Changeset 21613 in main

09/21/20 22:20:10 (4 weeks ago)
Katherine Benson

Updated text for OverallHealth?.xml health topic.

1 edited


  • adopters/hi/branches/2.3/src/main/webapps/ibisph-view-content/xml/topic/html_content/OverallHealth.xml

    r18891 r21613  
    1919                        <TITLE>Description</TITLE>
    2020                        <CONTENT>
    21                                 Summary measures of health status are statistics that use mortality data, or combine mortality and
    22                                 morbidity data to represent overall population health in a single number.<span class="SmallerFont"><sup><a href="#ref1">1</a></sup></span>
    23                                 Examples of summary measures include general health status and healthy days measures from the
    24                                 Behavioral Risk Factor Surveillance System (BRFSS) surveys, life expectancy, and years of potential
    25                                 life lost (YPLL). Measures that combine mortality and morbidity include health-adjusted life years
    26                                 (HALYs) or health-adjusted life expectancy (HALE), quality-adjusted life years (QALYs), years of
    27                                 healthy life (YHLs), and disability-adjusted life years (DALYs).
    28                                 <br/><br/>
     21                                Summary measures of overall health status and health-related quality of life (HRQOL) provide
     22                                information on the health of a population. People's subjective assessment of their physical and
     23                                mental health status and level of disability is important because when people feel healthy, they
     24                                are more likely to participate socially and economically in their community. Areas with unhealthy
     25                                populations lose productivity due to lost work time. Healthy residents are essential for creating
     26                                a vibrant and successful community. HRQOL measures have been included in Healthy People 2000,
     27                                2010, and 2020.
     28                                <br/><br/>
     29                                Self-assessed health status is a measure of how an individual perceives their health-rating it
     30                                as excellent, very good, good, fair, or poor. Self-assessed health status has been validated as a
     31                                useful indicator of health for a variety of populations and allows for broad comparisons across
     32                                different conditions and populations.
     33                                <br/><br/>
     34                                Physically and mentally unhealthy days measure the number of days in the past 30 days that
     35                                individuals rated their physical or mental health as not good.
     36                                <br/><br/>
     37                                Limitation of activity refers to a long-term reduction in a person's ability to do their usual
     38                                activities. Since 1997, in the National Health Interview Survey, limitation of activity has been
     39                                assessed by asking people about their limitations in:
     40                                <ul class="Indent">
     41                                        <li>Activities of daily living (such as bathing/showering, dressing, eating, getting in and
     42                                        out of bed, walking, using the toilet)</li>
     43                                        <li>Instrumental activities of daily living (such as using the telephone, doing light housework,
     44                                        doing heavy housework, preparing meals, shopping for personal items, managing money)</li>
     45                                        <li>Play, school, or work</li>
     46                                        <li>Remembering</li>
     47                                        <li>Any other activity that they cannot do because of limitations caused by physical, mental,
     48                                        or emotional problems</li>
     49                                </ul>
     50                                <br/>
     51                                The term disability describes people at risk of a limitation in their ability to fully participate
     52                                in society. People are identified as having a disability through a set of 6 standardized questions
     53                                developed for the American Community Survey (ACS). These questions ask if a person has difficulty
     54                                in any of these 6 domains of functioning:
     55                                <ul class="Indent">
     56                                        <li>Hearing</li>
     57                                        <li>Seeing</li>
     58                                        <li>Concentrating and remembering or making decisions</li>
     59                                        <li>Walking or climbing stairs</li>
     60                                        <li>Dressing or bathing</li>
     61                                        <li>Doing errands alone</li>
     62                                </ul>
     63                        </CONTENT>
     64                </ibis:ExpandableContent>
     66                <ibis:ExpandableContent titleLevel="2">
     67                        <TITLE>Why It's Important</TITLE>
     68                        <CONTENT>
     69                                In Healthy People 2020, the cross-cutting summary measures are called Foundation Health
     70                                Measures. These include measures of Overall Health Status, activity limitation and
     71                                disability. Such measures are a cornerstone of Healthy People because they reflect the
     72                                impact of actions and interventions implemented to achieve the Healthy People objectives
     73                                and goals. The measures are used to monitor improvement in population health in the
     74                                broadest sense.
     75                                <br/><br/>
     76                                <ul class="Indent">
     77                                        <li>Self-assessed health status: In 2017, 17.6% of adults in the United States
     78                                        reported their health to be fair or poor. Self-assessed health status varies by
     79                                        age with older adults being more likely to report fair or poor health. </li>
     80                                        <li>Unhealthy days: In 2017, adults in the United States reported on average 4.0
     81                                        physically unhealthy days and 4.0 mentally unhealthy days in the past 30 days with
     82                                        a combined average of 6.8 mentally or physically unhealthy days compared to 5.3 days
     83                                        among those 65 and older.  Physically unhealthy days increased with age with younger
     84                                        adults (aged 18-34) reporting 2.4 physically unhealthy days compared to 5.3 days
     85                                        among those 65 and older. Mentally unhealthy days decreased with age with adults aged
     86                                        18-34 reporting 4.9 mentally unhealthy days compared to 2.5 days among those 65 and
     87                                        older.</li>
     88                                        <li>Limitation of activity: In 2017, 5.5% of adults ages 18 to 34 (11.2 million
     89                                        adults) had a functional limitation of activity while 20.6% of adults age 65 and
     90                                        older (9.5 million adults) had a limitation of activity.</li>
     91                                        <li>Disability: 22.5% of adults in the U.S. have some type of disability. Adults with
     92                                        disabilities are more likely to be inactive, smoke, have high blood pressure and have
     93                                        obesity. It is estimated that 17% of total health care expenditures are associated
     94                                        with disability. In Hawaii, this amounts to about $1 billion per year.</li>
     95                                </ul>
     96                        </CONTENT>
     97                </ibis:ExpandableContent>
     99                <ibis:ExpandableContent titleLevel="2">
     100                        <TITLE>What Is Known</TITLE>
     101                        <CONTENT>
     102                                In Hawaii in 2017 (BRFSS)
     103                                <ul class="Indent">
     104                                        <li>14.8% of adults reported their health status to be fair or poor. There was no
     105                                        difference in health status by sex, but 25.6% of those aged 75 or older reported
     106                                        fair or poor health compared to only 9.8% among those 18-24 years old. Native
     107                                        Hawaiians (24.6%) were the most likely to report fair or poor health status compared
     108                                        to 11.5% of Caucasians. Low self-reported health status varied by education
     109                                        (40.0% among those with 8th grade education or lower vs. 7.5% among 4-year college
     110                                        graduates or higher) and income (30.8% among those in households earning less than
     111                                        $10,000/year compared to 7.9% in those earning $75,000 or more).</li>
     112                                        <li>10.4% of adults (age-adjusted prevalence) reported 14 or more days of poor
     113                                        physical health and 9.7% reported 14 or more days of poor mental health in the
     114                                        past 30 days.</li>
     115                                        <ul class="Indent">
     116                                                <li>Poor physical health varied by age (17.1% of those 75 years or older and
     117                                                6.6% of those 18-24 years old), race ethnicity (15.9% among Other Pacific
     118                                                Islanders vs 8.1% among Japanese), education (18.0% among those with less than
     119                                                a high school diploma compared to 6.5% among college graduates), and household
     120                                                income (18.6% among those earning less than $10,000/yr compared to 6.6% among
     121                                                those earning $75,000/year).</li>
     122                                                <li>Poor mental health was highest among Other Pacific Islanders (16.7%) and
     123                                                Native Hawaiians (14.4%) and lowest among Chinese and Filipinos (7.1%,
     124                                                respectively). There were also differences by age (12.6% among those 25-34
     125                                                year olds and 5.4% among those 75 years and older), education (16.9% among
     126                                                those with less than a high school diploma compared to 7.4% among college
     127                                                graduates), and income (23.2% among those in households earning $10,000 to
     128                                                $14,999/year compared to 7.4% among those earning $75,000 or more).</li>
     129                                        </ul>
     130                                        <li>20.3% of adults reported at least one disability<span class="SmallerFont"><sup><a href="#ref1">*</a></sup></span>
     131                                        in 2017. Disability varied by age with 48.4% of those over age 75 reporting at
     132                                        least one disability, race ethnicity (39.6% of Other Pacific Islanders and 32.6%
     133                                        of Native Hawaiians compared to 10.6% of Chinese), education (54.5% among those
     134                                        who did not attend high school compared to 12.6% among college graduates), household
     135                                        income (46.3% among those earning less than $10,000/year compared to 11.5% among
     136                                        those earning $75,000 or more), and employment status (83.5% of those who are unable
     137                                        to work report at least one disability compared to 14.8% of those employed for wages).</li>
     138                                </ul>
     139                                <br/>
    29140                                <hr/>
    31141                                <div class="SmallerFont">
    32                                         <a name="ref1"></a>1. Molla MT, Wagener DK, Madans JH. Summary measures of population health:
    33                                         Methods for calculating healthy life expectancy. Healthy People Statistical Notes, no. 21.
    34                                         Hyattsville, Maryland: National Center for Health Statistics. August 2001. Downloaded from
    35                                         <a href="">
    36                               </a> on 2/10/2015.
    37                                         <br/>
     142                                        <a name="ref1"></a>* Based on a series of questions. Are you blind or do you have
     143                                        serious difficulty seeing, even when wearing glasses? Are you deaf or do you have
     144                                        serious difficulty hearing? Because of a physical, mental, or emotional condition,
     145                                        do you have serious difficulty concentrating, remembering, or making decisions? Do you
     146                                        have difficulty dressing or bathing? Do you have serious difficulty walking or climbing
     147                                        stairs?
    38148                                </div>
    39149                        </CONTENT>
    42152                <ibis:ExpandableContent titleLevel="2">
    43                         <TITLE>Why It's Important</TITLE>
    44                         <CONTENT>
    45                                 Bergner and Rothman<span class="SmallerFont"><sup><a href="#ref2">2</a></sup></span> have suggested
    46                                 that health status assessment measures serve four different functions, including examination of the
    47                                 health of general populations, clinical interventions and their effects, changes in the health care
    48                                 delivery system, and health promotion activities and their effects.
    49                                 <br/><br/>
    50                                 <hr/>
    52                                 <div class="SmallerFont">
    53                                         <a name="ref2"></a>2. Bergner, M, and Rothman, ML. <a href="">
    54                                         Health Status Measures: An Overview and Guide for Selection</a>. <i>Annual Review of Public Health</i>
    55                                         8:191-210, 1987.
    56                                         As cited in Marilyn J. Field and Marthe R. Gold (Eds.) Summarizing Population Health: Directions
    57                                         for the Development and Application of Population Metrics, Committee on Summary Measures of
    58                                         Population Health. Institute of Medicine. Washington D.C., National Academy Press. 1998.
    59                                         Downloaded from <a href="">
    60                               </a> on 2/10/2015.
    61                                         <br/>
    62                                 </div>
    63                         </CONTENT>
    64                 </ibis:ExpandableContent>
    66                 <ibis:ExpandableContent titleLevel="2">
    67                         <TITLE>What Is Known</TITLE>
    68                         <CONTENT>
    70                         </CONTENT>
    71                 </ibis:ExpandableContent>
    73                 <ibis:ExpandableContent titleLevel="2">
    74153                        <TITLE>Who Is at Risk</TITLE>
    75154                        <CONTENT>
    77                         </CONTENT>
    78                 </ibis:ExpandableContent>
    80                 <ibis:ExpandableContent titleLevel="2">
    81                         <TITLE>How To Reduce Risk</TITLE>
    82                         <CONTENT>
    84                         </CONTENT>
    85                 </ibis:ExpandableContent>
     155                                There is no sole determinant of individual well-being. However, well-being is usually
     156                                dependent upon good health, positive social relationships, and availability and access
     157                                to basic resources (e.g., shelter, income).
     158                                <br/><br/>
     159                                Numerous studies have examined the associations between determinants of individual and
     160                                national levels of well-being. Many of these studies have used different measures of
     161                                well-being (e.g., life satisfaction, positive affect, psychological well-being), and
     162                                different methodologies resulting in occasional inconsistent findings related to well-being
     163                                and its predictors. In general, life satisfaction is dependent more closely on the
     164                                availability of basic needs being met (food, shelter, income) as well as access to modern
     165                                conveniences (e.g., electricity). Pleasant emotions are more closely associated with having
     166                                supportive relationships.
     167                                <ul class="Indent">
     168                                        <li>Some personality factors that are strongly associated with well-being include optimism,
     169                                        extroversion and self-esteem.</li>
     170                                        <li>Men and women tend to have similar levels of well-being.</li>
     171                                        <li>There is a U-shaped distribution of well-being by age where young and older adults
     172                                        tend to have more well-being than middle age adults.</li>
     173                                        <li>The relationship between income and well-being is complex. Depending on which types
     174                                        of measures are used and which comparisons are made, income correlates only modestly with
     175                                        well-being. In general, associations between income and well-being (usually measured in
     176                                        terms of life satisfaction) are stronger for those at lower economic levels, but studies
     177                                        also have found effects for those at higher income levels. Paid employment is critical
     178                                        to the well-being of individuals by conferring direct access to resources, as well as
     179                                        fostering satisfaction, meaning and purpose for some. Unemployment negatively affects
     180                                        well-being, both in the short- and long-term.</li>
     181                                        <li>Having supportive relationships is one of the strongest predictors of well-being,
     182                                        having a notably positive effect.</li>
     183                                </ul>
     184                        </CONTENT>
     185                </ibis:ExpandableContent>
    88187                <ibis:ExpandableContent titleLevel="2">
    89188                        <TITLE>How It's Tracked</TITLE>
    90189                        <CONTENT>
    91                                 A description of Life Expectancy calculation may be found on the
    92                                 <a ibis:href="resource/LifeExp.html">Life Expectancy</a> resource page in NM-IBIS.
    93                         </CONTENT>
    94                 </ibis:ExpandableContent>
     190                                Self-assessed health status and activity limitation are collected via the National Health
     191                                Interview Survey (NHIS), the Behavioral Risk Factor Surveillance System (BRFSS), and the
     192                                Youth Risk Behavior Survey (YRBS).
     193                                <br/><br/>
     194                                Disability is collected via the American Community Survey (ACS) and the BRFSS.
     195                                <br/><br/>
     196                                The CDC Healthy Days measures are an acknowledged standard for population health surveillance
     197                                by national and international groups. The Healthy Days questions have been included in the
     198                                following surveillance systems.
     199                                <ul class="Indent">
     200                                        <li>Behavioral Risk Factor Surveillance System (BRFSS) from 1993 through present</li>
     201                                        <li>National Health and Nutrition Examination Survey (NHANES) to respondents
     202                                        aged 12 years or older from 2000 to 2012</li>
     203                                        <li>Medicare Health Outcomes Survey (HOS) of Medicare Advantage beneficiaries
     204                                        since 2003. The National Committee for Quality Assurance has adopted the HOS as
     205                                        a component of HEDIS (Health Plan Employer Data and Information Set), the most
     206                                        widely used set of performance measures in the managed care industry.</li>
     207                                </ul>
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    95211<!-- 07202019 commenting out indicator reports for now P. Leo
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     350                                        <SELECTION>
     351                                                <TITLE>Measuring Healthy Days: Population Assessment of Health-Related Quality of Life</TITLE>
     352                                                <URL></URL>
     353                                        </SELECTION>
     354                                        <SELECTION>
     355                                                <TITLE>Disability and Health in Hawaii Factsheet from the CDC's National Center on Birth Defects and Developmental Disabilities</TITLE>
     356                                                <URL></URL>
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    241                 <br/>
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     364                        <TITLE>FAQs and Resources</TITLE>
     365                        <CONTENT>
     366                                <a href="">CDC Health Related Quality of Life</a> program in the Division of Population Health
     367                                <br/>
     368                                <a href="">CDC Disability and Health</a> in the
     369                                CDC's National Center on Birth Defects and Developmental Disabilities
     370                                <br/>
     371                        </CONTENT>
     372                </ibis:ExpandableContent>
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