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Long-Term Effects of Health Factor Modification in Milwaukee County

Shi, Lu PhD; van Meijgaard, Jeroen PhD; Fielding, Jonathan E. MD, MPH, MBA

Journal of Public Health Management and Practice: March/April 2013 - Volume 19 - Issue 2 - p 133–138
doi: 10.1097/PHH.0b013e31825490cd
Original Articles

We use the UCLA Health Forecasting Tool to forecast the 2011–2050 health trends in Milwaukee County. We first simulate a baseline scenario (S-1) that assumes no health behavior change, and compare this with three simulated intervention scenarios: expansion of Quitline reach to enhance smoking cessation (S-2), an increased penetration of diabetes screening (S-3) and construction of additional recreational facilities (S-4). We compared the disease-free life years (DFLY) gained from each intervention scenario by 2050 on a year-by-year and cumulative basis. Simulation results show that increasing access to recreational facilities achieves the greatest gain in DFLYs for every year from 2011 to 2050. By 2050, the cumulative DFLY gain is 22 393, 5956 and 41 396 for S-2, S-3, and S-4, respectively. The cost-effectiveness ratios for Quitline expansion, diabetes screening, and recreational facility construction are $1802, $1285, and $1322, per DFLY gained, respectively.

This study describes health factors from different categories and simulation results of the long-term impact of modifying these health factors on disease-free life years. It also discusses the long-term cost-effectiveness of these interventions.

Departments of Health Services (Drs Shi, Meijgaard, and Fielding), Pediatrics (Dr Fielding), University of California Los Angeles, Los Angeles; and Los Angeles Department of Public Health, Los Angeles, California. At the time of publication, Dr. Lu Shi is an assistant professor in Department of Public Health Sciences, Clemson University, Clemson, SC

Correspondence: Lu Shi, PhD, Department of Public Health Sciences, Clemson University. 525 Edwards Hall. Clemson, SC 29634 (

Robert Wood Johnson Foundation supported this study. We also thank Dr. Patrick L Remington and Dr. Bridget Booske Catlin, from Population Health Institute at University of Wisconsin Madison.

The authors declare no conflicts of interest.

© 2013 Lippincott Williams & Wilkins, Inc.