Smart(er) Measures

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Which of these challenges is most important to solve: teen pregnancy, hunger, diabetes, or drunk driving?

Where should we focus time and money to improve lives and our communities?

Just as sports and commerce have been recast by data, the health field is leading the way for different mental models that help us calculate value in the social sector. In the US last year, more than 600,000 people died from heart disease while about 75,000 died from diabetes. Does that make heart disease eight times worse than diabetes?

We’re well aware death is inevitable. Still, many conditions aren’t terminal but very costly for individuals and society. In fact, the non-fatal conditions account for the vast majority of health costs. With this rationale, health economists have created new measures. One is a unit identified as “disability-adjusted life years” or DALYs. DALYs calculate the years of healthy life. A DALY is generated by identifying the years of life lost when a person dies (compared with a projected average without the condition). Then, the total years lived with a disability are tallied. A DALY is generated based on estimates of how nonfatal conditions detract from perfect health.

Using this new measurement unit, one can rank health problems. For example, in 2012, scientists reported 200,000 more deaths by lung cancer than traffic accidents worldwide. But, when calculated in DALYs, road injuries are far worse. Most lung cancer deaths are among older folks. Those who tend to die in car accidents with frequency are young – in their 20s and 30s. Importantly, road injuries cause about 40 times more disabilities when people survive them. Should we invest in anti-smoking or road safety campaigns?

Mexico has moved to this kind of analysis for treatments. Now, childhood cancer treatments and emergency care for car accidents are high priorities. Australia has also used DALYs to focus on childhood obesity and other issues. The application of DALYs in the US identifies low back pain, depression and anxiety as enormous health concerns. They generate substantial costs because of prevalence along with significant pain and suffering.

New statistics offer different and valuable viewpoints. They can threaten the status quo. Capable leaders use them to support change and progress. DALYs are a great example of how, with new measures, we can enable rational decisions. Isn’t that smarter? In fact, it can affect how we live and die.

Lisa Wyatt, Ed.D. is chief strategy officer and managing partner in Phillips Wyatt Knowlton, Inc. PWK is a performance management resource for systems and social change with clients worldwide. Lisa has cross-sector and international experience. She is an author and W.K. Kellogg Leadership Fellow. See: www.pwkinc.com

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