Construction of a Health Well-being Index and Its Application in a Selected Fisher Community

Abstract

The World Health Organization defines health as a state of complete physical, mental and social wellbeing and not merely absence of disease or infirmity. The contemporary thinking is the recognition of dualism between objective and subjective measurements in measuring of health well-being. However, many currently used indexes depend only on either subjective or objective parameters. This study attempted a) to identify parameters to describe health well-being using both subjective and objective perspectives, b) to use identified parameters to construct an index, and c) to apply the constructed index to explore health well-being in a selected community in Sri Lanka. Twenty-three parameters related to health well-being were identified through a review of literature. Identified parameters were grouped into five sub themes as, i) physical fitness, ii) mental fitness, iii) healthy environment, iv) access to healthy food and clean water, and healthy behavior and v) and accessibility of medical services. The Rekawa fishing community in Southern Sri Lanka was selected to apply the prepared indicators. Four modes of fishing, a) beach seiners, b) one day fishing, c) multiday fishing, and d) lagoon fishing, were practiced by the community. Forty fisher households were selected from each of the four identified categories based on predominant engagement in selected mode of fishing. Twelve qualitative interviews were conducted to validate the quantitative findings. The incidences of daily betel use, smoking, and liquor consumption are 72%, 69% and 43% respectively. Mental fitness and healthy living environment is highest for lagoon fishers. One day fishers report highest physical fitness. Best sanitation and health habits are reported by beach seiners. Access to health services and availability of healthy food and water are highest in multiday fishers. The community records an overall value of 0.7 in health well-being index. There are no significant differences among health well-being of households by fishing mode. In conclusion, the constructed index can be used to compare health well-being of different sub groups of a community and among communities.