Canadian Journal of Public Health

, Volume 91, Issue 6, pp 465–470 | Cite as

Measuring Population Health: Correlates of the Health Utilities Index Among English and French Canadians

  • Jacek A. Kopec
  • J. Ivan Williams
  • Teresa To
  • Peter C. Austin


This study used cross-sectional data from the 1994/95 National Population Health Survey (NPHS) in Canada. The objective of the study was to examine the relationship between several established correlates of health status in the general population and the Health Utilities Index (HUI), a multidimensional, preference-based measure of health status. Analyses were carried out separately for the English-speaking (n=9,853) and French-speaking (n=1,519) respondents. The index correlated strongly with selfratings of health status and functional disability and varied as expected according to age, sex, and income. Subjects classified to different categories of chronic conditions reported different levels of health, as predicted. The HUI was also associated with the use of drugs and recent history of hospitalization. No major differences in the findings were observed between the two cultural groups. The results should be treated with caution due to the cross-sectional design and other methodological limitations of the study.


Cette étude est basée sur un échantillon de données provenant de l’Enquête nationale sur la santé de la population de 1994–95 au Canada. L’enquête avait pour objectif d’examiner la relation entre divers corrélats acceptés pour l’état de santé de la population en général et de l’Indice de l’état de santé (IES) qui est une mesure multidimensionnelle de l’état de santé basée sur la préférence. Les analyses étaient effectuées séparément pour les personnes interrogées anglophones (n = 9 853) et francophones (n = 1 519). L’indice correspondait nettement aux autoévaluations de l’état de la santé et de l’invalidité fonctionnelle et, conformément aux attentes, différait d’après l’âge, le sexe et le revenu. Comme prévu, les sujets classés dans des catégories différentes d’états chroniques signalaient des degrés de santé différents. L’IES était également associé à l’usage de médicaments et aux hospitalisations récentes. Aucune différence majeure n’a été constatée entre les deux groupes culturels. Les résultats devraient être traités avec prudence étant donné qu’ils étaient basés sur un échantillon et que l’étude avait d’autres restrictions méthodologiques.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Wolfson, MC. Social Proprioception: Measurement, Data, and Information from a Population Health Perspective. In: Evans RG, Barer ML, Marmor TR (Eds.), Why Are Some People Healthy and Others Not? The Determinants of Health of Populations. New York, NY: Aldine de Gruyter, 1994;287–316.Google Scholar
  2. 2.
    Erickson P, Kendall EA, Anderson JP, et al. Using composite health status measures to assess the nation’s health. Med Care 1989;27:S66–S76.CrossRefGoogle Scholar
  3. 3.
    Torrance GW, Boyle MH, Horwood, SP. Application of multiattribute utility theory to measure social preferences for health states. Oper Res 1982;30:1043–69.CrossRefGoogle Scholar
  4. 4.
    Froberg DG, Kane, RL. Methodology for measuring health-state preferences - I: Measurement strategies. J Clin Epidemiol 1989;42:345–54.CrossRefGoogle Scholar
  5. 5.
    Kaplan RM, Bush JW, Berry, CC. Health status: Types of validity and the Index of Well-Being. Health Serv Res 1976;11:478–507.PubMedPubMedCentralGoogle Scholar
  6. 6.
    The EuroQol Group. EuroQol - a new facility for the measurement of health-related quality of life. Health Policy 1990;16:199–208.CrossRefGoogle Scholar
  7. 7.
    Torrance GW, Feeny DH, Furlong WJ, et al. Multiattribute utility function for a comprehensive health status classification system. Health Utilities Index Mark 2. Med Care 1996;34:702–22.CrossRefGoogle Scholar
  8. 8.
    Feeny DH, Torrance GW, Furlong, WJ. Health Utilities Index. In: Spilker B (Ed.), Quality of Life and Pharmacoeconomics in Clinical Trials 2nd Edition. Philadelphia: Lippincott-Raven Press, 1996;239–52.Google Scholar
  9. 9.
    Boyle MH, Torrance GW, Sinclair JC, et al. Economic evaluation of neonatal intensive care of very-low-birth-weight infants. N Engl J Med 1983;308:1330–37.CrossRefGoogle Scholar
  10. 10.
    Cadman D, Goldsmith C, Torrance G, et al. Development of a health status index for Ontario children. Final Report to Ontario Ministry of Health. Hamilton, 1986.Google Scholar
  11. 11.
    Feeny D, Furlong W, Barr, RD. A comprehensive multiattribute system for classifying the health status of survivors of childhood cancer. J Clinical Oncology 1992;10:923–28.CrossRefGoogle Scholar
  12. 12.
    Costet N, Le Gales C, Buron C, et al. French cross-cultural adaptation of the Health Utilities Indexes Mark 2 (HUI2) and 3 (HUI3) classification systems. Qual Life Res 1998;7:245–56.CrossRefGoogle Scholar
  13. 13.
    Beaton DE, Hogg-Johnson S, Bombardier C. Evaluating changes in health status: Reliability and responsiveness of five generic health status measures in workers with musculoskeletal disorders. J Clin Epidemiol 1997;50:79–93.CrossRefGoogle Scholar
  14. 14.
    Mathias SD, Bates MM, Pasta DJ, et al. Use of the Health Utilities Index with stroke patients and their caregivers. Stroke 1997;28:1888–94.CrossRefGoogle Scholar
  15. 15.
    Whitton AC, Rhydderch H, Furlong W, et al. Self-reported comprehensive health status of adult brain tumor patients using the Health Utilities Index. Cancer 1997;80:258–65.CrossRefGoogle Scholar
  16. 16.
    Boyle MH, Furlong W, Feeny D, et al. Reliability of the Health Utilities Index - Mark III used in the 1991 cycle 6 Canadian General Social Survey Health Questionnaire. Qual Life Res 1995;4:249–57.CrossRefGoogle Scholar
  17. 17.
    Grootendorst PV, Feeny DH, Furlong W. Does it matter whom and how you ask? Inter- and intra-rater agreement in the Ontario Health Survey. J Clin Epidemiol 1997;50:127–35.CrossRefGoogle Scholar
  18. 18.
    Gold M, Franks P, Erickson P. Assessing the health of the nation. The predictive validity of a preference-based measure and self-rated health. Med Care 1996;34:163–77.CrossRefGoogle Scholar
  19. 19.
    Ontario Ministry of Health. The Ontario Health Survey 1990: User’s Guide Volume One Documentation. Ottawa, 1991.Google Scholar
  20. 20.
    Statistics Canada. General Social Survey (99); Public Use Microdata File Documentation and User’s Guide. Ottawa: Ministry of Industry Science and Technology, 1992.Google Scholar
  21. 21.
    Statistics Canada. NPHS Public Use Microdata Documentation. Ottawa, 1995.Google Scholar
  22. 22.
    Wolfson, MC. Health-adjusted life expectancy. Health Rep 1996;8:41–46.PubMedGoogle Scholar
  23. 23.
    Berthelot J-M, Roberge R, Wolfson M. The calculation of health-adjusted life expectancy for a Canadian province using a multi-attribute utility function: A first attempt. In: Robine JM, Mathers CD, Bone RM, Romieu I, Calculation of Health Expectancies: Harmonization, Consensus Achieved, and Future Perspectives. Montrouge, France: Colloque INSERM/John Libbey Ltd., 1993;226:161–72.Google Scholar
  24. 24.
    Roberge R, Berthelot JM, Wolfson M. The Health Utility Index: Measuring health differences in Ontario by socioeconomic status. Health Rep 1995;7:25–32.PubMedGoogle Scholar
  25. 25.
    Mittmann N, Kostas T, Risebrough N, Liu, BA. Utility scores for chronic conditions in a community-dwelling population. Pharmacoeconomics 1999;15:369–76.CrossRefGoogle Scholar
  26. 26.
    Federal, Provincial and Territorial Advisory Committee on Population Health. Statistical Report on the Health of Canadians. Ottawa: Health Canada, Statistics Canada, 1999.Google Scholar
  27. 27.
    Statistics Canada. Report of the Canadian Health and Disability Survey (1983–1984). Ottawa: Minister of Supply and Services, Catalogue 82-555E; 1986.Google Scholar
  28. 28.
    Hamilton, MK. The Health and Activity Limitation Survey. Health Rep 1989;1:175–87.PubMedGoogle Scholar
  29. 29.
    Nagi SZ, Marsh J. Disability, health status, and utilization of health services. Int J Health Services 1980;10:657–76.CrossRefGoogle Scholar
  30. 30.
    Pope, GC. Medical conditions, health status, and health services utilization. Health Serv Res 1988;22:857–77.PubMedPubMedCentralGoogle Scholar
  31. 31.
    Martin J, Letzer H, Elliot D. The prevalence of disability among adults. OPCS Survey of Disability in Great Britain. Report 1. London, HMSO, 1988.Google Scholar
  32. 32.
    Idler EL, Benyamini Y. Self-rated health and mortality: A review of twenty-seven community studies. J Health Soc Behav 1997;38:21–37.CrossRefGoogle Scholar
  33. 33.
    Rosholm JU, Christensen K. Relationship between drug use and self-reported health in elderly Danes. Eur J Clin Pharmacol 1997;53:179–83.CrossRefGoogle Scholar
  34. 34.
    Hosmer DW, Lemeshow S. Applied Logistic Regression. New York: John Wiley and Sons, 1989.Google Scholar
  35. 35.
    Revicki, DA. Relationship between health utility and psychometric health status measures. Med Care 1992;30:MS274–MS282.CrossRefGoogle Scholar
  36. 36.
    Katz JN, Phillyps CB, Fossel AH, et al. Stability and responsiveness of utility measures. Med Care 1994;32:183–88.CrossRefGoogle Scholar
  37. 37.
    Chancellor JVM, Coyle D, Drummond, MF. Constructing health state preference values from descriptive quality of life outcomes: Mission impossible? Qual Life Res 1997;6:159–68.CrossRefGoogle Scholar
  38. 38.
    Macintyre S, Hunt K, Sweeting H. Gender differences in health: Are things really as simple as they seem? Soc Sci Med 1996;42(4):617–24.CrossRefGoogle Scholar
  39. 39.
    Verbrugge LM, Wingard, DL. Sex differentials in health and mortality. Health Matrix 1987;5:3–19.PubMedGoogle Scholar
  40. 40.
    Kind P, Dolan P, Gudex C, Williams A. PatVariations in population health status: Results from a United Kingdom national questionnaire survey. BMJ 1998;316:736–41.CrossRefGoogle Scholar
  41. 41.
    Torrance GW, Furlong W, Feeny D, et al. Provisional Health Index for the Ontario Health Survey. Final report to Statistics Canada of Project 44400900187. Hamilton: McMaster University, 1992.Google Scholar
  42. 42.
    Furlong W, Feeny D, Torrance GW, et al. Multiplicative multi-attribute utility function for the Health Utilities Index Mark 3 (HUI3) system: A technical report. Centre for Health Economics and Policy Analysis, Paper 98-11. Hamilton: McMaster University, 1998.Google Scholar

Copyright information

© The Canadian Public Health Association 2000

Authors and Affiliations

  • Jacek A. Kopec
    • 1
    • 2
    • 3
    • 4
  • J. Ivan Williams
    • 3
    • 4
  • Teresa To
    • 3
    • 4
    • 5
  • Peter C. Austin
    • 3
    • 4
  1. 1.Department of Health Care and EpidemiologyUniversity of British ColumbiaVancouverCanada
  2. 2.Arthritis Research Centre of CanadaVancouverCanada
  3. 3.Department of Public Health SciencesUniversity of TorontoTorontoCanada
  4. 4.Institute for Clinical Evaluative SciencesSunnybrook and Women’s College Health Sciences CentreTorontoCanada
  5. 5.Hospital for Sick ChildrenTorontoCanada

Personalised recommendations