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Journal of Public Health Advance Access published online on February 27, 2009
Journal of Public Health, doi:10.1093/pubmed/fdp012
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© The Author 2009, Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved

The statewide burden of obesity, smoking, low income and chronic diseases in the United States


Haomiao Jia, Assistant Professor1
Erica I. Lubetkin, Associate Medical Professor2

1 School of Nursing and Department of Biostatistics, Mailman School of Public Health, Columbia University, 630 West 168th Street, New York, NY 10032, USA
2 Department of Community Health and Social Medicine, Sophie Davis School of Biomedical Education/CUNY Medical School, New York, NY, USA


Address correspondence to: Haomiao Jia, E-mail: hj2198{at}columbia.edu


  Abstract

Background We developed an estimation equation of EuroQol EQ-5D index scores from the Healthy Days measures of the Centers for Disease Control and Prevention for use in burden of disease and cost-effectiveness studies in population subgroups. This study estimated EQ-5D scores, quality-adjusted life years (QALYs) and quality-adjusted life expectancy (QALE) for the USA and the individual states.

Methods We estimated the EQ-5D scores for respondents from the 2000–2003 Behavioral Risk Factor Surveillance System. We calculated QALYs and QALE lost to morbidity due to obesity/overweight, smoking, low income and chronic diseases.

Results The mean EQ-5D score for US adults was 0.870. The mean scores ranged from 0.826 (West Virginia) to 0.902 (Hawaii). Smoking contributed from 5.6 (Utah) to 12.3 (Kentucky) percent, obesity/overweight 5.4 (South Dakota) to 13.8 (Louisiana) percent, low income 16.6 (Hawaii) to 39.9 (South Carolina) percent and chronic diseases 8.7 (Minnesota) to 22.9 (Tennessee) percent of explainable QALYs lost. These risks contributed the greatest proportion of explainable QALYs and QALE lost in Kentucky, Tennessee and South Carolina.

Conclusions We estimated the burden of disease contributed by selected risk factors. Currently, such data are unavailable but are needed to set targets for reducing modifiable health risks and eliminating health disparities among at-risk populations.

Keywords: EuroQol EQ-5D, Healthy Days measures, health-related quality of life, quality-adjusted life expectancy, quality-adjusted life year


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