This chapter introduces a new approach for estimating Disability-Free Life Expectancy (DFLE) that combines familiar statistical elements—a latent-class trajectory model of disability and a “frailty” model of mortality—to capture within-group differences in DFLE. The chapter begins by reviewing the concept of DFLE, the two primary approaches for estimating it, and the motivation for the new approach. Next, it outlines the formal basis of DFLE estimation. The core section of the chapter develops the new joint model of disability prevalence and survivorship that can be used to calculate DFLE, bringing together the familiar statistical elements in a new way. We illustrate the new approach using panel data from the Health and Retirement Study. The illustration reveals distinct population subgroups in terms of DFLE, as well as within population groups identified by race or educational-attainment, and that within-group variation in DFLE is large. The findings compare favorably to those obtained from the multistate life table approach.

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Heterogeneity in Disability-Free Life Expectancy: A Discrete Mixture Model

  • Douglas A. Wolf,
  • Jennifer Karas Montez

摘要

This chapter introduces a new approach for estimating Disability-Free Life Expectancy (DFLE) that combines familiar statistical elements—a latent-class trajectory model of disability and a “frailty” model of mortality—to capture within-group differences in DFLE. The chapter begins by reviewing the concept of DFLE, the two primary approaches for estimating it, and the motivation for the new approach. Next, it outlines the formal basis of DFLE estimation. The core section of the chapter develops the new joint model of disability prevalence and survivorship that can be used to calculate DFLE, bringing together the familiar statistical elements in a new way. We illustrate the new approach using panel data from the Health and Retirement Study. The illustration reveals distinct population subgroups in terms of DFLE, as well as within population groups identified by race or educational-attainment, and that within-group variation in DFLE is large. The findings compare favorably to those obtained from the multistate life table approach.