Health Decline in Older Americans

As people age, their health declines. That's a given. But how steep is the decline and is it the same for everyone? These are the questions asked and answered by a National Bureau of Economic Research study, "The Persistence and Heterogeneity of Health among Older Americans" (Working Paper 20306).

Using longitudinal data from the Health and Retirement Study, NBER researchers compared the health status of 53-to-63-year-olds in 1994 with the cohort's health status (and survival rate) through 2010 by educational attainment and race and Hispanic origin. Better health at the beginning of the time period, the researchers found, resulted in better health (and a higher survival rate) at the end of the time period. Other findings...

•  Educational attainment is the single biggest determinant of health status throughout the aging process. Among 53-to-63-year-olds in 1994, the average health percentile of those with a college degree was 72.0 compared with an average health percentile of only 47.6 percent for their counterparts without a high school diploma. This large gap persisted over the years, even as each educational group experienced a decline in health.
• The decline in health as people age occurs at about the same rate regardless of education. "Over time, health declines by approximately the same amount (in percentiles) for persons at all levels of education," say the researchers. But those who begin the aging process in better health (the college educated) remain in relatively better health as they age, and they experience a lower mortality rate.
• Differences in educational attainment explain most of the gap in the health status of whites and blacks.