Abstract
This study developed and validated a Korean community health determinants index (K-CHDI), which can be used to assess the health status of the community. To develop composite indicators, we followed the guidelines of the Joint Research Centre of the Organization for Economic Cooperation and Development. We reviewed previous studies and formed a theoretical framework to systematize our domains and indicators, which were decided through a Delphi survey of healthcare experts. Data on indicators were obtained from the Korean Statistics and Community Health Survey. We applied the Min-Max normalization method and measured weights by the analytic hierarchy process. Health outcomes were estimated using mortality, years of life lost, years lived with disability, and disability-adjusted life years by standardizing sex and age. The value of the index is between 0 and 1; higher values indicate more positive health determinants. K-CHDI for 250 subnational regions (cities, counties, and districts, or Si·Gun·Gu) were correlated with health outcomes. The correlation coefficient was stronger in large cities than in medium-sized areas and small areas, and the higher the K-CHDI group, the higher the coefficient. The K-CHDI represents a reference standard for estimating health status using health determinants as composite indicators at the subnational level.
Highlights
In population health, various health determinants affect health gaps between groups, which is as important as the health gap between individuals [1]
In the opinion of our experts, health behaviors of the region should be included as the health determinants, and we categorized those indicators as an independent domain
Korean Community Health Determinants Index (K-CHDI) was developed by standardizing the Min-Max normalization method and applying the weights calculated by the public health experts’ analytic hierarchy process (AHP)
Summary
Various health determinants affect health gaps between groups, which is as important as the health gap between individuals [1]. Monitoring health differences and factors that may affect health variation multidimensionally with reliable, valid, and sustainable measurement is essential for planning related policies to eradicate those gaps. Most previous studies have evaluated health differences according to a single indicator, such as income or education. The composite index is composed of various indicators and calculated as a standardized value; it is highly useful for comparing health status between countries or regions. The Global Burden of Disease (GBD) Study developed a socio-demographic index (SDI), suggesting that a country’s burden of disease varies according to its degree of socioeconomic development [2].
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
