The Mosby Medical Encyclopedia (1992, p. 360) defines health as “a state of physical, mental, and social well-being and the absence of disease or other abnormal condition.” Economists take a radically different approach. They view health as a durable good, or type of capital, that provides services. The flow of services produced from the stock of health “capital” is consumed continuously over an individual’s lifetime. Each person is assumed to be endowed with a given stock of health at the beginning of a period, such as a year. Over the period, the stock of health depreciates with age and may be augmented by investments in medical services. Death occurs when an individual’s stock of health falls below a critical minimum level.
Naturally, the initial stock
of health, along with the rate of depreciation, varies from individual to
individual and depends on many factors, some of which are uncontrollable. For
example, a person has no control over the initial stock of health allocated at
birth, and a child with a congenital heart problem begins life with a
below-average stock of health. However, we learn later that medical services
may compensate for many defi ciencies, at least to some degree. The rate at
which health depreciates also depends on many factors, such as the individual’s
age, physical makeup, lifestyle, environmental factors, and the amount of
medical care consumed.
For example, the rate at
which health depreciates in a person diagnosed with high blood pressure is
likely to depend on the amount of medical care consumed (is this person under a
doctor’s care?), environmental factors (does he or she have a stressful
occupation?), and lifestyle (does the person smoke or have a weight problem?).
All these factors interact to determine the person’s stock of health at any
point in time, along with the pace at which it depreciates.
Regardless of how you define
it, health is a nebulous concept that defies precise measurement. In terms of
measurement, health depends as much on the quantity of life (that is, number of
life-years remaining) as it does on the quality of life. Quality of life has
become an increasingly important issue in recent years due to the
life-sustaining capabilities of today’s medical technology. The issue gained
national prominence in 1976 when, in a landmark court decision, the parents of
Karen Ann Quinlan were given the right to remove their daughter, who was in a
persistent vegetative state, from a ventilator. Because the quality of life is
a relative concept that is open to wide interpretation, researchers have
wrestled with developing an instrument that accurately measures health.
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