Indicators of health and disease frequency measures Manish Chaudhary MPH(BPKIHS) manish264@gmail.com

Indicators of health and disease frequency measures A health indicator is " a construct of public health surveillance that defines a measure of health (i.e., the occurrence of a disease or other health-related event) or a factor associated with health (i.e., health status or other risk factor) among a specified population, " Health indicators represent summary measure that capture relevant information on different health attributes and dimensions, and the performance of the health system. Seen together, these measures attempt to reflect and monitor the health status of a population.

Health indicators Health indicators are required to answer how healthy is a given community. Health indicators measure the health status of community; compare the health status of one country with that of another; assess the health care needs; allocate scare resources; monitor and evaluate health services, activities and programs.

Health indicators should have following characteristics: Should be valid Should be reliable Should be sensitive Should be specific Should be measurable Should be policy relevance Should be easy to use and interpret Should be understandable by information user

Type of health indicators Mortality indicators Morbidity indicators Disability rates Nutritional status indicators Health care delivery indicators Utilization rates Indicators of social and mental health Environmental indicators Socio-economic indicators Health policy indicators Indicators of quality of life Other indicators: social indicators, basic need indicators, health for all indicators.

Mortality The total number of death due to the disease is known as mortality. Mortality data provides the starting point in many epidemiological studies. The death rate or crude mortality rate is calculated as, CMR (CDR) = No. of death in a specified period x 10n Average total population during that period Mortality rate are also measure as specific death rates (disease specific, age specific, sex specific), case fatality rates, proportional mortality rate, survival rate.

The mortality data has following limitations The incomplete reporting of death Lack of accuracy Lack of uniformity Choosing a single cause of death Changing fashions in diagnosis

The mortality data are employed in: Explaining trends and differentials in overall mortality Indicating priorities for health action Allocation resources, Designing intervention program Assessment and monitoring of public health problems and programs.

Morbidity Morbidity is defined as "any departure subjective or objective, from a state of physiological well-being". Morbidity (sickness, illness, disability) measures: Person who were ill The illnesses The duration of illness

The morbidity data have values as follows: The morbidity is measured by incidence and prevalence. Describe extend and nature of the disease load in the community. Provide more comprehensive and more accurate and clinically relevant information on patient characterization. Serve as starting point for aetiological studies and play important role in disease prevention. Essential for monitoring and evaluation of diseases control activities.

Incidence Incidence rate is defined as “the number of new cases occurring in a defined population during a specified period of time".

Prevalence Prevalence helps to estimate the existing magnitude of health and disease problem in the community. Prevalence rates are useful in administrative and planning purpose because it measures the need for treatment, hospital beds, and equipments, health facilities and manpower needs.

The disability rate may be event type or person type indicators. Disability rates: The disability rate may be event type or person type indicators. Event type: Number of activity restricted days Bed disability days Work loss days Person type limitation of morbidity (confined to bed) limitation of activities (eating, washing)

Health care delivery indicators: doctor-population ratio doctor-nurse ratio population bed ratio population health/center

Utilization rates: To obtain information on health status, the extent of uses of health services are often investigated. e.g., Proportion of infants who receive antenatal care Proportion of pregnant women who receive antenatal care

Indicators of social and mental health: The social indicators include suicide, crime, road traffic accidents and mental indicators alcohol and drugs abuse, smoking etc. These social indicators provide a guide to social action for improving the health of the people.

Environmental indicators: These reflect the qualities of physical and biological environment in which disease occur and which the people live. These indicators include pollution of air and water, solid wastes, noise exposure to toxic substances in food or drink.

Socioeconomic indicators: These indirect indicators are of great importance in the interpretation of the indicators of health care. e.g. rate of population increase per capita GNP level of unemployment dependency ratio

Health policy indicators: The most important indicators is "allocation of adequate resources" i.e., proportion of GNP spent on health services; proportion of total health resources devoted to primary health care.

Indicator of quality of life: The physical quality of the life, infant mortality, life expectancy. Literacy etc are indicators of quality of life.

Other indicators: Social indicators: Population, family population, distribution of income Basic need of indicators: These include calorie consumption, assess to water etc

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