Profiling Health and Illness in Children and Adolescents
Barbara Starfield Anne Riley The Johns Hopkins University
Levels of ill health as defined by biomedical indicators of disease (such as laboratory values) are no longer sufficient to document either the impact of illness on the population or effectiveness of medical care received. Recent advances in health-status measurement have led to the availability of measures that represent the impact of illness on functional capacity and quality of life (QOL). Functional status measures indicate the effect that illness has on the ordinary everyday activities of people. QOL measures also assess how people feel about their illness ( Wilson & Cleary, 1995). Health-status measurement is moving increasingly to the use of multidomain approaches that are not specific to any one particular illness or type of illness but, rather, are useful across populations. Such core instruments may be supplemented by a disease-specific measure when used to assess the impact of a particular illness or type of illness.
In this chapter, we use the concept of health status to represent an even broader conceptualization than is usually encompassed by functional status or QOL in childhood and adolescence. We describe the development of a multidomain instrument that assesses not only manifestations of ill health and current health, but characteristics likely to be related to health in the future. In addition, this approach recognizes the importance of