MEASURING HEALTH-RELATED QUALITY-OF-LIFE FOR PUBLIC-HEALTH SURVEILLANCE

In public health research and practice, quality of life is increasingl y acknowledged as a valid and appropriate indicator of service need an d intervention appropriate indicator of service need and intervention outcomes. Health-related quality of life measures, including objective and subjective assessments of health, are particularly useful for eva luating efforts in the prevention of disabling chronic diseases. Such data can inform health policy, planning, and practice. Mechanisms for routinely monitoring quality of life of populations at the State and l ocal levels are currently lacking, however. This article discusses the rationale for and concepts measured by four quality of life questions developed for the 1993 Behavioral Risk Factor Surveillance System, a State-based telephone surveillance system. To encourage quality of lif e surveillance by States, the Centers for Disease Control and Preventi on's National Center for Chronic Disease Prevention and Health Promoti on held two related workshops, one in December 1991 and the other in J une 1992. The workshops convened experts in quality of life and functi onal status measurement and resulted in the formulation of items for t he Behavioral Risk Factor Surveillance System on self-perceived health , recent physical and mental health, and recent limitation in usual ac tivities. The criteria, including feasibility and generalizability, co nsidered by the Centers for Disease Control and Prevention and the wor kshop participants in the selection and development of these items are discussed. A model that conceptualizes the relationship of quality of life domains measured by the four survey items is presented and valid ated with preliminary data from the 1993 Behavioral Risk Factor Survei llance System. Finally, how States can use these measures to track pro gress towards the Year 2000 goal of improving quality of life is discu ssed.