European Health Examination Survey

Establishment of the EHES Reference Centre and the Joint Action for

the pilot EHES

HIC subgroup on HES meeting, 20 January 2010, Luxembourg

What is EHES?

• A health examination survey (HES) • Includes both questionnaire and physical

measurements• Based on a random sample of the

general population• For many health indicators, the most

reliable data source• Complementary to EHIS and

administrative registers

Why EHES?

• To collect comparable, high quality data on health of the European adult population

• To provide reliable and comparable data for planning and evaluation of health policies and health promotion activities, and research

Setting up EHESPhase I Phase II

Setting up EHES RC

Manual for all EU and EEA/EFTA countries

Training programme

Planning and preparing a national HES, including a pilot survey, in 14 countries

Full-size HES in the pilot countries

Planning, preparing and conducting a national HES in other countries

Gradual development to a sustainable EHES system

Funding through a Tender and Joint Action for 2 years in 2009-2011

0 1 2 3 4

Timing of the Phase I

2009 2011

08 0801 01

EHES Reference Centre

Joint Action

2010 2012

03

EHES target population

• Entire country• Permanent residents, including

institutionalized persons• Age group: 25-64 years

• Can be extend to 18+

EHES sampling

• Two stage sampling

• Sample size at least 4000 persons• Equal sample

size for each stratum

Selection of HES measurements

• Based on:• Epidemiological and public health criteria• Availability of international standards

• Existing recommendations:• ECHI list• Other Projects of the Public Health Programme• European Health Risk Monitoring (EHRM)

Project • WHO STEPS

What to include?

• A set of core questions and measurements will be included in all countries

• Additional questions and measurements can be included in each country based on their• Interests• Experience• Resources

Core measurements

• Physical measurements• Weight• Height• Waist circumference• Blood pressure

• Blood samples• Total cholesterol• HDL cholesterol• Fasting glucose

• Questionnaire items• Basic background

characteristics• Health behaviours• Health status

• Where applicable, EHIS question will be used

Additional measurements

• Physical measurements• Hip circumference• Physical function test• Dental examinations• Bone density• Etc.

• Various markers from blood samples

• Saliva samples• Urine samples• Etc.

• Wider questionnaires• Physical activity• Diet and nutrition• Drinking habits• Use of health services• Social support• Psychological distress• Mental health• Reproductive health • Etc.

HES measurements require

• Standardized protocols• Good training and quality control• Adherence to specific ethical and

legal requirements• Informed consent from the

participants

National HES models

• Light model• Questionnaire supplemented by a core

HES measurements

• Extensive model• Thorough clinical examination by a

survey team and several modules and/or several phases of fieldwork

• Potential for both health monitoring and specific epidemiological studies

The EHES Reference Centre

Established jointly by• National Institute for Health and

Welfare (THL), Helsinki, Finland• Istituto Superiore di Sanità (ISS),

Rome, Italy• Statistics Norway (SSB), Oslo,

Norway

Tasks for EHES Reference Centre

• EHES manuals• The EHES Manual• National Manuals

• Training programme• Training seminars• Training materials

• Quality control• Coordination of external

quality control • Preparation of

guidelines for internal quality control

• Blood sample handling and storage protocols

• Development of principles and rules for data sharing

• Development of data transfer and management system

• Development of reporting system• Basic reports

• Evaluation of the pilot surveys

• Final conference

Joint Action for piloting EHES

• Supports the national activities needed to build the capacity for organizing HES in 14 countries

Finland

Germany

Netherlands

Poland

Czech RepublicSlovakia

Hungary

Greece

ItalyMalta

Spain

Portugal

UK/England

Norway

Tasks of the Joint Action

• Preparation of national HES plans• Preparation of sampling descriptions• Completing field work for the pilot• Transferring the pilot HES data to the

EHES RC• Quality assessment of the pilot HES

data• Preparation of the national

dissemination and the reporting plan

More information

The EHES web site at

http://www.ehes.info