Abstract
We begin with a discussion of some vitally important conceptual and methodological issues. These issues concern our understanding of community, of health, of population health and its determinants, of the concept of ‘measurement’ and the values that underlie it, and our reasons for wishing to measure these constructs. We then present a framework for indicator categories, propose some criteria for indicator selection and suggest an initial set of core indicators. This indicator set reflects not simply health status - no matter how broadly defined - but also the environmental, social and economic determinants of health and the “healthfulness” of the community itself. Our most important conclusion is that if the information that is contained in the data of the indicator set is to be transformed into knowledge that can empower and emancipate the community, it has to be developed in consultation with the local community and local users of the information.
Abrégé
Nous débutons avec une discussion sur des questions conceptuelles et méthodologiques d’importance majeure. Ces questions touchent notre compréhension de la communauté, de la santé, de la santé de la population et de ses déterminants, du concept de « mesure » et des valeurs qui le sousentendent, et et des raisons que nous avons de vouloir mesurer ces éléments. Nous présentons ensuite un cadre pour les catégories d’indicateurs, proposons quelques critères pour la sélection d’indicateurs et suggérons une première série d’indicateurs principaux. Cette série d’indicateurs reflète non seulement l’état de santé - peu importe la globalité de sa définition - mais aussi les déterminants environnementaux, sociaux et économiques sur la santé et la « salubrité » de la communauté en tant que tel. Notre conclusion la plus importante est que si l’information contenue dans les données de la série d’indicateurs doit être transformée en connaissances qui peuvent renforcer et émanciper la communauté, elle doit être développée en consultation avec la communauté locale et les utilisateurs locaux de l’information.
Footnotes
This paper is abstracted from a lengthy report prepared by the authors for the Knowledge Development Division, Health Canada. The views herein do not necessarily reflect the views or opinions of Health Canada or the Government of Canada. The full report is to be published by the Centre for Health Promotion, University of Toronto, and ParticipACTION.
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