Citation

Stewart ST, Cutler DM, Rosen AB. Am. J. Public Health 2013; 103(11): e78-87.

Affiliation

Susan T. Stewart is with the National Bureau of Economic Research (NBER), Cambridge, MA; she also performed this research in previous positions with the Harvard University Interfaculty Program for Health Systems Improvement (PHSI), and the Harvard Initiative for Global Health, Cambridge. David M. Cutler is with the Department of Economics, Harvard University, Harvard PHSI, and the NBER. Allison B. Rosen is with the Department of Quantitative Health Sciences and Meyer's Primary Care Institute, University of Massachusetts Medical School, Worcester, and the NBER.

Copyright

(Copyright © 2013, American Public Health Association)

DOI

10.2105/AJPH.2013.301250

PMID

24028235

Abstract

Objectives. We used data from multiple national health surveys to systematically track the health of the US adult population. Methods. We estimated trends in quality-adjusted life expectancy (QALE) from 1987 to 2008 by using national mortality data combined with data on symptoms and impairments from the National Medical Expenditure Survey (1987), National Health Interview Survey (1987, 1994-1995, 1996), Medical Expenditure Panel Survey (1992, 1996, 2000-2008), National Nursing Home Survey (1985, 1995, and 1999), and Medicare Current Beneficiary Survey (1992, 1994-2008). We decomposed QALE into changes in life expectancy, impairments, symptoms, and smoking and body mass index. Results. Years of QALE increased overall and for all demographic groups-men, women, Whites, and Blacks-despite being slowed by increases in obesity and a rising prevalence of some symptoms and impairments. Overall QALE gains were large: 2.4 years at age 25 years and 1.7 years at age 65 years. Conclusions. Understanding and consistently tracking the drivers of QALE change is central to informed policymaking. Harmonizing data from multiple national surveys is an important step in building this infrastructure. (Am J Public Health. Published online ahead of print September 12, 2013: e1-e10. doi:10.2105/AJPH.2013.301250).

Language: en