Measuring Community Health Levels

Abstract

The common assumption that high morbidity rates denote health-care neglect has not been demonstrated for American communities. In Kit Carson County Health Study, high morbidity is associated with indices for high-level health care. Increased age-specific morbidity rates result from: earlier diagnosis, increased survival as a result of prompt and more effective health care, and possible survival of infants with low health potential into reproductive years, thus influencing the genetic pool of the population. Present attempts to measure effectiveness of health care ignore completely possible genetic differences in different population groups. To meet these difficulties it is proposed that in assessing community health functional capacity is substituted for morbidity and that, in measuring functional capacity death rates are taken into con-sideration. The development of a new type of life table which starts with conception and distributes the survivors according to their functional capacities is proposed. The index of health would be equivalent effective life years lived/1OO,OOO conceptions. Intermediate measures are also considered in the interim.