Zack Matthew M, Moriarty David G, Stroup Donna F, Ford Earl S, Mokdad Ali H
National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333, USA.
Public Health Rep. 2004 Sep-Oct;119(5):493-505. doi: 10.1016/j.phr.2004.07.007.
Health-related quality of life and self-rated health complement mortality and morbidity as measures used in tracking changes and disparities in population health. The objectives of this study were to determine whether and how health-related quality of life and self-rated health changed overall in U.S. adults and in specific sociodemographic and geographic groups from 1993 through 2001.
The authors analyzed data from annual cross-sectional Behavioral Risk Factor Surveillance System surveys of 1.2 million adults from randomly selected households with telephones in the 50 states and the District of Columbia.
Mean physically and mentally unhealthy days and activity limitation days remained constant early in the study period but increased later on. Mean unhealthy days increased about 14% during the study period. The percentage with fair or poor self-rated health increased from 13.4% in 1993 to 15.5% in 2001. Health-related quality of life and self-rated health worsened in most demographic groups, especially adults 45-54 years old, high school graduates without further education, and those with annual household incomes less than $50,000. However, adults 65 years old or older and people identified as non-Hispanic Asian/Pacific Islander reported stable or improving health-related quality of life and self-rated health. In 18 of the states and the District of Columbia, mean unhealthy days increased, while only North Dakota reported a decrease.
Population tracking of adult health-related quality of life and self-rated health identified worsening trends overall and for many groups, suggesting that the nation's overall health goals as identified in the Healthy People planning process are not being met.
与健康相关的生活质量和自我评估健康状况是用于追踪人群健康变化和差异的指标，可作为死亡率和发病率的补充。本研究的目的是确定1993年至2001年期间，美国成年人以及特定社会人口统计学和地理群体中，与健康相关的生活质量和自我评估健康状况总体上是否发生了变化以及如何变化。
作者分析了来自行为风险因素监测系统年度横断面调查的数据，这些数据来自美国50个州和哥伦比亚特区随机抽取的有电话家庭中的120万成年人。
在研究初期，身体和精神不健康天数及活动受限天数的平均值保持不变，但后期有所增加。在研究期间，不健康天数的平均值增加了约14%。自我评估健康状况为“一般”或“较差”的比例从1993年的13.4%上升至2001年的15.5%。在大多数人口群体中，与健康相关的生活质量和自我评估健康状况恶化，尤其是45至54岁的成年人、未接受继续教育的高中毕业生以及家庭年收入低于5万美元的人群。然而，65岁及以上的成年人以及被认定为非西班牙裔亚裔/太平洋岛民的人群报告称，与健康相关的生活质量和自我评估健康状况稳定或有所改善。在18个州和哥伦比亚特区，不健康天数的平均值增加，而只有北达科他州报告有所下降。
对成年人与健康相关的生活质量和自我评估健康状况的人群追踪发现，总体及许多群体都呈现恶化趋势，这表明《健康人民》规划过程中确定的国家总体健康目标未得到实现。
