EHES Core Measurements

core measurements

EHES Core Measurements, which are expected to be included in every national HES are

  • anthropometrics: height, weight and waist circumference,
  • blood pressure,
  • non-fasting blood samples for total and HDL-cholesterol and glycated haemoglobin (HbA1c),
  • fasting blood sample for glucose, and
  • questionnaire items: socio-economical factors, self-perceived health and chronic diseases, use of medication and last time when risk factors measured by a health professional, self-reported height and weight, and smoking.

The description of the selection criteria for the measurements is given in the EHES Manual, Part A, Chapter 5. The detailed measurement protocols, collection of biological samples and questionnaire items are described in the EHES Manual, Part B, Chapters 5-7.

Generally, all EHES core measurements provide indicators from major chronic diseases and their risk factors. These risk factors are largely preventable and treatable at both individual and community level.

Height, weight and waist circumference measure body composition. From height and weight, BMI, the measure used to define overweight and obesity, can be calculated. Obesity is a strong risk factor for hypertension, diabetes and osteoarthritis. It contributes to 10-13% of deaths in Europe.

Blood pressure, is a major modifiable risk factor of cardiovascular disease (CVD). CVD is the leading cause of disability in Europe. Blood pressure distribution is a strong indicator of the burden of hypertension in the population. The percentage of people with elevated blood pressure who are unaware of their condition varies from 10-60% between countries. This is an important indicator of the performance of the health care system.

The role of blood lipids composition is very similar with that of blood pressure.

Fasting blood glucose is an indicator of diabetes. There is indication that up to 40% of those with type 2 diabetes may be unaware of their condition.

Glycated haemoglobin (HbA1c), reflects the time-averaged blood glucose concentration during the previous 2-3 months. There is a close relationship between HbA1c and plasma glucose, and HbA1c superiors over glucose, especially in HESs, because its measurement does not require a fasting blood sample.

Questionnaire items are an essential part of the national HES. They will provide needed background and supporting information for the measurements. In the EHES, European Health Interview Survey (EHIS) questions are used when ever feasible.

Additional measurements

In addition to the Core Measurements, countries may include additional questionnaire modules, physical measurements, and collection of biological samples into the national HES. EHES provides standardized procedures also for additional measurements of

  • anthropometrics; hip circumference,
  • physical functioning; handgrip and timed chair stand test, and
  • collection of spot and 24 hours urine samples.

The EHES recommendations for these additional measurements are described in the EHES Manual, Part B, Chapters 5-6.

For other measurements, EHES provides references to existing standards. if a country plans to include a measurement for which there is no European standard procedure, it should keep in contact with the EHES Coordinating Centre and other countries planning to include a similar measurement. EHES encourages collaboration between the national survey organizers collecting these additional measurements.