Foreign Policy Blogs

Ranking disabilities – what does health mean to you?

How is health measured?  A consistent measure used by global health practitioners is the DALY, or Disability Adjusted Life Year, which compares one disease with another and uses this comparative measure to quantify the overall disease burden.  Karen Grepin recently posted about a collaboration between the WHO, Harvard University, among others, to update and revise the current DALY metrics.  The previous version, performed in 1990, used the opinions of health experts to assess the burden of diseases; this latest version, commencing in 2010, is instead asking for your participation. 

The survey is quick – it took me about 20 minutes – and it is fascinating.  It asks you to compare the conditions of two fictitious people and determine who, in your opinion, is healthier.  For example:

Imagine that the two people experience these health problems for one week and then return to normal health:The survey will ask you to imagine different health outcomes and compare them to each other. For example: “Imagine two people – the first person is completely blind, and the second person suffers from constant intense back pain. Who is healthier overall?”

The first person has episodes of headaches, memory problems, and difficulty concentrating.The second person has a broken foot bone, which causes pain, swelling, and difficulty walking.

Who do you think has a better health experience overall, the first person or the second person?

It then asks you to compare conditions within a given lifespan.  For example:
 
 

 

Which of the following two choices would you prefer?

The first choice: Imagine having 10 years left to live, and living for those ten years with the following health problems:You have chest pain that occurs with moderate physical activity, such as walking uphill or more than half a kilometer (around a quarter-mile) on level ground. After a brief rest, the pain goes away.Now the second choice: Imagine having none of these problems or limitations but having only 5 years left to live.
Finally, in the extended survey, you are asked to compare health programs which affect populations of differing sizes, with diseases that are fatal versus chronic.  Imagine there were two different health programs.
The first program prevented 1,000 people from getting an illness that causes rapid death.The second program prevented 2,000 people from getting an illness that is not fatal but causes the following lifelong health problems:
Some trouble remembering recent events. Difficulty concentrating and making decisions and plans.

Interesting, yes?  Help the consortium reach their goal of 50,000 respondents – take the survey.

 

Author

Cynthia Schweer Rayner

Cynthia Schweer Rayner is an independent consultant and philanthropy advisor specializing in public health, social entrepreneurship and scalable business models for positive social change. As a recovering management consultant, she spent several months living in South Africa, and later co-founded the US branch of an organization providing support to orphaned and vulnerable children. In 2009, she was an LGT Venture Philanthropy Fellow, working with mothers2mothers (m2m), a multinational non-profit organization employing mothers living with HIV as peer educators to positive pregnant women. She currently works with individuals, companies and nonprofits to finance and develop models for positive change. Cynthia has an MBA from INSEAD and a BA in English Literature from Georgetown University. She currently lives in Cape Town and visits New York frequently, where she co-owns a Manhattan-based yoga studio, mang'Oh yoga (www.mangohstudio.com).