Impact of selected risk factors on quality-adjusted life expectancy in Denmark.
OBJECTIVE
The construct quality-adjusted life years (QALYs) combines mortality and overall health status and can be used to quantify the impact of risk factors on population health. The purpose of the study was to estimate the impact of tobacco smoking, high alcohol consumption, physical inactivity, and overweight on QALYs.


METHODS
Life tables for each level of exposure to the risk factor were constructed mainly on the basis of the Danish National Cohort Study. QALYs were estimated for exposed and unexposed by Sullivan's method, by combining life tables, EQ-5D self-classified health status from the Danish Health Survey 2000, and Danish EQ-5D values.


RESULTS
The quality-adjusted life expectancy of 25-year-olds was 10-11 QALYs shorter for heavy smokers than for those who never smoke. The difference in life expectancy was 9-10 years. Men and women with high alcohol consumption could expect to lose about 5 and 3 QALYs, respectively. Sedentary persons could expect to have about 7 fewer QALYs than physically active persons. Obesity shortened QALYs by almost 3 for men and 6 for women.


CONCLUSIONS
Smoking, high alcohol consumption, physical inactivity, and obesity strongly reduce life expectancy and health-related quality of life. These results could be used by health policy-makers to evaluate the potential gains in public health due to interventions against these risk factors, when the prevalence of exposure to the risk factor is available.
Brønnum-Hansen
Henrik
H
National Institute of Public Health, Copenhagen, Denmark. hbh@niph.dk
Juel
Knud
K
Davidsen
Michael
M
Sørensen
Jan
J
D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects; D003718:Denmark / Q000453:epidemiology; D015444:Exercise; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008017:Life Expectancy; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D050177:Overweight; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects