The various definitions of health status indicate that it can be determined on the basis of both objective and subjective measures. Typically, in the workplace, it is determined on the basis of clinical biometric measures such as BMI (body mass index), blood pressure, weight, cholesterol levels and blood sugar level. These objective measures are derived through a process commonly known as biometric screening.
Since health status can involve both objective and subjective data, knowing these different data points is important.
Subjective Data Sources
• Biographical information
• Physical symptoms
• Past health history
• Family history
• Health beliefs and values
Objective Data Sources
• Physical characteristics
• Health, lifestyle and other behaviors
• Body systems functioning
• Measurements and screening results
• Results from lab testing
Since there is no standard for health status, it can be based on either objective or subjective data. Generally though, current approaches are focused almost exclusively on the effects of illness and the varying states of ill-health.
How individuals conceptualize their health has been shown to vary as a function of:
• Age and gender
• Social class
This means that how they view their health status will vary as well. Given that the conceptualization can vary, it is important to make the assessment about the individual employee as a whole person and not just about their current biometric data. This means that the employee needs to be viewed in the various contexts that can and will influence their health and not just as an isolated individual. An effective health assessment requires a contextual awareness and understanding in addition to observing and understanding any objective measurement and test results.
Despite the worksite wellness community's heavy reliance on objective measures as indicators of health, I found it interesting to read that "self-assessed health contributed significantly to the prediction of mortality, even after controlling for a wide array of objective health indicators." (Wright, 1977)
In his book, Healing Beyond the Body, Dr. Larry Dossey wrote: "Our own opinion about the state of our health is a better predictor than physical symptoms and objective factors such as extensive exams, laboratory tests or behaviors." Dr. Dossey also wrote that how people answer the question "Is your health excellent, good, fair, or poor is a better predictor of who will live or die over the next decade than in-depth physical examinations, and extensive laboratory tests."
The quotes by Wright and Dossey are particularly note-worthy given the worksite wellness community's heavy promotion of workplace biometric screening results as being indicators of an employee's health status. Given that health can be defined in very broad conceptual terms and health status can be very subjective as well, it may behoove the worksite wellness community to take a look at its current approach to wellness being limited to just individual employee health status that is based on biometrics and health risk assessments.
When it comes to the status of an employee's health, the worksite wellness community would be wise to look beyond just the results of biometric screenings.
Dossey, Larry. MD. 2001. Healing Beyond The Body. Boston: Shambhala Publications.
Wright, Stephen. 1997. Health Status Assessment in Cambridge Handbook of Psychology, Health and Medicine. Baum, Andre. Newman, Stanton. Weinman, John. West, Robert. McManus, Chris. (Eds.) New York: Cambridge University Press.