Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York; New York State Psychiatric Institute, New York, New York.
Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York; New York State Psychiatric Institute, New York, New York.
Am J Prev Med. 2018 Mar;54(3):325-333. doi: 10.1016/j.amepre.2017.11.012. Epub 2018 Jan 12.
Despite recent declining mortality of the U.S. population from most leading causes, uncertainty exists over trends in health-related quality of life.
The 2001-2002 and 2012-2013 National Epidemiologic Surveys on Alcohol and Related Conditions U.S. representative household surveys were analyzed for trends in health-related quality of life (n=79,402). Health-related quality of life was measured with the Short Form-6 Dimension scale derived from the Short Form-12. Changes in mean Short Form-6 Dimension ratings were attributed to changes in economic, social, substance abuse, mental, and medical risk factors.
Mean Short Form-6 Dimension ratings decreased from 0.820 (2001-2002) to 0.790 (2012-2013; p<0.0001). In regressions adjusted for age, sex, race/ethnicity, and education, variable proportions of this decline were attributable to medical (21.9%; obesity, cardiac disease, hypertension, arthritis, medical injury), economic (15.6%; financial crisis, job loss), substance use (15.3%; substance use disorder or marijuana use), mental health (13.1%; depression and anxiety disorders), and social (11.2%; partner, neighbor, or coworker problems) risks. In corresponding adjusted models, a larger percentage of the decline in Short Form-6 Dimension ratings of older adults (aged ≥55 years) was attributable to medical (35.3%) than substance use (7.4%) risk factors, whereas the reverse occurred for younger adults (aged 18-24 years; 5.7% and 19.7%) and adults aged 25-44 years (12.7% and 16.3%).
Between 2001-2002 and 2012-2013, there was a significant decline in average quality of life ratings of U.S. adults. The decline was partially attributed to increases in several modifiable risk factors, with medical disorders having a larger role than substance use disorders for older adults but the reverse for younger and middle-aged adults.
尽管美国人口因大多数主要死因导致的死亡率最近有所下降，但人们对与健康相关的生活质量趋势仍存在不确定性。
分析了 2001-2002 年和 2012-2013 年美国全国酒精与相关情况流行病学调查的全国代表性家庭调查，以了解与健康相关的生活质量趋势（n=79402）。采用健康状况调查问卷 6 维度量表（SF-6D）评估与健康相关的生活质量，SF-6D 量表由健康状况调查问卷 12 维度量表（SF-12）衍生而来。通过对经济、社会、物质滥用、精神和医疗风险因素的变化来解释 SF-6D 评分的变化。
SF-6D 评分均值从 2001-2002 年的 0.820 下降到 2012-2013 年的 0.790（p<0.0001）。在调整年龄、性别、种族/民族和教育因素的回归分析中，该下降的部分原因可归因于医疗（21.9%；肥胖、心脏病、高血压、关节炎、医疗损伤）、经济（15.6%；金融危机、失业）、物质使用（15.3%；物质使用障碍或大麻使用）、心理健康（13.1%；抑郁和焦虑障碍）和社会（11.2%；伴侣、邻居或同事问题）风险。在相应的调整模型中，年龄较大（≥55 岁）的成年人 SF-6D 评分下降的更大比例归因于医疗（35.3%）风险因素，而不是物质使用（7.4%）风险因素，而对于年龄较小（18-24 岁）和 25-44 岁的成年人则相反（分别为 5.7%和 19.7%）和 44 岁（12.7%和 16.3%）。
在 2001-2002 年至 2012-2013 年期间，美国成年人的平均生活质量评分显著下降。下降的部分原因是几个可改变的风险因素增加，对于老年人来说，医疗障碍的作用大于物质使用障碍，但对于年轻人和中年人来说则相反。
