An overview of the European Health Examination Survey Pilot Joint Action (original) (raw)
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Archives of Public Health
Background: Representative and reliable data on health and health determinants of the population and population subgroups are needed for evidence-informed policy making; planning and evaluation of prevention programmes; and research. Health examination surveys (HESs) including questionnaires, objective health measurements and analysis of biological samples, provide information on many health indicators that are available not at all or less reliably or completely through administrative registers or health interview surveys. Methods: Standardized cross-sectional HESs were already conducted in the 1980's and 1990's, in the framework of the WHO MONICA Project. The methodology was developed and finally, in 2010-2012, a European Health Examination Survey (EHES) Pilot Project was conducted. During this pilot phase, an EHES Coordinating Centre (EHES CC, formerly EHES Reference Centre) was established. Standardized protocols, guidelines and quality control procedures were prepared and tested in 12 countries which conducted pilot surveys, demonstrating the feasibility of standardized HES data collection in the European Union (EU). Currently, the EHES CC operates at the National Institute for Health and Welfare (THL), Finland. Its activities include maintaining and developing the standardized protocols, guidelines and training programme; maintaining the EHES network; providing professional support for countries planning and organizing their national HESs; external quality assessment for surveys organized in the EU Member States; and development of a centralized database and joint reporting system for HES data. Results: An increasing number of EU Member States are conducting national HESs, demonstrating a strong need for such surveys as part of the national health monitoring systems. Standardization of the data collection is essential to ensure that HES data are comparable across countries and over time. The work of the EHES CC helps to ensure the quality and comparability of HES data across the EU. Conclusions: HES data have been used for health monitoring and identifying public health problems; to develop health and prevention programmes; to support health policies and preparation of health-related legislation and regulations; and to develop clinical treatment guidelines and population reference values. HESs have also been utilized to prepare health measurement tools and diagnostic methods; in training and research and to increase health awareness among population.
EUROHIS: Developing common instruments for health surveys
2003
The availability and quality of data from population health surveys in Europe have greatly improved over the last 10-15 years, particularly in the countries of central and eastern Europe. The survey approach is now fully recognized to be a valuable method for health monitoring that is complementary to the registration approach. Nevertheless, the comparability of health survey data remains a challenge. Difficulties arise from two main sources: "man-made" variations between surveys owing to methodological differences (for example, in the way that indicators and health conditions are defined) and "natural" differences between populations caused by varying attitudes, behaviour and concepts of health. Moreover, it is not always possible to reliably identify and separate the two. The establishment of agreed standards in terms of recommended common methods and measurement instruments can largely improve control of the first main source of incomparability and, at the same time, increase the relevance and reliability of survey data. This has immediate benefits for public health practice, as we continuously make international comparisons to provide evidence for health policies. In the long term, however, we must reach beyond international harmonization of instruments: we must greatly improve the scientific understanding of the causes of any significant incomparability of health surveys between countries. These tasks are impossible without sincere international collaboration, with careful consideration of the similarities and differences among health concepts, approaches and patterns in different countries and organizations. The knowledge derived from such projects should be used to customize health strategies, models and skills so that they are better tailored to the specific needs and resources of each country. The special added value of such research arises from the cross-fertilization of ideas between cultures (including organizational cultures), the facilitation of multidisciplinary research, and the creation of links between health research, health policy and the individual citizen. The EUROHIS project has capitalized on this thinking. The project has required financial and scientific input from many different sources as well as a carefully planned programme of work. In particular, the support and generous financial contribution of the European Commission's Biomedical and Health Research Programme (BIOMED 2), which has financed the project as a Concerted Action, is gratefully acknowledged. EUROHIS demonstrates how WHO and the Commission can work collaboratively to deliver results that have greater impact than if the organizations worked alone. The project has contributed to the objectives of both organizations. It has allowed greater cross-cultural diversity and has therefore produced results of more general validity and relevance. The success of the EUROHIS project is clear, but the full impact of it will be decided by the use of its recommendations by the public health authorities in the Member States.
Creating a coherent set of indicators to monitor health across Europe: The Euro-REVES 2 project
The European Journal of Public Health, 2003
The EurcvREVES 2 project JEAN-MARIE ROBINE, CAROL JAGGER AND THE EURO-REVES GROUP * The Euro-REVES 2 project, 'Setting up of a coherent set of health expectancies for the European Union', was begun in 1998 under the European Health Monitoring Programme with the aim of selecting a concise set of instruments to simultaneously monitor mortality and the different facets of health. An in-depth analysis of the current health survey instruments in Europe together with a review of past research, found that, although harmonization in instruments appeared to exist superficially, major differences existed. Four instruments have been recommended (where necessary using existing instruments with modifications suggested by the research literature) covering physical and sensory functional limitations, activity restriction, self-perceived health and mental health. Additionally a new global activity limitation indicator (GALI) has been developed. These instruments are firmly anchored to past research and the health concepts behind the indicators and their relevance to policy and guidelines for implementation are explicitly made. The second phase of the project will recommend further instruments, leading to health expectancies that cover all the conceptual framework of population health measurement. This will allow assessment of health inequalities between the European Union countries, an appreciation of the causes and the production of profiles for each country in terms of the various facets of health.
Health indicators in the European regions--ISARE II
The European Journal of Public Health, 2007
the members of the ISARE II project team* Background: Most comparisons of health data in Europe take place at the national level. However, there is increased interest in looking at health data at a sub-national level. This is because of the increased importance in many European countries, of regions and devolved powers to them. This study aimed to establish the availability of health data at a regional level and to construct an experimental database. Methods: Using a network of country correspondents, data were collected on a series of topics from all the regions of that country. In addition, a supplementary list of data was collected from one region of each country. Results: Out of the then 15 Member States of the European Union (EU), 14 countries participated in the study. Thirteen countries were able to supply data. Where data were available, using the criteria we developed, these were of relatively good quality. Data on mortality was most readily available, but data on the important public health topics such as obesity was much more difficult to obtain, and absent in many cases. Conclusions: It is possible to construct a database and a resultant set of indicators for relevant sub-national areas of Member States in the EU. This is not likely to be achieved through current routine data collection systems unless significant changes are made to the data collection processes such as those undertaken by Eurostat. There is, also, an urgent need to introduce comprehensive sub-national data collections on important public health topics such as obesity and smoking.
Coverage of Health Topics by Surveys in the European Union
1998
Linkage with existing harmonisation activities The European Community Household Panel (ECHP) is a harmonised EU-wide survey developed by Eurostat in cooperation with the National Statistical Institutes (NSIs); sample size is 5,000 households on average per country. The first wave in 1994 was carried out in all MS at that time; 126,000 persons of 16 years and older were interviewed in 60,000 households. Each year until 1999 one wave will be executed, and thus in total 6 waves will be carried out. The survey contains a small health section (5 topics) and some health related indicators in other sections. In an annex to this report (which will be added later) this section will be discussed, with the aim to complete the information on data availability. Given the limited space for a health component in the ECHP, covering the wide area of social events in a birds' eye view, it can of course by no means provide all information on health which could best be collected by means of national surveys. The Eurobarometer is a half-yearly opinion survey funded by the Commission of the European Communities. It is EU-wide fielded via market research organisations; sample size is 1,000 persons for most countries. The main survey is on opinions regarding the European Union, but 'supplements' have been added to the survey, among others on questions that cover parts of the information needs for some of the EU health programmes (cancer, drugs, aids). In an annex (which will be added later to this report) recent health-related modules in the Eurobarometer will be discussed. The inclusion of health related topics in the Eurobarometer can only partially fulfil the information needs (relatively small sample size, quality aspects). Another very important international activity is the WHO Health For All indicators project (HFA, only the 'survey indicators') and in particular the WHO-Euro HIS project. In the following paragraphs the items related to these HFA indicators are presented separately in the list of areas/topics extracted from the EU public health programmes. The recommended instruments in the WHO/NCBS publication 'Health Interview Surveys. Towards international harmonisation of methods and instruments' (WHO, 1996) are used as a reference for evaluating the national questions on the items for which common instruments exist. The results of a WHO-Euro enquiry on items in health interview surveys conducted in 1995, the so-called survey of surveys, could not yet be COVERAGE OF HEALTH TOPICS BY SURVEYS IN THE EUROPEAN UNION C:\USR\SANDRINE\MDS\9035EN.DOC 6 21/05/2001 included in this study (WHO, 1997a, Fourth Consultation to develop common methods and instruments for health interview surveys in Europe, Copenhagen, 26-28 February 1997, INFO020305/26).
Evaluation of Health Interview Surveys and Health Examination Surveys in the European Union
The European Journal of Public Health, 2003
The project on Health Surveys in the EU supports health monitoring by developing a computerised health survey database, by reviewing and evaluating surveys, their methods and comparability, by recommending designs and methods, and by disseminating this information. It also assesses the coverage of specific health and health related areas in national and international surveys. At present, Health
The Belgian health examination survey: objectives, design and methods
Archives of Public Health
Background: In 2018 the first Belgian Health Examination Survey (BELHES) took place. The target group included all Belgian residents aged 18 years and older. The BELHES was organized as a second stage of the sixth Belgian Health Interview Survey (BHIS). This paper describes the study design, recruitment method and the methodological choices that were made in the BELHES. Methods: After a pilot period during the first quarter of the BHIS fieldwork, eligible BHIS participants were invited to participate in the BELHES until a predefined number (n = 1100) was reached. To obtain the required sample size, 4918 eligible BHIS participants had to be contacted. Data were collected at the participant's home by trained nurses. The data collection included: 1) a short set of questions through a face-to-face interview, 2) a clinical examination consisting of the measurement of height, weight, waist circumference, blood pressure and for people aged 50 years and older handgrip strength and 3) a collection of blood and urine samples. The BELHES followed as much as possible the guidelines provided in the framework of the European Health Examination Survey (EHES) initiative. Finally 1184 individuals participated in the BELHES, resulting in a participation rate of 24.1%. Results for all the core BELHES measurements were obtained for more than 90% of the participants. Conclusion: It is feasible to organize a health examination survey as a second stage of the BHIS. The first successfully organized BELHES provides useful information to support Belgian health decision-makers and health professionals. As the BELHES followed EHES recommendations to a large extent, the results can be compared with those from similar surveys in other EU (European Union) member states.