Morbidity indicators

But its rejection leaves a difficult question: if health is something less
that complete physical, mental, and social well-being, how is its scope
to be limited? Health professionals, researchers, and policy makers have
acknowledged the need for such limits, and have introduced the notion
of health-related quality of life (HRQL) as a way to set them. HRQL assessment
tools evolved from older mortality and morbidity indicators,
augmented by measures of functional status, subjective health experience,
and perceived components of “social health.” These instruments
were designed to assess the patient’s performance in, or satisfaction
with, areas of activity affected by her physical and mental functioning.
Since virtually all areas of activity are affected by health, however, these
measures had to limit themselves to the areas most directly or substantially
affected by health. Yet without an understanding of what counts
as “health-related” in this sense, that term does more to label than to
resolve the issue. The proliferation of HRQL instruments has not been
informed by a careful analysis of, or an explicit agreement on, that issue.