Age-specific prevalence and years of healthy life in a system with three health states

Paula Diehr, David Yanez, Ann Derleth, Anne B. Newman

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Consider a 3-state system with one absorbing state, such as Healthy, Sick, and Dead. Over time, the prevalence of the Healthy state will approach an 'equilibrium' value that is independent of the initial conditions. We derived this equilibrium prevalence (Prev:Equil) as a function of the local transition probabilities. We then used Prev:Equil to estimate the expected number of years spent in the healthy state over time. This estimate is similar to the one calculated by multi-state life table methods, and has the advantage of having an associated standard error. In longitudinal data for older adults, the standard error was accurate when a valid survival table was known from other sources, or when the available data set was sufficient to estimate survival accurately. Performance was better with fewer waves of data. If validated in other situations, these estimates of prevalence and years of healthy life (YHL) and their standard errors may be useful when the goal is to compare YHL for different populations.

Original languageEnglish (US)
Pages (from-to)1371-1386
Number of pages16
JournalStatistics in Medicine
Issue number9
StatePublished - Apr 30 2008
Externally publishedYes


  • Multi-state lifetable
  • Prevalence
  • Self-rated health
  • Sullivan method
  • Variance for area under the curve
  • Years of healthy life

ASJC Scopus subject areas

  • Epidemiology
  • Statistics and Probability


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