United NationsUnited Nations Economic Commission for Europe Statistical DivisionPopulation Unit

International initiatives on health and disability statistics

Vitalija Gaučaitė Wittich51st CSoD session, 12 February 2013

Vitalija Gaucaite Wittich- UNECEPopulation Unit Slide 2

Current International Initiatives

Washington Group on Disability Statistics (2001)

Budapest Initiative on the Measurement of Health Status (2005)

Model Disability Survey initiative (2012)

Vitalija Gaucaite Wittich- UNECEPopulation Unit Slide 3

Model Disability Survey (WHO/WB initiative)

Prompted by the UN Convention on the Rights of Persons with Disabilities (CRPD, art. 31)

Aims to produce a standardised survey instrument to gather data that is:• Internationally comparable• Allows to monitor national & global implementation

of CRPD Needs to built on existing experience

(Washington Group, Budapest Initiative)

Vitalija Gaucaite Wittich- UNECEPopulation Unit Slide 4

Washington Group on Disability Statistics

The main purpose is the promotion and co-ordination of international co-operation in the area of health statistics focusing on disability measures suitable for censuses and national surveys

A question set about limitations in basic activity functioning for use in national Censuses

Intends to compare levels of participation in employment, education, or family life for those with disability versus those without disability (social inclusion)

“City Group” – based on voluntary participation of statisticians across the world working on health statistics

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Budapest Initiative on the Measurement of Health Status 2004: Joint UNECE/WHO/Eurostat meeting on the

Measurement of Health Status Broad consensus on

the need for multiple indicators to provide a full statistical picture of population health, both for individual country use and for international comparisons; and

the immediate need for an indicator of ‘health state’

Task Force created by CES Bureau in October 2004 with the same Chairperson as Washington Group on Disability statistics

The first meeting held in Budapest in November 2005; since then known as the Budapest Initiative (BI)

Vitalija Gaucaite Wittich- UNECEPopulation Unit Slide 6

Budapest Initiative on the Measurement of Health Status

Purpose: To develop a new common instrument to measure health state suitable for inclusion in national interview surveys to provide basic necessary information on population health

Objectives: To develop a question set to assess overall health state

through a number of domains of functioning To describe trends in health over time within a country,

across subgroups of a population, and across countries To do so in the framework of official national

statistical systems

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Budapest Initiative on the Measurement of Health Status

Guiding Principles for the Question Set:Measure the health states of individualsOperationalize health state as functional abilityFocus on capacity rather than performanceMeasure across a parsimonious number of health domains, capturing the most variation in healthMeet high standards of validity and international comparabilitySimple and clear, and easily translated into many languages

Vitalija Gaucaite Wittich- UNECEPopulation Unit Slide 8

Health Status and Health States

Health states (capacities)

Determinants of health

Genetic contribution

Lifestyle/behaviour

Death

Physical environment

Physiological risk factors and

risk markers

Diseases,

symptoms and injuries

Domain 1

Domain 2

Domain N2

. .

.

.

HEALTH STATUS

Domain N1

Economic environment

Social environment

Physiological risk factors

and risk markers

Quality of life

Wellbeing

Health State: an individual’s levels of functioning within a set of health domains

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Budapest Initiative on the Measurement of Health Status

Domains for BI Questions:

•Vision

•Hearing

•Walking / Mobility

•Cognition

•Affect

•Pain and fatigue

•Upper body (optional M1/incl.M2)

•Communication (optional M1/incl.M2)

Vitalija Gaucaite Wittich- UNECEPopulation Unit Slide 10

Budapest Initiative on the Measurement of Health Status

First version of survey module (2005-2006)

•Tested in 2006 in 4 countries: Australia, Canada, Italy, U.S.

•Outcome: BI-M1 question set, endorsed by CES in 2007

Revised version of survey module (2008-2010)

• Developed in cooperation with Washington Group

• Three rounds of cognitive and field testing in 2008-2009 (in cooperation with WG and UNESCAP)

• Outcome: revised survey module finalized in 2010 and endorsed by CES Bureau in 2011

Vitalija Gaucaite Wittich- UNECEPopulation Unit Slide 11

Thank you

Available on UNECE website as electronic publication:

“Survey Module for Measuring Health State - Developed by the Budapest Initiative Task Force on Measurement of Health Status”

http://www.unece.org/publication/survey_module_measuring_health_state.html