Showing papers by "James F. Fries published in 1983"
TL;DR: In this century, we are progressing through three separate eras with dramatically different characteristics of health and illness as mentioned in this paper, and the major illness burdens of the United States are the chronic diseases.
Abstract: In this century, we are progressing through three separate eras with dramatically different characteristics of health and illness. We entered the century in an era of infectious disease, with tuberculosis the number one killer of our population, and smallpox, diphtheria, tetanus, and other infectious illnesses extremely prevalent. A reduction in mortality from these diseases of over 99% (Fries and Crapo, 1981; Cooper, 1982), has led to the present era, where the major illness burdens of the United States are the chronic diseases. Atherosclerosis and its complications, neoplasia, emphysema, diabetes, cirrhosis, and osteoarthritis have increased in prevalence even as the infectious illnesses which preceded them declined. It is one thesis of this discussion that this chronic disease era in its turn will slowly decline in significance, leaving a third era in which major health problems of the United States will be directly related to the process of senescence, and where the aging process itself, independent of specific disease, will constitute a major illness burden for the United States.
389 citations
162 citations
TL;DR: In this paper, the effects of such differences on the frequency and severity of side effects using the nonsteroidal anti-inflammatory drugs as a prototype were explored using the American Rheumatism Association Medical Information System Computer Data-Base System.
126 citations
Journal Article•
TL;DR: The compression of morbidity hypothesis envisions a potential reduction of lifetime morbidity and medical care costs by compression between an increasing average age at the onset of infirmity and the age at death, increasing also, but more slowly.
Abstract: The nature of the international health burden, its changes, its problems, and even its solutions over the next quarter century are surprisingly apparent at this time and are more positive than often supposed. The average period of lessened physical status is likely to shorten, and the need for and cost of hospitalization in the later life of the individual is likely to decrease. The period of infirm physical status will become increasingly compressed between the increasing age at onset of infirmity and the genetically determined lifespan of the individual. Illness at the end of life will come relatively suddenly, be multi-factorial in cause, will be highly resistant to further medical intervention, and will be characterized by increasing inevitability. Implications for retirement age, availability of useful work for older individuals, and programmes designed to stimulate rather than support are discussed.
4 citations