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Internationally comparable health indices.

ABSTRACT: One of the most intractable problems in international health research is the lack of comparability of health measures across countries or cultures. We develop a cross-country measurement model for health, in which functional limitations, self-reports of health, and a physical measure are interrelated to construct health indices. To establish comparability across countries, we define the measurement scales by the physical measure while other parameters vary by country to reflect cultural and linguistic differences in response patterns. We find significant cross-country variation in response styles of health reports along with variability in genuine health that is related to differences in national income. Our health indices achieve satisfactory reliability of about 80% and their gradients by age, income, and wealth for the most part show the expected patterns. Moreover, the health indices correlate much more strongly with income and net worth than self-reported health measures.

SUBMITTER: Meijer E

PROVIDER: S-EPMC3601939 | biostudies-literature | 2011 May

REPOSITORIES: biostudies-literature

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Internationally comparable health indices.

Meijer Erik E Kapteyn Arie A Andreyeva Tatiana T

Health economics 20110501 5

One of the most intractable problems in international health research is the lack of comparability of health measures across countries or cultures. We develop a cross-country measurement model for health, in which functional limitations, self-reports of health, and a physical measure are interrelated to construct health indices. To establish comparability across countries, we define the measurement scales by the physical measure while other parameters vary by country to reflect cultural and ling ...[more]

PMID: 20572201

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Project description:Anthropogenic activities are changing the state of ecosystems worldwide, affecting community composition and often resulting in loss of biodiversity. Rivers are among the most impacted ecosystems. Recording their current state with regular biomonitoring is important to assess the future trajectory of biodiversity. Traditional monitoring methods for ecological assessments are costly and time-intensive. Here, we compared monitoring of macroinvertebrates based on environmental DNA (eDNA) sampling with monitoring based on traditional kick-net sampling to assess biodiversity patterns at 92 river sites covering all major Swiss river catchments. From the kick-net community data, a biotic index (IBCH) based on 145 indicator taxa had been established. The index was matched by the taxonomically annotated eDNA data by using a machine learning approach. Our comparison of diversity patterns only uses the zero-radius Operational Taxonomic Units assigned to the indicator taxa. Overall, we found a strong congruence between both methods for the assessment of the total indicator community composition (gamma diversity). However, when assessing biodiversity at the site level (alpha diversity), the methods were less consistent and gave complementary data on composition. Specifically, environmental DNA retrieved significantly fewer indicator taxa per site than the kick-net approach. Importantly, however, the subsequent ecological classification of rivers based on the detected indicators resulted in similar biotic index scores for the kick-net and the eDNA data that was classified using a random forest approach. The majority of the predictions (72%) from the random forest classification resulted in the same river status categories as the kick-net approach. Thus, environmental DNA validly detected indicator communities and, combined with machine learning, provided reliable classifications of the ecological state of rivers. Overall, while environmental DNA gives complementary data on the macroinvertebrate community composition compared to the kick-net approach, the subsequently calculated indices for the ecological classification of river sites are nevertheless directly comparable and consistent.

Project description:OBJECTIVES:To provide a 7-year update of the most recent systematic review about the relationships between political features and population health outcomes. SETTING:Internationally comparative scholarly literature. DATA SOURCES:Ten scholarly bibliographic databases plus supplementary searches in bibliographies and Google Scholar were used to update a previous systematic review. The final search was conducted in November 2017. PRIMARY AND SECONDARY OUTCOME MEASURES:Any population health outcome measure, apart from healthcare spending. RESULTS:73 unique publications were identified from the previous systematic review. The database searches to update the literature identified 45?356 raw records with 35?207 remaining following de-duplication. 55 publications were identified from supplementary searches. In total, 258 publications proceeded to full-text review and 176 were included in narrative synthesis. 85 studies were assessed at low risk of bias, 89 at moderate risk of bias and none at high risk of bias. Assessment could not be conducted for two studies that had only book chapters. No meta-analysis was conducted. 102 studies assessed welfare state generosity and 79 found a positive association. Of the 17 studies that assessed political tradition, 15 were found to show a positive association with the left-of-centre tradition. 44 studies assessed democracy and 34 found a positive association. 28 studies assessed globalisation and 14 found a negative association, while seven were positive and seven inconclusive. CONCLUSIONS:This review concludes that welfare state generosity, left-of-centre democratic political tradition and democracy are generally positively associated with population health. Globalisation may be negatively associated with population health, but the results are less conclusive. It is important for the academic public health community to engage with the political evidence base in its research as well as in stakeholder engagement, in order to facilitate positive outcomes for population health.

Project description:Background:Population health indices such as disability adjusted life years (DALY) and quality adjusted life years (QALY) are often used in an effort to measure health of populations and identify areas of concern that require interventions. There has been an increase of number of population health indices since the last review published more than a decade ago. Therefore, this study aims to provide an overview of existing population health indices and examine the methods used to develop them. Methods:The search was conducted across three databases: PubMed, CINAHL and Emerald using four key concepts: 'health', 'index', 'context', 'develop', which was supplemented with Google searching and reference scanning. A researcher screened the titles, abstracts and subsequently full texts and confirmed the findings with the research team at each stage. Data charting was performed according to the included publications and identified indices. The collation was performed by describing the indices and made observation on its development method using a priori framework consist of four processes: underpinning theory, model or framework; data selection and processing; formation of index; testing of index. Results:Twenty-six publications describing population health indices were included, and 27 indices were identified. These indices covered the following health topics: overall health outcomes (n?=?15), outcomes for specific health topics (n?=?4), diseases outcome (n?=?6), assist health resource allocation for priority minority subgroup or geographic area (n?=?4), quality of health or health care (n?=?2). Twenty-one indices measure health for general populations while six measure defined subpopulations. Fourteen of the indices reported at least one of the development processes according to the a priori framework: underpinning theory, model or framework (n?=?7); data selection and processing (n?=?8); formation of index (n?=?12); testing of index (n?=?9). Conclusions:Few population health indices measure specific health topics or health of specific sub-population. There is also a lack of usage of theories, models or framework in developing these indices. Efforts to develop a guideline is proposed on how population health indices can be developed systematically and rigorously to ensure validity and comprehensive assessment of the indices.

Project description:BackgroundGirls and women need effective, safe, and affordable menstrual products. Single-use menstrual pads and tampons are regularly provided by agencies among resource-poor populations. Reusable menstrual pads (RMPs: fabric layers sewn together by an enterprise for manufacture of menstrual products) may be an effective alternative.MethodsFor this review (PROSPERO CRD42020179545) we searched databases (inception to November 1, 2020) for quantitative and qualitative studies that reported on leakage, acceptability, or safety of RMPs. Findings were summarised or combined using forest plots (random-effects meta-analysis). Potential costs and environmental savings associated with RMPs were estimated.ResultsA total of 44 studies were eligible (~14,800 participants). Most were conducted in low- and middle-income countries (LMIC, 78%), and 20% in refugee settings. The overall quality of studies was low. RMP uptake in cohort studies ranged from 22-100% (12 studies). One Ugandan trial among schoolgirls found leakage with RMPs was lower (44.4%, n = 72) compared to cloths (78%, n = 111, p<0.001). Self-reported skin-irritation was 23.8% after 3 months among RMP-users in a Ugandan cohort in a refugee setting (n = 267), compared to 72.8% at baseline with disposable pad use. There were no objective reports on infection. Challenges with washing and changing RMP were reported in LMIC studies, due to lack of water, privacy, soap, buckets, and sanitation/drying facilities. Among 69 brands, the average price for an RMP was $8.95 (standard deviation [sd] $5.08; LMIC $2.06, n = 10, high-income countries [HIC] $10.11), with a mean estimated lifetime of 4.3 years (sd 2.3; LMIC 2.9, n = 11; HIC 4.9 years, n = 23). In 5-year cost-estimates, in LMICs, 4-25 RMPs per period would be cheaper (170-417 US$) than 9-25 single-use pads, with waste-savings of ~600-1600 single-use pads. In HICs, 4-25 RMPs would be cheaper (33-245 US$) compared to 20 single-use tampons per period, with waste-savings of ~1300 tampons.ConclusionRMPs are used internationally and are an effective, safe, cheaper, and environmentally friendly option for menstrual product provision by programmes. Good quality studies in this field are needed.

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Internationally comparable health indices.

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Internationally comparable health indices.

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