Indicator Definitions – Health Status
Health is a fundamental resource for everyday living. Health allows us to have a more satisfying and meaningful life, improving our quality of life and well-being. Health is multidimensional, including physical, mental, emotional, and functional domains associated with individual and community resources. Clinicians and public health researchers use many different tools to measure health, sometimes with biomedical indicators or with subjective indicators that ask people about their overall health, or specific domains (e.g., physical, mental), from their own perspective.
Many studies show that self-rated health is associated with individual and social risk factors and can predict hospitalization and mortality. Addressing chronic disease risk factors and social determinants of health can help to improve overall health. Monitoring progress and identifying subgroups in which general health may need improvement can help inform federal, state and local programs that link people with poor health status to community-based resources.
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Definition Details
| Population: | All adults |
| Numerator: | Adults who report their general health status as “fair” or “poor”. |
| Denominator: | Adults who report their general health status as “excellent,” “very good,” “good,” “fair,” or “poor”. |
| Measure: | Prevalence (crude and age-adjusted) |
| Time Period of Case Definition: | Current |
| Summary: | Health status is a measure of how people perceive their health and is considered a good global assessment of a person’s well-being.1 Furthermore, it is a predictor of important health outcomes including mortality, morbidity, and functional status.2 Health status is also used to measure healthy life expectancy at the population level.3 In 2019, 15.3% of adults assessed their health as fair or poor. Substantial differences in the prevalence of fair or poor self-reported health status exist by age group, race, education level, urbanization level, and poverty status.4,5 Monitoring health status can inform individual- and population-level interventions and demonstrate improvements over time. |
| Notes: | This measure is based on self-assessment only and does not include an objective health component. |
| Data Source: | Behavioral Risk Factor Surveillance System (BRFSS) |
| Related Objectives or Recommendations: | Healthy People 2030 objective: OHM-8. Respondent-assessed health status — in good or better health |
| Related CDI Topic Area: | None |
| Reference 1: | World Health Organization. International Classification of Functioning, Disability and Health (ICF). World Health Organization. https://www.who.int/classifications/international-classification-of-functioning-disability-and-health |
| Reference 2: | DeSalvo KB, Bloser N, Reynolds K, He J, Muntner P. Mortality prediction with a single general self-rated health question. A meta-analysis. J Gen Intern Med. 2006;21(3):267–275. doi:10.1111/j.1525-1497.2005.00291.x |
| Reference 3: | Zhang YS, Shim H, Crimmins EM. Life expectancy and health expectancy. In: Rattan SI. Encyclopedia of Biomedical Gerontology. Academic Press; 2020:313–325. |
| Reference 4: | National Vital Statistics System (NVSS). Percentage of fair or poor health status for adults aged 18 and over, United States, 2019—2021. National Health Interview Survey, Centers for Disease Control and Prevention, US Dept of Health and Human Services. https://wwwn.cdc.gov/NHISDataQueryTool/SHS_adult/index.html |
| Reference 5: | Centers for Disease Control and Prevention. QuickStats: Percentage of adults aged ≥18 years with fair or poor health, by urbanization level and age group — National Health Interview Survey, United States, 2019. MMWR Morb Mortal Wkly Rep. 2021;70:1048. doi:10.15585/mmwr.mm7030a3 |
| Population: | All adults |
| Numerator: | Sum of the number of days during the past 30 days for which adults aged ≥ 18 years report that their physical health (including physical illness and injury) was not good. |
| Denominator: | Number of adults. |
| Measure: | Mean number of days (crude and age-adjusted) |
| Time Period of Case Definition: | Past 30 days |
| Summary: | Physically unhealthy days, one of CDC’s health-related quality of life measures (CDC HRQOL-4), is defined as a person’s perceived physical health over time.1 Physically unhealthy days asks about the number of days in the past 30 days a respondent experienced poor physical health because of physical illness or injury. In 2020, US adults reported an average of 3.1 recent physically unhealthy days with estimates higher for women than men.2 Promoting good physical health through individual- and community-level interventions (e.g., physical activity programs; smoking cessation programs, screening programs) can prevent chronic disease risk factors and adverse outcomes.3 |
| Notes: | None |
| Data Source: | Behavioral Risk Factor Surveillance System (BRFSS) |
| Related Objectives or Recommendations: | None |
| Related CDI Topic Area: | None |
| Reference 1: | Moriarty DG, Zack MM, Kobau R. The Centers for Disease Control and Prevention’s Healthy Days Measures – population tracking of perceived physical and mental health over time. Health Qual Life Outcomes. 2003;1:37. doi:10.1186/1477-7525-1-37 |
| Reference 2: | National Center for Chronic Disease Prevention and Health Promotion. Chronic Disease Indicators. Centers for Disease Control and Prevention, US Dept of Health and Human Services. Accessed October 26, 2022. https://www.cdc.gov/cdi/ |
| Reference 3: | National Center for Chronic Disease Prevention and Health Promotion. How You Can Prevent Chronic Diseases. Centers for Disease Control and Prevention, US Dept of Health and Human Services. Accessed November 29, 2022. https://www.cdc.gov/chronicdisease/about/prevent/index.htm |
| Population: | All adults |
| Numerator: | Adults who reported 14 or more days, during the past 30 days, that their physical health (including physical illness and injury) was not good |
| Denominator: | Adults who report 0 to 30 days, during the past 30 days, that their physical health (including physical illness and injury) was not good. |
| Measure: | Prevalence (crude and age-adjusted) |
| Time Period of Case Definition: | Past 30 days |
| Summary: | Physically unhealthy days, one of CDC’s health-related quality of life measures (CDC HRQOL-4), is defined as a person’s perceived physical health over time.1 Physically unhealthy days asks about the number of days in the past 30 days a respondent experienced poor physical health because of physical illness or injury. Frequent physical distress (FPD), defined as 14 or more physically unhealthy days during the past 30 days, is used to identify individuals with more severe or chronic health problems in the previous month.2 FPD is also negatively associated with life expectancy.23 In 2021, 11% of US adults reported FPD with estimates higher for women than men.4 Many chronic diseases can impact general health status, including physical distress. Practicing healthy behaviors (e.g., not smoking, eating healthy, being active, and limiting drinking) can reduce the likelihood of getting a chronic disease and improve the odds of staying well, feeling good, and living longer.5 more likely than male students and Asian and Black students were less likely than Hispanic and multiracial students.1 Children and adolescents growing up in poverty are two to three times more likely to develop mental health issues than peers who are not living in poverty.2,3 Although mental health issues in children and adolescents are widespread, they are treatable, and often preventable. In 2021, the Surgeon General issued an advisory that provides actionable recommendations for various audiences and sectors to support the mental health of children and adolescents.1 |
| Notes: | None |
| Data Source: | Behavioral Risk Factor Surveillance System (BRFSS) |
| Related Objectives or Recommendations: | None |
| Related CDI Topic Area: | None |
| Reference 1: | Moriarty DG, Zack MM, Kobau R. The Centers for Disease Control and Prevention’s Healthy Days Measures – population tracking of perceived physical and mental health over time. Health Qual Life Outcomes. 2003;1:37. doi:10.1186/1477-7525-1-37 |
| Reference 2: | Zahran HS, Kobau R, Moriarty DG, et al. Health-related quality of life surveillance–United States, 1993-2002. MMWR Surveill Summ. 2005;54(4):1–35. |
| Reference 3: | Dwyer-Lindgren L, Mackenbach JP, van Lenthe FJ, Mokdad AH. Self-reported general health, physical distress, mental distress, and activity limitation by US county, 1995-2012. Popul Health Metr. 2017;15(1):16. doi:10.1186/s12963-017-0133-5 |
| Reference 4: | America’s Health Rankings. Frequent Physical Distress in depth. United Health Foundation. Accessed May 4, 2023.https://www.americashealthrankings.org/explore/measures/Physical_distress?population=Physical_distress_Hispanic |
| Reference 5: | National Center for Chronic Disease Prevention and Health Promotion. How You Can Prevent Chronic Diseases. Centers for Disease Control and Prevention, US Dept of Health and Human Services. Accessed November 30, 2022. https://www.cdc.gov/chronicdisease/about/prevent/index.htm |
| Population: | All adults |
| Numerator: | Sum of the number of days during the past 30 days for which adults aged ≥ 18 years report that their usual activities (eg, self-care, work, and recreation) were limited because of poor physical or mental health. |
| Denominator: | Number of adults. |
| Measure: | Mean number of days (crude and age-adjusted) |
| Time Period of Case Definition: | Previous 30 days |
| Summary: | Activity limitation days, one of CDC’s health-related quality of life measures (CDC HRQOL-4), is defined as the number of days in the past 30 days a respondent experienced any limitations in their usual activities (i.e., self-care, work, or recreation) associated with poor physical or mental health.1 Activity limitation days varies by individual factors and social determinants of health.2 In 2021, US adults reported an average of 2.8 days with recent activity limitations with estimates higher for women than men.3 Individual- and community-level interventions (e.g., physical activity programs, smoking cessation programs) can help prevent and manage activity limitations and chronic disease.4 |
| Notes: | None |
| Data Source: | Behavioral Risk Factor Surveillance System (BRFSS) |
| Related Objectives or Recommendations: | Healthy People 2030 objective: OHM-6. Free of activity limitation (all ages) |
| Related CDI Topic Area: | None |
| Reference 1: | Moriarty DG, Zack MM, Kobau R. The Centers for Disease Control and Prevention’s Healthy Days Measures – population tracking of perceived physical and mental health over time. Health Qual Life Outcomes. 2003;1:37. doi:10.1186/1477-7525-1-37 |
| Reference 2: | Gerbi GB, Saint-Louis M, Archie-Booker E, Claridy MD, Miles-Richardson S. Factors associated with self-reported 14 or more activity limitation days among adults in the United States. ARC J Public Health Community Med. 2006;1(4):5–11. doi:10.20431/2456-0596.0104002 |
| Reference 3: | National Center for Chronic Disease Prevention and Health Promotion. Chronic Disease Indicators. Centers for Disease Control and Prevention, US Dept of Health and Human Services. Accessed October 26, 2022. https://www.cdc.gov/cdi/ |
| Reference 4: | National Center for Chronic Disease Prevention and Health Promotion. How You Can Prevent Chronic Diseases. Centers for Disease Control and Prevention, US Dept of Health and Human Services. Accessed November 29, 2022. https://www.cdc.gov/chronicdisease/about/prevent/index.htm |
| Population: | US population |
| Numerator: | Not applicable |
| Denominator: | Not applicable |
| Measure: | Life expectancy at birth |
| Time Period of Case Definition: | At birth |
| Summary: | In 2020, the life expectancy at birth nationally was 77.0 years.1 There are disparities in life expectancy by gender and race and ethnicity.1 Life expectancy at birth provides a snapshot of population health and mortality.2 |
| Notes: | Causes of changes in life expectancy at birth are not readily identifiable from this single indicator. |
| Data Source: | National Center for Health Statistics (NCHS) |
| Related Objectives or Recommendations: | None |
| Related CDI Topic Area: | None |
| Reference 1: | Arias E, Xu J. United States life tables, 2020. Natl Vital Stat Rep. 2022;71(1). doi:10.15620/cdc:118055 |
| Reference 2: | National Center for Health Statistics. Life Expectancy. Centers for Disease Control and Prevention, US Dept of Health and Human Services. https://www.cdc.gov/nchs/nvss/life-expectancy.htm |
| Population: | All adults |
| Numerator: | Adults who report they have ever been told by a doctor, nurse, or other health professional they had 1 or more of the following conditions: 1) current asthma; 2) a heart attack, angina, or coronary heart disease; 3) a stroke; 4) cancer other than skin cancer; 5) chronic obstructive pulmonary disease (COPD), emphysema, or chronic bronchitis; 6) some form of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia; 7) kidney disease, not including kidney stones, bladder infections, or incontinence; 8) a depressive disorder (depression); or 9) diabetes, not including gestational, borderline, or prediabetes. For current asthma, they also must report they still have asthma. |
| Denominator: | All adults |
| Measure: | Prevalence (crude and age-adjusted) |
| Time Period of Case Definition: | Current (asthma); Lifetime (all others) |
| Summary: | In 2018, 27.2% of U.S. adults had multiple chronic conditions (MCC; conditions include arthritis, cancer, chronic obstructive pulmonary disease, coronary heart disease, current asthma, diabetes, hepatitis, hypertension, stroke, and weak or failing kidneys).1 The prevalence of MCC significantly increased with advancing age and was highest among women, non-Hispanic White adults, and those living in rural areas.1 Public health approaches for the prevention and treatment of chronic diseases have traditionally focused on single conditions and risk factors. Recent trends in population growth and age distribution, coupled with increases in chronic diseases, have increased the prevalence of MCC with implications for prevention, treatment, public health programs, and planning.2 Coordinated health care approaches from public health, clinicians, and social programs that consider the broader context of multiple occurring chronic conditions, risk factors, and functional limitations may be needed to help people with MCC manage their conditions and improve their quality of life.2 |
| Notes: | Variations in which conditions are included when defining a multiple chronic conditions indicator exist.1-5 This indicator includes nine conditions that are assessed annually in BRFSS. It does not include all 20 proposed chronic conditions from the HHS Framework (for example, substance abuse, HIV, and hepatitis are not included).2 Obesity is not included in the HHS Office of the Assistant Secretary of Health list of selected chronic conditions.2,5 Most recently, alcohol abuse and drug abuse/substance abuse were delineated as different conditions thus increasing the number to 21 chronic conditions.5 |
| Data Source: | Behavioral Risk Factor Surveillance System (BRFSS) |
| Related Objectives or Recommendations: | None |
| Related CDI Topic Area: | None |
| Reference 1: | Boersma P, Black LI, Ward BW. Prevalence of multiple chronic conditions among US adults, 2018. Prev Chronic Dis. 2020;17:E106. doi:10.5888/pcd17.200130 |
| Reference 2: | Goodman RA, Posner SF, Huang ES, Parekh AK, Koh HK. Defining and measuring chronic conditions: imperatives for research, policy, program, and practice. Prev Chronic Dis 2013;10:120239. doi: 10.5888/pcd10.120239 |
| Reference 3: | Newman D, Tong M, Levine E, Kishore S. Prevalence of multiple chronic conditions by U.S. state and territory, 2017. PLoS One. 2020;15(5):e0232346. doi:10.1371/journal.pone.0232346. |
| Reference 4: | Watson KB, Carlson SA, Loustalot F, et al. Chronic conditions among adults aged 18─34 years — United States, 2019. MMWR Morb Mortal Wkly Rep 2022;71:964–970. doi: 10.15585/mmwr.mm7130a3 |
| Reference 5: | Centers for Medicare & Medicaid Services. Chronic Conditions. Accessed November 1, 2023. https://www.cms.gov/data-research/statistics-trends-and-reports/chronic-conditions/chronic-conditions |
Additional Data Sources
Last Reviewed: July 24, 2023