Compression of morbidity

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The compression of morbidity in public health is a hypothesis put forth[1] by James Fries, professor of medicine at Stanford University School of Medicine. The hypothesis was confirmed by a 1998 study of 1700 University of Pennsylvania alumni over a period of 20 years.[2]

Fries' hypothesis is that the burden of lifetime illness may be compressed into a shorter period before the time of death, if the age of onset of the first chronic infirmity can be postponed.[3] This hypothesis contrasts to the view that as the age of countries' populations tends to increase over time, they will become increasingly infirm and consume an ever-larger proportion of the national budget in healthcare costs.[4]

Ezekiel Emanuel, who is one of the architects of ObamaCare has stated that the compression of morbidity is a "fantasy" and that life is not worth living after age 75; therefore longevity should not be a goal of health care policy.[5] This has been refuted by Miguel Faria, who states that life can be worthwhile in healthy old age; that the compression of morbidity is a real phenomenon; that the hypothesis should be upgraded to a theory because of recent data on the lowering of health care costs despite increases in life span.[6] Faria has discussed how compression of morbidity in association with healthy lifestyles can lead to fruitful longevity.[7]

Fries posited that if the hypothesis is confirmed, healthcare costs and patient health overall will be improved.[3] In order to confirm this hypothesis, the evidence must show that it is possible to delay the onset of infirmity, and that corresponding increases in longevity will at least be modest. The recent article by Faria suggests that this may indeed be the case.[7]


  1. ^ Fries, James F. (1980). "Aging, Natural Death, and the Compression of Morbidity" (PDF). New England Journal of Medicine 303 (3): 130–5. doi:10.1056/NEJM198007173030304. PMID 7383070. 
  2. ^ Vita, Anthony J.; Terry, Richard B.; Hubert, Helen B.; Fries, James F. (1998). "Aging, Health Risks, and Cumulative Disability". New England Journal of Medicine 338 (15): 1035–41. doi:10.1056/NEJM199804093381506. PMID 9535669. 
  3. ^ a b Swartz, Aimee (2008). "James Fries: Healthy Aging Pioneer". American Journal of Public Health 98 (7): 1163–6. doi:10.2105/AJPH.2008.135731. PMC 2424092. PMID 18511711. 
  4. ^ "The compression of morbidity was prophetic in the sense that Jim looked at the reduction of morbidity and disability at a time when most gerontologists and epidemiologists thought we would see a pandemic of disability." —Richard Suzman, quoted in Swartz 2008
  5. ^ Emanuel EJ. "Why I hope to die at 75: An argument that society and families - and you - will be better off if nature takes its course swiftly and promptly". The Atlantic. Retrieved 7 April 2015. 
  6. ^ Faria MA. "Bioethics and why I hope to live beyond age 75 attaining wisdom!: A rebuttal to Dr. Ezekiel Emanuel′s 75 age limit.". Surg Neurol Int 2015;6:35. Retrieved 7 April 2015. 
  7. ^ a b Faria MA. "Longevity and compression of morbidity from a neuroscience perspective: Do we have a duty to die by a certain age?". Surg Neurol Int 2015;6:49. Retrieved 7 April 2015. 

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