MEASURING POPULATION HEALTH: A Review of Indicators

Abstract

This article reviews the historical development of population health indicators. We have long known that environmental, socioeconomic, early life conditions, individual actions, and medical care all interact to affect health. Present quantitative reporting on the impact of these factors on population health grew out of Bills of Mortality published in the 1500s. Since then, regular censuses, civil registration of vital statistics, and international classification systems have improved data quality and comparability. Regular national health interview surveys and application of administrative data contributed information on morbidity, health services use, and some social determinants of health. More recently, traditional health databases and datasets on "nonhealth" sector determinants have been linked. Statistical methods for map-making, risk adjustment, multilevel analysis, calculating population-attributable risks, and summary measures of population health have further helped to integrate information. Reports on the health of populations remain largely confined to focused areas. This paper suggests a conceptual framework for using indicators to report on all the domains of population health. Future ethical development of indicators will incorporate principles of justice, transparency, and effectiveness.

A Flexible Urban Health Index for Small Area Disparities

“…Perhaps a dozen or more schemes for assessing disparities have been developed. 19,[22][23][24][25][26][27][28][29] Of these, we have devolved on two measures of inequality, both of which derive from the distribution of the indicators (the I i S ) for a small area group. If we order the units by the size of the indicator (that is, by rank) on the abscissa and their Urban Health Index (the geometric mean of the proportions of the standardized indicators for each census tract) on the ordinate, we get a curve with roughly the shape shown in Fig.…”

Obesidad y cáncer en Chile: estimación de las fracciones atribuibles poblacionales

“…Cuarto, los estimados de FAP% para cáncer de mama debieran ser calculados diferencialmente en mujeres premenopáusicas y postmenopáusicas, dado que la evidencia epidemiológica señala que la obesidad estaría asociada a un mayor riesgo de este cáncer sólo en postmenopáusicas 17 . Finalmente, los datos actuales de incidencia representan el impacto por exposición a obesidad en décadas pasadas, donde las prevalencias eran más bajas que las actuales 18 .…”

Cost Variation among Subpopulations of Diverted Drug Offenders under California’s Proposition 36

“…Methods are congruent with standards set in the public health arena to integrate indicators drawn from health and non-health domains and apply cutting-edge statistical techniques to advance understanding of the determinants of health [7]. Briefly, we used a time-lagged cohort of individual offenders meeting SACPA eligibility criteria in the proximate years before the program was enacted (July 1, 1997, to June 30, 1998, N=42,706) to compare to the intervention cohort, which was composed of SACPAeligible nonviolent drug offenders convicted within the first 12 months of SACPA implementation (July 1, 2001, to June 30, 2002, N=37,991).…”

“…Many factors interact to affect health conditions [7], and the success of social interventions can substantially vary among certain populations [8]. Yet most evaluation efforts to date typically focus on determining overall program effects and costs, with less attention to inherent variability within them due to sample characteristics and/or contextual ecologies.…”