Inequalities in health : report of a research working group.

  • Great Britain. Department of Health and Social Security.
Date:
1980
Catalogue details

Licence: Open Government Licence

Credit: Inequalities in health : report of a research working group. Source: Wellcome Collection.

    18/438 (page 10)
    THE CHOICE OF INDICATORS OF HEALTH AND ILL-HEALTH 14.12 We have argued that conceptions of health tend to vary in time and according to place, and that depending on their experiences and situation, societies, and groups within those societies, will tend to emphasise some things more than others. Science, however, demands precision, and different aspects of the meaning of health and ill-health have to be translated into operational terms, and applied systematically. 1.13 Measures of the health of populations can take many different forms. Among the most familiar are mortality rates, prevalence or incidence morbidity rates, sickness-absence rates, and restricted-activity rates. Each of these indicators poses problems of measurement and has its limitations. For example, overdue dependence on mortality rates can induce comparative indifference towards problems of chronic illness. Undue dependence on morbidity-rates can discourage interest in congential and other permanently incapacitating conditions, as well as conditions affecting human well-being which fall outside the conventional classification of morbidity. Examples of the use of indicators are given below. 4.14 Partly because of the problems of measurement, but also (in the kind of analysis we have been invited to make) because of the need for time-series statistics, we have given precedence to mortality rates. However, we wish to call attention to the need for different measures of health in combination, and therefore to the importance of experimenting with indicators which allow relevant experiences among the population to be captured and examined in relation to the allocation of resources for health and the organisation of the health care system. Thus a combined indicator of pain and restricted activity is being developed (Culyer et al, 1972) and in current Canadian work indicators reflecting social, emotional and physical functioning. (Sackett et al, 1977). Again, the need to relate rather complex indicators of depression to the measurement of life events was felt to apply to the community generally and not just those selected for psychiatric treatment (Brown and Harris, 1978). 1-15 A distinction is often made between acute and chronic sickness and attempts are made to relate the utilisation of health services to these conditions. Thus during the early 1970s acute sickness was defined in the General Household Survey as restriction at any time during a two week reference period of the