National Health Index

Why is this project needed?

The National Health Index developed during this project will provide data on the need for social and healthcare services and social security benefits in relation to the disease groups and health problems with the greatest disease burden. The index also helps targeting preventive measures to promote wellbeing, health and safety.

Figure 1. Development of the National Health Index

The new National Health Index will be based chiefly on two previous indexes: the Morbidity Index of THL, the National Institute for Health and Welfare (in Finnish), and Kela’s Health Barometer (Figure 1).

Aims of the project

This project will develop a National Health Index that gathers more comprehensive data than the previous indexes on the health, work capacity and functional ability of the Finnish population. The index is calculated using a wide range of data from registers maintained by Kela, THL, Statistics Finland and the Finnish Centre for Pensions.

The index will provide a means to observe and forecast changes in morbidity and incapacity for work, including differences between regions and population groups. Such data are crucial in monitoring the attainment of the objectives set out for the health and social services reform and the social security reforms. The National Health Index will also provide data for assessing the effectiveness of services or of the social security system. In addition, the National Health Index will be a source of key data for the municipal and regional welfare reports.

The project’s aims are to

  • develop a National Health Index based on the Morbidity Index of THL and Kela’s Health Barometer;
  • supplement and review the contents of the subindices by disease groups and incapacity for work;
  • use the index to assess population health in municipalities and wellbeing services counties with different demographic structures;
  • produce information on topics such as socio-economic differences between population groups;
  • use the index to study changes in population health over time and to forecast future trends, taking into account demographic changes and the potential for disease prevention; and
  • establish a process for producing index data and to ensure regular updates to the index as well as open access to the data.

What are the building blocks of the National Health Index?

Data from a variety of sources will be used in the calculation of the National Health Index:

  • THL, the National Institute for Health and Welfare (Care Register for Health Care, outpatient visits to specialised and primary care and hospitalisation periods)
  • The Finnish Cancer Registry (diagnosed cancers)
  • Statistics Finland (causes of death and demographic data)
  • Finnish Centre for Pensions (disability pensions)
  • Kela (reimbursements for medicine expenses, and other health-based benefits)

The National Health Index consists of sub-indexes that cover the disease groups and health problems that are the most common and generate the greatest disease burden. The project will strive to identify the most reliable ways of describing regional differences in the prevalence of diseases and health problems at population level using data from different registers. The goal is to ensure that the index is not limited to describing potential differences in diagnostic and treatment practices or in the way entries are made in the patient information systems.

The project will look at the following disease groups:

  • cancers
  • cardiovascular diseases
  • diabetes
  • dementia
  • musculoskeletal diseases
  • severe mental health problems
  • accidents
  • chronic respiratory diseases
  • alcohol disorders

Additionally, a new sub-index that more comprehensively covers incapacity for work will be developed and evaluated during the project.

In determining the burden caused by the different health problems, the prevalence of each health problem is weighted based on the associated

  • costs
  • effects on quality of life
  • mortality
  • incapacity for work.

How to interpret the index data

The purpose of the National Health Index is to identify the disease burden of the most common health problems in each region, providing data on their impact and the changes that can be observed over time.

The National Health Index describes the health and work capacity of the population of wellbeing services counties and municipalities in relation to Finland’s entire population (entire population = 100). The higher the morbidity or incapacity for work in a region, the higher the index score.

The National Health Index will be published in both age-standardised and non-standardised versions. The age-standardised version reduces the impact of age structure on the results, thus making them suitable for cross-regional comparison, while the non-age-standardised index describes the actual disease burden in the region.

In addition to the age structure of the population, there are many other factors underlying regional differences in morbidity and incapacity for work. Lifestyle habits, such as smoking, alcohol consumption, exercise, sleep, and eating habits have an impact on the statistics, but those habits are in turn the result of many different factors. Unemployment, financial situation and education are all reflected in the health and work capacity of the population. Access to functioning social welfare and healthcare services is also important, as are cultural and genetic factors.

Timetable for the project and future data production

The National Health Index project will be carried out between 1 August 2021 and 31 May 2023 with funding from THL and Kela.

Alongside experts from Kela and THL, the project steering group will includes experts from the Finnish Centre for Pensions and Statistics Finland, who will participate in the development of index data production. Experts from other organisations will also be consulted. The project will ensure future access to regularly updated, reliable index data in an open online service for municipalities, wellbeing services counties and national use.

The aim is that first results of the National Health Index will be published by the end of 2022. The aim is also to update the data annually. Research based development of data production will continue with the aim of describing differences between population subgroups, such as socioeconomic differences.