Health Measurements INTRODUCTION Issues of health mea

Issues of health measurement include measurement practices themselves, the implications of health measurements for developing school-based programs both for education and health improvement, and the predictive implications of such measurements over time. Health measurement is a regular part of the work of the school nurse and school counselor. It may begin with various written materials such as applications which include measurements made outside the educational institution by private doctors and hospitals and include measurements made within the school itself by health professionals either assessing the entire student population periodically or maintaining records on those students who seek and receive health counseling and treatment. On the basis of these measurements, the school develops programs for instruction in health matters and may also develop community-based programs for health improvement, including counseling, inoculation, dietary advice, and so on.

Rice (1991) notes that health status as determined by health measurements of the population help determine priorities for government agencies and institutions at all levels. Recent studies indicate that there is ample room for improvement in the health status of Americans, and that when compared with other industrialized nations, Americans spend more for health care but have worse health. Four policy issues are related to this information by Rice: acc

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understanding of the risk for various health problems, leading to decisions as to how to reduce those risks. Hill and Faine (1992) see a Health Risk Appraisal as an educational and health promotion tool that is used to assess health-related behaviors and their effect on mortality risk. The risk factors so measured are those that can be modified by changes in behavior, such as smoking, diet, and the use of seat belts. Also measured are those behaviors that cannot be modified, such as family history, race, and sex. Data are used to estimate the individual's risk group (risk cohort), and this is in turn based on epidemiologic and actuarial data. Also measured is the person's achievable risk, based on the estimated decrease in risk if positive behavior changes are made. Hill and Faine also discuss the factors that must be considered in choosing a health risk appraisal program, and among these are the method of administration, the scientific documentation supporting the program, the cost of obtaining and entering the data, and available staff. One approach is self-reporting in which the appraisals are done directly on the computer or through the mail. Other programs use extensive clinical evaluations, perhaps including electro

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