Measuring Healthy Life Expectancy for the U.S. Population in 2007-2009 Man-Huei Chang, MPH Division of Epidemiologic and Analytic Methods for Population Health (Proposed) Epidemiology and Analysis Program Office Centers for Disease Control and Prevention Presentation at the 2012 National Conference on Health Statistics Washington, DC August 8, 2012 Office of Surveillance, Epidemiology, and Laboratory Services Epidemiology and Analysis Program Office
Measuring Healthy Life Expectancy for the U.S. Population in 2007-2009
Feb 25, 2016
Measuring Healthy Life Expectancy for the U.S. Population in 2007-2009. Man-Huei Chang, MPH. Division of Epidemiologic and Analytic Methods for Population Health (Proposed) Epidemiology and Analysis Program Office Centers for Disease Control and Prevention - PowerPoint PPT Presentation
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Measuring Healthy Life Expectancy for the U.S. Population in 2007-2009
Man-Huei Chang, MPH
Division of Epidemiologic and Analytic Methods for Population Health (Proposed)
Epidemiology and Analysis Program OfficeCenters for Disease Control and Prevention
Presentation at the 2012 National Conference on Health StatisticsWashington, DCAugust 8, 2012
Office of Surveillance, Epidemiology, and Laboratory ServicesEpidemiology and Analysis Program Office
Outline Objectives Data and Methods Results Conclusions
CDC Reporting Population Summary Measures
In 1982, Hahn et al. published YPLL-65 and suggested alternative measures (e.g., DALY,QALY,YHL,YAAL, and HLE)
CDC published Years of Potential Life Lost before age 65 (YPLL-65) and leading causes of death in MMWR 1982-1993
In 2000, a CDC Burden of Disease Workgroup recommended routinely reporting summary measures in MMWR
In December 2010, the Epidemiology and Analysis Program Office (EAPO) began working on HLE to monitor trends and disparities EAPO and NCHS collaborative effort Regular reporting of summary measures
Goals To promote public awareness of ‘premature’, ‘preventable’, and
‘unnecessary’ mortality; and To develop and implement effective interventions for good health and
longevity
Objectives
To estimate HLE for the U.S population and for smaller population subgroups
To assess disparities in HLE between different segments of the U.S. population
Data Sources Data: 2007-2009 Mortality rates (NCHS Vital Statistics System) Self-reported health status rates
NHIS (national, regional, divisional) BRFSS (state-level)
Population segments Total population (national) 4 regions 9 divisions 50 states and the District of Columbia
Demographic subgroups Age groups (5-year age intervals), sex, race (whites,
blacks), and ethnicity (Hispanics, non-Hispanics)
Health Status Data NHIS question on self-assessed health
status: “Would you say your health in general is excellent, very good, good, fair, or poor?”
1 Excellent 2 Very good 3 Good 4 Fair 5 Poor 7 Refused 9 Don't know
BRFSS question is the same as NHIS
Healthy
Unhealthy
HLE by Age and Sex – U.S. 2007-2009
0 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85+ 0
10
20
30
40
50
60
70
80
Age
Year Female
Male
HLE by Age and Race – U.S. 2007-2009
0 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85+ 0
10
20
30
40
50
60
70
80
Age
Year
White
Black
HLE by Age and Ethnicity - U.S. 2007-2009
0 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85+ 0
10
20
30
40
50
60
70
80
Age
Year
Non-Hispanic
Hispanic
70
72
74
76
78
80
82
75.8
80.3
78.4
74.1
80.6
77.8
Year
s
Male
Female
White
Black
Hispanic
Non-His-panic
Sex Race Ethnicity
LE by Selected Demographics - U.S. 2007-2009at Birth
16
17
18
19
20
17.6
19.7
18.8
17.4
20.1
18.6
Year
s
Male
Female
White
Black
Hispanic
Non-His-panic
Sex Race Ethnicity
LE by Selected Demographics - U.S. 2007-2009at Age 65
HLE at Age 65 by Sex and Region - U.S. 2007-2009
Northeast Midwest South West0.0
2.0
4.0
6.0
8.0
10.0
12.0
14.0
16.0
13.8 13.312.1
13.815.2 15.1
13.6
15.2
Male Female
Region
Year
All results were significant at p<0.001.
HLE at Age 65 by Race and Region - U.S. 2007-2009
Northeast Midwest South West0.0
2.0
4.0
6.0
8.0
10.0
12.0
14.0
16.014.8 14.6
13.314.7
11.710.9
10.311.7
White Black
Region
Year
All results were significant at p<0.001.
HLE at Age 65 by Ethnicity and Region - U.S. 2007-2009
Northeast Midwest South West0.0
2.0
4.0
6.0
8.0
10.0
12.0
14.0
16.0
11.7
13.4
11.912.7
14.7 14.313.0
14.8
Hispanic Non-Hispanic
Region
Year
All results were significant at p<0.001, except for the Midwest.
HLE at Age 65 by Race and Division - U.S. 2007-2009
New England
Middle Atlantic
East North Central
West North Central
South Atlantic
East South Central
West South Central
Mountain
Pacific
0 2 4 6 8 10 12 14 16 18
13.6
11.4
10.8
11.5
10.7
9.7
9.9
11.9
11.4
15.8
14.4
14.4
14.8
14.2
11.6
12.6
15.1
14.5
White BlackYear
State-Specific HLEat Age 20 U.S. Adults, 2007-2009
Male Female
US average: 49.0 US average: 51.8
State-Specific HLEat Age 20 U.S. Adults, 2007-2009
White Black
US average: 51.1 US average: 43.7
State-Specific HLEat Age 20 U.S. Adults, 2007-2009 Hispanic Non-Hispanic
US average: 48.3 US average: 50.6
Significant Disparities in HLEAge
All Races Race Ethnicity
Male Female Disparities White Black
Disparities Hispanic
Non-Hispanic
Disparities
Δ in HLE p-value Δ in HLE p-value Δ in HLE p-value0-4 67.7 70.7 3.0 <0.001 70.1 61.9 8.2 <0.001 67.1 69.4 2.3 <0.0015-9 63.3 66.3 2.9 <0.001 65.6 57.9 7.7 <0.001 62.6 65.0 2.4 <0.00110-14 58.5 61.4 2.9 <0.001 60.7 53.1 7.6 <0.001 57.8 60.1 2.4 <0.00115-19 53.6 56.5 2.9 <0.001 55.8 48.4 7.5 <0.001 53.0 55.3 2.3 <0.00120-24 49.0 51.8 2.8 <0.001 51.1 43.7 7.4 <0.001 48.3 50.6 2.3 <0.00125-29 44.5 47.1 2.6 <0.001 46.5 39.3 7.2 <0.001 43.7 46.0 2.2 <0.00130-34 40.0 42.5 2.5 <0.001 41.9 34.9 7.0 <0.001 39.2 41.4 2.2 <0.00135-39 35.5 38.0 2.4 <0.001 37.4 30.6 6.8 <0.001 34.7 37.0 2.3 <0.00140-44 31.2 33.6 2.4 <0.001 33.0 26.4 6.7 <0.001 30.3 32.6 2.3 <0.00145-49 27.0 29.3 2.3 <0.001 28.8 22.5 6.3 <0.001 26.1 28.4 2.3 <0.00150-54 23.1 25.3 2.2 <0.001 24.8 19.0 5.8 <0.001 22.1 24.4 2.3 <0.00155-59 19.5 21.5 2.0 <0.001 21.0 15.8 5.2 <0.001 18.4 20.7 2.3 <0.00160-64 16.1 17.9 1.8 <0.001 17.5 13.1 4.4 <0.001 15.2 17.2 2.1 <0.00165-69 13.1 14.6 1.5 <0.001 14.2 10.8 3.4 <0.001 12.2 14.0 1.8 <0.00170-74 10.2 11.4 1.2 <0.001 11.1 8.4 2.7 <0.001 9.6 11.0 1.4 <0.00175-79 7.7 8.6 0.9 <0.001 8.4 6.3 2.1 <0.001 7.2 8.3 1.1 <0.00180-84 5.5 6.1 0.6 <0.001 6.0 4.5 1.5 <0.001 4.9 5.9 1.1 <0.00185+ 3.8 3.9 0.1 0.144 4.0 3.0 1.0 <0.001 3.1 3.9 0.8 <0.001SOURCES: CDC/NCHS, National Vital Statistics System, National Health Interview Survey, and the U.S. Census Bureau.
Summary Disparities in HLE and LE observed among
population segments and geographical locations Differences in HLE among subpopulations result
from the combined effects of mortality and morbidity (impacted by demographic, socioeconomic, and environmental factors)
Use HLE to compare the health of populations, monitor trends in the health of a population, and identify health inequalities within populations
Conclusions HLE can be readily used by public health
officials, healthcare providers, and policy makers to understand the health status of populations
These results can be used as baseline to routinely monitor the health of the U.S. population and to identify health disparities in populations
Acknowledgements Co-authors
Michael Molla (NCHS) Benedict Truman (NCHHSTP) Heba Athar (EAPO) Ramal Moonesinghe (OMMHE) Paula Yoon (EAPO)
Special Thanks Stephanie Zaza (EAPO) Sukhjeet Ahuja (NAPSIS) Julia Homes (NCHS) Joyce Arbertha (NCHS) Stephanie Robinson (NCHS) Ajay Yesupriya (NCHS) Carl Kinkade (EAPO) Brenda Le (NCEH) Sigrid Economou (EAPO)
Disclaimer: The findings and conclusions in this presentation are those of the author, and do not necessarily represent the official position of the U.S. Centers for Disease Control and Prevention.
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