Computing population-based estimates of health-adjusted life expectancy.

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 Outcomes Study are taken as weights. Actuarial life-table methods using community mortality 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 mortality experience. A Bayesian method is developed combining the local data with regional 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.