Selection of health variables for the new 3-yearly SILC module Item 6.3.2 of the agenda Pascal Wolff ESTAT-F5 16-17 December 2014 Working Group Public.

Selection of health variables for the new 3-yearly SILC module Item 6.3.2 of the agenda

Pascal WolffESTAT-F5

16-17 December 2014 Working Group Public Health

Outline

1. Background: health data in SILC

2. Overall approach- Module development process- State of the discussion

3. Discussion

16-17 December 2014 Working Group Public Health 2

Background: Health data in SILC

• Currently: 7 annual variables

• In the future: Likely 7 annual variables in the nucleus Every 3-year health module (20 variables) Potentially other health-related variables (modules

on Access to services, Quality of life, Children and child care)


Why strengthening health in SILC?• Relevance

• Periodicity


Module development process• Wide consultation: SILC TF, Living Conditions WG, JAF

Expert Group• Looking for consensus … but need to reconcile users and

producers expectations• Provisional agreement on most variables in September

2014• Harmonisation with EHIS … but adaptations when

considered as useful• Variables and questions: need for input-harmonisation• Need for testing (before initial inclusion in 2017 SILC

module)


User perspective: possible use of future SILC for JAF Health

• Health status:o [Well-being (Quality of life module)]o (Mental health - refused by SILC TF)

• Health care system access:o Out-of-pocket payments for health careo Care utilisation

• Non-health care determinants:o Regular daily smoking o Obesityo (Risky single occasion drinking – refused by SILC TF)o Fruit consumption o Vegetable consumption o Physical activity


Producer perspective

• Reduction of number of topics more focus on selected ones (health status and access to care)

• Removal of some topics perceived as sensitive (diseases including depression, alcohol consumption)

• Adaptation or simplification of some topics to be more suited for SILC (out-patient care, physical activity)

• Integration with other SILC modules (unmet needs, mental well-being and informal care)

• Harmonisation of variables (with EHIS)• Testing envisaged


State of the discussionContent: 20 variables

o 17 agreed variables, 3 placeholders under discussiono Health state: 4 variables, strengthen health status part and

complement disability domaino Formal care: 3 variables, strengthen JAF 'access'o Financial burden: 3 new variables to complement JAF 'access'o Health behaviour: 7 variables, strengthen JAF 'lifestyles' and

provide more frequent data

Issues:o Sensitivity in SILC (e.g. BMI, alcohol consumption)o Relevance for SILC (e.g. BMI, physical activity)o Complexity of some variables (e.g. alcohol, fruits/vegetables)


EurostatEurostat

Health status: 4 variables

16-17 December 2014Working Group Public Health

9

Variable Why

1. Difficulty in seeing, even when wearing glasses or contact lenses

ECHI 36Strengthen health status content of SILC (incl. disability and long-term care)Recommended by Budapest Initiative

2. Difficulty in hearing even when using a hearing aid

3. Difficulty in walking or climbing steps

4. Difficulty in remembering or concentrating

EurostatEurostat

Formal care: 3 variables


10

Variable Why

5. Number of visits to a dentist or orthodontist

ECHI 72Health inequalities, Link with PH60-70 and N° 9

6. Number of consultations of a GPECHI 71Health inequalities, Link with PH40-50 and N° 8

7. Number of consultations of a specialistECHI 72Health inequalities, Link with PH40-50 and N° 8

EurostatEurostat

Financial burden: 3 variables


11

Variable Why

8. Financial burden of medical care (incl. hospital, generalist and specialist care)

JAF, equity of access to services

9. Financial burden of dental care

10. Financial burden of medicines

EurostatEurostat

Health behaviour: 7 variables


12

Variable Why

11. Body Mass IndexECHI 42, JAF, EHISPredictor of chronic disease and disability

12. Frequency of eating fruit, excluding juice

ECHI 49Link with WHO recommendation

13. Frequency of eating vegetables or salad

ECHI 50Link with WHO recommendation

14. Type of physical activity when working

Link with labour market and leisure-time physical activity

15. Time spent on physical activities (excluding working)

JAF, ECHI 52Monitoring the HEPA recommendation

EurostatEurostat

Health behaviour: Smoking


13

Variable Why

16. Type of smoking behaviour JAF, ECHI 44, OMC HC-S11

17. Average number of cigarettes a dayJAF, ECHI 44, OMC HC-S11,Severity of smoking

EurostatEurostat

Other health variables under discussion


Variable Why

Use of home care services for personal needs

Health inequalities, Ageing policies

Number of nights spent as a patient in a hospital

Link with health status and determinantsIssue: comparability

Use of any medicines prescribed by a doctor

Link to ECHI 74Medicine consumption and access to medicines

Frequency of consumption of an alcoholic drink

JAF, ECHI 47Link with risky alcohol consumption Issue: sensitivity

SILC health module - timetable

When Who What

September 2014

SILC Task-ForceDiscussion on the final list of variables

End 2015 Directors of Social Statistics

SILC part of the Integrated European Social Statistics (IESS). Nucleus is adopted

(2015 or) 2016

National Statistical Institutes

Pre-testing of some variables

2017National Statistical Institutes

Some variables are included in the 2017 ad-hoc module

2018 or 2019Directors of Social Statistics

Final decision on contents of rolling modules (incl. 3-year health module)


Thank you for your attention


Selection of health variables for the new 3-yearly SILC module Item 6.3.2 of the agenda Pascal Wolff ESTAT-F5 16-17 December 2014 Working Group Public.

Documents

group public healthbackground

group public healthwhy

group public healthstate

health data

selection of health

health status content

year health module

selected ones health