Health-related quality of life is viewed as an outcome of the health factors included in the County Health Rankings. Being healthy incorporates length of life and also the quality of those years. Measuring HRQoL helps characterize the burden of chronic diseases and disabilities in a population.
The CDC’s “Measuring Healthy Days” report lists several tools that have been used to assess HRQoL, including Medical Outcomes Study Short Forms (SF-12 and SF-36), Sickness Impact Profile, and Quality of Well-Being Scale. Although these measurement tools have been widely used and extensively validated in clinical and population settings, their length makes them impractical to use in population surveillance. Self-reported health and the number of physically and mentally unhealthy days per month are widely used measures for overall health and HRQoL of a population. Self-reported health has been used in numerous studies since the 1950s. There is no “gold standard” or clear criterion for the validity of self-reported health, but it is among the most frequently used health indicators in sociological health research. “Healthy days” are determined by asking people about the number of physically and mentally unhealthy days per month—these questions have been part of the CDC’s core Behavioral Risk Factor Surveillance Survey (BRFSS) questionnaire since 1993.