Forecasting the effects of obesity and smoking on U.S. life expectancy.
Forecasting the effects of obesity and smoking on U.S. life expectancy.
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预测肥胖和吸烟对美国预期寿命的影响。
DOI：
10.1056/nejmsa0900459
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发表时间：
2009-12-03
期刊：
影响因子：
--
通讯作者：
Rosen AB
中科院分区：
文献类型：
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作者：
Stewart ST;Cutler DM;Rosen AB
尽管在过去的30年里，肥胖的增加对美国人口的健康产生了不利的影响，但由于吸烟的减少，健康状况也得到了改善。更好地了解这些趋势对寿命和生活质量的共同影响，将有助于更有效地定位卫生保健资源。从2005年到2020年，假设过去的吸烟趋势（基于1978年至1979年、1990年至1991年、1999年至2001年和2004年至2006年的全国健康访谈调查数据）和过去的身体质量指数（BMI）趋势（基于1971年至1975年、1988年至1994年的全国健康与营养调查数据）持续下去，我们预测了具有代表性的18岁人群的预期寿命和质量调整后的预期寿命。1999年到2002年，2003年到2006年)。2003年医疗支出小组调查用于研究吸烟和身体质量指数对健康相关生活质量的影响。在多种情况下，BMI增加的负面影响超过了吸烟减少的积极影响。在基本情况下，从2005年到2020年，一个典型18岁的人的剩余预期寿命的增长被抑制了0.71年或0.91年的质量调整年。如果到2020年所有美国成年人都成为体重正常的不吸烟者，我们预测18岁的预期寿命将增加3.76个生命年或5.16个质量调整年。如果过去的肥胖趋势继续不受控制，对美国人口健康的负面影响将日益超过吸烟率下降所带来的积极影响。如果不能解决肥胖持续增加的问题，可能会导致自20世纪初以来观察到的健康稳步增长的模式受到侵蚀。
Although increases in obesity over the past 30 years have adversely affected the health of the U.S. population, there have been concomitant improvements in health because of reductions in smoking. Having a better understanding of the joint effects of these trends on longevity and quality of life will facilitate more efficient targeting of health care resources. For each year from 2005 through 2020, we forecasted life expectancy and quality-adjusted life expectancy for a representative 18-year-old, assuming a continuation of past trends in smoking (based on data from the National Health Interview Survey for 1978 through 1979, 1990 through 1991, 1999 through 2001, and 2004 through 2006) and past trends in body-mass index (BMI) (based on data from the National Health and Nutrition Examination Survey for 1971 through 1975, 1988 through 1994, 1999 through 2002, and 2003 through 2006). The 2003 Medical Expenditure Panel Survey was used to examine the effects of smoking and BMI on health-related quality of life. The negative effects of increasing BMI overwhelmed the positive effects of declines in smoking in multiple scenarios. In the base case, increases in the remaining life expectancy of a typical 18-year-old are held back by 0.71 years or 0.91 quality-adjusted years between 2005 and 2020. If all U.S. adults became nonsmokers of normal weight by 2020, we forecast that the life expectancy of an 18-year-old would increase by 3.76 life-years or 5.16 quality-adjusted years. If past obesity trends continue unchecked, the negative effects on the health of the U.S. population will increasingly outweigh the positive effects gained from declining smoking rates. Failure to address continued increases in obesity could result in an erosion of the pattern of steady gains in health observed since early in the 20th century.