The Centers for Disease Control and Prevention's Healthy Days Measures - population tracking of perceived physical and mental health over time

David G Moriarty, Mathew M Zack, Rosemarie Kobau, David G Moriarty, Mathew M Zack, Rosemarie Kobau

Abstract

To promote the health and quality of life of United States residents, the U.S. Department of Health and Human Services' Centers for Disease Control and Prevention (CDC) - with 54 state and territorial health agencies - has supported population surveillance of health-related quality of life (HRQOL). HRQOL was defined as "perceived physical and mental health over time." Commonly-used measures of health status and activity limitation were identified and a set of "Healthy Days" HRQOL measures was developed and validated. A core set of these measures (the CDC HRQOL-4) asks about self-rated general health and the number of recent days when a person was physically unhealthy, mentally unhealthy, or limited in usual activities. A summary measure combines physically and mentally unhealthy days. From 1993 to 2001, more than 1.2 million adults responded to the CDC HRQOL-4 in each state-based Behavioral Risk Factor Surveillance System (BRFSS) telephone interview. More than one fifth of all BRFSS respondents also responded to a set of related questions - including five items that assess the presence, main cause and duration of a current activity limitation, and the need for activity-related personal and routine care; as well as five items that ask about recent days of pain, depression, anxiety, sleeplessness, and vitality. The Healthy Days surveillance data are particularly useful for finding unmet health needs, identifying disparities among demographic and socioeconomic subpopulations, characterizing the symptom burden of disabilities and chronic diseases, and tracking population patterns and trends. The full set of 14 Healthy Days Measures (the CDC HRQOL-14) has shown good measurement properties in several populations, languages, and settings. The brief standard CDC HRQOL-4 is now often used in surveys, surveillance systems, prevention research, and population health report cards.

References

    1. Institute of Medicine, Committee on Assuring the Health of the Public in the 21st Centary The future of the public's health in the 21st century. Washington DC National Academy of Sciences. 2002.
    1. Gold M. Summary measures of population health and beyond: A look at U.S. federal activities in measuring the health of populations. Ottawa, Canada, WHO Conference Statistical Commission and Economic Commission for Europe Working paper No 11. October 23–25 2000.
    1. Hagerty MR, Cummins RA, Ferriss AL, Land K, Michalos AC, Peterson M, Sharpe A, Sirgy J, Vogel J. Quality of life indexes for national policy: review and agenda for research. Soc Indicators Res. 2001;55:1–96. doi: 10.1023/A:1010811312332.
    1. Hennessy CH, Moriarty DG, Zack MM, Scherr PA, Brackbill R. Measuring health-related quality of life for public health surveillance. Public Health Rep. 1994;109:665–672.
    1. Centers for Disease Control and Prevention Measuring Healthy Days: Population assessment of health-related quality of life. Atlanta Georgia CDC. 2000.
    1. Moriarty D, Zack M. Validation of the Centers for Disease Control and Prevention's Healthy Days Measures [abstract] Quality of Life Research, Abstracts Issue, 6th Annual Conference of the International Society for Quality of Life Research, Barcelona, Spain. 1999;8:617.
    1. Centers for Disease Control and Prevention Health-related quality of life and activity limitation – eight states, 1995. MMWR. 1998;47:134–140.
    1. Ounpuu S, Kreuger P, Vermeulen M, Chambers L. Using the U.S Behavioral Risk Factor Surveillance System's health related quality of life survey tool in a Canadian city. Can J of Public Health. 2000;91:67–72.
    1. Alfredsson J. Dagar med full hälsa i Gävleborgs län – ett försök att mäta hälsorelaterad livskvalitet i befolkningen med hjälp av CDC: s frågebatteri Healthy Days. Rapport från Samhällsmedicin Gävleborg. Landstinget Gävleborg. 2002;3
    1. Centers for Disease Control and Prevention Health-related quality of life – Puerto Rico, 1996–2000. MMWR. 2000;51:166–168.
    1. Newschaffer CJ. Validation of Behavioral Risk Factor Surveillance System (BRFSS) HRQOL measures in a statewide sample. Atlanta, Georgia, US Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion. 1998.
    1. Andresen EM, Fouts BS, Romeis JC, Brownson CA. Performance of health-related quality-of-life instruments in a spinal cord injured population. Arch Phys Med Rehab. 1999;80:877–884.
    1. Verbrugge LM, Merrill SS, Liu X. Measuring disability with parsimony. Disabil Rehab. 1999;21:295–306. doi: 10.1080/096382899297729.
    1. Currey SS, Rao JK, Winfield JB, Callahan LF. Performance of a generic health-related quality of life measure in a clinic population with a rheumatic disease. Arthritis Care Res.
    1. Ôunpuu S, Chambers LW, Patterson C, Chan D, Yusuf S. Validity of the US Behavioral Risk Factor Surveillance System's Health Related Quality of Life survey tool in a group of older Canadians. Chronic Dis Can. 2001;22:93–101.
    1. Andresen EM, Catlin TK, Wyrwich KW, Jackson-Thompson J. Retest reliability of surveillance questions on health related quality of life. J Epidemiol Community Health. 2003;57:339–343. doi: 10.1136/jech.57.5.339.
    1. Dominick KL, Ahern FM, Gold CH, Heller DA. Relationship of health-related quality of life to health care utilization and mortality among older adults. Aging Clin Exp Res. 2002;14:499–508.
    1. Schechter S, Beatty P, Willis GB. Asking survey respondents about health status: judgment and response issues. In: Schwarz N, Park DC, Knauper B, Sudman S, editor. Cognition, aging, and self-reports. Philadelphia: Psychology Press; 1998. pp. 265–283.
    1. Moum TA. Mode of administration and response style effects in self-reported health and health behavior: An experimental broad-population study. Presented at the National Conference on Sociology, Longyearbyen, Spitsbergen, Norway. June 18–20 1998.
    1. Andresen EM, Fitch CA, McLendon PM, Meyers AR. Reliability and validity of disability questions for US Census 2000. Am J Public Health. 2000;90:1297–1299.
    1. Nelson DE, Holtzman D, Bolen J, Stanwyck CA, Mack KA. Reliability and validity of measures from the Behavioral Risk Factor Surveillance System (BRFSS) Soz Praventivmed. 2001;46:S3–42.
    1. Coker AL, McKeown RE, Sanderson M, Davis KE, Valois RF, Huebner ES. Severe dating violence and quality of life among South Carolina high school students. Am J Prev Med. 2000;19:220–227. doi: 10.1016/S0749-3797(00)00227-0.
    1. Borawski E, Wu G, Jia H, Substance Abuse and Mental Health Services Administration, Centers for Disease Control and Prevention Self-reported frequent mental distress among adults – United States, 1993–1996. MMWR. 1998;47:325–331.
    1. Quality of Life (Patient Pages) JAMA. December 18 2002.
    1. Moriarty D, Zack M. Seasonal patterns in health-related quality of life among adults – Behavioral Risk Factor Surveillance System (BRFSS), 1993–2000 [abstract]. Presentation at 9th Annual Conference of the International Society for Quality of Life Research, October 30 – November 2, Orlando, Florida. Quality of Life Research, Abstracts Issue. 2002;11:635.
    1. Albert SM. Change in BRFSS health status/HRQOL measures predicts volume of medical use: results from the Harlem Men's Health Cohort [abstract] Program of 17th Annual BRFSS Conference, Memphis. 2000 March 14th–17th.
    1. Wilson BF, Benais S, Whitaker K, Beatty P, Hendershot G. Improving the feasibility of including deaf respondents in telephone surveys. Proceedings of the 1998 Survey Research Methods Section, American Statistical Association, Alexandria, Virginia. 1998. pp. 883–887.
    1. John R, Hennessy CH, Denny CH. Preventing chronic illness and disability among native American elders. In: Wykle ML, Ford AB, editor. Serving Minority Elders in the 21st Century. New York, Springer. 1999. pp. 51–71.
    1. U.S. Department of Health and Human Services A systematic approach to health improvement. Healthy People 2010. Washington, DC: US Government Printing Office. 2000.
    1. Centers for Disease Control and Prevention State differences in reported Healthy Days among adults – United States, 1993–1996. MMWR. 1998;47:239–244.
    1. Simon P, Lightstone A, Zeng Z, Wold C, Fielding J, Davis B, and Centers for Disease Control and Prevention Health-related quality of life – Los Angeles County, California, 1999. MMWR. 2001;50:556–559.
    1. Michalos AC, Zumbo BD. Healthy Days, health satisfaction, and satisfaction with the overall quality of life. Soc Indicators Res. 2002;59:321–338. doi: 10.1023/A:1019601213926.
    1. Diwan S. Unmet health needs and the quality of life of the elderly: development of a survey for states and communities (technical report) Atlanta, GA: Centers for Disease Control and Prevention. 1994.
    1. Ahluwalia IB, Holtzman D, Mack KA, Mokdad A. Health-related quality of life among women of reproductive age: Behavioral Risk Factor Surveillance System (BRFSS), 1998–2001. J Womens Health. 2003;12:5–10.
    1. Diamant AL, Wold C. Sexual orientation and variation in physical and mental health status among women. J Womens Health. 2003;12:41–49.
    1. Campbell VA, Crews JE, Moriarty DG, Zack MM, Blackman D. Surveillance for sensory impairment, activity limitation, and health-related quality of life among older adults – United States, 1993–1997. MMWR Surveill Summ. 1999;48:131–156.
    1. Calsyn RJ, Winter JP. Predicting four types of service needs in older adults. Eval Program Plann. 2001;24:157–166. doi: 10.1016/S0149-7189(01)00006-4.
    1. Lubetkin EI, Jia H, Gold MR. Depression, anxiety, and associated health status in low-income Chinese patients. Am J Prev Med. 2003;24:354–360. doi: 10.1016/S0749-3797(03)00017-5.
    1. Broyles RW, McAuley WJ, Baird-Holmes D. The medically vulnerable: their health risks, health status, and use of physician care. J Health Care Poor Underserved. 1999;10:186–200.
    1. Andresen EM, Prince-Caldwell A, Akinci F, Brownson CA, Hagglund K, Jackson-Thompson J, Crocker R. The Missouri disability epidemiology and health project. Am J Prev Med. 1999;16:63–71. doi: 10.1016/S0749-3797(98)00151-2.
    1. Vradenburg JA, Simoes EJ, Jackson-Thompson J, Murayi T. The prevalence of arthritis and activity limitation and their predictors in Missouri. J Community Health. 2002;27:91–107. doi: 10.1023/A:1014557016281.
    1. Mili F, Helmick CH, Zack MM, Moriarty DG. Health-related quality of life among adults reporting arthritis: Analysis of data from the Behavioral Risk Factor Surveillance System, US, 1996–1999. J Rheumatol. 2003;30:160–166.
    1. Centers for Disease Control and Prevention Health-related quality of life among persons with epilepsy – Texas 1998. MMWR. 2001;50:24–26.
    1. Ford ES, Moriarty DG, Zack MM, Mokdad AH, Chapman DP. Self-reported body mass index and health-related quality of life: findings from the Behavioral Risk Factor Surveillance System. Obes Res. 2001;9:21–31.
    1. Heo M, Allison DB, Faith MS, Zhu SK, Fontaine KR. Obesity and quality of life: mediating effects of pain and comorbidities. Obes Res. 2003;11:209–216.
    1. Ford ES, Mannino DM, Homa DM, Gwynn C, Redd SC, Moriarty DG, Mokdad AH. Self-reported asthma and health-related quality of life: findings from the Behavioral Risk Factor Surveillance System. Chest. 2003;123:119–127. doi: 10.1378/chest.123.1.119.
    1. Robert Wood Johnson Foundation and the Foundation for Accountability A portrait of the chronically ill in America, 2001. Princeton NJ: RWJF. 2002.
    1. Greenlund KJ, Giles WH, Keenan NL, Croft JB, Mensah GA. Physician advice, patient actions, and health-related quality of life in secondary prevention of stroke through diet and exercise. Stroke. 2002;33:565–571. doi: 10.1161/hs0202.102882.
    1. Valdmanis V, Smith DW, Page MR. Productivity and economic burden associated with diabetes. Am J Public Health. 2001;91:129–130.
    1. Yassin AS, Beckles GL, Messonnier ML. Disability and its economic impact among adults with diabetes. J Occup Environ Med. 2002;44:136–142. doi: 10.1097/00043764-200202000-00008.
    1. Vest JR, Catlin TK, Chen JJ, Brownson RC. Multistate analysis of factors associated with intimate partner violence. Am J Prev Med. pp. 156–164.
    1. Buescher PA, Ziya Gizlice Z. Healthy life expectancy in North Carolina, 1996–2000. Raleigh, NC: North Carolina Department of Health and Human Services, State Center for Health Statistics. 2002. Report no.129.
    1. Centers for Disease Control and Prevention Community indicators of health-related quality of life – United States, 1993–1997. MMWR. 2000;49:281–285.
    1. Jia H, Muennig P, Lubetkin EI, Gold MR. Predicting geographic variations in behavioral risk factors: an analysis of physical and mental healthy days. J Epidemiol Community Health.
    1. Lankenau BH, Hennessy CH, Moriarty DG, Schmid TL. Health-related quality of life: a new approach to measuring the health status of a population. Proceedings of the Ninth World Productivity Congress, Istanbul, Turkey. 1995.

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