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
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
Commonly Used Objective Measures
• Laboratory tests
• Radiological tests
• Physical exams
• Performance measures
• Medical records
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
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
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
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
International Efforts in the Measurement of Functioning
and Disability
• The Budapest Initiative on the Measurement of Health Status
• The Washington Group on Disability Statistics
Top Related