5229372884 County Health Rankings & Roadmaps, University of Wisconsin Population Health Institute, University of Wisconsin-Madison, Madison, WI, USA.
Public Health Rep. 2022 Mar-Apr;137(2):255-262. doi: 10.1177/0033354921999407. Epub 2021 Mar 11.
Life expectancy is a public health metric used to assess mortality. We describe life expectancy calculations for US counties and present methodologic considerations compared with years of potential life lost before age 75 (YPLL-75) and premature age-adjusted mortality (PAAM), 2 commonly used length-of-life metrics.
We used death data from the National Center for Health Statistics for 2015-2017 and other health measures from the 2019 County Health Rankings & Roadmaps. We calculated life expectancy from birth at the county level using an abridged life table and the Chiang method of variance. Studentized residuals identified counties with discordant life expectancy and YPLL-75 or PAAM values. Correlations tested associations of life expectancy with key health measures (eg, smoking, child poverty, uninsured).
Among 3073 US counties, life expectancy ranged from 62.4 to 98.0 years, with a mean of 77.4 years. Life expectancy was strongly and negatively correlated with YPLL-75 ( = 0.91) and PAAM ( = 0.95) at the county level. Life expectancy was also associated with other key health metrics, such as smoking, employment, and education rates, where an improvement in the health factor indicated improvement in the respective length-of-life measure. Counties with discordant life expectancy and YPLL-75 or PAAM values had differing age structures.
Commonly used length-of-life metrics in population health settings are differentiated by methodological matters, such as computation complexity, data availability, and differential risk among age groups, especially among the very old or very young. The choice of metric should consider these factors, in addition to practical concerns, such as the communication needs of the audience.
预期寿命是用于评估死亡率的公共卫生指标。我们描述了美国各县的预期寿命计算方法，并与在 75 岁之前的潜在生命损失年数 (YPLL-75) 和过早年龄调整死亡率 (PAAM) 进行了方法学比较，这两个常用的寿命衡量标准。
我们使用了国家卫生统计中心 2015-2017 年的死亡数据和 2019 年县健康排名和路线图中的其他健康指标。我们使用简化生命表和 Chiang 方差法在县级计算了从出生开始的预期寿命。学生化残差识别出与预期寿命和 YPLL-75 或 PAAM 值不一致的县。相关性检验了预期寿命与关键健康指标（如吸烟、儿童贫困、无保险）的关联。
在 3073 个美国县中，预期寿命范围从 62.4 岁到 98.0 岁，平均为 77.4 岁。预期寿命与 YPLL-75（r = 0.91）和 PAAM（r = 0.95）在县级呈强负相关。预期寿命还与其他关键健康指标相关，如吸烟、就业和教育率，其中健康因素的改善表明相应的寿命衡量标准有所改善。预期寿命和 YPLL-75 或 PAAM 值不一致的县具有不同的年龄结构。
在人口健康环境中常用的寿命衡量标准因方法学问题而有所不同，例如计算复杂性、数据可用性以及年龄组之间的差异风险，尤其是在非常年轻或非常年长的人群中。选择衡量标准除了要考虑实用性问题，如受众的沟通需求外，还应考虑这些因素。
