JMIR Publications

ABSTRACT

Background:

The association between lifestyle risk factors and the risk of mortality and chronic diseases has been established, while limited research has explored the impact of healthy lifestyle factors on lifetime healthcare expenditure using longitudinal individual data.

Objective:

We aimed to determine the individual and combined effects of five healthy lifestyle factors on life expectancy and lifetime healthcare expenditure in Taiwan.

Methods:

Using data from the National Health Interview Survey assemble cohort, five healthy lifestyle behaviors were defined and analyzed: (nonsmoking, avoiding excessive alcohol consumption, engaging in sufficient physical activity, ensuring sufficient fruit and vegetable intake, and maintaining a normal weight). We employed a rolling extrapolation algorithm that incorporated inverse probability of treatment weighting to estimate the life expectancy and lifetime healthcare expenditure of the study populations with and without healthy lifestyle factors.

Results:

A total of 19,893 participants aged 30 years and older were included. During a median follow-up period of 15.6 years, 3,815 deaths occurred. The multivariable-adjusted hazard ratios for all-cause mortality in participants adhering to all five healthy lifestyle factors, compared with those adhering to none, were 0.37 (95% confidence interval, 0.27 to 0.49). The number of healthy lifestyle factors was linearly correlated with life expectancy and lifetime healthcare expenditure. Participants aged 30 and above (mean age: 48.8 years) who adhered to the five healthy lifestyle behaviors had a life gain of 7.13 (1.33 to 11.11) years compared with the life gain of individuals adhering to one or none of healthy lifestyle behaviors (life expectancy: 29.19 years, 25.45 to 33.62). Furthermore, individuals who adopted five healthy lifestyle factors had an annual average healthcare expenditure reduction by 28.12% (4.43% to 57.61%), compared to those who adopted one or none of these healthy lifestyle factors.

Conclusions:

Adopting a healthy lifestyle is associated with a longer life expectancy and a reduction of healthcare expenditure in Taiwanese adults. This contribute to a more comprehensive understanding of the impact of healthy lifestyle factors on the overall health and economic burden. This study may serve as a valuable reference for policymakers and stakeholders involved in the development and implementation of health policies, providing evidence-based guidance for decision-making.