Vincenzo Atella (University of Rome Tor Vergata) on "The 'Double Expansion of Morbidity' Hypothesis: Evidence from Italy"

The gains in life expectancy (LE) experienced over the last decades have been accompanied by the increases in the number of years lived in bad health, lending support to the “expansion of morbidity” hypothesis. In this paper we revise this theory and propose the “Double Expansion of Morbidity” (DEM) hypothesis, arguing that not only have life expectancy gains been transformed into years lived in bad health, but also, due to anticipated onset of chronic diseases, the number of years spent in “good health” is actually reducing. Limited to the Italian case, we present and discuss a set of empirical evidence confirming the DEM hypothesis. In particular, we find that from 2000 to 2014 the average number of years spent with chronic conditions in Italy has increased by 6.4 years, of which 3.4 years due to the increase in LE and 3 years due to the reduction in the onset age of chronic conditions. Compared to the year 2000, in 2014 this phenomenon has generated an extra public health expenditure of 8.7 billion euros. We discuss the policy implications of these findings.