Summary Measures Of Population Health Research Articles

Herpes simplex encephalitis

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Global Patterns of Healthy Life Expectancy for Older Women

SUMMARY This paper focuses on patterns of healthy life expectancy for older women around the globe in the year 2000, and on the determinants of differences in disease and injury for older ages. Our study uses data from the World Health Organization for women and men in 191 countries. These data include a summary measure of population health, healthy life expectancy (HALE), which measures the number of years of life expected to be lived in good health, and a complementary measure of the loss of health (disability-adjusted life years or DALYs) due to a comprehensive set of disease and injury causes. We examine two topics in detail: (1) cross-national patterns of female-male differences in healthy life expectancy at age 60; and (2) identification of the major injury and disability causes of disability in women at older ages. Globally, the male-female gap is lower for HALE than for total life expectancy. The sex gap is highest for Russia (10.0 years) and lowest in North Africa and the Middle East, where males and females have similar levels of healthy life expectancy, and in some cases, females have lower levels of healthy life expectancy. We discuss the implications of the findings for international health policy.

HALYS and QALYS and DALYS, Oh My: similarities and differences in summary measures of population Health.

Health-adjusted life years (HALYs) are population health measures permitting morbidity and mortality to be simultaneously described within a single number. They are useful for overall estimates of burden of disease, comparisons of the relative impact of specific illnesses and conditions on communities, and in economic analyses. Quality-adjusted life years (QALYs) and disability-adjusted life years (DALYs) are types of HALYs whose original purposes were at variance. Their growing importance and the varied uptake of the methodology by different U.S. and international entities makes it useful to understand their differences as well as their similarities. A brief history of both measures is presented and methods for calculating them are reviewed. Methodological and ethical issues that have been raised in association with HALYs more generally are presented. Finally, we raise concerns about the practice of using different types of HALYs within different decision-making contexts and urge action that builds and clarifies this useful measurement field.

Update on World Health Organization’s Initiative to Assess Environmental Burden of Disease

∗ This work was in part supported by the United States Environmental Protection Agency, Cooperative Agreement 82 6570 –01-0. The content does not necessarily reflect the views of this Agency, nor of the World Health Organization. Copyright © 2001 by Lippincott Williams & Wilkins, Inc. In August 2000, the World Health Organization organised an expert consultation on Methodology for the assessment of the environmental burden of disease (EBD) in Buffalo, NY, to further advance the agenda of quantifying health impacts caused by environmental factors. The consultation took place following the 12 Annual Meeting of the International Society for Environmental Epidemiology, which also dedicated a special symposium to the environmental burden of disease. This Symposium reported on the progress on estimating the health impacts of indoor air pollution, noise, lead and climate change. Current efforts build on previous results obtained in the 1997 consultation “Methods for Health Impact Assessment in Environmental and Occupational Health”, to which Epidemiology devoted a special section in the September 1999 issue (1). This consultation was part of WHO’s intensified effort to develop methods and support countries by providing guidance to assess their environmental burden of disease in a consistent way. The Consultation was part of an ongoing process aiming at the following:

Summary measures of population health: methods for calculating healthy life expectancy.

This report is one of several appearing as Healthy People Statistical Notes that evaluate methodological issues pertaining to summary measures. Summary measures of population health are statistics that combine mortality and morbidity to represent overall population health in a single number--in this report, health expectancy measures. This report presents a comprehensive discussion of the methods for calculation and methodologic issues related to the interpretation of healthy life expectancy. These measures combine both mortality and morbidity using an abridged life-table procedure. Data from the National Center for Health Statistics and other sources will be used to illustrate the calculation of the statistics and the associated statistical tests.

Summary measures of population health: addressing the first goal of healthy people 2010, improving health expectancy.

This report is one of several Healthy People Statistical Notes that evaluate methodological issues pertaining to summary measures - statistics that combine mortality and morbidity data to represent overall population health in a single number. This report evaluates the consequences of changes in the components of health expectancy measures (i.e., mortality or morbidity) on the overall measure. Any activity limitation is used as a morbidity measure. Simulations are used to evaluate the impacts of reducing 1995 age-specific mortality or activity limitation rates by 5, 10, 25, and 50 percent at all ages. Then it is limited to ages under 25 years, 25 -64 years, and over 64 years. The impact of completely eliminating mortality or activity limitation for the younger age groups is also examined. In general, reducing morbidity rates results in greater changes than the same percent reduction in death rates. The same proportional reduction in age-specific rates for either mortality or morbidity has a greater impact if it occurs at older ages. Reducing mortality results in a greater change in life expectancy than in health expectancy and a decline in the proportion of life lived in healthy states. Reducing morbidity increases both health expectancy and the proportion of life lived in healthy states. Simultaneous reductions in mortality and morbidity have additive effects on health expectancy.

A critical examination of summary measures of population health.

In the past decade, interest has been rising in the development, calculation and use of summary measures of population health, which combine information on mortality and non-fatal health outcomes. This paper reviews the issues and challenges in the design and application of summary measures and presents a framework for evaluating different alternatives. Summary measures have a variety of uses, including comparisons of health in different populations and assessments of the relative contributions of different diseases, injuries and risk factors to the total disease burden in a population. Summary measures may be divided into two broad families: health expectancies and health gaps. Within each family, there are many different possible measures, but they share a number of inputs, including information on mortality, non-fatal health outcomes, and health state valuations. Other critical points include calculation methods and a range of conceptual and methodological issues regarding the definition, measurement and valuation of health states. This paper considers a set of basic criteria and desirable properties that may lead to rejection of certain summary measures and the development of new ones. Despite the extensive developmental agenda that remains, applications of summary measures cannot await the final resolution of all methodological issues, so they should focus on those measures that satisfy as many basic criteria and desirable properties as possible.