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Measuring Health Jennifer Madans, Ph.D. Associate Director for Science, NCHS

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Center for Health Statistics. Measuring Health Jennifer Madans, Ph.D. Associate Director for Science, NCHS. Measuring Health is one of NCHS’ Core Activities.

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Measuring Health Jennifer Madans, Ph.D. Associate Director for Science, NCHS

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  1. U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Center for Health Statistics Measuring Health Jennifer Madans, Ph.D. Associate Director for Science, NCHS

  2. Measuring Health is one of NCHS’ Core Activities • First need to determine how to measure health • A philosophical as well as technical challenge • Must meet the needs of various users • Problem is often too many measures but not the right ones • An ongoing challenge

  3. Before 1956 Health statistics in the US available on a continuing, national basis were limited to: • Mortality Rates • New cases of notifiable infectious disease

  4. 1956 National Health Survey ActPublic Law 652, 84th Congress • Authorized the U.S. National Health Survey • NCHS formed by bringing together the National Health Survey and the Vital Statistics System in 1960 • Called for: • Continuing survey and special studies on the Nation’s health • Studying methods and survey techniques for collecting and disseminating statistical

  5. Focus on Social Dimensions of Health “… morbidity is measured along an axis for which the scale is in terms of the effect that the morbidity has upon the lives of the people concerned. Such a scale, … may differ in a number of ways from the scale that medical sciences uses which can be broadly described as a continuum of pathological changes.” From Concepts and Definitions in the Health Household-Interview Survey (Series A-3) Sept 1958

  6. Measuring the Social Dimension of Health • Information on the social dimensions of health requires an interview survey based on self-report • Included an extensive discussion on defining disability • Questions should only ask about what can be learned in interview setting • What people know about their “health” • What they perceive to be the impact of conditions on their daily life

  7. Health as a Social Concept in the National Health Interview Survey • Measures of the Impact of health not of ‘objective’ health • Disability days • Bed Days • Work loss days • Limitation of Activity

  8. Comprehensive Measurement of Health • Recognizing the need for other measures of health, two other survey mechanisms were planned • Health Examination Survey – fielded in 1959 • National Health Care Surveys -- “family” of provider-based surveys • Hospital Discharge Survey fielded in 1965

  9. Objectives for an International Framework for Health Statistics • Clarify the content and hierarchical nature of health measures • Highlight the pressing need for general measures of population health • Identify an overall and coherent set of data collection systems • Identify areas where innovative approaches are needed • Institutionalize partnerships among the national statistical offices, ministries of health, and other constituencies within countries

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