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Selection of health variables for the new 3-yearly SILC module Item 6.3.2 of the agenda
Pascal WolffESTAT-F5
16-17 December 2014 Working Group Public Health
Outline
1. Background: health data in SILC
2. Overall approach- Module development process- State of the discussion
3. Discussion
16-17 December 2014 Working Group Public Health 2
Background: Health data in SILC
• Currently: 7 annual variables
• In the future: Likely 7 annual variables in the nucleus Every 3-year health module (20 variables) Potentially other health-related variables (modules
on Access to services, Quality of life, Children and child care)
16-17 December 2014 Working Group Public Health 3
Why strengthening health in SILC?• Relevance
• Periodicity
16-17 December 2014 Working Group Public Health 4
Module development process• Wide consultation: SILC TF, Living Conditions WG, JAF
Expert Group• Looking for consensus … but need to reconcile users and
producers expectations• Provisional agreement on most variables in September
2014• Harmonisation with EHIS … but adaptations when
considered as useful• Variables and questions: need for input-harmonisation• Need for testing (before initial inclusion in 2017 SILC
module)
16-17 December 2014 Working Group Public Health 5
User perspective: possible use of future SILC for JAF Health
• Health status:o [Well-being (Quality of life module)]o (Mental health - refused by SILC TF)
• Health care system access:o Out-of-pocket payments for health careo Care utilisation
• Non-health care determinants:o Regular daily smoking o Obesityo (Risky single occasion drinking – refused by SILC TF)o Fruit consumption o Vegetable consumption o Physical activity
16-17 December 2014 Working Group Public Health 6
Producer perspective
• Reduction of number of topics more focus on selected ones (health status and access to care)
• Removal of some topics perceived as sensitive (diseases including depression, alcohol consumption)
• Adaptation or simplification of some topics to be more suited for SILC (out-patient care, physical activity)
• Integration with other SILC modules (unmet needs, mental well-being and informal care)
• Harmonisation of variables (with EHIS)• Testing envisaged
16-17 December 2014 Working Group Public Health 7
State of the discussionContent: 20 variables
o 17 agreed variables, 3 placeholders under discussiono Health state: 4 variables, strengthen health status part and
complement disability domaino Formal care: 3 variables, strengthen JAF 'access'o Financial burden: 3 new variables to complement JAF 'access'o Health behaviour: 7 variables, strengthen JAF 'lifestyles' and
provide more frequent data
Issues:o Sensitivity in SILC (e.g. BMI, alcohol consumption)o Relevance for SILC (e.g. BMI, physical activity)o Complexity of some variables (e.g. alcohol, fruits/vegetables)
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EurostatEurostat
Health status: 4 variables
16-17 December 2014Working Group Public Health
9
Variable Why
1. Difficulty in seeing, even when wearing glasses or contact lenses
ECHI 36Strengthen health status content of SILC (incl. disability and long-term care)Recommended by Budapest Initiative
2. Difficulty in hearing even when using a hearing aid
3. Difficulty in walking or climbing steps
4. Difficulty in remembering or concentrating
EurostatEurostat
Formal care: 3 variables
16-17 December 2014Working Group Public Health
10
Variable Why
5. Number of visits to a dentist or orthodontist
ECHI 72Health inequalities, Link with PH60-70 and N° 9
6. Number of consultations of a GPECHI 71Health inequalities, Link with PH40-50 and N° 8
7. Number of consultations of a specialistECHI 72Health inequalities, Link with PH40-50 and N° 8
EurostatEurostat
Financial burden: 3 variables
16-17 December 2014Working Group Public Health
11
Variable Why
8. Financial burden of medical care (incl. hospital, generalist and specialist care)
JAF, equity of access to services
9. Financial burden of dental care
10. Financial burden of medicines
EurostatEurostat
Health behaviour: 7 variables
16-17 December 2014Working Group Public Health
12
Variable Why
11. Body Mass IndexECHI 42, JAF, EHISPredictor of chronic disease and disability
12. Frequency of eating fruit, excluding juice
ECHI 49Link with WHO recommendation
13. Frequency of eating vegetables or salad
ECHI 50Link with WHO recommendation
14. Type of physical activity when working
Link with labour market and leisure-time physical activity
15. Time spent on physical activities (excluding working)
JAF, ECHI 52Monitoring the HEPA recommendation
EurostatEurostat
Health behaviour: Smoking
16-17 December 2014Working Group Public Health
13
Variable Why
16. Type of smoking behaviour JAF, ECHI 44, OMC HC-S11
17. Average number of cigarettes a dayJAF, ECHI 44, OMC HC-S11,Severity of smoking
EurostatEurostat
Other health variables under discussion
16-17 December 2014 Working Group Public Health 14
Variable Why
Use of home care services for personal needs
Health inequalities, Ageing policies
Number of nights spent as a patient in a hospital
Link with health status and determinantsIssue: comparability
Use of any medicines prescribed by a doctor
Link to ECHI 74Medicine consumption and access to medicines
Frequency of consumption of an alcoholic drink
JAF, ECHI 47Link with risky alcohol consumption Issue: sensitivity
SILC health module - timetable
When Who What
September 2014
SILC Task-ForceDiscussion on the final list of variables
End 2015 Directors of Social Statistics
SILC part of the Integrated European Social Statistics (IESS). Nucleus is adopted
(2015 or) 2016
National Statistical Institutes
Pre-testing of some variables
2017National Statistical Institutes
Some variables are included in the 2017 ad-hoc module
2018 or 2019Directors of Social Statistics
Final decision on contents of rolling modules (incl. 3-year health module)
16-17 December 2014 Working Group Public Health 15
Thank you for your attention
16-17 December 2014 Working Group Public Health 16