Some important tools that we use to help assess risks for members are health risk assessments and risk calculators. At present, members will be using these tools in cooperation with our medical consultant or health coaches. While these are extremely helpful tools, you must keep in mind a famous quote from George Edward Pelham Box (October 18, 1919–March 28, 2013).
Box was a British statistician, who has been called “one of the great statistical minds of the 20th century”. He is credited for this wonderful quote, “All models are wrong, but some are useful“. It is usually considered to be applicable to statistical models, and to scientific models in general. It suggests that models (including what we use in risk appraisal) always fall short of the complexities of reality but can still be of use. Because of that, we use assessment and calculator tools when we deal with studying our members health and disease risks, but do so with caution.
A health risk assessment (HRA), sometimes referred to as a ‘health risk appraisal’, is a commonly used screening tool (and many times the initial step) of health promotion programs. Health risk assessments are crucial to the field of health promotion, an area of health which aims to help enable people to increase the amount of control they have with regards to their health.
Health risk assessments are usually broad in scope, while specific disease risk calculators are more focused on specific conditions. Most of our use of these tools are limited to risk calculators since they are easily available, whereas HRAs are usually too costly for us to use with such small numbers of members. Plus, we do not want to lose our focus on the leading causes of death and misery in the US, arteriosclerotic cardiovascular disease.
Overall, a health risk assessment is a health-related questionnaire which serves the purpose of evaluating individuals’ quality and life and health risks. Therefore, HRAs are a critical part of preventive medicine and self-care.
The HRA didn’t always exist. Its earliest conception may have been in the late 1940s, but the HRA became more firmly established in the 1970s as a response to the Framingham study. HRA development was based on the data collected from well-designed longitudinal studies done in Framingham containing detailed information on about 5,000 families. Questionnaires were used for collecting information which was, in turn, used for calculating risk computations. It was just a matter of time until the HRA was developed for the exact purpose of asking specific questions which were designed to calculate a person’s risk.
Eventually, HRAs were administered within a workplace setting around the 1980s. Until that point, HRAs were public and available for wide use. And, ever since, they have been revolutionizing the way health is seen and addressed by individuals and stakeholders the workplace, but currently are really only available to larger companies with many employees due to expensive tier pricing. Since HRAs were initially developed in the public sector under the eye of the US Public Health Service, and the Centers for Disease Control and Prevention (CDC), the concept should be classified as government intellectual property, and they should have remained freely available for use by its citizens. Future directions taken by The Agency for Healthcare Research and Quality (AHRQ), the lead Federal agency charged with improving the safety and quality of America’s health care system, might determine whether HRAs will once again be more widely available to other than big industry.