US General Health Status

Life Expectancy (with International Comparison)

Life expectancy is a summary mortality measure often used to describe the overall health status of a population. Life expectancy is defined as the average number of years a population of a certain age would be expected to live, given a set of age-specific death rates in a given year.

Healthy People 2020 monitors 2 life expectancy measures:

• Life expectancy at birth
• Life expectancy at age 65

International Comparison of Life Expectancy

Life expectancy is one of the most commonly used measures for international health comparison. In 2007, the United States ranked 27th and 26th out of 33 countries within its peer group of Organization for Economic Co-operation and Development (OECD) countries for life expectancy at birth for females and males, respectively.

Healthy Life Expectancy

Healthy life expectancy is the average number of healthy years a person can expect to live if age-specific death rates and age-specific morbidity rates remain the same throughout his or her lifetime. Thus, healthy life expectancy is a snapshot of current death and illness patterns and can illustrate the long-range implications of the prevailing age-specific death and illness rates. The measure allows for easy comparisons across populations and over long periods of time.

Healthy People 2020 tracks healthy life expectancy using 3 measures:

• Expected years of life in good or better health
• Expected years of life free of limitation of activity
• Expected years of life free of selected chronic diseases

Years of Potential Life Lost (with International Comparison)

YPLL is a summary measure of premature mortality (early death). It represents the total number of years not lived by people who die before reaching a given age. Deaths among younger people contribute more to the YPLL measure than deaths among older people.

YPLL is based on the number of deaths at each age up to some limit. For example, in the United States, the age limit is often placed at 75, so people who die before age 75 are defined as having lost some potential years of life. YPLL has declined in the United States over the past few decades.

International Comparison of Years of Potential Life Lost

Although annual YPLL statistics have improved in the United States, they are often higher than those of comparable countries and even some less wealthy nations. For the 31 OECD countries for which recent data were available, the United States ranked 29th for females and 27th for males.

Years of Potential Life Lost by Cause of Death

YPLL can be calculated as deaths from all causes or as a cause-specific measure. In the United States, cancer is the second leading cause of death but accounts for the largest YPLL per 100,000 for both males and females. Deaths from motor vehicle accidents are the second leading cause of YPLL for both sexes.

Physically and Mentally Unhealthy Days

Physically and mentally unhealthy days measure the number of days in the past 30 days that individuals rated their physical or mental health as not good. In 2008, individuals in the United States reported on average 3.6 physically unhealthy days and 3.4 mentally unhealthy days in the past 30 days.

Physically unhealthy days increased with age. In 2008, adults ages 18 to 24 reported an average of 2.1 physically unhealthy days in the past 30 days, while adults age 75 and older reported 6.0 days.

Mentally unhealthy days decreased with age. In 2008, adults ages 18 to 24 reported an average of 4.0 mentally unhealthy days in the past 30 days, while adults age 75 and older reported 2.0 days.

Self-Assessed Health Status

Self-assessed health status is a measure of how an individual perceives his or her health—rating it as excellent, very good, good, fair, or poor. Self-assessed health status has been validated as a useful indicator of health for a variety of populations and allows for broad comparisons across different conditions and populations.1 In 2007, 9.5% of individuals in the United States reported their health to be fair or poor.

Self-assessed health status varies by age. For example, 26.8% of individuals age 65 and older report fair or poor health.

Limitation of Activity

Limitation of activity refers to a long-term reduction in a person’s ability to do his or her usual activities. Since 1997, in the National Health Interview Survey, limitation of activity has been assessed by asking people about their limitations in:

• Activities of daily living (such as bathing/showering, dressing, eating, getting in and out of bed, walking, using the toilet)
• Instrumental activities of daily living (such as using the telephone, doing light housework, doing heavy housework, preparing meals, shopping for personal items, managing money)
• Play, school, or work
• Remembering
• Any other activity that they cannot do because of limitations caused by physical, mental, or emotional problems
• In 2006, 5.5% of adults ages 18 to 44 had a limitation of activity, while 7.3% of children under age 18 and 32.6% of non-institutionalized adults age 65 and older had a limitation of activity.

Chronic Disease Prevalence

Chronic diseases are the leading cause of death and disability in the United States, causing 7 out of 10 deaths each year. Heart disease, cancer, and stroke alone cause more than 50% of all deaths each year.2

In 2008, 107 million Americans—almost 1 out of every 2 adults age 18 or older—had at least 1 of 6 reported chronic illnesses:

• Cardiovascular disease
• Arthritis
• Diabetes
• Asthma
• Cancer
• Chronic obstructive pulmonary disease (COPD)