Résumé :
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[BDSP. Notice produite par INIST-CNRS I7mBsR0x. Diffusion soumise à autorisation]. Objectives. We sought to quantify the potential health impact of selected medical and nonmedical policy changes within the United States. Methods. Using data from the 1997-2000 National Health Interview Surveys (linked to mortality data through 2002) and the 1996-2002 Medical Expenditure Panel Surveys, we calculated age-specific health-related quality-of-life scores and mortality probabilities for 8 social and behavioral risk factors. We then used Markov models to estimate the quality-adjusted life years lost. Results. Ranked quality-adjusted life years lost were income less than 200% of the poverty line versus 200% or greater (464 million ; 95% confidence interval [CI]=368,564) ; current-smoker versus never-smoker (329 million ; 95% CI=226,382) ; body mass index 30 or higher versus 20 to less than 25 (205 million ; 95% CI=159,269) ; non-Hispanic Black versus non-Hispanic White (120 million ; 95% CI=83,163) ; and less than 12 years of school relative to 12 or more (74 million ; 95% CI=52,101). Binge drinking, overweight, and health insurance have relatively less influence on population health. Conclusions. Poverty, smoking, and high-school dropouts impose the greatest burden of disease in the United States.
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