Mehta Neil K, Patel Shivani A, Ali Mohammed K, Narayan K.M. Venkat
Neil K. Mehta (
Shivani A. Patel is a Rollins Assistant Professor in the Hubert Department of Global Health, Rollins School of Public Health, Emory University, in Atlanta, Georgia.
Health Aff (Millwood). 2017 Apr 1;36(4):626-635. doi: 10.1377/hlthaff.2016.1281.
Disability levels in the United States declined during the 1980s and 1990s, but these declines stalled more recently. Using data for 2013 from the Behavioral Risk Factor Surveillance System, we estimated the percentages of national and state disability that could be prevented through reductions in five modifiable health risk factors associated with disability: cigarette smoking, obesity, diabetes, high cholesterol, and hypertension. Taking into account risk-factor prevalence and the association between each risk factor and disability, we evaluated the fraction of disability preventable if risk factors were reduced under two scenarios: complete elimination of risk factors and reduction in all states to the lowest levels observed in states. If all five risk factors were eliminated, 53 percent of disability could be prevented nationally. The largest contributors were smoking (17 percent), obesity (16 percent), and hypertension (12 percent). If all states reduced risk-factor levels to the lowest observed levels, up to 7 percent of disability could be prevented nationally. Many states in the South and Midwest could experience disability reductions of more than 10 percent by attaining the same risk-factor levels as in states that had the lowest levels. Improved risk-factor prevention could result in the resumption of longer-term declines in US disability.
美国的残疾水平在20世纪80年代和90年代有所下降，但最近这些下降趋势停滞了。利用行为风险因素监测系统2013年的数据，我们估计了通过减少与残疾相关的五个可改变的健康风险因素（吸烟、肥胖、糖尿病、高胆固醇和高血压）可预防的全国和各州残疾百分比。考虑到风险因素的患病率以及每个风险因素与残疾之间的关联，我们评估了在两种情况下如果降低风险因素可预防的残疾比例：完全消除风险因素以及所有州将风险因素降至观察到的最低水平。如果消除所有五个风险因素，全国范围内53%的残疾可被预防。最大的贡献因素是吸烟（17%）、肥胖（16%）和高血压（12%）。如果所有州将风险因素水平降至观察到的最低水平，全国范围内高达7%的残疾可被预防。南部和中西部的许多州通过达到与最低水平的州相同的风险因素水平，残疾减少幅度可能超过10%。改善风险因素预防措施可能会使美国残疾水平的长期下降趋势得以恢复。
