Gender differences in quality-adjusted survival using a Health-Utilities Index

Purpose: Women live longer than men but experience high morbidity during later years. We attempt to represent life expectancy with adjustments for quality of life for men and women in the United States. Data Sources: Survival estimates were obtained from Vital Statistics of the United States Life Tables. Quality-of-life data were obtained for 12,220 participants, aged 32–85 years, in the 1982–1984 National Health and Nutrition Examination Survey I Epidemiologic Follow-Up Study (NHEFS). Method: Using public data tapes, scores for the Health-Utilities Index (HUI) were imputed for NHEFS. These scores were calculated separately for men and women in the United States population and broken down by age. Using mortality data, the quality-adjusted life expectancy was calculated separately for men and women. Results: The current life expectancy among men aged 32 years was 39.45 years. For women aged 32 years it was 44.83 years, suggesting a 5.38 female life-expectancy advantage. The life expectancy, adjusted for quality of life, was 31.8 years for men versus 33.1 years for women. Adjustment for quality of life reduced the 5.38-year female advantage to 1.3 years. Conclusions: Although women enjoy longer life expectancies than do men, this advantage is reduced when quality adjustments are used. The finding reflects high levels of morbidity among older women.