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Measuring Years of Healthy Life: Use of Summary Measures in The Healthy People Initiative

Measuring Years of Healthy Life: Use of Summary Measures in The Healthy People Initiative. Ritu Tuteja, MPH National Center for Health Statistics. History of Healthy People. Timeline of major developments 1979 Surgeon General’s report

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Measuring Years of Healthy Life: Use of Summary Measures in The Healthy People Initiative

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  1. Measuring Years of Healthy Life:Use of Summary Measures in The Healthy People Initiative Ritu Tuteja, MPH National Center for Health Statistics

  2. History of Healthy People Timeline of major developments 1979 Surgeon General’s report 1980 Promoting Health, Preventing Disease 1987 Healthy People Consortium 1990 Healthy People 2000 1995 Healthy People 2000 Midcourse Review 2000 Healthy People 2010 2001 Healthy People 2000 Final Review 2006 Healthy People 2010 Midcourse Review 2008 Healthy People 2020 Development & Regional Meetings 2009 Release of Framework and Draft Objectives 2010 Healthy People 2020 Released 2011 Healthy People 2010 Final Review

  3. Promoting Health, Preventing Disease-1990 Health Objectives for the Nation • Health status goals by age • Longevity goals considered only mortality/life expectancy

  4. Healthy People 2000 Goal 1: Increase the Span of Healthy Life for Americans Goal 2: Reduce Health Disparities Among Americans Goal 3: Achieve Access to Preventive Services for All Americans

  5. Healthy People 2010 Goal 1: Increase Quality and Years of Healthy Life Goal 2: Eliminate Health Disparities

  6. Healthy People 2020 Goal 1: Attain High Quality, Longer Lives Free of Preventable Disease, Disability, Injury and Premature Death Goal 2: Achieve Health Equity, Eliminate Disparities, and Improve the Health of all Groups Goal 3: Create Social and Physical Environments that Promote Good Health for All Goal 4: Promote Quality of Life, Healthy Development and Healthy Behaviors across All Life Stages

  7. Healthy People 2020 • 1200+ Objectives • 40 Topic Areas

  8. HP2020 Topic Areas Access to Health Services Adolescent Health Arthritis, Osteoporosis & Chronic Back Conditions Blood Disorders and Blood Safety Cancer Chronic Kidney Diseases Diabetes Disability and Secondary Conditions Early and Middle Childhood Educational And Community-Based Programs Environmental Health Family Planning Food Safety Genomics Global Health Health Communication and Health IT Healthcare-Associated Infections Hearing and Other Sensory or Communication Disorders Heart Disease and Stroke HIV Immunization and Infectious Diseases Injury and Violence Prevention Maternal, Infant and Child Health Medical Product Safety Mental Health and Mental Disorders Nutrition and Weight Status Occupational Safety and Health Older Adults Oral Health Physical Activity and Fitness Public Health Infrastructure Quality of Life and Well-Being Respiratory Diseases Sexually Transmitted Diseases Social Determinants Of Health Substance Abuse Tobacco Use Vision

  9. HP2020 Topic Areas Access to Health Services Adolescent Health Arthritis, Osteoporosis & Chronic Back Conditions Blood Disorders and Blood Safety Cancer Chronic Kidney Diseases Diabetes Disability and Secondary Conditions Early and Middle Childhood Educational And Community-Based Programs Environmental Health Family Planning Food Safety Genomics Global Health Health Communication and Health IT Healthcare-Associated Infections Hearing and Other Sensory or Communication Disorders Heart Disease and Stroke HIV Immunization and Infectious Diseases Injury and Violence Prevention Maternal, Infant and Child Health Medical Product Safety Mental Health and Mental Disorders Nutrition and Weight Status Occupational Safety and Health Older Adults Oral Health Physical Activity and Fitness Public Health Infrastructure Quality of Life and Well-Being Respiratory Diseases Sexually Transmitted Diseases Social Determinants Of Health Substance Abuse Tobacco Use Vision

  10. HP2020 Topic Areas Access to Health Services Adolescent Health Arthritis, Osteoporosis & Chronic Back Conditions Blood Disorders and Blood Safety Cancer Chronic Kidney Diseases Diabetes Disability and Secondary Conditions Early and Middle Childhood Educational And Community-Based Programs Environmental Health Family Planning Food Safety Genomics Global Health Health Communication and Health IT Healthcare-Associated Infections Hearing and Other Sensory or Communication Disorders Heart Disease and Stroke HIV Immunization and Infectious Diseases Injury and Violence Prevention Maternal, Infant and Child Health Medical Product Safety Mental Health and Mental Disorders Nutrition and Weight Status Occupational Safety and Health Older Adults Oral Health Physical Activity and Fitness Public Health Infrastructure Quality of Life and Well-Being Respiratory Diseases Sexually Transmitted Diseases Social Determinants Of Health Substance Abuse Tobacco Use Vision

  11. Healthy People 2020 Public Meetings October 22nd - Kansas City, Kansas November 7th – Philadelphia, Pennsylvania November 20th – Seattle, Washington Online Public Comment starting October 30th

  12. Healthy People 2010 Final Review

  13. Measuring Healthy Life Expectancies, HP 2010 Expected years in good or better health Global assessment question: “excellent, very good, good, fair, or poor”. Expected years free of activity limitation Any limitation in activity, or need for special equipment due to physical, mental, or emotional problems. Expected years free of selected chronic diseases Arthritis, asthma, cancer, diabetes, heart disease, high blood pressure, kidney disease, or stroke.

  14. Life Expectancy and Expected Years of Healthy Life from Birth, 2004 Expected years of life Free of activity limitation In good or better health Free of selected chronic diseases Years from birth

  15. Life Expectancy and Expected Years of Healthy Life from Birth, 2004 Expected years of life Free of activity limitation In good or better health Free of selected chronic diseases Years from birth Note: The categories white and black do not include persons of Hispanic origin

  16. Expected years of life Free of activity limitation In good or better health Free of selected chronic diseases Life Expectancy and Expected Years of Healthy Life from Birth, 2004 Years from birth Note: The categories white and black do not include persons of Hispanic origin

  17. Life Expectancy and Expected Years of Healthy Life from Age 65, 2004 Expected years of life Free of activity limitation In good or better health Free of selected chronic diseases Years from age 65

  18. Life Expectancy and Expected Years of Healthy Life from Age 65, 2004 Expected years of life Free of activity limitation In good or better health Free of selected chronic diseases Years from age 65 Note: The categories white and black do not include persons of Hispanic origin

  19. Expected years of life Free of activity limitation In good or better health Free of selected chronic diseases Life Expectancy and Expected Years of Healthy Life from Age 65, 2004 Years from age 65 Note: The categories white and black do not include persons of Hispanic origin

  20. Progress toward Quality and Years of Healthy Life Life expectancy continues to improve for all population groups Between 1999 and 2004, expected years in good or better health and expected years free of activity limitations increased slightly; expected years free ofselected chronic conditions decreased Women continue to have longer life expectancy than men; women live a greater proportion of their lives in healthy states than men (from age 65) Blacks have a shorter life expectancy than Whites; Blacks also live a greater proportion of life in unhealthy states compared to Whites

  21. Current Methodology US Life Tables • Mortality-US Life Tables • Under 85 years of age-Vital Statistics/Census • 85 years + - Medicare Data • Vital Statistics/Census • Age misreporting-overstatement • More prevalent in Census population than in Vital Statistics • Medicare • Proof of age requirement for enrollment • 99 percent of deaths to Americans age 65 and older

  22. Medicare vs. Vital Statistics Data United States Life Tables, 2005 (forthcoming)

  23. Medicare vs. Vital Statistics Data United States Life Tables, 2005 (forthcoming)

  24. Newly revised Methodology for US Life Tables • Probability of Dying-Ages 66-94: Combined Vital Statistics and Medicare Data -Contribution of Medicare increases with age • Probability of Dying-Ages 95-100: Exclusively Medicare

  25. Newly revised Methodology for US Life Tables Decrease in Life Expectancy for all groups

  26. Change in Rankings: Life Expectancy Males • At Birth: 22nd to 23rd • Age 65: 11th to 16th Females • At Birth: 24th to 24th • Age 65: 17th to 20th Implications for the Years of Healthy Life Measures OECD Health Data 2009- Year 2005 life expectancy data

  27. Future Directions Develop additional domains/measures Improve international comparability Improve understanding and interpretation/behavior of measures

  28. http://www.cdc.gov/nchs/hphome.htm

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