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January 23, 2008

Turning the Disability Tide: The Importance of Definitions

Author Affiliations

Author Affiliations: Institute for Health Policy, Massachusetts General Hospital and Harvard Medical School, Boston (Dr Iezzoni); and Department of Health Systems and Policy, School of Public Health, University of Medicine and Dentistry of New Jersey, Newark (Dr Freedman).

JAMA. 2008;299(3):332-334. doi:10.1001/jama.299.3.332

Forty million to 50 million individuals in the United States now live with potentially disabling conditions. According to the Institute of Medicine (IOM), this number will likely increase substantially in coming decades.1 Aging baby boomers will fuel much of this growth as this enormous cohort enters age ranges with the greatest disease and disability risks. Although rates of some serious limitations among elderly individuals have declined,2 sobering reports warn of higher rates of potentially impairing conditions among children3 and working-age adults.4 These latter trends are multifaceted with diverse contributors, including major therapeutic breakthroughs that now save lives of severely impaired individuals who would once have died and increasing prevalence of overweight and obesity among youth and young adults, along with associated problems such as diabetes. As recent reports suggest, overweight and obesity cause particular concerns not only because they are associated with increased mortality risks,5 but also because they increase the risk of functional limitations.6,7

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