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Measuring Health by Ms.Miha Alam ,University of Waterloo

This short article is focused on challenges of measuring health. It implores on what does it mean to be healthy considering the fact that health is subjective. Being healthy is not just the absence of disease; it entails aspects of physical, psychological, and social wellbeing. Since the definition of health is so subjective, there are huge controversies regarding how to measure health. There are a lot of debates regarding what the best measurements are. Are the indicators really measuring what we want them to measure? Are the indicators accurately depicting the health status of the population? It highlighted the fact that we cannot just measure bad health; we must also measure positive health. For instance, we must not only measure mortality rates but also measure wellbeing and happiness. Measuring health explains that health measurements are moving away from measuring bad health and moving towards a multi-dimensional approach, which is based on reducing health inequalities. The Kendrik article mentioned the four definitions of health. While all four definitions of health are comprehensive, we still cannot just go with one definition. All the definitions need to work together. One major critique of these definitions is that they are extremely individualistic. They don’t take people, culture and context into consideration. An example of this is - What wellbeing means to a woman, woman of color or a transsexual woman all varies. For instance, a woman in India usually has to bear emotional distress from living in a patriarchal society. However, a transsexual woman faces greater psychological stress in India due to the fact that being a trans woman is criminalized by law in India. Hence, health indicators need to not only measure emotional wellbeing of a woman but also transsexual woman in order to maintain a healthier society. Additionally, the definitions of health promote holistic wellbeing; however, for some people like people with disabilities, wellbeing means to maintain a happy and functional lifestyle while living with that disability.

Another concept is the differences and shortcomings of public health and population health.  Segall and Chapell (2000) explain that in order to analyze the population, you have to look at individuals as sample size. The problem with this is that we are using a few individuals to represent a large population. Hence, a researcher is making large generalizations about a population. Secondly, it is hard to make cross-cultural and national comparisons because health is subjective. Further, some measurements are just ignored because cultural factors and cultural norms differ from country to country. For instance, India does not permit abortion rights. Hence, measurements with regards to abortion just don’t exist. Moreover, many measures of health are indirect such as living conditions and smoking and such. Although measuring indirect factors of health is important, forming causal relationship between the independent and dependent variables becomes difficult. The take home of this article was that we need more reliable and better measurements of health.

Lastly, Etches et. al., (2006) iterates that data can be qualitative, quantitative as well as administrative. It can be collected via surveys, modeling and such. Although type of data collected and methods have evolved over the year, it is still hard to measure population health on a global scale.

In conclusion, there are several thematic conclusions that we can draw. First and foremost, health is hard to measure because health is subjective. The concept of measuring health has moved away from measuring illness and disease to measuring wellbeing. There are components of wellbeing, happiness, and psychological stability in measuring health and developing a healthy society. Health care researchers have moved away from just measuring bad health and have now started measuring good health as well. In general, there are problems with measuring health because of linear framework of statistics. There are issues with causality; sometimes indirect variable can affect direct variable as well. A researcher has to figure out which way the causality works. Additionally, several indirect factors can also have significant and consequential affect on health. Hence, these indirect factors must not be ignored. There are also issues with regards to ethics and appropriate research methods discussed above.