Health-Related Quality of Life & Well-Being | Healthy People 2020

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Health Related Quality of Life Well Being Midcourse Review Data
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Check out our interactional infographic to see advancement toward the Health Related Quality of Life Well Being objectives and other Healthy People topic areas .
Health-Related quality of Life and Well-Being is a new Topic Area for Healthy People 2020. More information on Health-Related Quality of Life and Well-Being can be found in the Foundation Health Measures section of this Web locate.


Improve health-related quality of life and wellbeing for all individuals .


Health-related quality of life ( HRQOL ) is a multi-dimensional concept that includes domains related to physical, mental, emotional, and social officiate. It goes beyond send measures of population health, life anticipation, and causes of death, and focuses on the impact health condition has on timbre of life .
A relate concept of HRQOL is wellbeing, which assesses the convinced aspects of a person ’ second life, such as positive emotions and life satisfaction. Well-being is a relative state where one maximizes his or her physical, mental, and social serve in the context of supportive environments to live a full, satisfy, and productive life. 1

Why is Health-Related Quality of Life & Well-Being Important?

healthy People 2020 emphasizes the importance of health-related timbre of life and wellbeing by including it as one of the inaugural ’ s 4 overarching goals, “ promoting quality of life, healthy development, and health behaviors across all life sentence stages. ” 2 It besides was established as one of the HP2020 4 foundation health measures. 3
The significance of quality of life and wellbeing as a populace health concern is not fresh. Since 1949, the World Health Organization ( WHO ) has noted that health is “ a submit of complete physical, mental, and social wellbeing and not merely an absence of disease and infirmity. ” 4 In 2005, WHO recognized the importance of evaluating and improving people ’ s quality of life in a position newspaper. 5 Because people are living longer than always before, researchers have changed the way they examine health, looking beyond causes of end and morbidity to examine the relationship of health to the timbre of an individual life .
When choice of biography is considered in the context of health and disease, it ’ mho normally referred to as health-related quality of liveliness ( HRQOL ). Researchers today agree that HRQOL is multidimensional and includes domains that are related to physical, mental, emotional, and social officiate and the social context in which people live. 6
The first overarch goal for the Healthy People 2010 decade was to increase quality and years of goodly life sentence. Measures of life anticipation and healthy life anticipation ( HLE ) were used to report on this goal for several populations, which relied on self-reported data related to health, including global health status, prevalence of certain chronic diseases, and natural process limitations. For healthy People 2020, choice of life is integral to each of the 4 overarch goals .
HHS agencies have begun to prioritize the evaluation and improvement of HRQOL. Improvements in HRQOL have become a major focus in health research, with scientists, clinicians, and policy makers recognizing the importance of individuals ’ self-rated have, beyond or in addition to objective or clinical measures of health .
Promoting wellbeing emphasizes a person ’ south physical, mental, and social resources and enhances protective factors and conditions that foster health. 7 alternatively of the traditional opinion of prevention as only avoiding or minimizing illness and risk factors, wellbeing besides focuses on disease resistance, resilience, and self-management ( hypertext transfer protocol : // )
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Healthy People 2020 Approach to Health-Related Quality of Life & Well-Being

While there are respective existing measures of HRQOL and wellbeing in use, methodological development in this sphere is ongoing. Over the ten, Healthy People 2020 is approaching the measurement of health-related quality of life and wellbeing from a multidisciplinary perspective that encompasses 3 complemental and relate domains :

  • Self-rated physical and mental health
  • Overall well-being
  • Participation in society

Although none of these domains alone can fully represent the concept of health-related timbre of biography or wellbeing, when viewed together they will provide a more complete representation to support monitoring of the health-related timbre of life and wellbeing of the U.S. population. HP2020 continues to develop measures in these 3 areas and plans to propose extra objectives for the HRQOL/WB subject area in the year ahead .
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Self-Rated Physical and Mental Health

HRQOL is a immanent and multidimensional concept that includes aspects of physical, mental, and social health. 8, 9 ) For Healthy People 2020, the Patient-Reported Outcomes Measurement Information System ( PROMIS ) Global Health Items were identified as dependable and valid measures of self-reported physical and genial health and are presently being considered to monitor these 2 domains across the decade. PROMIS is an NIH Roadmap enterprise designed to develop an electronic organization to collect self-reported HRQOL datum from diverse populations of individuals with a assortment of chronic diseases and demographic characteristics. 10, 11 Currently HHS monitors HRQOL in the United States by administering selected PROMIS and other HRQOL items on the Behavioral Risk Factors Surveillance System ( BRFSS ), the National Health and Nutrition Examination Survey ( NHANES ), and the National Health Interview Survey ( NHIS ). 8, 12,13

What is measured?

The PROMIS token banks include more than 1,000 self-report questions covering multiple HRQOL domains that have undergo rigorous qualitative and quantitative evaluation by both patients and experts. 14, 15 A 10-item ball-shaped HRQOL plate was developed to assess selected physical and mental health symptoms, including serve and general health perceptions. 12 The items were derived from HRQOL token banks which provide more precise indicators of domain-specific HRQOL. All items were tested in large and divers samples. individual items include fatigue, pain, aroused distress, and social activities. Most of the questions ask about a person ’ randomness experience “ in general ” and assess self-reported symptoms within the stopping point 7 days. The PROMIS measure provides an efficient assessment of HRQOL with minimal respondent burden and allows one to besides estimate 2 compendious measures of physical and mental health. 12 These 10 items were administered on the NHIS in 2010 and are besides expected to be included on NHIS in 2015 and 2020 .
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People with higher levels of wellbeing pronounce their life as going well. 16 People feel very healthy and full moon of department of energy to take on their daily activities. People are satisfied, concerned, and engaged with their lives. People experience a sense of skill from their activities and judge their lives to be meaningful. People are more often content or cheerful than depressed or anxious. People get along with others and experience good social relationships. personal factors, social circumstances, and community environments influence wellbeing .

What is measured?

wellbeing considers the forcible, mental, and social aspects of a person ’ s life. Physical well-being relates to vigor and life force, feeling very healthy and broad of energy. Mental well-being includes being satisfied with one ’ mho life ; balancing positive and negative emotions ; accepting one ’ sulfur self ; finding determination and mean in one ’ south life ; seeking personal emergence, autonomy, and competence ; believing one ‘s life and circumstances are under one ’ s master ; and by and large experiencing optimism. Social well-being involves providing and receiving timbre support from family, friends, and others .
goodly People is exploring measurement of these concepts at this time. specific survey questions are being identified as potential nationally representative sources of data to develop measures of wellbeing for the HRQOL/WB topic area .
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HRQOL and wellbeing besides reflects individuals ’ judgment of the impact of their health and functional status on their engagement in society. By measuring HRQOL through participation, quality of liveliness is not immediately equated to health or functional condition but reflects, preferably, the tied of community consolidation or affair, which is based on a person ’ second degree of participation, taking into account their health or functional status and the environment.

Underlying this participation measure is the rationale that a person with a functional limitation — for case, vision personnel casualty, mobility trouble, or intellectual disability — can live a hanker and productive biography and enjoy a dear quality of life. 17, 18 Poorer functional status can, and should not be, equated with poorer choice of life. quality of biography encompasses more than activities of daily know, health states, disease categories, or functional ability, “ because it directs care to the more complete social, psychological, and religious being. ” 17 Social engagement can be assessed through a determination of the degree to which people experience barriers to broad participation because of their current health state and the environment .

What is measured?

engagement in society includes education, use, and civil, social, and leisure activities, arsenic well as class role participation. participation is measured in the context of a person ’ s current health state and within the person ’ s current social and physical environments, therefore capturing a more aim construct of the HRQOL concept. 19
Under this model, health country and the social and forcible environment are defined as causal or background factors that impact HRQOL. 20 social engagement and a sense of wellbeing are then consequence indicators that in turn chew over or specify HRQOL .
healthy People is exploring measurement of these concepts at this time. specific review questions are being identified as potential nationally congressman sources of data to develop measures of participation for the HRQOL/WB topic area .
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1 Kobau R, Sniezek J, Zack MM, Lucas RE, Burns A. Well-being assessment : An evaluation of wellbeing scales for populace health and population estimates of wellbeing among U.S. adults. Health and Well Being. 2010 ; 2 ( 3 ) :272-297 .
2 healthy People 2020. healthy people 2020 Framework. The Vision, Mission, and Goals of Healthy People 2020. Overarching Goals. Available at hypertext transfer protocol : // [ PDF – 254KB ]
3 healthy People 2020. About healthy People. Foundation Health Measures. Available at hypertext transfer protocol : // .
4 World Health Organization. WHO Definition of Health. Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19-22 June, 1946 ; signed on 22 July 1946 by the representatives of 61 States ( official Records of the World Health Organization, no. 2, p. 100 ) and entered into force on 7 April 1948. available at hypertext transfer protocol : // [ PDF – 335KB ] .
5 World Health Organization. The World Health Organization Quality of Life assessment ( WHOQOL ) : military position newspaper from the World Health Organization. Soc Sci Med 2005 ; 41 ( 10 ) :1403–1409 .
6 Ferrans CE. Definitions and conceptual models of choice of life. In : Lipscomb J, Gotay CC, Snyder C, editors. Outcomes judgment in cancer. Cambridge, England : Cambridge University ; 2005. p. 14–30 .
7 Lindstrom B, Eriksson M. Salutogenesis. J Epidemiol & Community Health. 2005 ; 59:240-242 .
8 Ferrans CE. Definitions and conceptual models of quality of life. In : Lipscomb J, Gotay CC, Snyder C, editors. Outcomes assessment in cancer. Cambridge, England : Cambridge University. 2005:14–30 .
9 CDC. Measuring healthy days : population assessment of health-related quality of life. Atlanta, GA, 2000 .
10 Cella, D., Yount, S., Rothrock, N., Gershon, R., Cook, K., Reeve, B., Ader, D., Fries, J. F., Bruce, B., Matthias, R., & on behalf of the PROMIS cooperative group. The Patient Reported Outcomes Measurement Information System ( PROMIS ) : progress of an NIH Roadmap Cooperative Group during its foremost two years. Medical Care 2007 ; 45 : S3-11 .
11 Cella, D., Riley, W., Stone, A., Rothrock, N., Reeve, B., Yount, S., Amtmann, D., Bode R., Buysse D., Choi, S., Cook, K., DeVellis, R., DeWalt, D., Fries, J.F., Gershon, R., Hahn, E.A., Lai, J. S., Pilkonis, P., Revicki, D., Rose, M., Weifurt K., Hays, R., & on behalf of the PROMIS Cooperative Group ( 2010 ). initial adult health detail banks and first wave testing of the Patient-Reported Outcomes Measurement Information System ( PROMIS ) network : 2005-2008. Journal of Clinical Epidemiology 2010 ; 63:1179-1194 .
12 Hays, Ron D., et alabama. “ Development of physical and mental health compendious scores from the patient-reported outcomes measurement information system ( PROMIS ) global items. ” Quality of Life Research 2009 ; 18:873-880 .
13 Barile JP, Reeve B, Zack MM, Mitchell S, Kobau R, Cella D, Luncheon C, Wilder Smith A, Thompson WW ( 2013 ). Monitoring Population Health for Healthy People 2020 : psychometric Properties of the NIH PROMIS Global Health, CDC Healthy Days and Satisfaction with Life Instruments. quality of Life Research 2013 ; 22:1201-11. department of the interior : 10.1007/s11136-012-0246-z .
14 DeWalt, DA, Rothrock N, Yount S, Stone AA. evaluation of item candidates : The PROMIS qualitative detail review. Medical Care 2007 ; 45 : S12-S21 .
15 Reeve BB, Hays RD, Bjorner JB, Cook KF, Crane PK, Teresi JA, Thissen D, Revicki DA, Weiss DJ, Hamleton RK, Liu H, Gershon R, Reise SP, Lai JS, Cella D. Psychometric evaluation and calibration of health-related timbre of life detail banks. Medical Care 2007 ; 45 : S22-S31 .
16 Diener E, Lucas R, Schimmack U, Helliwell J. Well-Being for Public Policy. New York : Oxford University Press, Inc., 2009 .
17 Albrecht GL, Devlieger PJ. The disability paradox : high choice of life against all odds. Soc Sci Med 1999 ; 48:977–988 .
18 Krahn GL, Fujiura G, Drum CE, Cardinal BJ, Nosek MA ; the RRTC Expert Panel on Health Status Measurement. The dilemma of measuring perceived health condition in the context of disability. Disability and Health Journal 2009 ; 2:49–56.

19 Kindig DA, Asada Y, Booske B. A population health framework for setting national and state of matter health goals. JAMA 2008 ; 299 ( 17 ) :2081–2083 .
20 Schwartz CE, Andresen EM, Nosek MA, Krahn GL ; the RRTC Expert Panel on Health Status Measurement. Response Shift Theory : crucial implications for measuring quality of Life in People with Disability. Arch Phys Med Rehabil 2007 ; 88:529–536 .
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