Health-Related Quality of Life, Quality-Adjusted Life Years, and Quality-Adjusted Life Expectancy in New York City from 1995 to 2006

Lubetkin, Erica I.; Jia, Haomiao

doi:10.1007/s11524-009-9344-9

Health-Related Quality of Life, Quality-Adjusted Life Years, and Quality-Adjusted Life Expectancy in New York City from 1995 to 2006

Published: 13 March 2009

Volume 86, pages 551–561, (2009)
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Erica I. Lubetkin MD, MPh¹ &
Haomiao Jia^2,3

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Abstract

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.

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Authors and Affiliations

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
Erica I. Lubetkin MD, MPh
Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
Haomiao Jia
School of Nursing, Columbia University, New York, NY, USA
Haomiao Jia

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Erica I. Lubetkin MD, MPh
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Appendix

Healthy Days	Excellent self rated general health					Very good self-rated general health					Good self-rated general health
Healthy Days	18–24	25–44	45–64	65–74	75+	18–24	25–44	45–64	65–74	75+	18–24	25–44	45–64	65–74	75+
30	1.000	1.000	1.000	0.999	0.999	1.000	1.000	0.998	0.990	0.894	1.000	0.994	0.891	0.864	0.843
29	1.000	0.999	0.996	0.856	0.835	1.000	0.991	0.867	0.852	0.829	0.999	0.855	0.851	0.829	0.817
28	1.000	0.994	0.870	0.845	0.832	1.000	0.979	0.858	0.845	0.823	0.889	0.848	0.840	0.819	0.809
27	1.000	0.990	0.860	0.838	0.828	0.999	0.852	0.842	0.838	0.817	0.877	0.841	0.832	0.813	0.799
26	0.999	0.857	0.851	0.832	0.825	0.999	0.848	0.835	0.831	0.812	0.869	0.835	0.826	0.808	0.792
25	0.999	0.854	0.843	0.824	0.815	0.881	0.843	0.829	0.821	0.806	0.863	0.828	0.820	0.803	0.785
24	0.999	0.852	0.836	0.818	0.809	0.875	0.837	0.825	0.816	0.801	0.857	0.822	0.815	0.797	0.780
23	0.882	0.850	0.832	0.813	0.804	0.870	0.834	0.821	0.812	0.795	0.852	0.817	0.810	0.790	0.776
22	0.877	0.847	0.829	0.809	0.797	0.865	0.830	0.817	0.808	0.788	0.847	0.811	0.806	0.782	0.768
21	0.875	0.846	0.828	0.807	0.794	0.863	0.829	0.815	0.806	0.786	0.844	0.808	0.803	0.778	0.766
20	0.871	0.841	0.825	0.803	0.786	0.859	0.826	0.810	0.803	0.783	0.841	0.803	0.799	0.766	0.751
19	0.867	0.835	0.823	0.798	0.779	0.856	0.822	0.806	0.798	0.747	0.840	0.798	0.795	0.759	0.741
18	0.866	0.834	0.822	0.797	0.779	0.854	0.821	0.804	0.796	0.746	0.838	0.796	0.793	0.757	0.740
17	0.865	0.833	0.821	0.796	0.778	0.852	0.820	0.803	0.794	0.745	0.836	0.794	0.791	0.753	0.739
16	0.862	0.831	0.820	0.790	0.775	0.849	0.818	0.801	0.783	0.742	0.834	0.790	0.788	0.745	0.731
15	0.858	0.828	0.812	0.770	0.746	0.843	0.810	0.796	0.768	0.737	0.827	0.780	0.778	0.729	0.718
14	0.855	0.825	0.805	0.766	0.738	0.837	0.803	0.792	0.761	0.733	0.821	0.772	0.748	0.723	0.713
13	0.853	0.824	0.804	0.765	0.737	0.835	0.801	0.790	0.759	0.732	0.819	0.769	0.745	0.722	0.712
12	0.851	0.824	0.802	0.765	0.736	0.833	0.800	0.787	0.756	0.731	0.816	0.767	0.743	0.720	0.711
11	0.849	0.823	0.802	0.764	0.735	0.831	0.799	0.785	0.753	0.731	0.815	0.765	0.741	0.719	0.711
10	0.841	0.821	0.800	0.763	0.729	0.828	0.796	0.779	0.730	0.724	0.809	0.759	0.737	0.711	0.708
9	0.835	0.814	0.797	0.758	0.724	0.824	0.792	0.771	0.723	0.716	0.802	0.745	0.732	0.704	0.640
8	0.833	0.810	0.796	0.750	0.721	0.821	0.789	0.768	0.719	0.713	0.798	0.730	0.721	0.702	0.636
7	0.832	0.809	0.795	0.748	0.720	0.817	0.788	0.765	0.718	0.712	0.794	0.728	0.717	0.702	0.636
6	0.831	0.808	0.795	0.746	0.720	0.814	0.787	0.764	0.717	0.712	0.793	0.727	0.714	0.701	0.633
5	0.829	0.806	0.793	0.742	0.718	0.810	0.783	0.761	0.713	0.709	0.789	0.724	0.710	0.699	0.628
4	0.827	0.804	0.791	0.737	0.715	0.808	0.778	0.757	0.708	0.707	0.785	0.720	0.706	0.696	0.624
3	0.825	0.804	0.790	0.736	0.714	0.806	0.774	0.755	0.707	0.705	0.782	0.718	0.704	0.695	0.623
2	0.822	0.802	0.787	0.723	0.668	0.804	0.754	0.749	0.706	0.665	0.775	0.701	0.694	0.644	0.621
1	0.815	0.800	0.781	0.718	0.659	0.801	0.745	0.719	0.703	0.649	0.759	0.697	0.690	0.616	0.614
0	0.690	0.634	0.629	0.586	0.533	0.644	0.603	0.538	0.526	0.507	0.548	0.504	0.492	0.484	0.461
Healthy Days	Fair self-rated general health					Poor self-rated general health
Healthy Days	18–24	25–44	45–64	65–74	75+	18–24	25–44	45–64	65–74	75+
30	0.999	0.981	0.867	0.852	0.834	0.904	0.857	0.851	0.849	0.828
29	0.889	0.846	0.836	0.823	0.807	0.879	0.830	0.829	0.818	0.798
28	0.884	0.838	0.829	0.818	0.798	0.871	0.826	0.823	0.813	0.794
27	0.876	0.829	0.820	0.810	0.789	0.865	0.820	0.816	0.807	0.789
26	0.867	0.820	0.814	0.805	0.786	0.859	0.815	0.811	0.802	0.783
25	0.857	0.812	0.807	0.799	0.780	0.853	0.810	0.803	0.795	0.776
24	0.853	0.806	0.801	0.793	0.776	0.848	0.805	0.799	0.782	0.769
23	0.849	0.801	0.796	0.783	0.772	0.843	0.800	0.794	0.760	0.755
22	0.844	0.797	0.789	0.772	0.753	0.837	0.791	0.787	0.749	0.732
21	0.842	0.794	0.785	0.770	0.750	0.834	0.786	0.781	0.748	0.728
20	0.840	0.787	0.779	0.760	0.745	0.830	0.771	0.762	0.744	0.722
19	0.836	0.773	0.768	0.751	0.732	0.825	0.763	0.752	0.740	0.718
18	0.834	0.771	0.756	0.749	0.729	0.823	0.760	0.750	0.739	0.717
17	0.832	0.769	0.751	0.747	0.726	0.821	0.756	0.749	0.738	0.716
16	0.829	0.765	0.747	0.736	0.723	0.814	0.750	0.745	0.735	0.714
15	0.822	0.754	0.739	0.727	0.714	0.802	0.738	0.731	0.725	0.708
14	0.815	0.734	0.721	0.715	0.707	0.792	0.732	0.716	0.713	0.702
13	0.810	0.732	0.716	0.710	0.706	0.784	0.731	0.712	0.709	0.701
12	0.806	0.731	0.713	0.706	0.702	0.754	0.729	0.708	0.701	0.700
11	0.804	0.729	0.710	0.705	0.666	0.748	0.728	0.705	0.699	0.654
10	0.798	0.724	0.705	0.698	0.645	0.737	0.721	0.699	0.694	0.640
9	0.790	0.715	0.697	0.688	0.638	0.720	0.706	0.690	0.676	0.632
8	0.783	0.699	0.692	0.652	0.635	0.704	0.684	0.681	0.629	0.616
7	0.763	0.681	0.668	0.644	0.634	0.684	0.643	0.629	0.628	0.612
6	0.753	0.675	0.640	0.635	0.621	0.637	0.637	0.627	0.609	0.603
5	0.742	0.632	0.628	0.620	0.599	0.627	0.624	0.603	0.593	0.571
4	0.732	0.629	0.619	0.613	0.580	0.619	0.619	0.596	0.558	0.556
3	0.726	0.628	0.616	0.612	0.569	0.618	0.617	0.594	0.554	0.548
2	0.715	0.626	0.611	0.610	0.548	0.615	0.610	0.589	0.550	0.531
1	0.703	0.621	0.604	0.571	0.516	0.605	0.568	0.550	0.546	0.511
0	0.487	0.443	0.434	0.431	0.416	0.475	0.431	0.386	0.350	0.325

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Lubetkin, E.I., Jia, H. Health-Related Quality of Life, Quality-Adjusted Life Years, and Quality-Adjusted Life Expectancy in New York City from 1995 to 2006. J Urban Health 86, 551–561 (2009). https://doi.org/10.1007/s11524-009-9344-9

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Received: 18 August 2008
Accepted: 09 February 2009
Published: 13 March 2009
Issue Date: July 2009
DOI: https://doi.org/10.1007/s11524-009-9344-9

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Health-Related Quality of Life, Quality-Adjusted Life Years, and Quality-Adjusted Life Expectancy in New York City from 1995 to 2006

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