title: US trends in quality-adjusted life expectancy from 1987 to 2008: combining national surveys to more broadly track the health of the nation.
abstract: OBJECTIVE
  We used data from multiple national health surveys to systematically track the health of the US adult population.
  
  
  METHODS
  We estimated trends in quality-adjusted life expectancy (QALE) from 1987 to 2008 by using national mortality data combined with data on symptoms and impairments from the National Medical Expenditure Survey (1987), National Health Interview Survey (1987, 1994-1995, 1996), Medical Expenditure Panel Survey (1992, 1996, 2000-2008), National Nursing Home Survey (1985, 1995, and 1999), and Medicare Current Beneficiary Survey (1992, 1994-2008). We decomposed QALE into changes in life expectancy, impairments, symptoms, and smoking and body mass index.
  
  
  RESULTS
  Years of QALE increased overall and for all demographic groups-men, women, Whites, and Blacks-despite being slowed by increases in obesity and a rising prevalence of some symptoms and impairments. Overall QALE gains were large: 2.4 years at age 25 years and 1.7 years at age 65 years.
  
  
  CONCLUSIONS
  Understanding and consistently tracking the drivers of QALE change is central to informed policymaking. Harmonizing data from multiple national surveys is an important step in building this infrastructure.
authors.affiliation: Susan T. Stewart is with the National Bureau of Economic Research (NBER), Cambridge, MA; she also performed this research in previous positions with the Harvard University Interfaculty Program for Health Systems Improvement (PHSI), and the Harvard Initiative for Global Health, Cambridge. David M. Cutler is with the Department of Economics, Harvard University, Harvard PHSI, and the NBER. Allison B. Rosen is with the Department of Quantitative Health Sciences and Meyer's Primary Care Institute, University of Massachusetts Medical School, Worcester, and the NBER.
authors.forename: Susan T
authors.initials: ST
authors.lastname: Stewart
authors.forename: David M
authors.initials: DM
authors.lastname: Cutler
authors.forename: Allison B
authors.initials: AB
authors.lastname: Rosen
mesh_terms: D000328:Adult; D000368:Aged; D044383:Black People; D005260:Female; D006801:Humans; D008017:Life Expectancy / Q000208:ethnology / Q000639:trends*; D008297:Male; D009765:Obesity / Q000453:epidemiology; D019057:Quality-Adjusted Life Years; D012907:Smoking / Q000453:epidemiology / Q000639:trends; D014481:United States / Q000453:epidemiology; D044465:White People; D001741:Black or African American
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