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Population Health Metrics

, 14:23

First Online: 12 July 2016Received: 29 November 2015Accepted: 23 June 2016DOI: 10.1186-s12963-016-0092-2

Cite this article as: Cao, B. Popul Health Metrics 2016 14: 23. doi:10.1186-s12963-016-0092-2


BackgroundIn the past three decades, the elderly population in the United States experienced increase in life expectancy LE and disability-free life expectancy LE, but decrease in life expectancy with disability LE. Smoking and obesity are two major risk factors that had negative impacts on these trends. While smoking prevalence continues to decline in recent decades, obesity prevalence has been growing and is currently at a high level. This study aims to forecast the healthy life expectancy for older adults aged 55 to 85 in the US from 2011 to 2040, in relation to their smoking and obesity history.

MethodsFirst, population-level mortality data from the Human Mortality Database HMD and individual-level disability data from the US National Health Interview Survey NHIS were used to estimate the transition rates between different health states from 1982 to 2010, using a multi-state life table MSLT model. Second, the estimated transition rates were fitted and projected up to 2040, using a modified Lee-Carter model that incorporates cohort smoking and obesity history from NHIS.

ResultsMortality and morbidity for both sexes will continue to decline in the next decades. Relative to 2010, men are expected to have 3.2 years gain in LE and 0.8 years loss in LE. For women, there will be 1.8 years gain in LE and 0.8 years loss in LE. By 2040, men and women are expected to spend respectively 80 % and 75 % of their remaining life expectancy between 55 and 85 disability-free.

ConclusionsSmoking and obesity have independent negative impacts on both the survival and disability of the US older population in the coming decades, and are responsible for the present and future gender disparity in mortality and morbidity. Overall, the US older population is expected to enjoy sustained health improvements and compression of disability, largely due to decline in smoking.

KeywordsHealthy life expectancy Forecast Mortality Morbidity Smoking Obesity Multi-state life table Lee-Carter model Electronic supplementary materialThe online version of this article doi:10.1186-s12963-016-0092-2 contains supplementary material, which is available to authorized users.

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Author: Bochen Cao

Source: https://link.springer.com/

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