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 EHES Phase IPhase 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

Timing of the Phase I EHES Reference Centre Joint Action

EHES target population Entire country Permanent residents, including institutionalized persons Age group: 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

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