目的： 本文档收集了 50 个计算器问题各自的权威来源。 基调： 谨慎、基于证据、非危言耸听。 目标受众： 有兴趣估算剩余预期寿命并改善生活习惯的最终用户。 免责声明： 这不是临床医疗建议。除非另有说明，所描述的关联均为观察性研究结果。
1. Current age
Calculator variable: age — 剩余预期寿命的最强基线驱动因素。
Why it matters: 年龄是剩余预期寿命的主要决定因素。国家统计机构提供的生命表显示，随着年龄增长，剩余寿命呈可预测的下降趋势，尽管下降速度因性别、国家和日历年份而异。基线估计值来自期间生命表，该表假设当前死亡率将持续到未来。
Recommended sources
Title: WHO Global Health Estimates — Life expectancy and healthy life expectancy
Publisher: World Health Organization
Year/date: 每年更新
Why useful: 提供所有 WHO 成员国标准化的预期寿命估计值和生命表，用作特定年龄剩余预期寿命的基线参考。
Evidence strength: High
Title: Human Mortality Database — Life tables for developed countries
URL: https://www.mortality.org/
Publisher: University of California, Berkeley (USA) & Max Planck Institute for Demographic Research (Germany)
Year/date: 持续更新
Why useful: 覆盖 40 多个国家的金标准统一生命表；可比较不同年龄段的特定死亡率模式。
Evidence strength: High
Title: OECD Data — Life expectancy at birth
URL: https://www.oecd.org/en/data/indicators/life-expectancy-at-birth.html
Publisher: Organisation for Economic Co-operation and Development
Year/date: Updated annually
Why useful: Direct OECD indicator page for comparable life expectancy at birth data across OECD countries, with definitions and downloadable data.
Evidence strength: High
Suggested reference text for website
您当前的年龄是剩余预期寿命最强的单一预测指标。我们使用 WHO 及其他统计机构的国家生命表建立基线：年龄越大，平均剩余寿命越短，但您的当前年龄与预期寿命之间的差距缩小速度可能比您想象的更慢。这被称为「死亡率减速」。
Notes / caveats
- 期间生命表假设当前死亡率保持不变，这可能低估未来的增长。
- 期间表未捕捉到队列效应（一生中医疗保健的改善）。
- 基线估计值因国家和性别而有显著差异。
2. Sex at birth
Calculator variable: sex — 仅用于人群层面精算基线差异。
Why it matters: 在几乎所有人群中，女性寿命始终长于男性，全球差距约为 4–7 年。这种差异源于生物学因素（激素、遗传、免疫系统差异）和行为/社会因素（冒险行为、就医行为、职业危害）的共同作用。计算器使用适度调整以反映这些精算差异。
Recommended sources
Title: WHO Global Health Observatory — Life expectancy and healthy life expectancy by sex
URL: https://www.who.int/data/gho/data/indicators/indicator-details/GHO/life-expectancy-at-birth-(years)
Publisher: World Health Organization
Year/date: 每年更新
Why useful: 提供全球按性别分列的预期寿命数据；显示各地区女性优势的一致性。
Evidence strength: High
Title: From sex differences to sex inequalities in life expectancy: A cross-country observational benchmarking analysis
URL: https://doi.org/10.1371/journal.pmed.1004828
Publisher: PLOS Medicine
Year/date: 2025
Why useful: 涵盖 237 个国家多个年龄段的预期寿命性别差异与不平等的跨国分析。
Evidence strength: High
Title: Our World in Data — Life expectancy by sex
URL: https://ourworldindata.org/life-expectancy
Publisher: Our World in Data / University of Oxford
Year/date: 每年更新
Why useful: 清晰、来源可靠的视觉化图表，展示性别差距如何随国家和时间变化。
Evidence strength: High
Suggested reference text for website
平均而言，在几乎所有国家，女性寿命均长于男性——全球差距约为 4–7 年。这反映了生物学因素（激素、遗传和免疫差异）与行为因素（冒险行为、医疗保健使用、职业危害）的综合作用。计算器会根据性别进行小幅精算调整，但个人习惯和健康远比这重要得多。
Notes / caveats
- 在调整行为与职业因素后，差距缩小。
- 双性人和非二元性别个体未纳入人群生命表。
- 该差距在不同国家间差异很大（从约 2 年到 10 年以上不等）。
3. Country and city where you live
Calculator variable: country — 国家和城市有助于通过医疗保健可及性、空气质量、安全、步行便利性、收入、污染和当地死亡率模式来优化估算。
Why it matters: 不同国家之间，甚至同一国家不同城市之间的预期寿命差异可达 10–20 年以上。关键驱动因素包括医疗体系质量与可及性、空气污染水平、暴力犯罪率、道路安全、步行便利性、收入水平和传染病负担。计算器基于已发布的寿命表使用国家特异性调整，并辅以基于可用空气质量、安全和健康数据的城市级调整。这些城市调整应视为近似代理指标，而非每个城市的精确精算表。
Recommended sources
Life expectancy
Title: WHO Global Health Observatory — Life expectancy at birth, by country
URL: https://www.who.int/data/gho/data/indicators/indicator-details/GHO/life-expectancy-at-birth-(years)
Publisher: World Health Organization
Year/date: 每年更新
Why useful: 国家层面预期寿命的标准参考，支持直接比较。
Evidence strength: High
Title: Human Mortality Database — Life tables for developed countries
URL: https://www.mortality.org/
Publisher: University of California, Berkeley & Max Planck Institute for Demographic Research
Year/date: 持续更新
Why useful: 金标准统一生命表，支持 40 多个国家年龄特异性死亡率模式的比较。
Evidence strength: High
Air pollution
Title: WHO Ambient Air Quality Database, update Jan 2024, Version 6.1
URL: https://www.who.int/data/gho/data/themes/air-pollution/who-air-quality-database
Publisher: World Health Organization
Year/date: 2024
Why useful: Specific WHO city and country air-quality database covering PM₂.₅ and other pollutant levels, used as a directional input for pollution-related mortality context.
Evidence strength: High
Safety and road risk
Title: WHO Global Status Report on Road Safety 2023
URL: https://www.who.int/publications/i/item/9789240086517
Publisher: World Health Organization
Year/date: 2023
Why useful: 国家级道路交通死亡率数据，是不同地点外因死亡率变化的主要组成部分。
Evidence strength: High
Subnational variation
Title: GBD Results Tool — life expectancy and mortality by location
URL: https://vizhub.healthdata.org/gbd-results/
Publisher: Institute for Health Metrics and Evaluation (IHME)
Year/date: Updated regularly
Why useful: Interactive GBD tool for filtering mortality, rates, causes, locations, years, sex, and age groups; useful for checking location-level mortality context.
Evidence strength: High
Title: Our World in Data — Life expectancy by country
URL: https://ourworldindata.org/grapher/life-expectancy-at-birth
Publisher: Our World in Data / University of Oxford
Year/date: 每年更新
Why useful: 全球及次国家级预期寿命数据清晰、易用的可视化图表，附有来源链接。
Evidence strength: High
Suggested reference text for website
您居住的地方对您的预期寿命有重大影响。不同国家之间的国民预期寿命差异超过 20 年，其驱动因素包括医疗保健、污染、安全、收入和生活方式模式的差异。即使在同一个国家内，城市层面的差异也可能达到数年。我们的城市调整基于已发布的预期寿命数据、空气质量指数和安全统计数据，但应视为近似值。
Notes / caveats
- 国家层面的平均值掩盖了巨大的国内差异（城市与农村、富裕与贫困地区）。
- 计算器使用一组精选城市；同一国家内的其他地点可能有所不同。
- 各国数据质量和报告标准存在差异。
4. Smoking status
Calculator variable: smoking — 烟草暴露是最大可改变的长寿因素之一。
Why it matters: 吸烟是全球可预防的过早死亡的首要原因。它与肺癌、心血管疾病、COPD 及多种其他疾病有因果关系。曾经吸烟者可逐渐降低超额风险，但完全风险逆转需要多年时间，且取决于累积暴露量。计算器区分从不吸烟者、曾经吸烟者、偶尔吸烟者和每日吸烟者。
Recommended sources
Title: The Health Consequences of Smoking — 50 Years of Progress: A Report of the Surgeon General
URL: https://www.ncbi.nlm.nih.gov/books/NBK179276/
Publisher: U.S. National Library of Medicine / CDC (NCBI Bookshelf)
Year/date: 2014
Why useful: 数十年吸烟危害证据的综合总结；死亡率影响估算的金标准参考。
Evidence strength: High
Title: WHO global report on trends in prevalence of tobacco use 2000–2024 and projections 2025–2030, sixth edition
URL: https://www.who.int/publications/i/item/9789240116276
Publisher: World Health Organization
Year/date: 2025
Why useful: 世界卫生组织关于烟草使用趋势和预测的最新全球报告，取代了较早的2000–2025年版。
Evidence strength: High
Title: Smoking and mortality — beyond established causes
URL: https://www.nejm.org/doi/full/10.1056/NEJMsa1407211
Publisher: New England Journal of Medicine
Year/date: 2015
Why useful: 利用大型合并队列量化吸烟在已知原因之外的超额死亡率。
Evidence strength: High
Suggested reference text for website
吸烟是导致过早死亡的最大单一可改变风险因素。研究估计，每日吸烟者比从不吸烟者寿命缩短约 6–10 年，具体因吸烟量和开始吸烟年龄而异。好消息是：在任何年龄戒烟都能降低超额风险，曾经吸烟者的预期寿命会随时间推移部分恢复。
Notes / caveats
- 估算值因吸烟量、开始吸烟年龄和戒断持续时间而异。
- 曾经吸烟者的残留风险取决于累积暴露量和戒烟时间。
- 因果关系已充分确立（不仅仅是观察性研究）。
5. Body mass index (BMI)
Calculator variable: bmi — 体成分可优化估算。
Why it matters: 在大型流行病学研究中，低 BMI（体重过轻）和高 BMI（肥胖）均与死亡率风险增加相关。该关系呈 J 形，大多数人群的最低死亡率通常出现在 22–25 kg/m² 范围内。腹部脂肪分布可能更具预测性，但 BMI 仍然是研究最广泛、最易获得的指标。
Recommended sources
Title: Body-mass index and all-cause mortality: individual-participant-data meta-analysis of 239 prospective studies (The Global BMI Mortality Collaboration)
URL: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)30175-1/fulltext
Publisher: The Lancet
Year/date: 2016
Why useful: 涵盖四大洲的大规模荟萃分析（1060 万参与者），量化 BMI 与死亡率的关联。
Evidence strength: High
Title: WHO Fact Sheet — Obesity and overweight
URL: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
Publisher: World Health Organization
Year/date: 2024 年更新
Why useful: WHO 关于 BMI 分类及相关健康风险的官方参考。
Evidence strength: High
Title: Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019
URL: https://doi.org/10.1016/S0140-6736(20)30752-2
Publisher: The Lancet / Global Burden of Disease
Year/date: 2020
Why useful: GBD 2019综合风险因素分析，涵盖204个国家和地区的高体重指数。
Evidence strength: High
Suggested reference text for website
您的体重指数是总体死亡风险的一个广泛研究的预测指标。极低和极高的 BMI 均与预期寿命缩短相关，最低风险通常出现在 22–25 范围内。这些估计来自涉及数百万参与者的国际大型荟萃分析。
Notes / caveats
- BMI 不区分肌肉和脂肪；运动员可能被错误分类。
- 最佳 BMI 可能随年龄增长而上移（「肥胖悖论」存在争议）。
- 腰围可能是更强的风险预测指标（参见腰围身高比问题）。
6. Weekly physical activity
Calculator variable: activity — 包括快走、骑自行车、运动、健身房、主动通勤或类似强度的活动。
Why it matters: 体力活动是可改变的长寿因素中最有力的之一。达到 WHO 指南（每周 150–300 分钟中等强度活动）可使全因死亡率降低 20–30%。更高活动量可带来额外收益，但证据表明在非常高活动量时收益可能趋于稳定而非逆转。
Recommended sources
Title: WHO Guidelines on Physical Activity and Sedentary Behaviour
URL: https://www.who.int/publications/i/item/9789240015128
Publisher: World Health Organization
Year/date: 2020
Why useful: 官方全球建议；总结了体力活动与死亡率之间剂量反应关系的证据。
Evidence strength: High
Title: Dose-response associations between accelerometry measured physical activity and sedentary time and all cause mortality
URL: https://doi.org/10.1136/bmj.l4570
Publisher: The BMJ
Year/date: 2019
Why useful: Device-measured activity study supporting dose-response associations between physical activity, sedentary time, and all-cause mortality without relying only on self-report.
Evidence strength: High
Title: Physical Activity Guidelines for Americans (2nd edition)
URL: https://health.gov/sites/default/files/2019-09/Physical_Activity_Guidelines_2nd_edition.pdf
Publisher: U.S. Department of Health and Human Services
Year/date: 2018
Why useful: 体力活动与降低全因死亡率、CVD、糖尿病和癌症相关证据的全面综述。
Evidence strength: High
Suggested reference text for website
定期体力活动与更长的寿命密切相关。达到 WHO 指南（每周 150–300 分钟中等强度活动）的成年人，其早逝风险比不活动者低 20–30%。更多的活动通常带来更多收益，但证据表明在非常高的活动量时收益可能趋于稳定而非逆转。
Notes / caveats
- 自我报告的活动水平往往高估实际水平。
- 收益在不同年龄、性别和族裔群体中具有一致性。
- 即使是最久坐人群中少量的活动增加也能产生有意义的风险降低。
7. Overall diet pattern
Calculator variable: diet — 地中海式、最低加工、高纤维饮食通常得分更高。
Why it matters: 富含全植物性食物、健康脂肪且超加工食品含量低的饮食模式，始终与较低的全因死亡率、心血管疾病和癌症风险相关。地中海饮食是在长寿结局方面研究最为广泛的饮食模式。
Recommended sources
Title: Association of changes in diet quality with total and cause-specific mortality (NHS / HPFS)
URL: https://www.nejm.org/doi/full/10.1056/NEJMoa1613502
Publisher: New England Journal of Medicine
Year/date: 2017
Why useful: 证明在 12 年内改善饮食质量与后续死亡率降低相关。
Evidence strength: High
Title: Global Burden of Disease — Health effects of dietary risks in 195 countries (GBD 2017 Diet Collaborators)
URL: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)30041-8/fulltext
Publisher: The Lancet
Year/date: 2019
Why useful: 饮食归因死亡率的全球综合估算；强调低全谷物、高钠和低水果摄入是主要饮食风险。
Evidence strength: High
Title: The Mediterranean diet and health: a comprehensive overview
URL: https://pubmed.ncbi.nlm.nih.gov/34423871/
Publisher: Journal of Internal Medicine
Year/date: 2021
Why useful: 涵盖心血管、癌症、代谢和死亡率相关结局的地中海饮食证据的广泛同行评审综述。
Evidence strength: High
Suggested reference text for website
您日常的饮食是最重要的长寿杠杆之一。富含全植物性食物、健康脂肪和纤维的饮食——如地中海饮食——始终与较低的死亡风险相关。相反，大量摄入超加工食品则与较高风险相关。
Notes / caveats
- 饮食评估依赖自我报告，存在测量误差。
- 整体饮食模式比单一营养素更易于研究，但仍可能存在残余混杂。
- 收益可能反映了累积的长期暴露。
8. Average sleep duration
Calculator variable: sleep — 长期睡眠规律性和时长影响代谢和心血管风险。
Why it matters: 在前瞻性队列的荟萃分析中，短时间（<6 小时）和长时间（>9 小时）的习惯性睡眠时长均与全因死亡率增加相关。最低风险一致出现在每晚约 7–8 小时。因果机制包括代谢失调、炎症和心血管压力。
Recommended sources
Title: Sleep duration and all-cause mortality: a systematic review and meta-analysis of prospective studies
URL: https://academic.oup.com/sleep/article/33/5/585/2453896
Publisher: Sleep (Oxford Academic) / NIH
Year/date: 2010
Why useful: 16 项前瞻性研究的荟萃分析，显示 U 形关联；短睡眠和长睡眠均增加死亡风险。
Evidence strength: High
Title: CDC Sleep and Sleep Disorders — How Much Sleep Do You Need?
URL: https://www.cdc.gov/sleep/about/index.html
Publisher: U.S. Centers for Disease Control and Prevention
Year/date: 2024 年更新
Why useful: 官方公共卫生建议及支持证据。
Evidence strength: High
Title: Recommended Amount of Sleep for a Healthy Adult: A Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society
URL: https://doi.org/10.5665/sleep.4716
Publisher: Sleep
Year/date: 2015
Why useful: 基于系统性证据审查的共识性建议，即成年人每晚应至少睡眠7小时。
Evidence strength: High
Suggested reference text for website
睡眠时长与死亡率呈 U 形关系：过少（不足 6 小时）和过多（超过 9 小时）均与较高风险相关。七到八小时似乎是大多数成年人的最佳时长。睡眠质量和规律性与时长同样重要。
Notes / caveats
- 长睡眠可能是潜在疾病的标志（反向因果）而非直接原因。
- 睡眠质量是重要的混杂因素，仅靠时长无法捕捉。
- 存在个体差异；有些人睡眠较少也能正常生活而无明显损害。
9. Blood pressure status
Calculator variable: blood_pressure — 若您了解，请使用治疗或未治疗状态。
Why it matters: 血压升高是全球心血管疾病和过早死亡的首要可改变风险因素。收缩压每增加 20 mmHg，心血管死亡风险即翻倍。治疗可有效降低风险，但接受治疗者与自然血压正常者相比仍有一定程度的风险升高。
Recommended sources
Title: Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021
URL: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00933-4/fulltext
Publisher: The Lancet / Global Burden of Disease Study
Year/date: 2024
Why useful: GBD risk-factor analysis quantifying high systolic blood pressure as one of the leading contributors to global disease burden and mortality.
Evidence strength: High
Title: WHO Fact Sheet — Hypertension
URL: https://www.who.int/news-room/fact-sheets/detail/hypertension
Publisher: World Health Organization
Year/date: 2023 年更新
Why useful: 全球高血压患病率、风险和治疗的权威概述。
Evidence strength: High
Title: Age-specific relevance of usual blood pressure to vascular mortality (Prospective Studies Collaboration)
URL: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(02)11911-8/fulltext
Publisher: The Lancet
Year/date: 2002
Why useful: 里程碑式的 100 万成年人荟萃分析，显示血压与死亡率在低至 115/75 mmHg 范围内呈对数线性关系。
Evidence strength: High
Suggested reference text for website
高血压是全球范围内导致过早死亡的最大单一因素。血压与死亡率之间的关系是连续的：即使是中度升高也会增加心血管风险。治疗可以降低但无法完全消除这种超额风险。
Notes / caveats
- 单次读数不能作为诊断依据；计算器询问的是总体状态。
- 经治疗的高血压与血压正常者相比仍存在残留风险。
- 血压目标值因年龄和合并症而异；近期各组织的指南有所不同。
10. Major chronic disease
Calculator variable: diagnoses — 包括已诊断的心脏病、癌症、糖尿病、COPD、肾脏疾病或中风。
Why it matters: 重大慢性疾病的诊断会显著降低预期寿命，但其影响程度因疾病类型、严重程度和管理质量而异。管理良好的单一疾病的影响远小于多种或控制不佳的疾病。这些是计算器使用的最强预测指标之一。
Recommended sources
Title: Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021
URL: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00367-2/fulltext
Publisher: The Lancet / Global Burden of Disease Study
Year/date: 2024
Why useful: Cause-specific mortality and life expectancy decomposition reference for major diseases by age, sex, location, and year.
Evidence strength: High
Title: WHO Fact Sheet — Cardiovascular diseases (CVDs)
URL: https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)
Publisher: World Health Organization
Year/date: Updated regularly
Why useful: Direct WHO fact sheet for the largest chronic-disease mortality category; used as an institutional context source alongside GBD and multimorbidity evidence.
Evidence strength: High
Title: Relationship between multimorbidity, demographic factors and mortality: findings from the UK Biobank cohort
URL: https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-019-1305-x
Publisher: BMC Medicine
Year/date: 2019
Why useful: 大型英国生物银行队列研究，量化多病共存和人口统计学因素与死亡风险的关系。
Evidence strength: High
Suggested reference text for website
重大慢性疾病的诊断——如心脏病、癌症、糖尿病、COPD、肾脏疾病或中风——会显著影响预期寿命。影响程度取决于具体疾病、管理状况以及是否存在多种疾病。控制良好的单一疾病的影响远小于多种或控制不佳的疾病。
Notes / caveats
- 自我报告的诊断可能不准确；计算器要求仅报告正式诊断的疾病。
- 「管理良好」是自我评估，可能与临床指标不一致。
- 「不愿透露」选项允许在不受惩罚的情况下跳过。
11. Alcohol intake
Calculator variable: alcohol — 平均每周饮酒模式。
Why it matters: 饮酒与多种癌症、肝脏疾病、心血管疾病和事故有因果关系。近期大规模研究对适度饮酒的保护作用提出了质疑，提示任何酒精摄入都可能增加总体死亡风险，尽管在高摄入量水平下风险梯度最为陡峭。
Recommended sources
Title: Global Burden of Disease — Alcohol use and burden for 195 countries (GBD 2016 Alcohol Collaborators)
URL: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31310-2/fulltext
Publisher: The Lancet
Year/date: 2018
Why useful: 大规模分析得出结论，任何水平的饮酒均不能改善健康；最安全的水平是零。
Evidence strength: High
Title: WHO Fact Sheet — Alcohol
URL: https://www.who.int/news-room/fact-sheets/detail/alcohol
Publisher: World Health Organization
Year/date: 2024 年更新
Why useful: WHO 关于酒精作为致癌物及死亡率和疾病负担因素的官方立场。
Evidence strength: High
Title: Association Between Daily Alcohol Intake and Risk of All-Cause Mortality
URL: https://doi.org/10.1001/jamanetworkopen.2023.6185
Publisher: JAMA Network Open
Year/date: 2023
Why useful: 更新的系统综述和荟萃分析显示，少量饮酒没有显著的保护性关联，较高摄入量则死亡风险增加。
Evidence strength: High
Suggested reference text for website
饮酒与癌症、肝脏疾病和心血管疾病风险增加相关。越来越多的证据表明，不存在完全零风险的饮酒水平。重度饮酒和酗酒模式尤其具有较高的死亡风险。
Notes / caveats
- 「J 形曲线」（提示低剂量有益）存在争议，可能反映了社会经济地位和健康状况的混杂因素。
- 饮酒模式（酗酒与规律适量）与总摄入量同等重要。
- 计算器询问的是平均每周模式，而非精确单位。
12. Hours sitting per day
Calculator variable: sitting — 工作、通勤和休闲时间合计。
Why it matters: 长时间久坐与全因死亡率、心血管疾病和糖尿病风险增加相关，且独立于体力活动水平。风险在 >8 小时/天时最为显著，高水平的体力活动可部分缓解该风险。
Recommended sources
Title: Sedentary Time and Its Association With Risk for Disease Incidence, Mortality, and Hospitalization in Adults: A Systematic Review and Meta-analysis
URL: https://www.acpjournals.org/doi/10.7326/M14-1651
Publisher: Annals of Internal Medicine
Year/date: 2015
Why useful: Meta-analysis of 47 studies showing higher disease incidence, mortality, and hospitalization risk with prolonged sedentary time, with risk attenuated but not eliminated by physical activity.
Evidence strength: High
Title: WHO Guidelines on Physical Activity and Sedentary Behaviour (Chapter on sedentary behaviour)
URL: https://www.who.int/publications/i/item/9789240015128
Publisher: World Health Organization
Year/date: 2020
Why useful: 官方指南建议限制久坐时间，并以任何强度的活动替代。
Evidence strength: High
Suggested reference text for website
长时间久坐与更高的死亡风险相关，即使对于定期运动的人也是如此。风险随每日总久坐时间的增加而上升，尤其在超过 8 小时之后。在一天中用轻度活动打断久坐时间可能有助于降低这一风险。
Notes / caveats
- 久坐时间估算为自我报告，常被低估。
- 与体力活动的交互作用复杂：高活动量可缓冲但无法消除久坐风险。
- 久坐的类型（如主动与被动屏幕时间）可能有关。
13. Average daily steps
Calculator variable: steps — 手机/手表估算即可。
Why it matters: 每日步数是总日常活动量的一个直观、可通过设备测量替代指标。使用加速度计数据的大型研究显示一种非线性剂量反应关系：死亡风险持续下降至约 8,000–12,000 步/天，此后收益递减。
Recommended sources
Title: Association of Daily Step Count and Step Intensity With Mortality Among US Adults
URL: https://jamanetwork.com/journals/jama/fullarticle/2763292
Publisher: JAMA
Year/date: 2020
Why useful: 大型NHANES加速度计研究显示，较高的每日步数与较低的全因死亡率相关。
Evidence strength: High
Title: Daily step count and all-cause mortality: a dose-response meta-analysis of 15 international cohorts
URL: https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(21)00302-9/fulltext
Publisher: The Lancet Public Health
Year/date: 2022
Why useful: 15 个队列（约 50,000 名参与者）的荟萃分析，确认步数与死亡率之间的负相关关系。
Evidence strength: High
Suggested reference text for website
每日步数是估算您总每日活动量的简单方法。使用计步器的研究表明，死亡风险持续下降至大约每天 10,000 步。即使在低基线水平上适度增加也能产生有意义的收益。
Notes / caveats
- 手机和手表的步数计数相当准确，但非临床级别。
- 步数强度（步频）可能带来超出总步数的额外收益。
- 收益在高步数水平上趋于平稳。
14. Strength training
Calculator variable: strength — 抗阻训练、健美操、负重工作或同等活动。
Why it matters: 肌肉力量和肌肉量与全因死亡率呈负相关。抗阻训练独立于有氧活动降低死亡风险。它还有助于维持代谢健康、骨密度和老年时的功能独立性。
Recommended sources
Title: Muscle-strengthening activities are associated with lower risk and mortality in major non-communicable diseases: a systematic review and meta-analysis of cohort studies
URL: https://doi.org/10.1136/bjsports-2021-105061
Publisher: British Journal of Sports Medicine (BMJ)
Year/date: 2022
Why useful: 大型荟萃分析显示，增肌活动与 10–20% 的全因死亡率降低相关，独立于有氧活动。
Evidence strength: High
Title: Muscular strength in male adolescents and premature death: cohort study of 1 million participants
URL: https://www.bmj.com/content/345/bmj.e7279
Publisher: The BMJ
Year/date: 2012
Why useful: 大型队列显示青少年肌肉力量与后期死亡率之间的负相关关系。
Evidence strength: High
Suggested reference text for website
力量训练——无论是使用负重、体重练习还是弹力带——与较低的死亡风险相关，且独立于有氧运动。每周两次似乎足以看到效果。维持肌肉力量也有助于晚年保持活动能力和健康。
Notes / caveats
- 不同研究对「抗阻训练」的定义不同，使得剂量反应估算为近似值。
- 力量训练的收益部分通过瘦体重的维持来介导。
- 有氧+抗阻训练联合可能最为理想。
15. Cardiorespiratory fitness
Calculator variable: vo2 — 相对于同龄人。
Why it matters: 在多项队列研究中，心肺适能（VO₂max）是死亡率的强预测因子。运动能力每增加 1-MET，死亡风险约降低 10–15%。
Recommended sources
Title: Exercise capacity and mortality among men referred for exercise testing (The Cleveland Clinic study)
URL: https://www.nejm.org/doi/full/10.1056/NEJMoa011858
Publisher: New England Journal of Medicine
Year/date: 2002
Why useful: 里程碑式研究显示运动能力是比已确立的风险因素更强的死亡率预测因子。
Evidence strength: High
Title: Cardiorespiratory fitness and mortality from all causes, cardiovascular disease and cancer: dose–response meta-analysis of cohort studies
URL: https://doi.org/10.1136/bjsports-2021-104876
Publisher: British Journal of Sports Medicine (BMJ)
Year/date: 2022
Why useful: 剂量反应荟萃分析确认心肺适能与全因、CVD 和癌症死亡率之间存在强烈的负相关关系。
Evidence strength: High
Suggested reference text for website
您的心肺健康程度——心肺适能——是长寿的最强预测因子之一，甚至可能比吸烟或高血压等标准风险因素更强。即使是适度的健康改善也与死亡风险的有意义降低相关。
Notes / caveats
- VO₂max 很少被直接测量；与同龄人的自我评估为近似值。
- 适能部分由遗传决定，但通过训练高度可改变。
- 该问题旨在作为无测量值用户的自我评估。
16. Waist-to-height risk
Calculator variable: waist — 若腰围超过身高的一半，风险通常更高。
Why it matters: 在许多研究中，腰围身高比（WHtR）比 BMI 更能反映腹部肥胖。腰围超过身高的一半被视为心血管代谢风险增加的有效筛查阈值。WHtR 可能是比 BMI 更强的死亡率预测因子，尤其在老年人中。
Recommended sources
Title: Waist-to-height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: systematic review and meta-analysis
URL: https://onlinelibrary.wiley.com/doi/full/10.1111/j.1467-789X.2011.00952.x
Publisher: Obesity Reviews (Wiley)
Year/date: 2012
Why useful: Systematic review and meta-analysis supporting waist-to-height ratio as a screening tool and the practical “waist less than half height” rule.
Evidence strength: High
Title: Central fatness and risk of all cause mortality: systematic review and dose-response meta-analysis of 72 prospective cohort studies
URL: https://doi.org/10.1136/bmj.m3324
Publisher: The BMJ
Year/date: 2020
Why useful: 涵盖中心性肥胖指标（包括腰围身高比）与全因死亡率的大型系统综述和剂量反应荟萃分析。
Evidence strength: High
Suggested reference text for website
您身体脂肪的分布位置很重要。腰围超过身高的一半与较高的心血管代谢风险相关，即使您的 BMI 正常。这一简单的比值是一个有广泛研究支持的实用筛查工具。
Notes / caveats
- 腰围由用户自行报告，可能不精确。
- WHtR 是筛查工具，而非诊断指标。
- 0.5 的阈值是人群层面的指导值，而非个人的绝对截断值。
17. Family longevity
Calculator variable: family — 父母或祖父母活到 80 多岁/90 多岁且无明显残疾。
Why it matters: 父母长寿是个体长寿的最强预测因子之一，部分反映共享遗传因素，部分反映共享环境和健康行为。父母活到 90 多岁的人在所有主要死亡原因中的死亡率均显著较低。
Recommended sources
Title: Health and function of participants in the Long Life Family Study: A comparison with other cohorts
URL: https://pubmed.ncbi.nlm.nih.gov/21258136/
Publisher: Aging
Year/date: 2011
Why useful: 长寿家庭研究的比较，描述了长寿家族成员的健康和功能模式。
Evidence strength: High
Title: Parental longevity and mortality risk in offspring: the Framingham Heart Study
URL: https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.111.089060
Publisher: Circulation (American Heart Association)
Year/date: 2012
Why useful: 前瞻性研究显示父母活到 85 岁以上与后代死亡率显著降低相关。
Evidence strength: High
Suggested reference text for website
拥有活到 80 多岁或 90 多岁且无明显残疾的父母或祖父母，与您自己活得更长的概率更高相关。这反映了共享遗传、家庭健康习惯和社会经济环境的综合作用。
Notes / caveats
- 长寿为中度可遗传（估计值为 15–30%）。
- 父母长寿可能受共享环境的混杂影响，难以与遗传因素分离。
- 没有家族长寿史并不排除通过健康行为实现个体长寿。
18. Social connection
Calculator variable: social — 与朋友、家人、伴侣或社区有规律的支持性接触。
Why it matters: 社会孤立和孤独感与全因死亡率增加相关——在某些荟萃分析中，其效应量与吸烟和肥胖相当。机制包括直接的生理效应（炎症、应激反应）和行为途径（较低的健康维护、延迟就医）。
Recommended sources
Title: Social relationships and mortality risk: a meta-analytic review
URL: https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1000316
Publisher: PLOS Medicine
Year/date: 2010
Why useful: 148 项研究的荟萃分析显示，社会关系较强者的生存几率提高 50%。
Evidence strength: High
Title: Social isolation and loneliness among older people: advocacy brief
URL: https://www.who.int/publications/i/item/9789240030749
Publisher: World Health Organization
Year/date: 2021
Why useful: 世界卫生组织官方倡导简报，确认社会隔离和孤独是老年人的重要健康风险。
Evidence strength: High
Suggested reference text for website
强大的社会关系——与朋友、家人或社区——始终与更长的寿命相关。在某些研究中，与社会孤立相关的死亡风险可与吸烟或肥胖相媲美。社会关系似乎通过多种途径同时有益于心理健康和身体健康。
Notes / caveats
- 社会关系为自我报告，具有多维性（结构、功能、质量）。
- 因果方向存在争议：更健康的人可能社交更活跃。
- 孤独感（主观）和孤立（客观）是不同但相关的概念。
19. Chronic stress
Calculator variable: stress — 压力感觉持续或难以恢复的频率。
Why it matters: 慢性心理压力会激活下丘脑-垂体-肾上腺（HPA）轴和交感神经系统，导致加速的生物衰老、心血管疾病、代谢功能障碍和免疫抑制。感知压力量表是健康结局的良好验证预测指标。
Recommended sources
Title: Allostatic Load and Mortality: A Systematic Review and Meta-Analysis
URL: https://doi.org/10.1016/j.amepre.2022.02.003
Publisher: American Journal of Preventive Medicine
Year/date: 2022
Why useful: 系统综述和荟萃分析，将高适应性负荷（一种累积压力负担的衡量指标）与全因死亡率联系起来。
Evidence strength: High
Title: Psychological stress and cardiovascular disease (INTERHEART study)
URL: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(04)17019-0/fulltext
Publisher: The Lancet
Year/date: 2004
Why useful: 涵盖 52 个国家的大型病例对照研究，显示心理社会压力是心肌梗死的重要风险因素。
Evidence strength: High
Suggested reference text for website
感觉难以恢复的长期压力与健康风险增加相关，包括心血管疾病和加速的生物衰老。当身体的应激反应系统持续激活时，可能影响几乎每一个器官系统。
Notes / caveats
- 压力感知高度主观；相同的客观负荷对不同个体的影响不同。
- 该关系是双向的：健康状况差增加压力，压力恶化健康状况。
- 应对资源和社会支持调节压力的影响。
20. Mental health stability
Calculator variable: mental_health — 情绪、焦虑、目标感和日常功能能力。
Why it matters: 心理健康状况——特别是抑郁症和焦虑症——与全因死亡率增加相关，部分通过直接生理效应，部分通过行为途径（体力活动减少、饮食不良、吸烟、治疗依从性降低），部分通过自杀风险增加。
Recommended sources
Title: Comprehensive Meta-Analysis of Excess Mortality in Depression in the General Community Versus Patients With Specific Illnesses
URL: https://psychiatryonline.org/doi/10.1176/appi.ajp.2013.13030325
Publisher: American Journal of Psychiatry
Year/date: 2014
Why useful: 荟萃分析量化了社区和特定疾病人群中与抑郁症相关的超额死亡率。
Evidence strength: High
Title: WHO Mental Health and Substance Use
URL: https://www.who.int/health-topics/mental-health
Publisher: World Health Organization
Year/date: 定期更新
Why useful: WHO 关于全球心理健康负担的官方参考。
Evidence strength: High
Suggested reference text for website
心理健康与身体健康和寿命密切相关。抑郁症和慢性焦虑与较高的全因死亡率相关，但这种关系是复杂的，涉及生物学和行为途径。寻求心理健康支持可以同时改善生活质量和身体健康结局。
Notes / caveats
- 心理健康为自我评估；该问题不是诊断工具。
- 治疗可显著改善结局；管理良好的疾病风险低得多。
- 自杀是严重未经治疗的抑郁症的直接死亡原因。
21. Preventive care
Calculator variable: preventive — 体检、筛查、疫苗接种、牙科护理和早期治疗。
Why it matters: 定期预防性护理有助于早期发现可治疗疾病、更好地管理慢性疾病以及提高疫苗接种率——所有这些都可降低死亡率。然而，健康成年人年度常规体检的证据好坏参半；基于年龄、性别和风险状况的针对性筛查更有力支持。
Recommended sources
Title: General health checks in adults for reducing morbidity and mortality from disease
URL: https://pmc.ncbi.nlm.nih.gov/articles/PMC6353639/
Publisher: Cochrane Database of Systematic Reviews
Year/date: 2019
Why useful: Cochrane系统综述显示，在广泛的成年人群中，一般健康检查对死亡率的降低有限或没有影响，支持对预防性护理益处的谨慎解释。
Evidence strength: Medium
Title: WHO — Primary health care
URL: https://www.who.int/health-topics/primary-health-care
Publisher: World Health Organization
Year/date: 定期更新
Why useful: WHO 关于预防性健康服务、筛查和初级保健的官方框架。
Evidence strength: High
Title: U.S. Preventive Services Task Force (USPSTF) Recommendations
URL: https://www.uspreventiveservicestaskforce.org/uspstf/
Publisher: U.S. Preventive Services Task Force
Year/date: 定期更新
Why useful: 基于证据的临床预防服务建议；筛查指南的金标准。
Evidence strength: High
Suggested reference text for website
定期预防性护理——包括适龄筛查、疫苗接种和牙科就诊——有助于及早发现健康问题并更好地管理已有疾病。虽然健康成年人年度体检的证据好坏参半，但基于年龄和风险因素的针对性预防护理是有充分支持的。
Notes / caveats
- 预防性护理的可及性因国家和保险状况而异。
- 过度筛查可能导致伤害（假阳性、过度诊断）——建议在收益与伤害之间取得平衡。
- 该问题捕捉的是总体倾向，而非具体的指南依从性。
22. Cholesterol risk
Calculator variable: cholesterol — LDL/非-HDL 状态或已知血脂风险。
Why it matters: 低密度脂蛋白胆固醇升高是动脉粥样硬化性心血管疾病的已确凿因果风险因素，而心血管疾病是全球首要死因。降脂治疗（他汀类药物、生活方式）在一级和二级预防中均可显著减少心血管事件和死亡率。
Recommended sources
Title: 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk
URL: https://doi.org/10.1093/eurheartj/ehz455
Publisher: European Heart Journal
Year/date: 2019
Why useful: 总结 LDL-C 和血脂调整以降低心血管风险证据的主要临床指南。
Evidence strength: High
Title: WHO Fact Sheet — Cardiovascular diseases (CVDs)
URL: https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)
Publisher: World Health Organization
Year/date: 2024 年更新
Why useful: CVD 作为全球首要死因的概述，胆固醇是关键风险因素。
Evidence strength: High
Suggested reference text for website
低密度脂蛋白胆固醇升高是心血管疾病（全球首要死因）的一个已确凿风险因素。通过饮食、运动或药物（在适应症下）降低 LDL 可减少心血管风险。胆固醇与死亡率之间的关系是连续的，而非基于阈值。
Notes / caveats
- 总胆固醇本身不能反映 LDL/HDL/甘油三酯的完整情况。
- 该问题询问的是对血脂状况的自我了解，可能不精确。
- 胆固醇在老年时的作用有所不同；在非常年长者中关联减弱。
23. Glucose / diabetes status
Calculator variable: glucose — 若已知，请使用 A1C、空腹血糖或诊断结果。
Why it matters: 糖尿病是失明、肾衰竭、心脏病发作、中风和下肢截肢的主要原因。控制不良的糖尿病会显著降低预期寿命，而管理良好的糖尿病影响则小得多。糖尿病前期也伴有升高的心血管风险。
Recommended sources
Title: WHO Fact Sheet — Diabetes
URL: https://www.who.int/news-room/fact-sheets/detail/diabetes
Publisher: World Health Organization
Year/date: 2024 年更新
Why useful: 全球糖尿病患病率、并发症和死亡率负担的官方概述。
Evidence strength: High
Title: Effect of intensive glucose lowering treatment on all cause mortality, cardiovascular death, and microvascular events in type 2 diabetes: meta-analysis of randomised controlled trials
URL: https://pmc.ncbi.nlm.nih.gov/articles/PMC3144314/
Publisher: The BMJ
Year/date: 2011
Why useful: 随机试验的荟萃分析显示了2型糖尿病中强化降糖治疗的复杂风险-效益权衡。
Evidence strength: High
Suggested reference text for website
糖尿病，尤其是在控制不良的情况下，与预期寿命的显著降低相关。风险来自心血管并发症、肾脏疾病和其他长期效应。然而，管理良好的糖尿病影响要小得多，而且糖尿病前期向糖尿病的进展是可以预防的。
Notes / caveats
- 1 型和 2 型糖尿病有不同的轨迹；该问题不作区分。
- A1C 是控制评估的金标准，但用户可能不了解。
- 「糖尿病前期」是一个风险类别，而非疾病；许多人不会进展为糖尿病。
24. Air quality exposure
Calculator variable: pollution — 家庭/工作场所周围的长期暴露。
Why it matters: 环境空气污染——特别是细颗粒物（PM₂.₅）——是全球早逝的首要环境风险因素，导致心血管疾病、肺癌和呼吸道感染。即使是适度的城市污染水平也可测量地增加死亡风险。
Recommended sources
Title: WHO Ambient Air Quality Database, update Jan 2024, Version 6.1
URL: https://www.who.int/data/gho/data/themes/air-pollution/who-air-quality-database
Publisher: World Health Organization
Year/date: 2024
Why useful: Specific WHO city and country air-quality database covering PM₂.₅ and other pollutant levels, useful for estimating pollution exposure context.
Evidence strength: High
Title: Global Burden of Disease — Air pollution as a risk factor
URL: https://www.healthdata.org/research-analysis/health-risks-issues/air-pollution
Publisher: Institute for Health Metrics and Evaluation (IHME)
Year/date: 2024 年更新
Why useful: 按地区和污染源量化可归因于空气污染的死亡数和 DALYs。
Evidence strength: High
Suggested reference text for website
空气质量是影响预期寿命的重要环境因素。长期暴露于细颗粒物（PM₂.₅）与心血管和呼吸系统疾病风险增加相关，即使暴露水平低于许多国家的现行监管标准。
Notes / caveats
- 个体暴露取决于具体地点、户外活动时间和住房质量。
- 空气污染的影响经数十年累积；短期峰值具有不同的健康影响。
- 室内空气质量（此处未涵盖）也很重要。
25. Daily safety risk
Calculator variable: safety — 交通、工作场所危险、暴力或高风险活动。
Why it matters: 外因导致的死亡——事故、暴力和职业危害——因地点、职业和生活方式而显著不同。在许多环境中，伤害死亡率是预期寿命缩短的主要因素，尤其是在年轻人群中。
Recommended sources
Title: WHO Global Status Report on Road Safety 2023
URL: https://www.who.int/publications/i/item/9789240086517
Publisher: World Health Organization
Year/date: 2023
Why useful: 全球道路交通死亡综合数据，是伤害死亡的主要原因。
Evidence strength: High
Title: GBD Results Tool — injury and violence mortality estimates
URL: https://vizhub.healthdata.org/gbd-results/
Publisher: Institute for Health Metrics and Evaluation (IHME)
Year/date: Updated regularly
Why useful: Interactive GBD tool for filtering injuries, deaths, rates, location, year, sex, and age; useful for comparing external-cause mortality context.
Evidence strength: High
Suggested reference text for website
来自交通、暴力或工作场所危害的伤害是全球早逝的主要原因，尤其在较年轻年龄组中。风险因地点、职业和个人行为而有显著差异。我们的调整反映了已发布的伤害死亡率数据。
Notes / caveats
- 安全为自我评估；客观风险可能与感知风险不同。
- 该问题并非意在引起恐慌；大多数用户属于低风险类别。
- 不同风险类型（交通vs暴力vs职业）被合并为一个问题。
26. Driving safety
Calculator variable: driving — 安全带、速度、分心、酒后驾驶和头盔使用。
Why it matters: 道路交通伤害是全球 5–29 岁人群的首要死因。个人驾驶行为（安全带使用、速度、分心、酒精）深刻影响个人受伤风险。仅安全带使用即可将致命伤害风险降低约 50%。
Recommended sources
Title: WHO Global Status Report on Road Safety 2023
URL: https://www.who.int/publications/i/item/9789240086517
Publisher: World Health Organization
Year/date: 2023
Why useful: 全球道路交通死亡、安全带使用、限速法和分心驾驶的详细数据。
Evidence strength: High
Title: Seatbelt use and risk of major injuries sustained by vehicle occupants during motor-vehicle crashes: a systematic review and meta-analysis of cohort studies
URL: https://doi.org/10.1186/s12889-018-6280-1
Publisher: BMC Public Health (Springer)
Year/date: 2018
Why useful: 量化安全带使用与机动车碰撞中致命和严重伤害风险显著降低相关的荟萃分析。
Evidence strength: High
Suggested reference text for website
驾驶行为——包括安全带使用、速度、分心和酒后驾驶——强烈影响致命伤害风险。仅安全带使用即可将碰撞死亡风险降低约 50%。道路交通碰撞是早逝的主要原因，尤其在年轻成年人中。
Notes / caveats
- 驾驶风险因地点而异（城市与农村、各国的道路安全状况）。
- 该问题将多种行为合并为单一自我评估。
- 非驾驶者（行人、骑自行车者）也面临道路交通伤害风险。
27. Work pattern
Calculator variable: work — 体力消耗、轮班、自主权和恢复时间。
Why it matters: 职业因素——轮班工作、体力需求、工作压力和恢复时间——与心血管和代谢疾病风险相关。IARC 将夜班工作列为可能致癌物。高压力工作（高要求、低控制）与不良健康结局的关联最强。
Recommended sources
Title: Job strain as a risk factor for coronary heart disease: a collaborative meta-analysis of individual participant data
URL: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60994-5/fulltext
Publisher: The Lancet
Year/date: 2012
Why useful: Large pooled individual-participant meta-analysis showing job strain (high demand and low control) associated with increased coronary heart disease risk.
Evidence strength: High
Title: WHO/IARC — Night shift work as a probable carcinogen
Publisher: International Agency for Research on Cancer (IARC / WHO)
Year/date: 2020
Why useful: 夜班工作被正式分类为 Group 2A（可能）致癌物；回顾轮班工作与癌症及其他疾病的证据。
Evidence strength: High
Suggested reference text for website
您的工作模式——包括体力需求、轮班时间和恢复——可能影响长期健康。高压力工作和夜班工作与心血管风险增加相关。充分的恢复和自主权可能有助于缓冲这些影响。
Notes / caveats
- 该问题将多个维度（体力、时间、心理社会）合并为一个自我评估。
- 工作影响与其他生活方式因素（睡眠、活动、饮食）相互作用。
- 该关系是双向的：健康影响工作能力，工作影响健康。
28. Financial security
Calculator variable: income_security — 负担住房、食物、医疗保健和紧急情况的能力。
Why it matters: 收入和财务安全是最有力的健康社会决定因素之一。收入与预期寿命之间的关系是分级的——收入阶梯的每一步都与更长的寿命相关。财务不安全感造成压力，限制医疗保健、健康食品和安全住房的可及性，并与更高的死亡率相关。
Recommended sources
Title: The association between income and life expectancy in the United States (Chetty et al.)
URL: https://jamanetwork.com/journals/jama/fullarticle/2513561
Publisher: JAMA
Year/date: 2016
Why useful: 里程碑式研究显示美国收入最高与最低者之间的预期寿命差距为 10–15 年。
Evidence strength: High
Title: WHO — Social determinants of health
URL: https://www.who.int/health-topics/social-determinants-of-health
Publisher: World Health Organization
Year/date: 定期更新
Why useful: WHO 关于收入、教育、住房和社会条件如何影响健康结局的官方框架。
Evidence strength: High
Suggested reference text for website
财务安全与预期寿命密切相关。收入更高、财务状况更稳定的人往往活得更长，这反映了更好的医疗保健、营养、安全住房和更低压力的可及性。这种关系存在于整个收入谱系，而不仅仅是在低端。
Notes / caveats
- 收入-死亡率梯度已充分确立，但因果路径复杂。
- 社会中的相对收入可能与绝对收入同等重要。
- 该问题询问的是主观财务安全感，而非客观收入。
29. Education / health literacy
Calculator variable: education — 舒适地获取健康信息和服务的能力。
Why it matters: 教育水平是健康的最强社会决定因素之一。更高的教育程度与更低的死亡率、更好的健康行为、更高的健康素养以及更有效地使用医疗保健系统相关。每多接受一年教育都与死亡风险的可测量降低相关。
Recommended sources
Title: The causal effects of education on adult health, mortality and income: evidence from Mendelian randomization and the raising of school leaving age
URL: https://pubmed.ncbi.nlm.nih.gov/37463867/
Publisher: International Journal of Epidemiology
Year/date: 2023
Why useful: Mendelian randomization and policy-change evidence supporting a causal relationship between education and adult health, mortality, and income outcomes.
Evidence strength: High
Title: Effects of education on adult mortality: a global systematic review and meta-analysis
URL: https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(23)00306-7/fulltext
Publisher: The Lancet Public Health
Year/date: 2024
Why useful: Global systematic review and meta-analysis estimating the association between years of education and adult all-cause mortality risk.
Evidence strength: High
Suggested reference text for website
教育和健康素养——寻找、理解和使用健康信息的能力——始终与更长的寿命相关。更高的教育水平与更好的健康行为、更有效的医疗保健使用以及所有主要死因的较低死亡风险相关。
Notes / caveats
- 该关联部分为因果性，部分反映了混杂因素（社会经济背景、智力等）。
- 即使没有正规教育，健康素养也可能很高。
- 该关系在不同教育系统和医疗模式的国家中普遍存在。
30. Sense of purpose
Calculator variable: purpose — 感觉日常生活有方向和有意义的承诺。
Why it matters: 在前瞻性队列研究中，生活目标感或意义感与较低的全因死亡率、心血管事件和认知能力下降相关。这种关联在调整抑郁、身体健康和社会经济状况后仍然存在。
Recommended sources
Title: Purpose in Life as a Predictor of Mortality Across Adulthood
URL: https://journals.sagepub.com/doi/10.1177/0956797614531799
Publisher: Psychological Science (SAGE)
Year/date: 2014
Why useful: MIDUS纵向样本显示，生活目标感预测了14年间较低的死亡率。
Evidence strength: Medium
Title: Purpose in Life and Its Relationship to All-Cause Mortality and Cardiovascular Events: A Meta-Analysis
URL: https://pubmed.ncbi.nlm.nih.gov/26630073/
Publisher: Psychosomatic Medicine
Year/date: 2016
Why useful: 前瞻性证据的荟萃分析，将生活目标感与全因死亡率和心血管事件联系起来。
Evidence strength: Medium
Suggested reference text for website
拥有生活目标感和方向感与更好的健康和更长的寿命相关。报告有强烈生活目标感的人往往死亡风险较低，可能通过更好的压力调节、更健康的行为和更大的社会参与度实现。
Notes / caveats
- 因果方向存在争议：更健康的人可能报告更高的目标感。
- 目标感受到文化塑造，并具有高度个体性。
- 该关联在规模上适中，但在不同队列中具有一致性。
31. Oral health
Calculator variable: oral_health — 牙龈疾病和牙科护理可反映更广泛的炎症和可及性。
Why it matters: 口腔健康状况不佳——尤其是牙周炎——与心血管疾病、糖尿病并发症、呼吸道感染和全因死亡率风险增加相关。牙周病是慢性炎症的标志物，并可能通过全身性炎症途径直接促成疾病。
Recommended sources
Title: Oral health and all-cause, cardiovascular disease, and respiratory mortality in older people in the UK and USA
URL: https://pubmed.ncbi.nlm.nih.gov/34385519/
Publisher: Scientific Reports
Year/date: 2021
Why useful: 将口腔健康指标与老年人全因、心血管和呼吸系统死亡率联系起来的大型队列分析。
Evidence strength: Medium
Title: WHO Global Oral Health Status Report 2022
URL: https://www.who.int/publications/i/item/9789240061484
Publisher: World Health Organization
Year/date: 2022
Why useful: 关于口腔疾病负担及其与全身健康联系的全球综合报告。
Evidence strength: High
Suggested reference text for website
口腔健康与整体健康相关。牙龈疾病（牙周炎）与心血管疾病和其他全身性疾病风险增加相关，可能通过共享的炎症途径实现。定期牙科护理和良好的口腔卫生与更好的长期健康结局相关。
Notes / caveats
- 口腔健康与全身性疾病之间的关系部分受到吸烟、社会经济状况和医疗保健可及性的混杂影响。
- 该问题不区分牙龈炎、牙周炎和无牙症。
- 定期牙科就诊既是口腔健康的代理指标，也是整体医疗保健参与度的代理指标。
32. Sun protection
Calculator variable: sun — 在高紫外线暴露或肤色较浅时尤其相关。
Why it matters: 阳光暴露与健康具有双重关系：适量暴露对维生素 D 合成至关重要，但过度暴露是皮肤癌（包括黑色素瘤）的主要原因。紫外线辐射被 IARC 列为 Group 1 致癌物。防晒行为（防晒霜、衣物、遮阴）可显著降低皮肤癌风险。
Recommended sources
Title: IARC Monographs — Radiation, Volume 100D: Solar and ultraviolet radiation
Publisher: International Agency for Research on Cancer (IARC / WHO)
Year/date: 2012
Why useful: Official IARC monograph volume that includes solar and ultraviolet radiation classification and evidence review.
Evidence strength: High
Title: WHO — Ultraviolet radiation and skin cancer
URL: https://www.who.int/news-room/fact-sheets/detail/ultraviolet-radiation
Publisher: World Health Organization
Year/date: 2024 年更新
Why useful: WHO 关于紫外线相关皮肤癌风险和预防建议的官方概况。
Evidence strength: High
Suggested reference text for website
保护皮肤免受过度阳光照射可降低皮肤癌（包括黑色素瘤）的风险。紫外线暴露与皮肤癌之间的关系已充分确立。对于肤色较浅、居住在高紫外线地区以及有大量累积户外暴露的人来说，防晒尤为重要。
Notes / caveats
- 适量阳光暴露有益于维生素 D 合成；该问题关注的是过度无保护的暴露。
- 皮肤癌死亡率与其他癌症相比相对较低，但可以预防。
- 风险因皮肤类型、纬度和日晒行为而有很大差异。
33. Non-prescribed drug risk
Calculator variable: substances — 包括阿片类药物、兴奋剂、镇静剂或其他高风险使用。
Why it matters: 非处方药物使用——特别是阿片类药物、兴奋剂和镇静剂——与通过过量使用、传染病（HIV、肝炎）、心血管事件和事故导致的死亡率显著增加相关。阿片类药物危机已显著降低了受影响国家的预期寿命。
Recommended sources
Title: WHO — Opioid overdose
URL: https://www.who.int/news-room/fact-sheets/detail/opioid-overdose
Publisher: World Health Organization
Year/date: 2024 年更新
Why useful: 全球阿片类药物过量死亡率的官方数据；风险因素和预防策略。
Evidence strength: High
Title: CDC NCHS — Provisional Drug Overdose Death Counts
URL: https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm
Publisher: U.S. Centers for Disease Control and Prevention, National Center for Health Statistics
Year/date: Updated regularly
Why useful: Official overdose death surveillance data; useful for tracking overdose mortality trends, though it is not itself a life expectancy decomposition.
Evidence strength: High
Title: Impact of opioid overdoses on US life expectancy and years of life lost, 2019–2022
URL: https://pmc.ncbi.nlm.nih.gov/articles/PMC11228948/
Publisher: PubMed Central
Year/date: 2024
Why useful: Specific analysis connecting opioid overdose deaths with life expectancy and years of life lost in the United States.
Evidence strength: High
Suggested reference text for website
非处方药物使用——包括阿片类药物、兴奋剂和镇静剂——具有显著的健康风险，包括过量使用、传染病和心血管并发症。阿片类药物危机已在多个国家可测量地降低了预期寿命。过去的使用（如果已停止）风险要低得多。
Notes / caveats
- 该问题区分当前使用和过去使用，因为风险特征截然不同。
- 过量风险取决于剂量、纯度、给药途径和多药并用。
- 污名化可能导致低报；「不愿透露」选项可用。
34. Sleep quality
Calculator variable: sleep_quality — 恢复性睡眠、失眠、打鼾或疑似呼吸暂停。
Why it matters: 睡眠质量——而不仅仅是时长——与健康结局独立相关。睡眠质量差、失眠症状和睡眠呼吸障碍（如阻塞性睡眠呼吸暂停）与心血管疾病、认知能力下降、代谢功能障碍和死亡率增加相关。
Recommended sources
Title: Sudden death in individuals with obstructive sleep apnoea: a systematic review and meta-analysis
URL: https://doi.org/10.1136/bmjresp-2020-000656
Publisher: BMJ Open Respiratory Research
Year/date: 2021
Why useful: 系统综述和荟萃分析将阻塞性睡眠呼吸暂停与猝死风险联系起来；对该问题的睡眠呼吸障碍部分有用。
Evidence strength: Medium
Title: Insomnia and mortality: A meta-analysis
URL: https://pubmed.ncbi.nlm.nih.gov/30529432/
Publisher: Sleep Medicine Reviews
Year/date: 2019
Why useful: Meta-analysis of insomnia and mortality evidence; more directly matches the insomnia component of the sleep-quality question.
Evidence strength: Medium
Suggested reference text for website
睡眠质量与睡眠时长同样重要。慢性失眠、睡醒后无恢复感和疑似睡眠呼吸暂停与较高的死亡风险相关。治疗睡眠障碍——尤其是阻塞性睡眠呼吸暂停——可以同时改善生活质量和长期健康结局。
Notes / caveats
- 睡眠质量是自我报告和主观的。
- 睡眠呼吸暂停诊断不足；打鼾是筛查信号，而非诊断依据。
- 该问题将多个维度（恢复感、失眠、呼吸暂停指标）合并为一个评估。
35. Sugary drinks
Calculator variable: hydration — 每日含糖饮料。
Why it matters: 含糖饮料（SSB）的消费始终与肥胖、2 型糖尿病、心血管疾病和全因死亡率风险增加相关。SSB 提供热量但不产生饱腹感，并导致快速血糖峰值。减少 SSB 摄入是最可行的饮食健康改善措施之一。
Recommended sources
Title: Sugar intake and all-cause mortality—differences between sugar-sweetened beverages, artificially sweetened beverages, and pure fruit juices
URL: https://doi.org/10.1186/s12916-020-01579-w
Publisher: BMC Medicine
Year/date: 2020
Why useful: 含糖饮料、人工甜味饮料和纯果汁与全因死亡率关系的前瞻性比较分析。
Evidence strength: High
Title: WHO Guideline — Sugar intake for adults and children
URL: https://www.who.int/publications/i/item/9789241549028
Publisher: World Health Organization
Year/date: 2015
Why useful: WHO 关于限制游离糖（包括 SSB）摄入量低于总能量 10% 的官方建议。
Evidence strength: High
Suggested reference text for website
含糖饮料始终与肥胖、糖尿病、心血管疾病和过早死亡的更高风险相关。它们提供热量而无营养，并迅速升高血糖。减少或戒除含糖饮料是最有效的健康饮食改变之一。
Notes / caveats
- 该问题专门针对 SSB，而非所有饮料。
- 人工甜味饮料具有不同的（仍存在争议的）风险特征。
- 消费模式（如随餐与单独饮用）可能影响代谢影响。
36. Fiber intake
Calculator variable: fiber — 豆类、全谷物、蔬菜、水果、坚果和种子。
Why it matters: 膳食纤维摄入始终与降低的全因和心血管死亡率相关。高纤维饮食可降低胆固醇、改善血糖控制、支持肠道微生物组健康并促进饱腹感。大多数人群的纤维摄入量远低于推荐的 25–30 克/天。
Recommended sources
Title: Carbohydrate quality and human health: a series of systematic reviews and meta-analyses
URL: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31809-9/fulltext
Publisher: The Lancet
Year/date: 2019
Why useful: Large systematic review series including evidence on dietary fibre, whole grains, all-cause mortality, cardiovascular mortality, and non-communicable disease outcomes.
Evidence strength: High
Title: WHO — Healthy diet fact sheet
URL: https://www.who.int/news-room/fact-sheets/detail/healthy-diet
Publisher: World Health Organization
Year/date: 2024 年更新
Why useful: WHO 关于纤维摄入作为健康饮食一部分的官方建议。
Evidence strength: High
Suggested reference text for website
纤维——来自全谷物、豆类、蔬菜、水果、坚果和种子——与较低的死亡风险密切相关。大多数人的摄入量远低于推荐的 25–30 克/天。增加纤维摄入是最有证据支持的长寿饮食改变之一。
Notes / caveats
- 纤维摄入为自我报告，难以准确估计。
- 不同纤维类型（可溶性vs不可溶性）具有不同的健康效应。
- 如果过快增加，高纤维摄入可能引起消化不适。
37. Protein adequacy
Calculator variable: protein — 在衰老和力量维持中尤为重要。
Why it matters: 充足的蛋白质摄入对肌肉维持、免疫功能和代谢健康至关重要。老年人需要比年轻人更高的蛋白质摄入量（1.2–1.5 g/kg/天）以对抗肌肉减少症（与年龄相关的肌肉流失）。低蛋白质摄入与老年人群的虚弱和死亡率增加相关。
Recommended sources
Title: Dietary intake of total, animal, and plant proteins and risk of all cause, cardiovascular, and cancer mortality: systematic review and dose-response meta-analysis of prospective cohort studies
URL: https://www.bmj.com/content/370/bmj.m2412
Publisher: The BMJ
Year/date: 2020
Why useful: 系统综述和剂量反应荟萃分析，检查总蛋白质、动物蛋白和植物蛋白摄入量与全因和特定原因死亡率的关系。
Evidence strength: High
Title: Evidence-Based Recommendations for Optimal Dietary Protein Intake in Older People: A Position Paper From the PROT-AGE Study Group
URL: https://doi.org/10.1016/j.jamda.2013.05.021
Publisher: Journal of the American Medical Directors Association (JAMDA)
Year/date: 2013
Why useful: 为老年人提供基于证据的蛋白质摄入建议以维持肌肉功能并预防肌肉减少症的共识立场文件。
Evidence strength: High
Suggested reference text for website
摄入足够的蛋白质有助于支持肌肉维持、免疫功能和整体健康——尤其是在您年龄增长的过程中。老年人可能比年轻人需要更多的蛋白质来维持力量和功能。高收入国家的大多数人蛋白质摄入充足，但在一日三餐中的分布很重要。
Notes / caveats
- 蛋白质充足性为自我评估，可能不反映实际摄入量。
- 蛋白质的质量和来源（动物vs植物）可能比总摄入量更重要。
- 过量蛋白质摄入（尤其来自动物来源）可能带来其他健康风险。
38. Medication adherence
Calculator variable: med_adherence — 如果已开具处方药，您服药的可靠性如何？
Why it matters: 药物不依从性与住院率增加、疾病进展和死亡率升高相关——尤其对于心血管疾病、糖尿病和高血压。约 50% 的慢性疾病患者未按处方服药。
Recommended sources
Title: Medication adherence: Importance, issues and policy: A policy statement from the American Heart Association
URL: https://pubmed.ncbi.nlm.nih.gov/32800791/
Publisher: Progress in Cardiovascular Diseases
Year/date: 2021
Why useful: 总结药物依从性对慢性心血管风险管理与结局重要性的权威政策声明。
Evidence strength: Medium
Title: WHO — Adherence to long-term therapies: evidence for action
URL: https://apps.who.int/iris/handle/10665/42682
Publisher: World Health Organization (IRIS)
Year/date: 2003
Why useful: WHO 关于全球药物不依从性范围和影响的经典报告。
Evidence strength: High
Suggested reference text for website
按处方服药与显著更好的健康结局相关。对慢性疾病（如血压、胆固醇或糖尿病药物）药物依从性差与更高的住院率和死亡率相关。
Notes / caveats
- 依从性为自我报告，很可能被高估。
- 不依从的原因各不相同（费用、副作用、遗忘、信念），具有不同的含义。
- 该问题仅适用于已开具处方药的用户；「未服药」是一个有效选项。
39. Vaccination status
Calculator variable: vaccines — 适合您年龄和地点的常规成人疫苗接种。
Why it matters: 成人疫苗接种可预防导致显著发病率和死亡的疫苗可预防疾病，尤其在老年人中。仅流感疫苗接种即可在流感季节将老年人全因死亡率降低约 20–40%。COVID-19 疫苗已在全球防止了数百万人死亡。
Recommended sources
Title: WHO — Vaccination and immunization
URL: https://www.who.int/health-topics/vaccines-and-immunization
Publisher: World Health Organization
Year/date: 定期更新
Why useful: WHO 关于疫苗可预防疾病和成人免疫建议的官方信息。
Evidence strength: High
Title: Impact of Influenza Vaccination on All-Cause Mortality and Hospitalization for Pneumonia in Adults and the Elderly with Diabetes: A Meta-Analysis of Observational Studies
URL: https://www.mdpi.com/2076-393X/8/2/263
Publisher: Vaccines
Year/date: 2020
Why useful: 荟萃分析专注于患有糖尿病的成人和老年人；可作为高风险人群的示例，而非一般老年人群的估计。
Evidence strength: Medium
Suggested reference text for website
及时接种推荐的成人疫苗——包括流感、COVID-19、肺炎球菌疫苗以及基于您年龄和健康状况的其他疫苗——可降低可能缩短预期寿命的严重传染病的风险。
Notes / caveats
- 疫苗有效性因季节（流感）和个体免疫反应而异。
- 建议因国家、年龄和潜在健康状况而异。
- 该问题涉及一般疫苗接种状态，而非特定疫苗。
40. Late-night screen habit
Calculator variable: screen_time — 临睡前的屏幕使用会降低睡眠质量。
Why it matters: 夜间屏幕暴露通过蓝光发射抑制褪黑素分泌，可能延迟入睡、降低睡眠质量并扰乱昼夜节律。慢性昼夜节律紊乱与代谢疾病、心血管风险乃至可能的癌症相关。
Recommended sources
Title: Electronic Media Use and Sleep Quality: Updated Systematic Review and Meta-Analysis
URL: https://doi.org/10.2196/48356
Publisher: Journal of Medical Internet Research
Year/date: 2024
Why useful: 更新的系统综述和荟萃分析，将电子媒体使用与睡眠质量结局联系起来。
Evidence strength: Medium
Title: Blue light has a dark side
URL: https://www.health.harvard.edu/staying-healthy/blue-light-has-a-dark-side
Publisher: Harvard Health Publishing
Year/date: July 24, 2024
Why useful: Accessible clinical overview of blue light effects on sleep and circadian rhythms; useful as context, not as a primary mortality source.
Evidence strength: Medium
Suggested reference text for website
深夜使用屏幕——尤其是手机、平板电脑和电脑——会通过抑制褪黑素和干扰身体生物钟来干扰睡眠。虽然对死亡率的直接影响很小，但对睡眠质量和昼夜节律健康的下游效应已有充分证据。
Notes / caveats
- 屏幕时间对健康的影响主要通过睡眠中断来介导。
- 蓝光过滤功能和夜间模式可减少但不能消除影响。
- 内容类型（如压力性与放松性）可能与光线暴露独立相关。
41. Time outdoors / nature
Calculator variable: nature — 活动、日照、恢复和心理健康代理指标。
Why it matters: 户外活动时间与更高的体力活动水平、更好的维生素 D 状态、改善的心理健康和降低的死亡率相关。绿色空间可及性与较低的心血管死亡率、更好的免疫功能和改善的幸福感相关。
Recommended sources
Title: Green spaces and mortality: a systematic review and meta-analysis of cohort studies
URL: https://doi.org/10.1016/S2542-5196(19)30215-3
Publisher: The Lancet Planetary Health
Year/date: 2019
Why useful: 队列研究的荟萃分析显示绿色空间暴露与降低的全因和心血管死亡率相关。
Evidence strength: Medium
Title: Associations between Nature Exposure and Health: A Review of the Evidence
URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8125471/
Publisher: International Journal of Environmental Research and Public Health (via PubMed Central)
Year/date: 2021
Why useful: Broad review of health benefits associated with nature exposure, including mental health, activity, and other intermediate health outcomes.
Evidence strength: Medium
Suggested reference text for website
在户外自然环境中度过的时间与更好的身心健康相关。定期接触绿色空间可能通过增加体力活动、减轻压力和改善空气质量来降低心血管死亡率风险。
Notes / caveats
- 该问题捕捉的是一种广泛行为；具体机制难以分离。
- 社会经济状况的混杂因素（绿色空间可及性与收入相关）。
- 关联在幅度上适中，但在不同研究中具有一致性。
42. Heat/cold resilience
Calculator variable: heat — 住房和工作场所对极端温度的防护。
Why it matters: 极端温度——无论是高温还是低温——与死亡率增加相关，尤其在脆弱人群中（老年人、慢性疾病患者）。气候变化正在全球范围内增加高温相关死亡率。住房质量、空调可及性和职业暴露改变个人风险。
Recommended sources
Title: Heat and health (WHO)
URL: https://www.who.int/news-room/fact-sheets/detail/climate-change-heat-and-health
Publisher: World Health Organization
Year/date: 2024 年更新
Why useful: WHO 关于高温相关死亡率和风险因素的官方信息；包括适应策略。
Evidence strength: High
Title: The 2024 report of the Lancet Countdown on health and climate change: facing record-breaking threats from delayed action
URL: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)01822-1/fulltext
Publisher: The Lancet
Year/date: 2024
Why useful: 年度跟踪报告涵盖与气候相关的健康风险，包括热暴露和与热相关的死亡率趋势。
Evidence strength: High
Suggested reference text for website
极端温度暴露——无论是高温还是低温——会增加死亡风险，尤其对于老年人和慢性疾病患者。住房质量、空调可及性和工作场所防护可以降低这种风险。气候变化正在增加危险高温事件的频率。
Notes / caveats
- 目前大多数地区低温相关死亡率超过高温相关死亡率。
- 个体脆弱性因年龄、健康状况和社会经济资源而异。
- 该问题捕捉的是主观防护状态，而非客观温度暴露。
43. Fall risk
Calculator variable: falls — 平衡能力、虚弱、危险因素或既往跌倒史。
Why it matters: 跌倒是 65 岁以上成年人伤害相关死亡的主要原因，也是导致残疾的主要原因。跌倒风险随年龄增长、虚弱、平衡受损、药物使用和环境危险因素而增加。既往跌倒史是未来跌倒的最强预测因子。
Recommended sources
Title: WHO Fact Sheet — Falls
URL: https://www.who.int/news-room/fact-sheets/detail/falls
Publisher: World Health Organization
Year/date: 2024 年更新
Why useful: 全球跌倒发生率、死亡率和风险因素数据；预防策略。
Evidence strength: High
Title: CDC — STEADI (Stopping Elderly Accidents, Deaths & Injuries)
URL: https://www.cdc.gov/steadi/index.html
Publisher: U.S. Centers for Disease Control and Prevention
Year/date: 2024 年更新
Why useful: CDC 官方跌倒预防计划，提供基于证据的风险评估工具。
Evidence strength: High
Suggested reference text for website
跌倒是老年人伤害和死亡的主要原因。跌倒风险随年龄增长、平衡问题、肌肉无力和某些药物使用而增加。既往跌倒史是未来跌倒的最强预测因子，但许多跌倒是可以通过锻炼、家居改造和视力矫正来预防的。
Notes / caveats
- 跌倒风险对老年人（65 岁以上）最为相关，但年轻成年人也可能面临风险。
- 自我报告的跌倒风险可能与客观测量结果不一致。
- 该问题捕捉的是总体意识而非临床风险评估。
44. Hearing/vision correction
Calculator variable: hearing — 未经治疗的感觉损失会影响事故、认知和社会关系。
Why it matters: 未经治疗的听力损失与认知能力下降、社会孤立、抑郁和全因死亡率增加相关。视力损害增加跌倒风险、事故并降低生活质量。矫正（助听器、眼镜、白内障手术）可显著缓解这些风险。
Recommended sources
Title: Association between hearing aid use and mortality in adults with hearing loss in the USA: a mortality follow-up study of a cross-sectional cohort
URL: https://pubmed.ncbi.nlm.nih.gov/38183998/
Publisher: The Lancet Healthy Longevity
Year/date: 2024
Why useful: 检查助听器使用与听力损失成年人死亡率关系的死亡率随访研究。
Evidence strength: Medium
Title: WHO — Deafness and hearing loss
URL: https://www.who.int/health-topics/hearing-loss
Publisher: World Health Organization
Year/date: Updated regularly
Why useful: 世界卫生组织关于听力损失患病率、后果和公共卫生应对措施的官方概述。
Evidence strength: High
Title: WHO Fact Sheet — Blindness and vision impairment
URL: https://www.who.int/news-room/fact-sheets/detail/blindness-and-visual-impairment
Publisher: World Health Organization
Year/date: Updated regularly
Why useful: 世界卫生组织关于视力损伤的官方情况说明书，包括功能后果以及预防或矫正途径。
Evidence strength: High
Suggested reference text for website
未经治疗的听力和视力损失与较高的死亡风险相关，可能通过社会孤立、认知能力下降和事故等途径实现。通过助听器、眼镜或手术矫正这些损伤与更好的健康结局相关。
Notes / caveats
- 与死亡率的关联部分通过跌倒风险增加和认知能力下降来介导。
- 尽管益处明确，助听器使用率仍然很低。
- 该问题将听力和视力合并为一个评估。
45. Cognitive engagement
Calculator variable: cognition — 学习、阅读、复杂工作、语言、音乐、游戏或创意项目。
Why it matters: 认知参与和终身学习与痴呆和认知能力下降风险降低相关。「认知储备」的概念表明，智力刺激活动可建立大脑韧性。然而，认知参与与全因死亡率之间直接的证据较为有限。
Recommended sources
Title: Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission
URL: https://doi.org/10.1016/S0140-6736(24)01296-0
Publisher: The Lancet
Year/date: 2024
Why useful: 权威委员会报告关于可改变的痴呆风险因素，包括教育、认知储备、社会关系及其他与认知参与相关的预防杠杆。
Evidence strength: High
Title: WHO — Risk reduction of cognitive decline and dementia
URL: https://www.who.int/publications/i/item/9789241550543
Publisher: World Health Organization
Year/date: 2019
Why useful: WHO 指南将认知参与确定为认知衰退风险降低的推荐干预措施。
Evidence strength: High
Suggested reference text for website
通过阅读、学习、创意工作或复杂爱好保持智力活跃与晚年更好的认知健康相关。虽然对预期寿命的直接影响较为有限，但维持认知功能对生活质量和独立生活至关重要。
Notes / caveats
- 认知参与难以测量和量化。
- 与痴呆风险的关联受到教育、社会经济状况和基线认知能力的混杂影响。
- 主要益处在于健康寿命（生活质量）而非延长寿命本身。
46. Community participation
Calculator variable: community — 社团、志愿服务、信仰团体、地方项目或互助组织。
Why it matters: 社区参与和志愿服务与较低的全因死亡率和更好的心理健康相关。社会整合提供情感支持、目标感和体力活动机会。该效应独立于其他形式的社会关系。
Recommended sources
Title: Volunteering by older adults and risk of mortality: A meta-analysis
URL: https://doi.org/10.1037/a0031519
Publisher: Psychology and Aging
Year/date: 2013
Why useful: 组织志愿服务与中老年和老年人死亡风险的荟萃分析。
Evidence strength: Medium
Title: Association of Religious Service Attendance With Mortality Among Women
URL: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2521827
Publisher: JAMA Internal Medicine
Year/date: 2016
Why useful: 前瞻性队列研究显示，参加宗教仪式与女性较低的死亡率相关，可能反映了社区参与、社会支持和相关行为。
Evidence strength: Medium
Suggested reference text for website
定期参与社区活动——社团、志愿服务、信仰团体或地方项目——与较低的死亡风险相关。这可能反映了社会关系、目标感以及经常伴随社区参与的健康行为的益处。
Notes / caveats
- 因果方向难以确定：更健康的人可能参与更多。
- 不同类型的社区参与可能具有不同的效果。
- 收益似乎来自参与的质量，而不仅仅是成员身份。
47. Care responsibilities
Calculator variable: pets_care — 宠物、家人、孩子或其他人，增加活动和社会节奏。
Why it matters: 照护责任对健康具有双重影响。适度照护（如养宠物、育儿）与更好的健康结局相关。高负担、无恢复时间的无偿照护与压力增加、抑郁和死亡率风险增加相关。
Recommended sources
Title: Dog, cat, bird, fish, and other pet ownership and mortality: Evidence from the HILDA cohort
URL: https://doi.org/10.1371/journal.pone.0305546
Publisher: PLOS ONE
Year/date: 2024
Why useful: 检查不同类型宠物饲养与死亡率关系的大型队列研究；作为陪伴和照护责任的代理指标。
Evidence strength: Medium
Title: Family caregiving and all-cause mortality: a meta-analysis
URL: https://pmc.ncbi.nlm.nih.gov/articles/PMC6227628/
Publisher: American Journal of Preventive Medicine (via PubMed Central)
Year/date: 2018
Why useful: 荟萃分析检查了家庭照护与全因死亡率之间的混合关系。
Evidence strength: Medium
Suggested reference text for website
照护责任——对宠物、孩子或家人——对健康具有混合影响。低到中度照护可以提供生活结构、活动和陪伴。高负担照护且无充足恢复时间与压力增加和健康风险增加相关。
Notes / caveats
- 该问题区分支持性和负担性照护。
- 宠物饲养的影响较为温和，部分可由体力活动增加解释。
- 照护者负担取决于被照护者的状况、可用支持以及照护者自身的健康。
48. Outlook
Calculator variable: optimism` — 通常相信问题是可以解决的。
Why it matters: 乐观——一种相信好事会发生的普遍预期——与降低的全因死亡率、心血管疾病和更好的健康行为相关。该关联在调整抑郁、健康状况和社会经济因素后仍然存在。
Recommended sources
Title: Association of Optimism With Cardiovascular Events and All-Cause Mortality: A Systematic Review and Meta-analysis
URL: https://pubmed.ncbi.nlm.nih.gov/31560385/
Publisher: JAMA Network Open
Year/date: 2019
Why useful: 系统综述和荟萃分析将乐观与心血管事件和全因死亡率联系起来。
Evidence strength: Medium
Title: Optimism and Cardiovascular Health: Longitudinal Findings From the Coronary Artery Risk Development in Young Adults Study
URL: https://pmc.ncbi.nlm.nih.gov/articles/PMC9901360/
Publisher: Psychosomatic Medicine
Year/date: 2020
Why useful: 将乐观与心血管健康轨迹联系起来的纵向队列证据。
Evidence strength: Medium
Suggested reference text for website
普遍乐观的 outlook——感觉问题是可以解决的——与更好的健康和更长的寿命相关。乐观的人往往心血管风险较低、健康行为更好、压力管理更有效。
Notes / caveats
- 乐观部分可遗传，部分由生活状况塑造。
- 关联程度适中，可能是双向的。
- 气质性乐观不同于不切实际的乐观（可能导致冒险行为）。
49. Food environment
Calculator variable: environment_food — 在家庭/工作场所附近获取健康食品的便利程度。
Why it matters: 本地食品环境——与超市、农贸市场、快餐店的距离以及食品价格——塑造饮食模式和健康结局。「食品荒漠」（获取健康、可负担食品受限的地区）与较差的饮食质量、较高的肥胖率和增加的心血管死亡率相关。
Recommended sources
Title: Time-varying exposure to food retailers and cardiovascular disease hospitalization and mortality in the Netherlands: a nationwide prospective cohort study
URL: https://doi.org/10.1186/s12916-024-03648-w
Publisher: BMC Medicine
Year/date: 2024
Why useful: 全国性队列研究将更健康的食品零售暴露与心血管住院和死亡率结局联系起来。
Evidence strength: Medium
Title: WHO Fact Sheet — Healthy diet
URL: https://www.who.int/news-room/fact-sheets/detail/healthy-diet
Publisher: World Health Organization
Year/date: Updated regularly
Why useful: Official WHO dietary guidance used as general nutrition context; the food-environment mortality link is supported more directly by the cohort source above.
Evidence strength: Medium
Suggested reference text for website
在您的社区找到健康、可负担食品的便利程度会影响您的饮食和健康。新鲜农产品和全食品获取受限的区域——有时称为「食品荒漠」——与较差的健康结局相关，包括较高的心血管死亡率。
Notes / caveats
- 该问题捕捉的是对食品可及性的主观感知，可能与客观测量不同。
- 食品环境的影响受到收入、教育和社区安全的混杂。
- 个人选择可以在一定程度上克服不利的食品环境。
50. Readiness to improve
Calculator variable: readiness — 用于决定 CTA 最终应提供什么。
Why it matters: 改变的准备度不是直接的死亡率预测指标，但它是成功行为改变的一个已充分确立的决定因素。行为改变阶段模型（跨理论模型）表明，「准备好」的人更有可能采纳并维持健康改善行为。该问题帮助计算器提供适当的后续步骤。
Recommended sources
Title: The Transtheoretical Model of Health Behavior Change (Prochaska & Velicer)
URL: https://doi.org/10.4278/0890-1171-12.1.38
Publisher: American Journal of Health Promotion (SAGE)
Year/date: 1997
Why useful: 关于行为改变阶段模型的基础论文；改变准备度与成功的健康行为采纳相关。
Evidence strength: Medium
Title: The transtheoretical model and stages of change
URL: https://pubmed.ncbi.nlm.nih.gov/14760267/
Publisher: Health Education Research
Year/date: 2004
Why useful: Review of the stages-of-change model and readiness concepts used for behaviour-change tailoring.
Evidence strength: Medium
Suggested reference text for website
您做出改变的准备度是健康改善能否持久的有力预测指标。感觉准备好行动的人更有可能成功采纳更健康的习惯。该问题帮助我们根据您当前所处阶段量身定制建议。
Notes / caveats
- 准备度是一个心理构念，而非直接的健康预测指标。
- 动机随时间波动；今天的准备度可能无法预测长期行为。
- 该问题的纳入主要是为了个性化计算器的建议。
计算器公共权重
下表显示了计算器当前使用的方向性年度调整。这些是透明的启发式权重，而非临床验证的系数。
权重应用于基于年龄的人群基线，并在估算内设上限。它们是基于人群证据的教育性近似值，而非经过验证的医疗、精算或个人风险模型。
| # | 问题 | 信号类型 | 使用的调整 | 应用方式 | 证据 |
|---|---|---|---|---|---|
| 1 | Current ageage必填 | Baseline | 18-29: baseline 82.5y; 30-39: baseline 83.2y; 40-49: baseline 84.0y; 50-59: baseline 85.0y; 60-69: baseline 86.8y; 70-79: baseline 89.2y; 80+: baseline 93.5y | Sets the population baseline life expectancy before answer-level adjustments. | 证据 |
| 2 | Sex at birthsex必填 | Population baseline | Female: +3.8y; Male: 0.0y; Intersex / prefer not to say: +1.6y | Applies the fixed adjustment attached to the selected answer. | 证据 |
| 3 | Country and city where you livecountry必填 | Location baseline | 204 city options: -2.3y to +3.4y; full city table below | Applies a fixed city-level heuristic using healthcare, air quality, safety, walkability, and mortality context. | 证据 |
| 4 | Smoking statussmoking必填 | Risk/protection | Never smoked: +2.2y; Former smoker: -0.8y; Occasional smoker: -3.0y; Daily smoker: -7.5y | Applies the fixed adjustment attached to the selected answer. | 证据 |
| 5 | Body mass indexbmi必填 | Risk/protection | <18.5: -1.5y; 18.5-24.9: +1.4y; 25-29.9: -0.5y; 30-34.9: -2.0y; 35+: -4.5y | Applies a rule-based adjustment from the entered value. | 证据 |
| 6 | Weekly physical activityactivity必填 | Protective behavior | 300+ minutes: +3.2y; 150-299 minutes: +2.1y; 60-149 minutes: +0.4y; Under 60 minutes: -2.5y | Applies the fixed adjustment attached to the selected answer. | 证据 |
| 7 | Overall diet patterndiet必填 | Protective behavior | Mediterranean / whole-food focused: +2.4y; Mostly balanced: +1.0y; Mixed, many processed foods: -0.8y; Fast food / low produce most days: -2.8y | Applies the fixed adjustment attached to the selected answer. | 证据 |
| 8 | Average sleep durationsleep必填 | Risk/protection | 7-8 hours: +1.7y; 6 or 9 hours: +0.2y; Under 6 hours: -1.8y; Over 9 hours: -1.0y | Applies the fixed adjustment attached to the selected answer. | 证据 |
| 9 | Blood pressure statusblood_pressure必填 | Clinical risk | Normal: +1.7y; Elevated but monitored: -0.4y; High, treated: -1.0y; High, untreated / unknown: -2.8y | Applies the fixed adjustment attached to the selected answer. | 证据 |
| 10 | Major chronic diseasediagnoses必填 | Clinical risk | None known: +1.5y; One, well managed: -2.2y; Multiple or poorly controlled: -6.0y; Prefer not to say: -1.0y | Applies the fixed adjustment attached to the selected answer. | 证据 |
| 11 | Alcohol intakealcohol | Behavioral risk | None or rare: +0.6y; Moderate: +0.1y; Heavy weekly use: -2.5y; Binge drinking: -3.0y | Applies the fixed adjustment attached to the selected answer. | 证据 |
| 12 | Hours sitting per daysitting | Behavioral risk | 0-5 hours: +0.8y; 6-8 hours: -0.2y; >8 hours: -1.5y | Applies a rule-based adjustment from the entered value. | 证据 |
| 13 | Average daily stepssteps | Protective behavior | 10,000+: +1.4y; 7,000-9,999: +0.9y; 4,000-6,999: 0.0y; Under 4,000: -1.4y | Applies the fixed adjustment attached to the selected answer. | 证据 |
| 14 | Strength trainingstrength | Protective behavior | 2+ times weekly: +1.1y; Sometimes: +0.2y; Rarely: -0.5y | Applies the fixed adjustment attached to the selected answer. | 证据 |
| 15 | Cardiorespiratory fitnessvo2 | Fitness proxy | High: +2.0y; Average: +0.4y; Low: -2.0y; Unknown: 0.0y | Applies the fixed adjustment attached to the selected answer. | 证据 |
| 16 | Waist-to-height riskwaist | Clinical proxy | Waist is under half my height: +0.8y; Waist is over half my height: -1.4y | Applies the fixed adjustment attached to the selected answer. | 证据 |
| 17 | Family longevityfamily | Non-modifiable proxy | Strong longevity: +1.8y; Average: 0.0y; Early cardiovascular/cancer history: -1.6y | Applies the fixed adjustment attached to the selected answer. | 证据 |
| 18 | Social connectionsocial | Social risk/protection | Strong: +1.1y; Moderate: +0.2y; Isolated: -1.8y | Applies the fixed adjustment attached to the selected answer. | 证据 |
| 19 | Chronic stressstress | Psychosocial proxy | 1: +1.0y; 2: +0.5y; 3: 0.0y; 4: -0.8y; 5: -1.8y | Applies a rule-based adjustment from the entered value. | 证据 |
| 20 | Mental health stabilitymental_health | Psychosocial proxy | Stable and supported: +0.9y; Some challenges, managed: -0.2y; Frequent unmanaged difficulty: -1.7y | Applies the fixed adjustment attached to the selected answer. | 证据 |
| 21 | Preventive carepreventive | Care access/proxy | Consistent: +1.3y; Occasional: 0.0y; Rare: -1.4y | Applies the fixed adjustment attached to the selected answer. | 证据 |
| 22 | Cholesterol riskcholesterol | Clinical risk | Optimal or treated well: +0.9y; Borderline: -0.3y; High / untreated / unknown: -1.5y | Applies the fixed adjustment attached to the selected answer. | 证据 |
| 23 | Glucose / diabetes statusglucose | Clinical risk | Normal: +0.9y; Prediabetes: -1.1y; Diabetes, managed: -2.0y; Diabetes, poorly controlled: -4.0y | Applies the fixed adjustment attached to the selected answer. | 证据 |
| 24 | Air quality exposurepollution | Environmental risk | Clean air most days: +0.6y; Moderate urban exposure: -0.3y; High pollution / smoke exposure: -1.4y | Applies the fixed adjustment attached to the selected answer. | 证据 |
| 25 | Daily safety risksafety | Injury risk | Low: +0.5y; Moderate: -0.4y; High: -2.0y | Applies the fixed adjustment attached to the selected answer. | 证据 |
| 26 | Driving safetydriving | Injury risk | Very safe: +0.5y; Average: 0.0y; Frequent risk: -1.2y | Applies the fixed adjustment attached to the selected answer. | 证据 |
| 27 | Work patternwork | Occupational proxy | Balanced / autonomous: +0.7y; Sedentary but manageable: -0.2y; Night shifts / high strain: -1.4y | Applies the fixed adjustment attached to the selected answer. | 证据 |
| 28 | Financial securityincome_security | Socioeconomic proxy | Secure: +1.0y; Some pressure: -0.4y; Insecure: -1.7y | Applies the fixed adjustment attached to the selected answer. | 证据 |
| 29 | Education / health literacyeducation | Socioeconomic proxy | High: +0.8y; Medium: +0.2y; Low: -0.8y | Applies the fixed adjustment attached to the selected answer. | 证据 |
| 30 | Sense of purposepurpose | Psychosocial proxy | 1: -1.0y; 2: -0.4y; 3: +0.2y; 4: +0.8y; 5: +1.2y | Applies a rule-based adjustment from the entered value. | 证据 |
| 31 | Oral healthoral_health | Health proxy | Good, regular dental care: +0.4y; Some issues: -0.3y; Poor / untreated: -0.9y | Applies the fixed adjustment attached to the selected answer. | 证据 |
| 32 | Sun protectionsun | Cancer-risk proxy | Consistent: +0.3y; Sometimes: 0.0y; Rarely: -0.5y | Applies the fixed adjustment attached to the selected answer. | 证据 |
| 33 | Non-prescribed drug risksubstances | High-risk behavior | None: +0.5y; Past, not current: -0.3y; Current risk: -4.0y | Applies the fixed adjustment attached to the selected answer. | 证据 |
| 34 | Sleep qualitysleep_quality | Risk/protection | Restorative: +0.8y; Mixed: -0.2y; Poor / possible apnea: -1.5y | Applies the fixed adjustment attached to the selected answer. | 证据 |
| 35 | Sugary drinkshydration | Dietary proxy | Rare: +0.4y; Several weekly: -0.2y; Daily: -0.9y | Applies the fixed adjustment attached to the selected answer. | 证据 |
| 36 | Fiber intakefiber | Dietary proxy | High most days: +0.9y; Moderate: +0.2y; Low: -0.8y | Applies the fixed adjustment attached to the selected answer. | 证据 |
| 37 | Protein adequacyprotein | Nutrition proxy | Adequate: +0.4y; Unsure: 0.0y; Often low: -0.5y | Applies the fixed adjustment attached to the selected answer. | 证据 |
| 38 | Medication adherencemed_adherence | Care behavior | No medication / fully adherent: +0.6y; Occasional misses: -0.4y; Often not taken: -1.4y | Applies the fixed adjustment attached to the selected answer. | 证据 |
| 39 | Vaccination statusvaccines | Preventive care | Up to date: +0.6y; Partly: 0.0y; Avoid/unknown: -0.8y | Applies the fixed adjustment attached to the selected answer. | 证据 |
| 40 | Late-night screen habitscreen_time | Sleep proxy | Rare: +0.2y; Sometimes: 0.0y; Most nights: -0.4y | Applies the fixed adjustment attached to the selected answer. | 证据 |
| 41 | Time outdoors / naturenature | Lifestyle/environment proxy | Most days: +0.5y; Weekly: +0.1y; Rarely: -0.4y | Applies the fixed adjustment attached to the selected answer. | 证据 |
| 42 | Heat/cold resilienceheat | Environmental risk | Well protected: +0.3y; Some exposure: -0.3y; Frequent exposure: -1.0y | Applies the fixed adjustment attached to the selected answer. | 证据 |
| 43 | Fall riskfalls | Injury risk | Low: +0.4y; Some concern: -0.5y; High: -1.5y | Applies the fixed adjustment attached to the selected answer. | 证据 |
| 44 | Hearing/vision correctionhearing | Sensory-function proxy | Good or corrected: +0.4y; Some untreated issues: -0.4y; Significant untreated issues: -1.0y | Applies the fixed adjustment attached to the selected answer. | 证据 |
| 45 | Cognitive engagementcognition | Cognitive-health proxy | Daily: +0.6y; Weekly: +0.2y; Rare: -0.4y | Applies the fixed adjustment attached to the selected answer. | 证据 |
| 46 | Community participationcommunity | Social proxy | Regular: +0.7y; Occasional: +0.1y; None: -0.3y | Applies the fixed adjustment attached to the selected answer. | 证据 |
| 47 | Care responsibilitiespets_care | Caregiving proxy | Supportive rhythm: +0.3y; Neutral: 0.0y; High burden/no recovery: -0.7y | Applies the fixed adjustment attached to the selected answer. | 证据 |
| 48 | Outlookoptimism | Psychosocial proxy | 1: -0.8y; 2: -0.2y; 3: +0.2y; 4: +0.6y; 5: +0.9y | Applies a rule-based adjustment from the entered value. | 证据 |
| 49 | Food environmentenvironment_food | Food-access proxy | Easy: +0.5y; Mixed: 0.0y; Difficult: -0.7y | Applies the fixed adjustment attached to the selected answer. | 证据 |
| 50 | Readiness to improvereadiness | Behavior-change proxy | Ready now: +0.6y; Interested but unsure: +0.1y; Not a priority: -0.4y | Applies the fixed adjustment attached to the selected answer. | 证据 |
国家和城市权重
所选城市应用一个固定的位置调整。城市值是医疗可及性、空气质量、安全、步行便利性和当地死亡率背景的近似代理。
| 国家 | 城市 | 使用的调整 | 信号 |
|---|---|---|---|
| Argentina | Buenos Aires | +0.1y | Healthcare moderate; air moderate; safety mixed; walkability high; mortality context mixed |
| Argentina | Cordoba | 0.0y | Healthcare moderate; air moderate; safety mixed; walkability moderate; mortality context mixed |
| Argentina | Mendoza | +0.2y | Healthcare moderate; air moderate; safety moderate; walkability moderate; mortality context mixed |
| Australia | Adelaide | +2.0y | Healthcare high; air high; safety high; walkability moderate; mortality context high |
| Australia | Brisbane | +2.0y | Healthcare high; air high; safety high; walkability moderate; mortality context high |
| Australia | Canberra | +2.2y | Healthcare high; air high; safety very high; walkability moderate; mortality context high |
| Australia | Melbourne | +2.2y | Healthcare high; air high; safety high; walkability high; mortality context high |
| Australia | Perth | +2.0y | Healthcare high; air high; safety high; walkability moderate; mortality context high |
| Australia | Sydney | +2.1y | Healthcare high; air high; safety high; walkability high; mortality context high |
| Austria | Graz | +2.2y | Healthcare high; air high; safety high; walkability high; mortality context high |
| Austria | Vienna | +2.3y | Healthcare high; air high; safety high; walkability very high; mortality context high |
| Belgium | Antwerp | +1.9y | Healthcare high; air moderate; safety high; walkability high; mortality context high |
| Belgium | Brussels | +1.9y | Healthcare high; air moderate; safety high; walkability high; mortality context high |
| Belgium | Ghent | +2.0y | Healthcare high; air moderate; safety high; walkability high; mortality context high |
| Brazil | Belo Horizonte | -0.6y | Healthcare moderate; air moderate; safety mixed; walkability moderate; mortality context mixed |
| Brazil | Brasilia | -0.6y | Healthcare moderate; air moderate; safety mixed; walkability low; mortality context mixed |
| Brazil | Curitiba | -0.4y | Healthcare moderate; air moderate; safety mixed; walkability moderate; mortality context mixed |
| Brazil | Florianopolis | -0.2y | Healthcare moderate; air high; safety moderate; walkability moderate; mortality context mixed |
| Brazil | Porto Alegre | -0.6y | Healthcare moderate; air moderate; safety mixed; walkability moderate; mortality context mixed |
| Brazil | Recife | -0.9y | Healthcare moderate; air moderate; safety mixed; walkability moderate; mortality context mixed |
| Brazil | Rio de Janeiro | -0.9y | Healthcare moderate; air moderate; safety mixed; walkability high; mortality context mixed |
| Brazil | Salvador | -1.0y | Healthcare moderate; air moderate; safety mixed; walkability moderate; mortality context mixed |
| Brazil | Sao Paulo | -0.7y | Healthcare moderate; air mixed; safety mixed; walkability high; mortality context mixed |
| Canada | Calgary | +2.1y | Healthcare high; air high; safety high; walkability moderate; mortality context high |
| Canada | Edmonton | +2.0y | Healthcare high; air high; safety high; walkability moderate; mortality context high |
| Canada | Halifax | +2.1y | Healthcare high; air high; safety high; walkability moderate; mortality context high |
| Canada | Montreal | +2.1y | Healthcare high; air high; safety high; walkability high; mortality context high |
| Canada | Ottawa | +2.2y | Healthcare high; air high; safety very high; walkability moderate; mortality context high |
| Canada | Quebec City | +2.2y | Healthcare high; air high; safety very high; walkability high; mortality context high |
| Canada | Toronto | +2.2y | Healthcare high; air high; safety high; walkability high; mortality context high |
| Canada | Vancouver | +2.3y | Healthcare high; air high; safety high; walkability high; mortality context high |
| Chile | Santiago | +0.7y | Healthcare moderate; air mixed; safety moderate; walkability moderate; mortality context moderate |
| Chile | Valparaiso | +0.5y | Healthcare moderate; air moderate; safety mixed; walkability moderate; mortality context moderate |
| China | Beijing | +0.6y | Healthcare high; air mixed; safety high; walkability moderate; mortality context moderate |
| China | Chengdu | +0.5y | Healthcare moderate; air mixed; safety high; walkability moderate; mortality context moderate |
| China | Chongqing | +0.4y | Healthcare moderate; air mixed; safety high; walkability moderate; mortality context moderate |
| China | Guangzhou | +0.6y | Healthcare high; air mixed; safety high; walkability moderate; mortality context moderate |
| China | Hangzhou | +0.8y | Healthcare high; air moderate; safety high; walkability moderate; mortality context moderate |
| China | Nanjing | +0.7y | Healthcare high; air mixed; safety high; walkability moderate; mortality context moderate |
| China | Shanghai | +0.9y | Healthcare high; air moderate; safety high; walkability high; mortality context moderate |
| China | Shenzhen | +0.8y | Healthcare high; air moderate; safety high; walkability moderate; mortality context moderate |
| China | Suzhou | +0.7y | Healthcare high; air moderate; safety high; walkability moderate; mortality context moderate |
| China | Wuhan | +0.5y | Healthcare high; air mixed; safety high; walkability moderate; mortality context moderate |
| China | Xian | +0.4y | Healthcare moderate; air mixed; safety high; walkability moderate; mortality context moderate |
| Czechia | Brno | +0.8y | Healthcare high; air moderate; safety high; walkability high; mortality context moderate |
| Czechia | Prague | +0.9y | Healthcare high; air moderate; safety high; walkability very high; mortality context moderate |
| Denmark | Aarhus | +2.3y | Healthcare high; air high; safety very high; walkability high; mortality context high |
| Denmark | Copenhagen | +2.3y | Healthcare high; air high; safety very high; walkability very high; mortality context high |
| Egypt | Alexandria | -1.8y | Healthcare mixed; air mixed; safety mixed; walkability moderate; mortality context low |
| Egypt | Cairo | -2.1y | Healthcare mixed; air low; safety mixed; walkability moderate; mortality context low |
| Finland | Helsinki | +2.3y | Healthcare high; air high; safety very high; walkability high; mortality context high |
| Finland | Tampere | +2.2y | Healthcare high; air high; safety very high; walkability moderate; mortality context high |
| France | Bordeaux | +2.0y | Healthcare high; air high; safety high; walkability high; mortality context high |
| France | Lille | +1.9y | Healthcare high; air moderate; safety high; walkability high; mortality context high |
| France | Lyon | +2.1y | Healthcare high; air moderate; safety high; walkability high; mortality context high |
| France | Marseille | +1.9y | Healthcare high; air moderate; safety mixed; walkability moderate; mortality context high |
| France | Montpellier | +2.0y | Healthcare high; air high; safety high; walkability high; mortality context high |
| France | Nantes | +2.0y | Healthcare high; air high; safety high; walkability high; mortality context high |
| France | Nice | +2.0y | Healthcare high; air high; safety high; walkability high; mortality context high |
| France | Paris | +2.1y | Healthcare high; air moderate; safety high; walkability very high; mortality context high |
| France | Strasbourg | +2.0y | Healthcare high; air high; safety high; walkability very high; mortality context high |
| France | Toulouse | +2.0y | Healthcare high; air high; safety high; walkability high; mortality context high |
| Germany | Berlin | +2.1y | Healthcare high; air high; safety high; walkability very high; mortality context high |
| Germany | Cologne | +2.0y | Healthcare high; air moderate; safety high; walkability high; mortality context high |
| Germany | Dresden | +2.0y | Healthcare high; air high; safety high; walkability high; mortality context high |
| Germany | Dusseldorf | +2.0y | Healthcare high; air moderate; safety high; walkability high; mortality context high |
| Germany | Frankfurt | +2.0y | Healthcare high; air moderate; safety high; walkability high; mortality context high |
| Germany | Hamburg | +2.0y | Healthcare high; air high; safety high; walkability high; mortality context high |
| Germany | Hannover | +2.0y | Healthcare high; air high; safety high; walkability moderate; mortality context high |
| Germany | Leipzig | +1.9y | Healthcare high; air high; safety high; walkability high; mortality context high |
| Germany | Munich | +2.2y | Healthcare high; air high; safety very high; walkability high; mortality context high |
| Germany | Stuttgart | +2.0y | Healthcare high; air moderate; safety high; walkability moderate; mortality context high |
| Greece | Athens | +1.2y | Healthcare high; air moderate; safety moderate; walkability high; mortality context moderate |
| Greece | Thessaloniki | +1.0y | Healthcare high; air moderate; safety moderate; walkability high; mortality context moderate |
| India | Ahmedabad | -1.8y | Healthcare mixed; air low; safety mixed; walkability moderate; mortality context low |
| India | Bangalore | -1.4y | Healthcare moderate; air mixed; safety mixed; walkability moderate; mortality context low |
| India | Chennai | -1.7y | Healthcare moderate; air mixed; safety mixed; walkability moderate; mortality context low |
| India | Delhi | -2.2y | Healthcare moderate; air low; safety mixed; walkability moderate; mortality context low |
| India | Hyderabad | -1.6y | Healthcare moderate; air mixed; safety mixed; walkability moderate; mortality context low |
| India | Kolkata | -1.9y | Healthcare mixed; air low; safety mixed; walkability moderate; mortality context low |
| India | Mumbai | -1.7y | Healthcare moderate; air mixed; safety mixed; walkability high; mortality context low |
| India | Pune | -1.5y | Healthcare moderate; air mixed; safety mixed; walkability moderate; mortality context low |
| Ireland | Cork | +1.9y | Healthcare high; air high; safety high; walkability moderate; mortality context high |
| Ireland | Dublin | +1.9y | Healthcare high; air high; safety high; walkability high; mortality context high |
| Israel | Haifa | +2.0y | Healthcare high; air moderate; safety moderate; walkability moderate; mortality context high |
| Israel | Jerusalem | +2.0y | Healthcare high; air moderate; safety moderate; walkability high; mortality context high |
| Israel | Tel Aviv | +2.1y | Healthcare high; air moderate; safety moderate; walkability very high; mortality context high |
| Italy | Bari | +1.9y | Healthcare high; air high; safety moderate; walkability high; mortality context high |
| Italy | Bologna | +2.2y | Healthcare high; air moderate; safety high; walkability very high; mortality context high |
| Italy | Catania | +1.6y | Healthcare high; air moderate; safety mixed; walkability moderate; mortality context high |
| Italy | Florence | +2.2y | Healthcare high; air high; safety high; walkability very high; mortality context high |
| Italy | Genoa | +2.0y | Healthcare high; air high; safety high; walkability moderate; mortality context high |
| Italy | Milan | +2.3y | Healthcare high; air mixed; safety high; walkability very high; mortality context high |
| Italy | Naples | +1.7y | Healthcare high; air moderate; safety mixed; walkability high; mortality context high |
| Italy | Padua | +2.2y | Healthcare high; air moderate; safety high; walkability high; mortality context high |
| Italy | Palermo | +1.7y | Healthcare high; air moderate; safety mixed; walkability moderate; mortality context high |
| Italy | Rome | +2.1y | Healthcare high; air moderate; safety high; walkability high; mortality context high |
| Italy | Turin | +2.0y | Healthcare high; air mixed; safety high; walkability high; mortality context high |
| Italy | Venice | +2.1y | Healthcare high; air moderate; safety high; walkability very high; mortality context high |
| Italy | Verona | +2.1y | Healthcare high; air moderate; safety high; walkability high; mortality context high |
| Japan | Fukuoka | +3.1y | Healthcare very high; air high; safety very high; walkability high; mortality context very high |
| Japan | Kyoto | +3.2y | Healthcare very high; air high; safety very high; walkability very high; mortality context very high |
| Japan | Nagoya | +3.1y | Healthcare very high; air high; safety very high; walkability high; mortality context very high |
| Japan | Osaka | +3.1y | Healthcare very high; air high; safety very high; walkability very high; mortality context very high |
| Japan | Sapporo | +3.1y | Healthcare very high; air high; safety very high; walkability high; mortality context very high |
| Japan | Tokyo | +3.3y | Healthcare very high; air high; safety very high; walkability very high; mortality context very high |
| Japan | Yokohama | +3.1y | Healthcare very high; air high; safety very high; walkability high; mortality context very high |
| Malaysia | George Town | +0.3y | Healthcare moderate; air moderate; safety moderate; walkability high; mortality context moderate |
| Malaysia | Kuala Lumpur | +0.2y | Healthcare moderate; air mixed; safety moderate; walkability moderate; mortality context moderate |
| Mexico | Guadalajara | -0.7y | Healthcare moderate; air moderate; safety mixed; walkability moderate; mortality context mixed |
| Mexico | Merida | -0.4y | Healthcare moderate; air high; safety moderate; walkability moderate; mortality context mixed |
| Mexico | Mexico City | -0.8y | Healthcare moderate; air mixed; safety mixed; walkability high; mortality context mixed |
| Mexico | Monterrey | -0.6y | Healthcare moderate; air mixed; safety mixed; walkability moderate; mortality context mixed |
| Mexico | Puebla | -0.7y | Healthcare moderate; air moderate; safety mixed; walkability moderate; mortality context mixed |
| Netherlands | Amsterdam | +2.1y | Healthcare high; air high; safety high; walkability very high; mortality context high |
| Netherlands | Eindhoven | +2.0y | Healthcare high; air high; safety high; walkability high; mortality context high |
| Netherlands | Rotterdam | +2.0y | Healthcare high; air moderate; safety high; walkability high; mortality context high |
| Netherlands | The Hague | +2.1y | Healthcare high; air high; safety high; walkability very high; mortality context high |
| New Zealand | Auckland | +2.2y | Healthcare high; air high; safety high; walkability moderate; mortality context high |
| New Zealand | Christchurch | +2.2y | Healthcare high; air high; safety high; walkability moderate; mortality context high |
| New Zealand | Wellington | +2.2y | Healthcare high; air high; safety high; walkability high; mortality context high |
| Norway | Bergen | +2.4y | Healthcare high; air high; safety very high; walkability moderate; mortality context high |
| Norway | Oslo | +2.5y | Healthcare high; air high; safety very high; walkability high; mortality context high |
| Norway | Trondheim | +2.4y | Healthcare high; air high; safety very high; walkability high; mortality context high |
| Poland | Gdansk | +0.6y | Healthcare high; air moderate; safety high; walkability high; mortality context moderate |
| Poland | Krakow | +0.5y | Healthcare high; air mixed; safety high; walkability high; mortality context moderate |
| Poland | Warsaw | +0.4y | Healthcare high; air moderate; safety high; walkability high; mortality context moderate |
| Poland | Wroclaw | +0.5y | Healthcare high; air moderate; safety high; walkability high; mortality context moderate |
| Portugal | Braga | +2.0y | Healthcare high; air high; safety high; walkability moderate; mortality context high |
| Portugal | Coimbra | +2.0y | Healthcare high; air high; safety high; walkability high; mortality context high |
| Portugal | Lisbon | +2.0y | Healthcare high; air high; safety high; walkability very high; mortality context high |
| Portugal | Porto | +2.0y | Healthcare high; air high; safety high; walkability high; mortality context high |
| Singapore | Singapore | +3.4y | Healthcare very high; air moderate; safety very high; walkability high; mortality context very high |
| South Africa | Cape Town | -2.0y | Healthcare mixed; air moderate; safety mixed; walkability moderate; mortality context low |
| South Africa | Durban | -2.2y | Healthcare mixed; air moderate; safety mixed; walkability moderate; mortality context low |
| South Africa | Johannesburg | -2.3y | Healthcare mixed; air moderate; safety mixed; walkability low; mortality context low |
| South Africa | Pretoria | -2.1y | Healthcare mixed; air moderate; safety mixed; walkability low; mortality context low |
| South Korea | Busan | +2.7y | Healthcare very high; air high; safety very high; walkability high; mortality context high |
| South Korea | Daegu | +2.6y | Healthcare very high; air moderate; safety very high; walkability high; mortality context high |
| South Korea | Daejeon | +2.7y | Healthcare very high; air high; safety very high; walkability moderate; mortality context high |
| South Korea | Incheon | +2.6y | Healthcare very high; air moderate; safety very high; walkability moderate; mortality context high |
| South Korea | Seoul | +2.8y | Healthcare very high; air moderate; safety very high; walkability very high; mortality context high |
| Spain | Barcelona | +2.1y | Healthcare high; air moderate; safety high; walkability very high; mortality context high |
| Spain | Bilbao | +2.1y | Healthcare high; air high; safety high; walkability high; mortality context high |
| Spain | Madrid | +2.2y | Healthcare high; air moderate; safety high; walkability high; mortality context high |
| Spain | Malaga | +2.0y | Healthcare high; air high; safety high; walkability high; mortality context high |
| Spain | Seville | +2.0y | Healthcare high; air moderate; safety high; walkability high; mortality context high |
| Spain | Valencia | +2.1y | Healthcare high; air high; safety high; walkability very high; mortality context high |
| Sweden | Gothenburg | +2.3y | Healthcare high; air high; safety very high; walkability high; mortality context high |
| Sweden | Malmo | +2.2y | Healthcare high; air high; safety high; walkability very high; mortality context high |
| Sweden | Stockholm | +2.4y | Healthcare high; air high; safety very high; walkability very high; mortality context high |
| Switzerland | Basel | +3.0y | Healthcare very high; air high; safety very high; walkability high; mortality context very high |
| Switzerland | Bern | +3.1y | Healthcare very high; air high; safety very high; walkability high; mortality context very high |
| Switzerland | Geneva | +3.1y | Healthcare very high; air high; safety very high; walkability high; mortality context very high |
| Switzerland | Lausanne | +3.1y | Healthcare very high; air high; safety very high; walkability high; mortality context very high |
| Switzerland | Zurich | +3.2y | Healthcare very high; air high; safety very high; walkability very high; mortality context very high |
| Taiwan | Kaohsiung | +2.2y | Healthcare high; air moderate; safety high; walkability moderate; mortality context high |
| Taiwan | Taichung | +2.3y | Healthcare high; air moderate; safety high; walkability moderate; mortality context high |
| Taiwan | Taipei | +2.4y | Healthcare high; air moderate; safety high; walkability very high; mortality context high |
| Thailand | Bangkok | -0.3y | Healthcare moderate; air mixed; safety moderate; walkability moderate; mortality context mixed |
| Thailand | Chiang Mai | -0.4y | Healthcare moderate; air mixed; safety moderate; walkability moderate; mortality context mixed |
| Turkey | Ankara | -0.2y | Healthcare moderate; air moderate; safety moderate; walkability moderate; mortality context mixed |
| Turkey | Istanbul | -0.4y | Healthcare moderate; air mixed; safety moderate; walkability high; mortality context mixed |
| United Arab Emirates | Abu Dhabi | +0.9y | Healthcare high; air mixed; safety very high; walkability moderate; mortality context moderate |
| United Arab Emirates | Dubai | +0.8y | Healthcare high; air mixed; safety high; walkability moderate; mortality context moderate |
| United Kingdom | Belfast | +1.4y | Healthcare high; air high; safety moderate; walkability moderate; mortality context moderate |
| United Kingdom | Birmingham | +1.5y | Healthcare high; air moderate; safety moderate; walkability moderate; mortality context moderate |
| United Kingdom | Bristol | +1.7y | Healthcare high; air high; safety high; walkability high; mortality context moderate |
| United Kingdom | Cardiff | +1.6y | Healthcare high; air high; safety high; walkability high; mortality context moderate |
| United Kingdom | Edinburgh | +1.7y | Healthcare high; air high; safety high; walkability very high; mortality context moderate |
| United Kingdom | Glasgow | +1.3y | Healthcare high; air high; safety moderate; walkability high; mortality context moderate |
| United Kingdom | Leeds | +1.5y | Healthcare high; air moderate; safety moderate; walkability moderate; mortality context moderate |
| United Kingdom | Liverpool | +1.4y | Healthcare high; air moderate; safety moderate; walkability high; mortality context moderate |
| United Kingdom | London | +1.7y | Healthcare high; air moderate; safety high; walkability very high; mortality context moderate |
| United Kingdom | Manchester | +1.5y | Healthcare high; air moderate; safety moderate; walkability high; mortality context moderate |
| United Kingdom | Newcastle | +1.4y | Healthcare high; air high; safety moderate; walkability high; mortality context moderate |
| United States | Atlanta | +0.4y | Healthcare high; air moderate; safety mixed; walkability moderate; mortality context mixed |
| United States | Austin | +0.6y | Healthcare high; air moderate; safety moderate; walkability moderate; mortality context mixed |
| United States | Baltimore | +0.2y | Healthcare high; air moderate; safety mixed; walkability moderate; mortality context mixed |
| United States | Boston | +0.9y | Healthcare high; air high; safety high; walkability very high; mortality context mixed |
| United States | Charlotte | +0.4y | Healthcare high; air moderate; safety moderate; walkability low; mortality context mixed |
| United States | Chicago | +0.5y | Healthcare high; air moderate; safety mixed; walkability high; mortality context mixed |
| United States | Dallas | +0.4y | Healthcare high; air moderate; safety moderate; walkability low; mortality context mixed |
| United States | Denver | +0.7y | Healthcare high; air moderate; safety moderate; walkability moderate; mortality context mixed |
| United States | Houston | +0.3y | Healthcare high; air mixed; safety moderate; walkability low; mortality context mixed |
| United States | Las Vegas | +0.2y | Healthcare high; air moderate; safety moderate; walkability low; mortality context mixed |
| United States | Los Angeles | +0.5y | Healthcare high; air mixed; safety moderate; walkability moderate; mortality context mixed |
| United States | Miami | +0.5y | Healthcare high; air high; safety moderate; walkability moderate; mortality context mixed |
| United States | Minneapolis | +0.7y | Healthcare high; air high; safety high; walkability high; mortality context mixed |
| United States | Nashville | +0.3y | Healthcare high; air moderate; safety moderate; walkability low; mortality context mixed |
| United States | New Orleans | +0.1y | Healthcare high; air moderate; safety mixed; walkability moderate; mortality context mixed |
| United States | New York | +0.8y | Healthcare high; air moderate; safety moderate; walkability very high; mortality context mixed |
| United States | Orlando | +0.4y | Healthcare high; air moderate; safety moderate; walkability low; mortality context mixed |
| United States | Philadelphia | +0.5y | Healthcare high; air moderate; safety mixed; walkability high; mortality context mixed |
| United States | Phoenix | +0.2y | Healthcare high; air moderate; safety moderate; walkability low; mortality context mixed |
| United States | Portland | +0.7y | Healthcare high; air high; safety moderate; walkability high; mortality context mixed |
| United States | Sacramento | +0.5y | Healthcare high; air moderate; safety moderate; walkability moderate; mortality context mixed |
| United States | San Antonio | +0.3y | Healthcare high; air moderate; safety moderate; walkability low; mortality context mixed |
| United States | San Diego | +0.8y | Healthcare high; air high; safety high; walkability moderate; mortality context mixed |
| United States | San Francisco | +0.8y | Healthcare high; air high; safety moderate; walkability very high; mortality context mixed |
| United States | San Jose | +0.8y | Healthcare high; air high; safety high; walkability moderate; mortality context mixed |
| United States | Seattle | +0.9y | Healthcare high; air high; safety high; walkability high; mortality context mixed |
| United States | Tampa | +0.4y | Healthcare high; air high; safety moderate; walkability low; mortality context mixed |
| United States | Washington | +0.7y | Healthcare high; air moderate; safety mixed; walkability very high; mortality context mixed |