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State-specific healthy life expectancy in years at age 65 years, both sexes — United States, 2007–2009 - was generally less in the South.

 

Senior Citizen Longevity & Statistics

Healthy life expectancy lowest for seniors in South, those that are black or male

Highest HLE during 2007-2009 for senior citizens at age 65 living in Hawaii; lowest in Mississippi

Senior women have more healthy years ahead than men.

July 25, 2013 - People living in the South, regardless of race, and blacks throughout the United States, have lower healthy life expectancy at age 65, according to a report in the Morbidity and Mortality Weekly Report released this month by the Centers for Disease Control and Prevention. And, not surprisingly, senior women have higher HLE than do senior men.

Healthy life expectancy (HLE) is a population health measure that combines mortality data with morbidity or health status data to estimate expected years of life in good health for persons at a given age. HLE accounts for quantity and quality of life and can be used to describe and monitor the health status of populations.

These calculations indicate that, during 2007–2009, females had a greater HLE than males at age 65 years in every state and DC. HLE was greater for whites than for blacks in all states from which sufficient data were available and DC, except in Nevada and New Mexico.

 

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CDC used 2007-2009 data from the National Vital Statistics Systems, U.S. Census Bureau, and Behavioral Risk Factor Surveillance System to calculate HLEs by sex and race for each of the 50 states and Washington, D.C., for all people aged 65 years.

“Where you live in the United States shouldn't determine how long and how healthy you live - but it does, far more than it should,” said CDC Director Tom Frieden, M.D., M.P.H. 

“Not only do people in certain states and African-Americans live shorter lives, they also live a greater proportion of their last years in poor health. It will be important moving forward to support prevention programs that make it easier for people to be healthy no matter where they live."

For all adults at 65, the highest HLE was observed in Hawaii (16.2 years) and the lowest was in Mississippi (10.8 years). By race, HLE estimates for whites were lowest among Southern states. For blacks, HLE was comparatively low throughout the United States, except in Nevada and New Mexico.  HLE was greater for females than for males in all states, with the difference ranging from 0.7 years in Louisiana to 3.1 years in North Dakota and South Dakota.

Other findings:

   ● HLE was greater for whites than for blacks in all states and Washington, D.C., that had sufficient data, except Nevada and New Mexico.

   ● HLE for males at age 65 years varied between a low of 10.1 years in Mississippi and a high of 15.0 years in Hawaii.

   ● HLE for females at age 65 years varied between a low of 11.4 years in Mississippi and a high of 17.3 years in Hawaii.

HLE estimates can predict future health service needs, evaluate health programs, and identify trends and inequalities.  Furthermore, examining HLE as a percent of life expectancy can reveal populations that might be enduring illness or disability for years. Public health officials, health care providers, and policymakers can use HLE to monitor and understand the health status of a population.

State-specific healthy life expectancy in years at age 65 years, by race — United States, 2007–2009

Data for 11 states were not reported because the total number of deaths from 2007 to 2009 for the black population in those states was <700: Alaska, Hawaii, Idaho, Maine, Montana, New Hampshire, North Dakota, South Dakota, Utah, Vermont, and Wyoming.

The figure above shows state-specific healthy life expectancy (HLE) in years at age 65 years, by race, in the United States during 2007-2009. By race, HLE estimates for whites were lowest among southern states. For blacks, HLE estimates were comparatively low throughout the United States, except for a few southwestern states. For whites aged 65 years, HLE varied between a low of 11.0 years in West Virginia and a high of 18.8 years in DC.

State-specific healthy life expectancy in years at age 65 years, by sex — United States, 2007–2009

For both sexes, estimated HLE generally was less in the South than elsewhere in the United States (Figure 1). HLE for males at age 65 years varied from a low of 10.1 years in Mississippi to a high of 15.0 years in Hawaii (Table). HLE for females at age 65 years varied from a low of 11.4 years in Mississippi to a high of 17.3 years in Hawaii. HLE was greater for females than for males in all states, with the difference ranging from 0.7 years in Louisiana to 3.1 years in North Dakota and South Dakota.

 

Editorial Note by Researchers

"HLE estimates in this report identified disparities by sex, race, and state among persons aged 65 years. During 2007–2009, females had a greater HLE than males at age 65 years in every state and DC. HLE was greater for whites than for blacks in all states for which sufficient data were available and DC, except for a difference of <1 year that was observed in Nevada and New Mexico. In general, at age 65 years, HLEs within individual states varied up to 3 years by sex and up to 8 years by race. HLEs for all persons aged 65 years varied between states by 6 years.

"Over the past century in the United States, a general decline in death rates has resulted in a corresponding increase in LE. Because differences in HLE by demographics might result from variations in morbidity or mortality, examining HLE as a percentage of LE reveals populations that might be enduring illness or disability for more years.

"Although HLE measures do not identify the reasons for poor health or shorter lives, they provide a snapshot of the health status of a population. From this measure it is not possible to determine why some states have higher HLE than others.

"Many factors influence a person's health status as they age, including 1) safe and healthy living environments, 2) healthy behaviors (e.g., exercise and not smoking), 3) getting the recommended clinical preventive services (e.g., vaccines, cancer screenings, and blood pressure checks), and 4) having access to good quality health care when it is needed.

"The findings in this report are subject to at least five limitations.

First, BRFSS includes a self-assessed health status question, which might be influenced by age, sex, race/ethnicity, culture, and several social and behavior factors, resulting in rankings of health status that might be assessed inconsistently across demographic groups. However, self-reported health status questions, as used in BRFSS, have been shown to be a good predictor of future disability, hospitalization, and mortality.

"Second, possible misclassification of demographic information on the death certificate and misclassification because of the bridging procedure used to categorize persons of multiple race in the census data might have occurred.

"Third, the BRFSS median response rates in the low 50% raise the possibility of response bias.

"Fourth, BRFSS is a telephone interview-based survey that did not include persons without access to a landline telephone in its 2007–2009 surveys.

"Finally, state-specific HLE estimates might not be precise for small groups (especially blacks) by age and sex because of small BRFSS samples and low death counts in some states.

"HLE measures reflect current mortality rates and health status for various populations and suggest the long-range implications of the prevailing age-specific death and illness rates. HLE is a relatively simple measure that can be readily used by public health officials, health-care providers, and policy makers to understand the health status of a population. The results presented in this study can be used as a baseline for states to monitor the HLE of persons aged 65 years as they age, identify health disparities among subpopulations, and target resources to improve population health."

Acknowledgments

Sukhjeet Ahuja, MD, National Association for Public Health Statistics and Information Systems. Stephanie Zaza, MD, Rachel B. Kaufmann, PhD, Carl Kinkade, MCRP, Eric Knudsen, Jose Aponte, Epidemiology and Analysis Program Office; Brenda Le, MSPH, National Center for Environmental Health; Robert N. Anderson, PhD, Joyce A. Arbertha, National Center for Health Statistics; Sigrid A. Economou, Public Health Surveillance and Informatics Program Office, CDC.

>> For the full report online, visit http://www.cdc.gov/mmwr. Or, download a complete pdf report.

>> U.S. Department of Health and Human Services

 

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