Health assessment in the Framingham Offspring Study: a research proposal

This paper proposes that a broader health assessment be made in the Framingham Offspring/Spouse Study than is undertaken in the Framingham Study. The Offspring Study is composed of the children (and their spouses) of the members of the original Framingham Study cohort. The Offspring population has a broader age range and an average age that is approximately 30 years younger than the original parent cohort. Therefore, mortality and morbidity measures, which were used as indices of health status for the parent cohort and which focus on the negative "sickness" component of health, are less appropriate for use in this relatively healthy population. Thus, we propose a broader conceptual framework of health that emphasizes the positive "wellness" side of the health continuum. The essential components of the comprehensive health index we describe include global health perceptions, measures of physical, mental, and social functioning across valued social roles, the ability to withstand stress as mediated by the coping process and social resources, and the assessment of genetic, behavioral, and physiological risk factors. One purpose of the proposal is to stimulate discussion in the hope of achieving general agreement regarding a shared conceptual frame of reference that would guide the development and testing of a reliable and valid health status instrument.