Long abstract

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Labour Market and Social Policy Occasional Paper No. 44

There is strong policy interest in monitoring trends on the prevalence of chronic diseases and disability rates, both nationally and internationally, in light of rising life expectancy and population ageing. However, international comparisons of health and disability survey data are difficult because different instruments are used to measure various health and disability dimensions in national surveys.

This inventory examines the comparability of survey instruments used to measure health and disability in various OECD countries. It extends a similar inventory prepared by the Danish Institute of Public Health for Eurostat in 1999. Some 30 surveys from 23 OECD countries are reviewed in detail and compared. These include a mix of cross-sectional and longitudinal surveys, general health and disability-specific surveys, and surveys covering the entire population and some targeting the elderly population only. The domains covered include selected health conditions (chronic physical conditions, mental health and pain) and various activity limitations (ADL, IADL, limitation in work and social activities, and general limitations in usual activities). The main finding is that, beside a few items related to the prevalence of chronic conditions (both generally and for a few important diseases) and general activity limitations, current differences in measurement instruments limit the comparability of data only to those countries that are using the same instrument (e.g., SF-36, EuroQol-5D, HUI-3 or the WHO-Europe long-term disability list). The main problem is not "what" is being measured in various surveys (since the health dimensions and activity limitations tend to be fairly common) but rather "how" specifically these health conditions and limitations are measured. Unless progress is achieved in using some common instrument(s) to measure these health and disability dimensions, cross-survey (and cross-country) comparisons will remain limited.