Estimating health-adjusted life expectancy conditional on risk factors: results for smoking and obesity.
Cast your vote
You can rate an item by clicking the amount of stars they wish to award to this item.
When enough users have cast their vote on this item, the average rating will also be shown.
Your vote was cast
Thank you for your feedback
Thank you for your feedback
MetadataShow full item record
TitleEstimating health-adjusted life expectancy conditional on risk factors: results for smoking and obesity.
PubliekssamenvattingABSTRACT: BACKGROUND: Smoking and obesity are risk factors causing a large burden of disease. To help formulate and prioritize among smoking and obesity prevention activities, estimations of health-adjusted life expectancy (HALE) for cohorts that differ solely in their lifestyle (e.g. smoking vs. non smoking) can provide valuable information. Furthermore, in combination with estimates of life expectancy (LE), it can be tested whether prevention of obesity and smoking results in compression of morbidity. METHODS: Using a dynamic population model that calculates the incidence of chronic disease conditional on epidemiological risk factors, we estimated LE and HALE at age 20 for a cohort of smokers with a normal weight (BMI < 25), a cohort of non-smoking obese people (BMI>30) and a cohort of 'healthy living' people (i.e. non smoking with a BMI < 25). Health state valuations for the different cohorts were calculated using the estimated disease prevalence rates in combination with data from the Dutch Burden of Disease study. Health state valuations are multiplied with life years to estimate HALE. Absolute compression of morbidity is defined as a reduction in unhealthy life expectancy (LE-HALE) and relative compression as a reduction in the proportion of life lived in good health (LE-HALE)/LE. RESULTS: Estimates of HALE are highest for a 'healthy living' cohort (54.8 years for men and 55.4 years for women at age 20). Differences in HALE compared to 'healthy living' men at age 20 are 7.8 and 4.6 for respectively smoking and obese men. Differences in HALE compared to 'healthy living' women at age 20 are 6.0 and 4.5 for respectively smoking and obese women. Unhealthy life expectancy is about equal for all cohorts, meaning that successful prevention would not result in absolute compression of morbidity. Sensitivity analyses demonstrate that although estimates of LE and HALE are sensitive to changes in disease epidemiology, differences in LE and HALE between the different cohorts are fairly robust. In most cases, elimination of smoking or obesity does not result in absolute compression of morbidity but slightly increases the part of life lived in good health. CONCLUSION: Differences in HALE between smoking, obese and 'healthy living' cohorts are substantial and similar to differences in LE. However, our results do not indicate that substantial compression of morbidity is to be expected as a result of successful smoking or obesity prevention.
- Evaluating compression or expansion of morbidity in Canada: trends in life expectancy and health-adjusted life expectancy from 1994 to 2010.
- Authors: Steensma C, Loukine L, Choi BC
- Issue date: 2017 Mar
- Comparing life expectancy and health-adjusted life expectancy by body mass index category in adult Canadians: a descriptive study.
- Authors: Steensma C, Loukine L, Orpana H, Lo E, Choi B, Waters C, Martel S
- Issue date: 2013 Nov 19
- Impact of diabetes mellitus on life expectancy and health-adjusted life expectancy in Canada.
- Authors: Loukine L, Waters C, Choi BC, Ellison J
- Issue date: 2012 Apr 24
- Life expectancy and healthy life expectancy of Japan: the fastest graying society in the world.
- Authors: Tokudome S, Hashimoto S, Igata A
- Issue date: 2016 Oct 28
- Future healthy life expectancy among older adults in the US: a forecast based on cohort smoking and obesity history.
- Authors: Cao B
- Issue date: 2016