Lubetkin Erica I, Jia Haomiao
Department of Community Health and Social Medicine, Sophie Davis School of Biomedical Education at The City College of New York, 160 Convent Avenue, H404B, New York, NY 10031, USA.
J Urban Health. 2009 Jul;86(4):551-61. doi: 10.1007/s11524-009-9344-9. Epub 2009 Mar 13.
We applied our previously developed estimation equation to predict EQ-5D index scores from the Centers for Disease Control and Prevention's Healthy Days measures for the New York City (NYC) adult population from 1995 to 2006 and compared these trends over time with the US general population. Such scores enabled us to examine the burden of disease attributable to smoking and overweight/obesity at both the local and national levels. We employed the estimation equation to the 1993-2007 Behavioral Risk Factor Surveillance System (BRFSS) data to obtain EQ-5D index scores for all survey respondents based on their age, self-rated health status, and overall number of unhealthy days. With the combination of mortality data, we calculated trends of quality-adjusted life years (QALYs), life expectancy (LE), and quality-adjusted life expectancy (QALE) as well as the percent of QALYs and QALE lost contributed by smoking and overweight/obesity. Mean EQ-5D index scores for NYC adults decreased from 0.874 to 0.852 but, more recently, have increased to 0.869. The LE of an 18-year-old living in NYC increased 4.7 years and QALE increased 2.6 years. The contribution of smoking to the proportion of QALYs lost decreased from 6.7% to 3.5%, while the contribution of overweight/obesity to the proportion of QALYs lost increased from 4.5% to 16.9%. The proportion of QALEs lost due to smoking decreased from 5.5% to 4.5%, while the proportion of QALEs lost due to overweight/obesity increased from 3.5% to 11.8%. Because the Healthy Days measures have been included in the BRFSS since 1993, translating Healthy Days Measures to a preference-based measure is a useful method for longitudinal tracking of population health at the local, state, and national level.
我们应用先前开发的估计方程,根据疾病控制与预防中心针对1995年至2006年纽约市成年人口的健康天数测量数据,预测EQ-5D指数得分,并将这些随时间变化的趋势与美国普通人群进行比较。这些得分使我们能够在地方和国家层面研究吸烟及超重/肥胖所致的疾病负担。我们将该估计方程应用于1993 - 2007年行为风险因素监测系统(BRFSS)的数据,根据所有调查对象的年龄、自我评估健康状况及不健康天数总数,得出他们的EQ-5D指数得分。结合死亡率数据,我们计算了质量调整生命年(QALY)、预期寿命(LE)和质量调整预期寿命(QALE)的趋势,以及吸烟和超重/肥胖导致的QALY和QALE损失百分比。纽约市成年人的EQ-5D指数平均得分从0.874降至0.852,但最近又升至0.869。居住在纽约市的18岁人群的预期寿命增加了4.7岁,质量调整预期寿命增加了2.6岁。吸烟导致的QALY损失比例从6.7%降至3.5%,而超重/肥胖导致的QALY损失比例从4.5%增至16.9%。吸烟导致的QALE损失比例从5.5%降至4.5%,而超重/肥胖导致的QALE损失比例从3.5%增至11.8%。由于自1993年起健康天数测量已纳入BRFSS,将健康天数测量转化为基于偏好的测量方法,是在地方、州和国家层面纵向跟踪人群健康的一种有用方法。