Estimating life expectancy adjusted by self-rated health status in the United States: national health interview survey linked to the mortality

Cho, H (通讯作者),Natl Canc Ctr, Dept Canc Control & Populat Hlth, Grad Sch Canc Sci & Policy, 323 Ilsan Ro, Goyang Si 10408, Gyeonggi Do, South Korea.
2022-1-20
Background Life expectancy is increasingly incorporated in evidence-based screening and treatment guidelines to facilitate patient-centered clinical decision-making. However, life expectancy estimates from standard life tables do not account for health status, an important prognostic factor for premature death. This study aims to address this research gap and develop life tables incorporating the health status of adults in the United States. Methods Data from the National Health Interview Survey (1986-2004) linked to mortality follow-up through to 2006 (age >= 40, n = 729,531) were used to develop life tables. The impact of self-rated health (excellent, very good, good, fair, poor) on survival was quantified in 5-year age groups, incorporating complex survey design and weights. Life expectancies were estimated by extrapolating the modeled survival probabilities. Results Life expectancies incorporating health status differed substantially from standard US life tables and by health status. Poor self-rated health more significantly affected the survival of younger compared to older individuals, resulting in substantial decreases in life expectancy. At age 40 years, hazards of dying for white men who reported poor vs. excellent health was 8.5 (95% CI: 7.0,10.3) times greater, resulting in a 23-year difference in life expectancy (poor vs. excellent: 22 vs. 45), while at age 80 years, the hazards ratio was 2.4 (95% CI: 2.1, 2.8) and life expectancy difference was 5 years (5 vs. 10). Relative to the US general population, life expectancies of adults (age < 65) with poor health were approximately 5-15 years shorter. Conclusions Considerable shortage in life expectancy due to poor self-rated health existed. The life table developed can be helpful by including a patient perspective on their health and be used in conjunction with other predictive models in clinical decision making, particularly for younger adults in poor health, for whom life tables including comorbid conditions are limited.
BMC PUBLIC HEALTH
卷号:22|期号:1
收录类别:SCIE
语种
英语
来源机构
National Cancer Center - Korea (NCC); Information Management Services, Inc.; American Cancer Society; National Institutes of Health (NIH) - USA; NIH National Cancer Institute (NCI)
资助信息
H. Cho received funding from the National Cancer Institute, USA (HHSN261201400609P), and the National Research Foundation of Korea, funded by the Korean Ministry of Science and ICT (Grant No. NRF2020R1A2C1A01011584). The funding sources had no role in the design of the study and collection, analysis, and interpretation of data, and in writing the manuscript.
被引频次(WOS)
1
被引频次(其他)
1
180天使用计数
3
2013以来使用计数
4
EISSN
1471-2458
出版年
2022-1-20
DOI
10.1186/s12889-021-12332-0
WOS学科分类
Public, Environmental & Occupational Health
学科领域
循证公共卫生
关键词
Self-rated health status Life expectancy Survival Mortality health survey National Health Interview Survey
资助机构
National Cancer Institute, USA(United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Cancer Institute (NCI)) National Research Foundation of Korea - Korean Ministry of Science and ICT