Compression of Morbidity Theory

In 1980, Dr. James Fries, Professor of Medicine, Stanford University introduced the compression of morbidity theory. This theory states that “most illness was chronic and occurred in later life and postulated that the lifetime burden of illness could be reduced if the onset of chronic illness could be postponed and if this postponement could be greater than increases in life expectancy.” (Fries, 1980).

Compression of Morbidity Theory
Compression of Morbidity Theory
Figure 1. Possible scenarios for future morbidity and longevity. Present lifetime morbidity, portrayed as the shaded area, is contrasted with three possible future scenarios.
Source: Fries JF. Measuring and monitoring success in compressing morbidity. Annals of Internal Medicine. 139(5 Pt 2):455-9, 2003 Sep 2.

Estimated present lifetime morbidity is portrayed with three possible future scenarios: life extension, shift-to-the-right, and compression of morbidity. The lines represent the length of life, and the shaded triangles depict lifetime morbidity. Two arrows are shown for each scenario: The left arrow represents the median age at onset of chronic morbidity and the right arrow represents the median age at death. Alternative health futures are determined by the relative movement of these arrows over time. If the arrows separate, lifetime morbidity increases, and if they come closer, morbidity is compressed. In each scenario, some extension of life expectancy is envisioned. The illustrative use of age 55 years as the present age of onset of chronic morbidity is drawn from the data of Bruce B et al showing this to be the median age of detectable chronic disability (Bruce).

While it is true that good preventive medicine and a healthy lifestyle can postpone disability due to chronic illness, there comes a stage in every person’s life where significant illness related debility is experienced. As the illness progresses, it becomes the source of bio-psycho-socio-spiritual suffering.


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