Skip to main content Accessibility help

Health impacts of epidemiological environment change: measurement issues

  • Joses Kirigia (a1)


Epidemiological environment (EE) could be denned as a set of conditions and processes, both physical and social, that influence the interaction between human beings and disease agents. The human epidemiological environment is shaped by various aspects of development and global change, viz. the influences of human population size, mobility, geographic distribution, urbanization, and nutrition status; modernization (macro-and microeconomic enterprise); loss of indigenous medicinal knowledge; microbial evolution of antibiotic resistance; land conversion and biodiversity loss; agricultural intensification; stratospheric ozone depletion; and climatic change (Daily and Ehrlich, 1995). Health status is affected greatly not only by economic development (e.g. by policies influencing per capita income and its distribution), but also through changes in EE.



Hide All
Behrman, J.R. (1993), ‘Health and economic growth: theory, evidence and policy’, in World Health Organization, Macroeconomic Environment and Health, Geneva: World Health Organization, 2162.
Bergner, M., Bobbit, R.A., Carter, W.B. and Gilson, B.S. (1981), ‘The Sickness Impact Profile: development and final revision of a health status measure’, Medical Care 8: 787805.
British Medical Association (BMA) (1990), Family Health Encyclopedia, London: Dorling Kindersley.
Cairns, J. (1992), ‘Discounting and health benefits: another perspective’, Health Economics 1(1): 7679.
Chen, M.M. and Bryant, B.E. (1975), ‘The measurement of health—a critical and selective overview’, International Journal of Epidemiology 4(4): 257264.
Culyer, A.J., ed. (1983), Health Indicators: An International Study of the European Science Foundation, London: Martin Robertson.
Culyer, A.J. (1992), ‘The morality of efficiency in health care—some uncomfortable implications’, Health Economics 1(1): 718.
Culyer, A.J. (1993), ‘Health, health expenditures and equity’, in Van Doorslaer, E., Wagstaff, A. and Rutten, F., eds., Equity in Finance and Delivery of Health Care: An International Perspective, Oxford University Press.
Culyer, A.J. and Wagstaff, A. (1992), ‘QALYs versus HYEs: a theoretical exposition’, York Discussion Paper Series No. 14, Centre for Health Economics, University of York.
Culyer, A.J., Lavers, R. and Williams, A. (1972), ‘Health indicators’, in Shonfield, A. and Shaw, S., eds., Social Indicators and Social Policy, London: Heinemann.
Davis, A. (1986), ‘Recent advance in schistosomiasis’, Quarterly Journal of Medicine 226: 95110.
Donaldson, C, Atkinson, A., Bond, J. and Wright, K. (1988), ‘Should QALYs be programme specific?’, Journal of Health Economics 7: 239257.
Drummond, M.F. (1987), ‘Resource allocation decisions in health care: a role for quality of life assessments’, Journal of Chronic Diseases, 40(6): 605616.
Drummond, M.F. (1989), ‘Output measurement for resource allocation decision in health care’, Oxford Review of Economic Policy 5: 5974.
Drummond, M.F. (1991), ‘Output measurement for resource allocation in health care’, in McGuire, A., Fen, P and Mayhew, K., eds., Providing Health Care: The Economics Systems of Finance and Delivery, Oxford University Press, 99119.
Forsyth, D.M. (1969), ‘A longitudinal study of endemic urinary schistosomiasis in a small East African community’, Bulletin of the World Health Organization, 40: 771783.
Forsyth, D.M. and Bradly, D.J. (1966), ‘The consequences of bilharziasis: medical and public health importance in North-West Tanzania’, Bulletin of the World Health Organization 34: 715735.
Garni, A. (1989), ‘The quality of QALYs (quality-adjusted-life-years): do QALYs measure what they at least intend to measure?’, Health Policy 13: 8183.
Gerald, K., Dobson, M. and Hall, J. (1993), ‘Framing and labelling effects in health descriptions: quality life years for treatment of breast cancer’, Journal of Clinical Epidemiology 46: 7784.
Hunt, S.L., McEwan, J. and McKenna, S.P. (1985), ‘Measuring health status: a new tool for clinicians and epidemiologists’, Journal of the Royal College of General Practitioners, 185188.
Kaplan, R.M., Anderson, J.P., Wu, A.W., Mathews, C., Kozin, F. and Orenstein, D. (1989), ‘The quality of well-being scale: applications in AIDS, cystic fibrosis and arthritis’, Medical Care 27: S27S43.
Katz, S., Ford, A.B., Moskowitz, R.W., Jacobson, B.A. and Jaffe, M.W. (1963), ‘The index of ADL: a standardized measure of biological and physiological indicators’, Journal of Gerontology 29: 555563.
Kind, P. (1988), ‘Issues in the design and construction of a quality of life measure in Baldwin, S., Godfrey, C. and Propper, C., eds., The Quality of Life: Perspectives and Policies, London: Routledge, 6371.
Kind, P. and Gudex, C., (1988), ‘The QALY toolkif,’ Discussion Paper, Centre for Health Economics, University of York.
Kind, P. and Gudex, C., (1994), ‘Measuring health status in the community: a comparison of methods’, Journal of Epidemiology and Community Health 48: 8691.
Kind, P., Rosser, R. and Williams, A. (1982), ‘The valuation of quality of life: some psychometric evidence’, in Jones-Lee, M.W., ed., The Value of Life and Safety, London: North Holland.
Kind, P., Dolan, P., Gudex, C. and Williams, A.H. (1994), ‘Practical and methodological issues in the development of the EuroQol: the York experience’, Advances in Medical Sociology 5: 219253.
Kirigia, J.M. (1994), ‘Economics of schistosomiasis interventions: a case study of the Mwea Irrigation Scheme in Kenya’, D. Phil, thesis, University of York.
Kirigia, J.M. (1996), ‘Economic evaluation of Schistosomiasis Interventions: a feasibility test of the contingent valuation (WTP) approach’, Working Paper No. 16, Health Economics Unit, University of Cape Town.
Kirigia, J.M. and McLntyre, D. (1996), ‘Economic evaluation of Schistosomiasis Interventions: A feasibility test of the health states preference (utility) measurement approach’, Working Paper No. 18, Health Economics Unit, University of Cape Town.
Loomes, G. and McKenzie, L. (1989), ‘The use of QALYs in health care decision making’, Social Science and Medicine 28(4): 299308.
Mehrez, A. and Gafni, A. (1989), ‘Quality adjusted life years, utility theory, and healthy years equivalents’, Medical Decision Making 9, 142149.
Mooney, G. and Olsen, J.A. (1991), ‘QALYs: where next?’, in McGuire, A., Fen, P. and Mayhew, K., eds., Providing Health Care: the Economics System of Finance and Delivery, Oxford University Press, 120140.
Murray, C.J.L. (1994), ‘Quantifying the burden of disease: the technical basis for disability-adjusted life years’, Bulletin of the World Health Organization 72(3): 429445.
Murray, C.J.L. and Lopez, A.D. (1994a), ‘Global and regional cause-of-death patterns in 1990’, Bulletin of the World Health Organization 72(3): 447480.
Murray, C.J.L. and Lopez, A.D. (1994b), ‘Quantifying disability: data, methods and results’, Bulletin of the World Health Organization 72(3): 481494.
Murray, C.J.L., Lopez, A.D. and Jamison, D.T. (1994), ‘The global burden of disease in 1990: summary results, sensitivity analysis and future directions’, Bulletin of the World Health Organization 72(3): 495509.
Parsonage, M. and Neuburger, H. (1992), ‘Discounting and health benefits’, Health Economics 1(1): 7176.
Patrick, D.L., Bush, J.W. and Chen, M.M. (1973), ‘Methods for measuring levels of well-being for a health status index’, Health Services Research 8: 229244.
Sackett, D.L. and Torrance, G.W. (1978), ‘The utility of different health states as perceived by the general public’, Journal of Chronic Disease 31: 697704.
Torrance, G.W. (1986), ‘Measurement of health state utilities for economic appraisal’, Journal of Health Economics 5: 130.
Torrance, G.W., Sackett, D.L. and Thomas, W.H. (1972), ‘A utility maximization model for evaluation of health care programmes’, Health Service Research 7: 118133.
Warford, J.J. (1995), ‘Environment, health, and sustainable development: the role of economic instruments and policies’, Bulletin of the World Health Organization 73(3): 387395.
Williams, A. (1995), ‘The economics of coronary artery bypass grafting’, British Medical Journal 291: 326329.
Williams, A. and Anderson, R. (1975), Efficiency in the social services, Oxford: Basil Blackwell.
World Health Organization (WHO) (1993), Women, Health and Environment: An Anthology, Geneva: WHO.


Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed