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Popul Health Manag. 2017 Feb;20(1):13-22. doi: 10.1089/pop.2015.0162. Epub 2016 Mar 31.

Leveraging Health-Related Quality of Life in Population Health Management: The Case for Healthy Days.

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1 Humana Inc. , Louisville, Kentucky.
2 Robert Wood Johnson Foundation , Princeton, New Jersey.
3 Centers for Disease Control and Prevention , Atlanta, Georgia .
4 Mailman School of Public Health, Columbia University , New York, New York.
5 School of Nursing, Columbia University , New York, New York.


Measuring population health with morbidity and mortality data, often collected at the site of care, fails to capture the individual's perspective on health and well-being. Because health happens outside the walls of medical facilities, a holistic and singular measure of health that can easily be captured for an entire population could aid in understanding the well-being of communities. This paper postulates that Healthy Days, a health-related quality of life measure developed and validated by the Centers for Disease Control and Prevention, is an ideal survey instrument to advance population health. A systematic literature review was conducted and revealed a strong evidence base using Healthy Days with significant correlations to chronic disease conditions. Building on the literature base and experience, methods for analyzing Healthy Days data are discussed, including stratified sampling techniques, statistical measures to account for variance, and modeling techniques for skewed distributions. Using such analytic techniques, Healthy Days has been used extensively in national health surveillance. As the health care system faces increasing costs and constrained resources, the Healthy Days survey instrument can be used to inform public policies and allocate health service resources. Because Healthy Days captures broad dimensions of health from the individual's perspective, it is a simple way to holistically measure the health and well-being of a population and its trend over time. Expanded use of Healthy Days can aid population health managers and contribute to the understanding of the broader determinants of the nation's and individual community's health and aid in evaluating progress toward health goals.

[Indexed for MEDLINE]
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Conflict of interest statement

Author Disclosure Statement The authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Drs. Davidson, Happe, Miao, Prewitt, and Slabaugh, Mr. Cordier and Mr. Havens are employees of Humana Inc. Drs. Happe and Slabaugh own Humana stock. No external financial support was provided to Humana for this research. Dr. Jia received compensation from Humana for his contributions. Drs. Shah and Zack report no conflict of interest. The investigators retained full independence in the conduct of this research. The findings and conclusions in this report are those of the author and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

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