Methods for complex evaluation of the population health in relation to environmental factors based on use of integral indices. Descriptive review (Report 2)
https://doi.org/10.47470/0044-197X-2026-70-2-93-100
EDN: knsmfz
Abstract
This paper presents the second part of descriptive reviews on methodological tools for the comprehensive assessment of public health, focusing on index-based indicators and measures of population health burden and health-related quality of life. The manuscript is centered on instruments for assessing health losses and the multidimensional evaluation of health determinants, continuing the analysis of metrics of achieved health status.
The purpose of the study is to describe the principles of construction, methodological features, fields of application, advantages, and limitations of integral indicators focused on the assessment of disease burden (DALY, QALY) and multidimensional composite indices.
The analysis of the scientific literature was conducted using the method of «snowball» based on scientific articles indexed in bibliographic databases including Scopus, Web of Science, PubMed. Priority was given to conceptually foundational documents describing the methodology for indicator development. In addition, reviews and reports from international organizations (WHO, OECD, UN) were analyzed.
DALY (Disability-Adjusted Life Years) was shown to be «gold standard» for monitoring inequalities and gaps in population health status, with identification of the most significant risk factors. QALY (Quality-Adjusted Life Years), based on subjective health state utility assessments, enables comparison of the effectiveness of heterogeneous medical technologies within pharmacoeconomic evaluations. Composite indices, such as the Human Development Index and the English Health Index provide a comprehensive cross-sectoral and interagency assessment by integrating social, economic, and environmental determinants into a single metric.
Research limitations. The review is narrative (descriptive), without strict systematization search strategy by study type, publication date, or source.
Conclusion. The choice of a specific assessment tool should be determined by the research objectives, the availability and quality of input data, and the required level of detail for supporting decision-making, including in the field of sanitary and epidemiological well-being.
Contribution of the authors:
Glukhikh M.V., Ukhabov V.М. — editing, writing the text, approval of the final version of the article;
Onishchenko G.G. — study concept and design, editing, approval of the final version of the article;
Klein S.D. — editing, writing the text, approval of the final version of the article, collection and processing material, writing the text.
All authors are responsible for the integrity of all parts of the manuscript and approval of its final version.
Funding. The study had no sponsorship.
Conflict of interest. The authors declare no conflict of interest.
Received: February 12, 2026 / Accepted: February 19, 2026 / Published: April 30, 2026
About the Authors
Maxim V. GlukhikhRussian Federation
PhD (Medicine), senior research, Head, Laboratory of methods complex sanitary and hygienic analysis and expertise, Department of sanitary and hygienic analysis and monitoring systemic methods, Federal Scientific Center for Medical and Preventive Health Risk Management Technologies, Perm, 614045, Russian Federation
e-mail: gluhih@fcrisk.ru
Gennadiy G. Onishchenko
Russian Federation
DSc (Medicine), Professor, Academician of the Russian Academy of Sciences, Deputy President of the Russian Academy of Education, Moscow, 119121, Russian Federation
e-mail: journal@fcrisk.ru
Sofia D. Klein
Russian Federation
Master of International Business, National Research University “Higher School of Economics”, Moscow, 119602, Russian Federation
e-mail: klein.sophia@yandex.ru
Viktor M. Ukhabov
Russian Federation
DSc (Medicine), Professor Department of common hygiene and specialized hygienic disciplines, Perm State Medical University named after academician E.A. Wagner, Perm, 614990, Russian Federation
e-mail: uhabovvm@yandex.ru
References
1. Onishchenko G.G., Zaitseva N.V., Kleyn S.V., Glukhikh M.V. Methods for complex population health evaluation in relation to environmental factors based on use of integral indices. Descriptive review (Report 1). Zdravookhranenie Rossiiskoi Federatsii. 2024; 68(6): 449–58. https://doi.org/10.47470/0044-197X-2024-68-6-449-458 https://elibrary.ru/okeywi (in Russian)
2. Murray C.J., Salomon J.A., Mathers C. A critical examination of summary measures of population health. Bull. World Health Organ. 2000; 78(8): 981–94.
3. Field M.J., Gold M.R., eds. Summarizing Population Health: Directions for the Development and Application of Population Metrics. Washington: National Academies Press; 1998. https://doi.org/10.17226/6124
4. Sullivan D.F. A single index of mortality and morbidity. HSMHA Health Rep. 1971; 86(4): 347–54.
5. WHO. Methods for life expectancy and healthy life expectancy. Global Health Estimates Technical Paper; 2014.
6. Murray C.J. Quantifying the burden of disease: the technical basis for disability-adjusted life years. Bull. World Health Organ. 1994; 72(3): 429–45.
7. GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020; 396(10258): 1204–22. https://doi.org/10.1016/S0140-6736(20)30925-9
8. Weinstein M.C., Siegel J.E., Gold M.R., Kamlet M.S., Russell L.B. Recommendations of the panel on cost-effectiveness in health and medicine. JAMA. 1996; 276(15): 1253–8.
9. Lalonde M. A New Perspective on the Health of Canadians. Ottawa; 1974. Available at: https://phac-aspc.gc.ca/ph-sp/pdf/perspect-eng.pdf
10. Dahlgren G., Whitehead M. Policies and Strategies to Promote Social Equity in Health. Stockholm; 1991.
11. McGranahan D.V., Richard-Proust C., Sovani N.V., Subramanian M. Contents and Measurement of Socioeconomic Development. New York: Praeger Publishers; 1972.
12. Morris M.D. Measuring the Condition of the World’s Poor: The Physical Quality of Life Index. New York: Pergamon Press; 1979.
13. UNDP. Human Development Report 1990. Oxford University Press; 1990.
14. NHS Digital. The Health Index for England; 2020. Available at: https://digital.nhs.uk/data-and-information/publications/statistical/health-survey-for-england
15. OECD. Handbook on Constructing Composite Indicators: Methodology and User Guide. OECD Publishing; 2008.
16. Wohlin C. Guidelines for snowballing in systematic literature studies and a replication in software engineering. In: Proceedings of the 18th International Conference on Evaluation and Assessment in Software Engineering (EASE ‘14). Volume 38. New York; 2014: 1–10. https://doi.org/10.1145/2601248.2601268
17. Weinstein M.C., Torrance G., Mcguire A. QALY: The Basics. Good Clinical Practice. 2015; (2): 70–8. https://elibrary.ru/zrbytn (in Russian)
18. McGranahan D.V. Analysis of socio-economic development through a system of indicators. Ann. Am. Acad. Pol. Soc. Sci. 1971; 393(1): 65–81. https://doi.org/10.1177/000271627139300106
19. Morris D. A physical quality of life index. Urban Ecol. 1978; 3(3): 225–40. https://doi.org/10.1016/0304-4009(78)90015-3
20. Klasen S. Human Development Indices and Indicators: A Critical Evaluation. New York; 2018. Available at: https://hdr.undp.org/system/files/documents/klasenfinal.pdf
21. Office for National Statistics (ONS). Health Index contents and definitions; 2022. Available at: https://ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthandwellbeing/methodologies/healthindexindicatorsanddefinitions#toc
22. Rubo M., Czuppon P. How should we speak about years of life lost (YLL) values? Eur. J. Epidemiol. 2023; 38(3): 345–7. https://doi.org/10.1007/s10654-023-00966-w
23. Romeder J.M., McWhinnie J.R. Potential years of life lost between ages 1 and 70: an indicator of premature mortality for health planning. Int. J. Epidemiol. 1977; 6(2): 143–51. https://doi.org/10.1093/ije/6.2.143
24. Maximova K., Rozen S., Springett J., Stachenko S. The use of potential years of life lost for monitoring premature mortality from chronic diseases: Canadian perspectives. Ca. J. Public Health. 2016; 107(2): e202–4. https://doi.org/10.17269/cjph.107.5261
25. Tsugane S. Why has Japan become the world’s most long-lived country: insights from a food and nutrition perspective. Eur. J. Clin. Nutr. 2021; 75(6): 921–8. https://doi.org/10.1038/s41430-020-0677-5
26. RoSPA. The Big Book of Accident Prevention. The Royal Society for the Prevention of Accidents. Birmingham; 2012. Available at: https://unionsafety.eu/ELibrary/media/elibrarymedia/TheBigBookOfAccidentPrevention.pdf
27. Braithwaite R.S., Roberts M.S. Are discount rates too high? Population health and intergenerational equity. Med. Decis. Making. 2021; 41(2): 245–9. https://doi.org/10.1177/0272989X20979816
28. Kim Y.E., Jung Y.S., Ock M., Yoon S.J. DALY estimation approaches: understanding and using the incidence-based approach and the prevalence-based approach. J. Prev. Med. Public Health. 2022; 55(1): 10–8. https://doi.org/10.3961/jpmph.21.597
29. Gold M.R., Stevenson D., Fryback D.G. HALYS and QALYS and DALYS, Oh My: similarities and differences in summary measures of population Health. Annu. Rev. Public Health. 2002; 23: 115–34. https://doi.org/10.1146/annurev.publhealth.23.100901.140513
30. Touré M., Kouakou C.R.C., Poder T.G. Dimensions used in instruments for QALY calculation: a systematic review. Int. J. Environ. Res. Public Health. 2021; 18(9): 4428. https://doi.org/10.3390/ijerph18094428
31. Santos M.E. Santos G. Composite Indices of Development. In: Currie-Alder B., Kanbur R., Malone D., Medhora R., eds. International Development: Ideas, Experience and Prospects. Oxford: Oxford University Press; 2014: 133–50.
32. Bandura R. Composite indicators and rankings: Inventory 2011. Technical report. New York; UNDP: 2011.
33. Lutz W., Striessnig E., Dimitrova A., Ghislandi S., Lijadi A., Reiter C., et al. Years of good life is a well-being indicator designed to serve research on sustainability. Proc. Natl Acad. Sci. USA. 2021; 118(12): e1907351118. https://doi.org/10.1073/pnas.1907351118
34. Kottke T.E., Gallagher J.M., Rauri S., Tillema J.O., Pronk N.P., Knudson S.M. New Summary measures of population health and well-being for implementation by health plans and accountable care organizations. Prev. Chronic Dis. 2016; 13: E89. https://doi.org/10.5888/pcd13.160224
35. Happiness Research Institute & Leaps by Bayer. Wellbeing Adjusted Life Years. Berlin; 2020. Available at: https://happinessresearchinstitute.com/_files/ugd/928487_cd21db9946b74c4fa2e88ee87397d53a.pdf
36. Greco S., Ishizaka A., Tasiou M., Torrisi G. On the methodological framework of composite indices: a review of the issues of weighting, aggregation, and robustness. Soc. Indic. Res. 2019; 141(1): 61–94. https://doi.org/10.1007/s11205-017-1832-9
37. Zhgun T.V. An algorithm for constructing integral quality indicator of complex systems for a sequence of observations. Vestnik Yuzhno-Ural’skogo gosudarstvennogo universiteta. Seriya: Vychislitel’naya matematika i informatika. 2017; 6(1): 5–25. https://doi.org/10.14529/cmse170101 https://elibrary.ru/ygfabd (in Russian)
38. Indico Calculation Methodology. Methodology building the 2023 policy coherence index; 2023. Available at: https://indicedecoherencia.org/wp-content/uploads/2023/10/Indico-2023-Methodology.pdf
39. JRC Indicators Explorer. Available at: https://composite-indicators.jrc.ec.europa.eu/explorer
Review
For citations:
Glukhikh M.V., Onishchenko G.G., Klein S.D., Ukhabov V.M. Methods for complex evaluation of the population health in relation to environmental factors based on use of integral indices. Descriptive review (Report 2). Health care of the Russian Federation. 2026;70(2):93-100. (In Russ.) https://doi.org/10.47470/0044-197X-2026-70-2-93-100. EDN: knsmfz
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