Health burden associated with unhealthy lifestyle behaviors in the general Chinese population

This study estimated and compared the loss in quality-adjusted life years (QALYs) associated with common unhealthy lifestyle behaviors in the general Chinese population.

A large-scale cross-sectional study was conducted using a self-report questionnaire among 21,909 Chinese residents (aged 12 years or older). We identified seven unhealthy lifestyle behaviors including drinking, smoking, sugar-sweetened beverage intake, breakfast skipping, prolonged sitting time, insufficient sleep duration, and poor sleep quality. In this survey, health utility of the participants was derived using the five-level EuroQol five-dimensional questionnaire (EQ-5D-5L). Regression models were used to analyze the effects of each unhealthy lifestyle behavior on health utility. The annual QALY loss per 100,000 persons was calculated for each condition, incorporating behavior prevalence and health utility data.

Among the seven behaviors, insufficient sleep duration (64.6%) and sugar-sweetened beverage intake (61.7%) were the most prevalent. All the assessed behaviors were associated with significantly reduced EQ-5D index scores, and poor sleep quality had the most profound impact on the index score (β = −0.066; 95% confidence interval (CI): −0.071, −0.062). Poor sleep quality had the largest annual QALY loss per 100,000 persons at −1082.4 (95% CI: −1164.4, −1016.8), followed by prolonged sitting time at −957.5 (95% CI : −1110.7 to −842.6) and breakfast skipping at −779.0 (95% CI: −943.0 to −656.0).

Sleep-related problems are prevalent among Chinese residents and are associated with a significant health burden. Therefore, greater attention should be paid to these issues, and effective prevention strategies need to be developed in the future.