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The Role of Functioning in Measuring Well-Being Jennifer Madans, Ph.D.

The Role of Functioning in Measuring Well-Being Jennifer Madans, Ph.D. Associate Director for Science, NCHS 4 th OECD World Forum on Statistics, Knowledge and Policy - Measuring Well-Being for Development and Policy Making October, 2012. What is Health?.

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The Role of Functioning in Measuring Well-Being Jennifer Madans, Ph.D.

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  1. The Role of Functioning in Measuring Well-Being Jennifer Madans, Ph.D. Associate Director for Science, NCHS 4th OECD World Forum on Statistics, Knowledge and Policy - Measuring Well-Being for Development and Policy Making October, 2012

  2. What is Health? • Medically-based objective definitions • Focus on pathologies/biology • Subjective measure (self-report) used as a proxy for objective measures • Disease state • Use of health care • Subjective measures (self-report) used as the intended indicator of a dimension of health • What concepts are we trying to measure? • How can we operationalize the concept? • Need to address issues of validity and reliability

  3. Commonly Used Objective Measures • Laboratory tests • Radiological tests • Physical exams • Performance measures • Medical records

  4. Commonly Used Subjective Measures as the Intended Indicator • Summary measures of health • Self-reported health status (also used as proxy for objective measures) • Composite measures • Functioning/disability measures • Functioning ‘within the skin’ • Interaction with the environment • Impact of accommodation • Health-related quality of life/well-being

  5. Functioning as the Key to Well Being for Health and Health Care Policy • Role of health statistical agency: Monitor key indicators of health and health care over time and across population subgroups to inform policy • Need for easy to understand summary or composite measures

  6. Functioning as the Key to Well Being for Health and Health Care Policy • Functioning is a critical aspect of health • Functioning can be seen as the outcome of: • Determinants and risk factors • Disease states • Use of health care • Environmental barriers and facilitators

  7. Functioning as the Key to Well Being for Health and Health Care Policy • Policy objective -- Minimize participation restrictions due to limitations in functioning ‘within the skin’ • Statistical data used to: • Measure level of participation and monitor change in participation • Measure level of functioning and change in functional abilities ‘within the skin’ and with accommodation • Relate to program and policy interventions

  8. International Efforts in the Measurement of Functioning and Disability • The Budapest Initiative on the Measurement of Health Status • The Washington Group on Disability Statistics

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