Health-Risk Appraisal

Your future health is largely determined by what you do now. You lifestyle and your habits have a dominant influence on how healthy you are, how healthy you will be, how much time you will spend in hospitals, and how rapidly you will “physiologically” age.

Recently, techniques have been developed for mathematically estimating your future health risks, and these techniques are variously termed “health-risk appraisal,” “health-hazard appraisal,” or “health assessment.” You complete a questionnaire or other wise provide information about your lifestyle and health habits. Your responses are mathematically combined to complete estimates of your likelihood of developing major medical problems such as heart disease and cancer. Other estimates such as your “physiologic” age and your life expectancy also may be calculated. These techniques form an increasingly important part of comprehensive health-education programs, such as Healthtrac, Senior Healthtrac, and the Taking Care Program of the Center for Corporate Health Promotion. These techniques also have a potentially large role in helping you shape your own personal health program.

There are several things that you should know about health appraisal. First, the results are only estimates. Even though based on the best medical studies, such as the Framingham study, data from these studies are incomplete and may not apply equally to all populations. In general, the estimates may be accurate to within 10 or 20 percent. Think of health-risk scores as similar to IQ or achievement-test scores; they are approximately correct but not exact. Second, the predictions are only averages, and some people will do better than predicted and others worse. Third, any single assessment represents you at one point in time, while your actual risks depend on the changes that you make and your average lifetime health habits as well. Regular repeated assessments can help show your current status and the benefits you have achieved by lifestyle changes. Fourth, a good health-risk appraisal should be based only on those relatively few risk factors that are scientifically well established and that are associated with major health problems. These include cigarette smoking, exercise, automobile seat-belt use, alcohol intake, obesity, salt, fat intake, blood pressure, cholesterol levels, stress level, and dietary fiber. Fifth, the assessment itself provides no health benefits unless it results in changes in your health-related behaviors, and assessment might even increase anxiety. Therefore, these assessments are best used as part of a program that not only identifies risk, but educates, motivates for change, provides suggestions and recommendations, and reinforces positive effects.

I am enthusiastic about the growing role of health-promotion programs that focus attention on prevention of disease and about the use of good health-assessment tools. Well-designed programs are already having a large effect on decreasing human illness.