Computing Population-based Estimates of Health-adjusted Life Expectancy

Abstract

Observed health-adjusted life expectancy (HALE) is an indicator of population health. There are a number of ways to compute HALE for a community. The authors surveyed several methods and demonstrate resulting variation in the estimates of HALE. Quality of well-being (QWB) measures from 1,430 participants in the Beaver Dam Health Out comes Study are taken as weights. Actuarial life-table methods using community mor tality data, State of Wisconsin census data from two time frames, and U.S. census data are used with the QWB to estimate HALE. Measurement of community population health using HALE computations can be completed with national, regional, or local data. Community-level estimates may not be well approximated using large-scale mor tality experience. A Bayesian method is developed combining the local data with re gional data. The Bayesian method creates a smooth set of rates, retains the local flavor of the community, and gives a measure of variability of the estimated HALE. Key words: quality-of-life measures; Bayesian methodology; Gibbs sampling. (Med Decis Making 1999;19:90-97)