Would you rather live longer or better?

As human longevity increases into the 70s, health professionals are now looking at what can be done to extend the portion of a lifetime free of chronic disabilities.

A study released last week by the Illinois Department of Public Health shows the number of disability-free years at the end of a lifetime varies significantly across the state.

For example, in the northern part of the state, in Lake and Kendall counties, a male resident at age 65 can statistically expect to live another 20 years. Of those, the study shows, up to 12-13 years will be spent without a chronic disability, defined as limiting mobility in some way.

Not so in the southeast rural counties of the state, where men are predicted to live about 19 years, but only have 5-8 years of disability-free living.

The study by Mohammed Shahidullah and Nelson Agbodo of the IDPH in the Illinois Morbidity and Mortality Bulletin shows men and women in Illinois are living longer, better lives than ever before.

“People are living longer than they were 30-40 years ago,” said Shahidullah. “But at the end of life, people become really sick at different ages for different reasons. There may be things we can do to postpone that,” he said.

The study seeks to measure how different regional populations “compress morbidity” by delaying the onset of chronic disabilities as late into life as possible. By breaking the data out by county, the IDPH hopes to better target health services and programs for the elderly.

Using data from 2009-11, the study shows in Illinois, the average male who has made it to age 65 can expect to live another 18 years. Of that, 11.5 years is likely to be free of any functional disability, the study says. It’s slightly worse for women, but only because they tend to live longer. Women age 65 have a predicted 12.7 years free of disabling conditions, but because they live two years longer than men, they spend more time disabled at the end of life.

But the study shows a sharp discrepancy between disability-free life expectancies in urban/suburban and rural Illinois.

Chances are you’ll have a more independent old age if you live in seven counties in Illinois which have the most “compressed” end-of-life disabilities for residents over age 65, the study shows.

Residents of Boone, Champaign, DuPage, Kane, Lake, Stephenson and Woodford are likely to eke out 13 or more years of disability-free life.

Counties near, but not in, urban areas also have later onset of chronic disabilities, such as the northern counties of Kendall and DeKalb and Central Illinois counties McHenry and McLean and Peoria, which all have 12-plus years of disability-free life on average for residents over age 65.

Counties such as Cook, Winnebago, Madison, Tazewell and St. Clair have expected mobile life expectancies of 11 years.

But in rural southeastern Illinois, old age has a far smaller window for a high quality of life, the study shows.

“It’s a regional problem,” said Nancy Holt, director of public health for the Southern Seven Health organization. “We have high smoking rates and a high population is overweight. We have high obesity, and high rates of cancer. It’s lifestyle down here, it really is.”

Demographically, the region is 84 percent white, 13 percent black and 2 percent Hispanic/Latino. Because of few opportunities in the area, almost 20 percent of residents live in poverty. Only 14 percent of residents have achieved a bachelor’s degree. The median household income is $37,393 compared to the median state income of $56,797, according to U.S. Census statistics.

The percentage of overweight persons in the region is 71 percent with 62 percent of residents obese. One out of five children age 10-17 is obese, according to the Southern Seven organization.

Hardin County is located in the southeast tip of Illinois. Hardin has the highest incidence of cancer in the state and is ranked last in the state for health on the University of Wisconsin Population Health Institute County Health Rankings list, which aggregates data from across the country.

According to the IDPH study, a male in Hardin County age 65 can expect to live 19 years longer, but only 5.83 years disability free. It’s a bit better for women in Hardin who are predicted to live 8.40 years disability free, but unfortunately, on average they die sooner, after 16.2 years, the study shows.

Holt said the rural areas of Illinois have few healthy food options and grocery stores are hard to reach without a car.

“We have a county north of us that doesn’t have a single grocery store,” she said. “We have convenience stores and people buy food like frozen pizzas at the dollar store.”

The regional health department is focusing on obesity education in schools because it’s easier to teach children good nutrition than to change a person who’s set in his or her ways. Plus, reducing obesity also brings down “co-morbidities” of cancer, heart disease and diabetes.

“The answer lies with the young people,” Holt said. “We’re trying to educate the kids young — the younger the better. We’re exploring nutrition in the schools and helping to design physical education classes for maximum benefit.”

With improvements in the health of younger people as well as unknown medical advances, health departments across the state are hoping young residents will grow up to enjoy an old age with as much mobility and independence as possible.

“Life expectancy, whether disability-free or not, is really a summary of overall health,” said Tiefu Shen, editor of the IDPH bulletin. “It is influenced by a lot of factors and conditions. Income is one very important factor. Other than poverty and income, other things can impact life expectancy: There’s education, employment and nutrition. The presence of good public health is very strong,” he said.

— Quality of life varies throughout state —