Question

You have been asked to provide evidence of the health status of a given population (state or country); which rates and measurements would you use? why?

Answer 1

There are 3 main measures and rates used to indicate health status of a population:-

1. Mortality- Number or rate of death is very essential to identify the impact of a particular disease. Age related mortality rate provide additional insight. Age at death and cause provide instant depiction of health status. Mortality provides crude butbut simple way to assess health conditions.
2. Morbidity- Morbidity can be described using the following frequency measurements: hospital discharge rate, attack/incidence rate, prevalence and case fatality. In CVD, attack rates generally include first and recurrent events, while incidence rates represent only first event. The importance of these measures differs according to the disease as well as the age range. In younger age groups the most important indicators are incidence, case fatality and prevalence; in older people, attack rate and prevalence are more important since patients with chronic diseases require more continuous therapy and rehabilitation, and have a greater impact on the public health system. For acute events, incidence rates are in general target measures, while for chronic conditions incidence as well as prevalence may be of interest. Incidence is used mostly for etiological research objectives; attack rate and prevalence are useful for hospital planning and for primary care.
3. Disability- Disability-Adjusted Life Year (DALY): takes into account years lost due to premature mortality and years lived with disability . It is equal to the sum of the number of years of life lost due to CVD in a population (YLL) and the number of years lived with disability of known severity and duration for a CVD in a population (YLD); ii) Potential Years of Life Lost (PYLL): it is a measure of the impact of premature mortality on the population. PYLL is the sum of the years that people dying from a CVD would have lived, had they experienced a normal life expectancy, usually determined at 65 years; iii) Activities of Daily Living (ADL): the ADL index measures six basic functions (moving between rooms, using the lavatory, washing and bathing, dressing and undressing, getting in and out of bed, and feeding oneself) and has a score of A (independent in every item), B (dependent in one item), C (dependent in two items), D (dependent in three items), E (dependent in four items), F (dependent in five items) and G (dependent in all functions),iv) Instrumental Activities of Daily Living (IADL): the IADL-scale measures more complex functions (using the telephone, getting to places beyond walking distance, grocery shopping, preparing meals, doing housework or handyman work, doing laundry, taking medications, managing money). The score ranges from 8 (able to perform all functions) to 0 (cannot perform any function. v) EuroQol (EQ): the EQ is a standardised instrument for use as a measure of health outcome. Applicable to a wide range of health conditions and treatments, it provides a simple descriptive profile and a single index value for health status that can be used in the clinical and economic evaluation of health care as well as population health survey.