Measuring the health of people in places: a scoping review of OECD member countries

Background: Defining and measuring population health in places is fundamental for local and national planning and conducting within-country and cross-national health comparisons. Yet availability and comparability of place-level health data is unknown.

Methods: A scoping review was performed to identify how Organisation for Economic Co-operation and Development (OECD) countries measure overall health for sub-national geographies within each country. The search was conducted across MEDLINE, Scopus and Google Scholar, supplemented by searching all 38 OECD countries statistical agency and public health institute websites.

Results: Sixty publications were selected, plus extracted information from 37 of 38 OECD countries statistical agency and/or public health institute websites. Data sources varied by categorisation into mortality (n=7) or morbidity (n=5) health indicators: the former mostly from national statistical agencies and the latter from population-level surveys. Region was the most common geographic scale: eight indicators for 26 countries, two indicators for 24 countries and one indicator for 20 countries. Similar but slightly fewer indicators were available for urban areas (max countries per most frequent indicator = 24), followed by municipality (range of 1-14 countries per indicator). Other geographies, particularly those at smaller granularity, were infrequently available across health indicators and countries.

Conclusion: Health indicator data at sub-national geographies are generally only available for a limited number of indicators at large administrative boundaries. Relative uniformity of health indicator question format allows cross-national comparisons. However, wider availability of health indicators at smaller, and non-administrative, geographies is needed to explore the best way to measure population health in local areas.