with a large number of figures and tables.
The views expressed in the book are not of my employer, the State Teachers
RetirementSystemofOhio.
References
Arora, S. (2005). On epidemiologic and economic transitions: A historical view. In G. Lopez-
Casasnovas,B.Rivera,L.Currias(Eds.),Healthandeconomicgrowth:Findingsandpolicy
implications(pp.197–238).Cambridge:MITpress.
Arora,S.(2013).Understandingagingduringtheepidemiologictransition.ResearchinEconomic
History,29,1–69.
Floud,R.,Fogel,R.W.,Harris,B.,&Hong,S.C.(2011).Thechangingbody,healthnutritionand
humandevelopmentinthewesternworldsince1700(NBER).NewYork:CambridgeUniver-
sityPress.
Contents
1 AgingandNon-communicableDisease. . . . . . . . . . . . . . . . . . . . . . 1
1.1 CriticaltoHealthcareSpending. . . . . . . . . . . . . . . . . . . . . . . . 1
1.2 GraspedbyTwoParameters. . . . . . . . . . . . . . . . . . . . . . . . . . 2
1.3 ThatClarifySomeScenarios. . . . . . . . . . . . . . . . . . . . . . . . . . 5
1.4 AndthePotentialChoicesforPolicy. . . . . . . . . . . . . . . . . . . . 9
1.5 ButItTakesaWhiletoSeeHow. . .. . . . .. . . . .. . . .. . . . .. 13
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
2 TheEpidemiologicTransition. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
2.1 SeenasRegimes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
2.2 AndinDataOveratLeastTwoCenturies. . . . . . . . . . . . . . . . 27
2.3 ThatShowtheMainFeaturesoftheRegimes. . . . . . . . . . . . . . 28
2.4 AswellasoftheParadoxofAging. . . . . . . . . . . . . . . . . . . . . 39
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
3 TheProfilesofAging. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
3.1 AcrossGenerations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
3.2 ExposeKeyFeaturesofAging. . . . . . . . . . . . . . . . . . . . . . . . 49
3.3 AndClarifytheDebateAboutItsProspects. . . . . . . . . . . . . . . 57
3.4 AsDotheSub-categoriesofNon-communicableDiseases. . . . 60
3.5 So,Too,theChildhoodGrowththeProfilesHadTrailed. . . . . . 64
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70
4 ResolvingtheParadoxofAging. . . . . . . . . . . . . . . . . . . . . . . . . . . 73
4.1 RequiresLinkingCohort-ProfilestotheAggregate. . . . . . . . . . 73
4.2 AndSimulatingtheAggregate’sPath. .. . . .. . . .. . . . .. . . .. 77
4.3 WhichExposestheSourceoftheParadox. . . . . . . . . . . . . . . . 83
4.4 AndtheShortfallsofPeriod-Profiles. . . . . . . . . . . . . . . . . . . . 83
4.5 SheddingMoreLightontheOutlooksofAging. . . . . . . . . . . . 88
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90
ix