# Presentation: 378435

## Measuring Progress Towards Goal 1: Increase the Quality and Years of Healthy Life

- Erin Reidy
- National Center for Health Statistics

## Goal 1 of Healthy People 2010

- “Help individuals of all ages increase life expectancy and improve their quality of life”
- Differences in life expectancy by nation and demographic group suggests both need and opportunity for improvement
- Quality of healthy life reflects both physical and mental health, as well as an ability to react to factors in one’s physical and social environment

**Notes:**
- lower life expectancy in US compared to other nations; varying levels of life expectancy by demographic group within the US

## HP2010 Recommendations

- Set of summary measures which incorporate mortality and diverse aspects of morbidity
- Suggested measures
- Years of life without disability
- Years of life without functioning problems
- Years of life in very good health
- Years of life with good health behaviors

## Summary Measures

- Length of time spent in different states of health until death
- HP2010 will use multiple definitions of health states to compute four general summary measures
- Advantages
- Comparisons of health
- One population at two or more points in time
- 2 or more populations at one point in time
- Removes influence of age composition
- Limitations
- Interpretation
- Needs consistent, reliable prevalence data for all age groups

## Goal 1 Measures

- Years of life in good or better health
- Years of life without disability
- Years of life without chronic disease
- Heart disease, cancer, diabetes, hypertension, asthma, kidney disease
- Years of life without risk factors
- Smoking, leisure-time physical activity, and obesity

## Data

- National Health Interview Survey 1999-2000, 2001-2002
- Continuous, cross-sectional, nationally representative survey
- 43,000 households; 106,000 persons
- Study population/Time period
- All ages
- 1999-2000, 2001-2002

## Data

- National Vital Statistics System- Mortality
- Complete registration of all deaths in the United States
- Study population/Time period
- All ages
- 1999-2000, 2001-2002

## Measures	

- Healthy Life
- Self-rated health
- Years without chronic diseases
- Prevalence of cancer, heart disease, diabetes, arthritis, and chronic kidney disease

## Analysis

- Sullivan method
- Life table technique
- Age-specific mortality
- Age-specific prevalence
- By demographic characteristics
- Age: 0, 30, 65
*Sex*
*Race: White, non-Hispanic; Black, non-Hispanic*

## Fair or Poor Self-rated Health by Age

- Source: National Health Interview Survey (NHIS), NCHS, CDC; National Vital Statistics System (NVSS), NHCS, CDC.

- 1999-2000

- 2001-2002

## Healthy Life Expectancy, 1999-2000

- Source: National Health Interview Survey (NHIS), NCHS, CDC; National Vital Statistics System (NVSS), NHCS, CDC.

- Life Expectancy

- Years of Life in good or better health

**6.7%**

**10.2%**

**23.7%**

## Healthy Life Expectancy, 2001-2002

- Source: National Health Interview Survey (NHIS), NCHS, CDC; National Vital Statistics System (NVSS), NHCS, CDC.

- Life Expectancy

- Years of Life in good or better health

**8.0%**

**12.4%**

**30.2%**

## Chronic Disease Prevalence by Age

- Source: National Health Interview Survey (NHIS), NCHS, CDC; National Vital Statistics System (NVSS), NHCS, CDC.

- 1999-2000

- 2001-2002

## Years without Chronic Disease, 1999-2000

- Source: National Health Interview Survey (NHIS), NCHS, CDC; National Vital Statistics System (NVSS), NHCS, CDC.

- Years of Life without chronic disease

- Life Expectancy

**34.6%**

**47.1%**

**71.5%**

## Years without Chronic Disease, 2001-2002

- Source: National Health Interview Survey (NHIS), NCHS, CDC; National Vital Statistics System (NVSS), NHCS, CDC.

- Life Expectancy

- Years of Life without chronic disease

**37.5%**

**50.8%**

**77.4%**

## Discussion

- Larger proportion of life expected to be spent with chronic diseases than in fair or poor health
- Significant decreases in years of healthy life at ages 0, 30, and 65.
- Significant decreases in years of life without chronic diseases at ages 0, 30, and 65.

## Future Issues

- Multiple data sources
- Institutionalized population
- Race/Ethnicity
- Observed vs. self-reported

## Conclusion

- Summary measures are an effective technique to compare health states of a population over time
- Healthy People 2010 will analyze progress towards Goal 1 using four composite summary measures
- Initial analyses suggest a decrease in years lived in good health and years lived without chronic diseases between 1999-00 and 2001-02