Aged disability and community care in Australia: issues for southern Africa
DOI:
https://doi.org/10.21504/sajg.v2i2.24Abstract
Disability among the aged is an issue of growing importance to southern Africa as it is throughout the world. New methods and debates about disability and ageing are illustrated by a discussion of the Australian situation. First, trends in mortality and life expectancy are outlined, and the debate about the compression of mortality critically examined. Second, the same techniques of analysis are applied to disability and handicap rates derived from national surveys. The hypothesis of compression of morbidity or illness is also critically examined. Third, the impact on the community of disability is discussed, and expectations of life "free of community services" and ''free of institutionalization" are calculated. Finally, trends in health-risk factors and the contributions of various diseases to health expectations are outlined. Southern African countries are also part of the movement to measure quality-of-life years-not only quantity - and need to develop their population monitoring of disability and demands for community care. The development will facilitate policy planning to improve the management of community services provided for the elderly by families, the community and formal providers.References
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Manton, K.G. 1982. Changing concepts of morbidity and mortality in the elderly population. Milbank Quarterly, 60: 183-244.
Martin, C.A., Hobbs, M.S.T., Armstrong, B.K. & de Klerk, N.H. 1989. Trends in the incidence of myocardial infarction in Western Australia between 1971 and 1982. American Journal of Epidemiology, 129: 655-68.
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Olshansky, S.J .. Rudberg, M.A., Carnes, B.A .. Cassel, C.K. & Brody, J.A. 1991. Trading off longer life for worsening health. Journal of Aging and Health. 3: 194-216.
Robine, J.M. & Ritchie, K. 1991. Healthy life expectancy: evaluation of a global indicator of change in population health. British Medical Journal. 302: 457-60.
Sullivan, D.G. 1971. A single index of mortality and morbidity. HSMHA Health Reports. 86: 347-54.
Simons, L.A., Friedlander, Y., McCallum, J., Simons, J., Powell. J., Heller, R. & Barry, G. 1991. The Dubbo study of the health of the elderly: correlates of coronary heart disease at study entry. Journal of the American Geriatrics Society. 39: 584-90.
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Verbrugge, L.M. 1989. Recent, present, and future health of American adults. Annual Review of Public Health, I 0: 333-61.
Verbrugge, L.M. 1992. Disability transitions for older persons with arthritis. Journal of Ageing and Health. 4(2): 212-43.
Verbrugge, L.M., Gates, D.M. & Ike, R.W. 1991. Risk factors for disability among US adults with arthritis. Journal of Clinical Epidemiology, 44: 167-82.
World Health Organization. 1980. International classification of impairments, disabilities, and handicaps. A manual of classification relating to the consequences of disease. Geneva: World Health Organization.
Australian Bureau of Statistics. 1989-90. National Health Survey of Musculoskeletal Conditions. Australia. Cat No. 4374.
Australian Bureau of Statistics. 1990. Projections of the population of Australia. State and Territories, 1989 10 2031. Cat. No. 3222.0.
Australian lnstitute of Health and Welfare. 1990. Australia's health 1990: the second biennial report of the Australian Institute of Health. Canberra: Australian Government Publishing Services.
Australian Institute of Health and Welfare. 1992. Australia's health 1992: the third biennial report of the Australian Institute of Health and Welfare. Canberra: Australian Government Publishing Service.
Felson, D.T., Anderson, J.J., Naimark, A., Walker, A.M. & Meenan, R.F. 1988. Obesity and knee osteoarthritis: the Framingham study. Annals of Internal Medicine, 109: 18-24.
Fries, J.F. 1980. Ageing, national death and the compression of morbidity. New England Journal of Medicine. 303(3): 130-35.
Fries. J.F. 1983. The compression of morbidity. Milbank Quarterly. 61(3): 397-419.
Fries, J.F. 1989. The compression of morbidity: near or far? Milbank Quarterly. 67: 208-32.
Guralnik, J. & Schneider, E.L. 1987. The compression of morbidity: a dream which may come true, someday! Gerontologica Perspecta, 1: 8-13.
Kalucy, E. & Baum, F. 1992. The epidemiology of caring: the pattern in a South Australian suburban population. Australian Journal on Ageing, 11(3): 3-8.
Manton, K.G. 1982. Changing concepts of morbidity and mortality in the elderly population. Milbank Quarterly, 60: 183-244.
Martin, C.A., Hobbs, M.S.T., Armstrong, B.K. & de Klerk, N.H. 1989. Trends in the incidence of myocardial infarction in Western Australia between 1971 and 1982. American Journal of Epidemiology, 129: 655-68.
Mathers, C. 1991. Health expectancies in Australia.l981 and 1988. Canberra: Australian Government Publishing Services.
Mathers. C. 1992. Estimating gains in health expectancy due to elimination of specified diseases. Paper presented at the Fifth Meeting of the International Network on Health Expectancy (REVES-5). Onawa. February 19-2 1. 1992.
McCallum, J. 1990. Health: the quality of survival in older age. Australia's Health 1990. Canberra: Australian Institute of Health.
Olshansky, S.J., Carnes, B.A. & Cassel, C. 1990. In search of Methuselah: estimating the upper limits to human longevity. Science, 250: 634-40.
Olshansky, S.J .. Rudberg, M.A., Carnes, B.A .. Cassel, C.K. & Brody, J.A. 1991. Trading off longer life for worsening health. Journal of Aging and Health. 3: 194-216.
Robine, J.M. & Ritchie, K. 1991. Healthy life expectancy: evaluation of a global indicator of change in population health. British Medical Journal. 302: 457-60.
Sullivan, D.G. 1971. A single index of mortality and morbidity. HSMHA Health Reports. 86: 347-54.
Simons, L.A., Friedlander, Y., McCallum, J., Simons, J., Powell. J., Heller, R. & Barry, G. 1991. The Dubbo study of the health of the elderly: correlates of coronary heart disease at study entry. Journal of the American Geriatrics Society. 39: 584-90.
Tsai, S.P .. Lee, E.S. & Hardy, R.J. 1978. The effects of a reduction in leading causes of death: potential gains in life expectancy. American Journal of Public Health, 68:966-71.
Verbrugge, L.M. 1989. Recent, present, and future health of American adults. Annual Review of Public Health, I 0: 333-61.
Verbrugge, L.M. 1992. Disability transitions for older persons with arthritis. Journal of Ageing and Health. 4(2): 212-43.
Verbrugge, L.M., Gates, D.M. & Ike, R.W. 1991. Risk factors for disability among US adults with arthritis. Journal of Clinical Epidemiology, 44: 167-82.
World Health Organization. 1980. International classification of impairments, disabilities, and handicaps. A manual of classification relating to the consequences of disease. Geneva: World Health Organization.
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1993-10-01
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