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National Institute of Public Health

How to Achieve Good Public Health and Wellness for Your Longevity


It's time to start working on improving your health starting today's date . . . In the "public health corps" and in health, wellness, fitness and disease, the concept of health-related quality of life refers to a person or group's believed physical and mental health over a measured time period.healthy means overall wellness Physicians have often used health-related quality of life to measure the affect of chronic illness and disease in their patients, to help better understand how an disease issue interferes with a person's overall wellness and health and the impact on their every-day healthy life and healthy lifestyle goals.

Public health corps professionals and a public health clinic may also sometimes utilize health-related quality-of-life issues to measure the effects of various health and wellness conditions, short or long-term disabilities, and disease in diverse populations. Tracking health-related quality of life in different populations can identify groups with poor physical or mental health and can help guide policies or work to improve their health.

Answer the set of questions called the "Healthy Days Measurements" to measure health-related quality of life. These health questions include the following:

Would you say that in general your overall health is:

  • Excellent
  • Very good
  • Good or Average
  • Fair
  • Poor

Now thinking about your general physical wellness and health, which includes physical illness and injury, for how many days during the past 30 days was your physical health not good?

Now thinking about your mental health, which includes stress, depression, and problems with emotions, how many days during the past 30-days was your mental health not good?

During the past 30 days, for about how many days did poor physical or mental health keep you from doing your usual activities, such as self-care, work, or recreation?

This section includes the four core questions above, and ten additional questions about health-related quality of life. These questions ask about recent pain, depression, anxiety, sleeplessness, vitality, and the cause, duration, and severity of a current activity limitation an individual may have in his or her life.

How is the summary index of unhealthy days calculated?

Unhealthy days are an estimate of the overall number of days during the previous 30 days when the respondent felt that either his or her physical or mental health was not good. To obtain this estimate, responses to questions 2 and 3 are combined to calculate a summary index of overall unhealthy days, with a maximum of 30 poor health days per month.



For example, a person reporting 4 physically unhealthy days and 2 mentally unhealthy days is assigned a value of 6 unhealthy days, and someone who reports 30 physically unhealthy days and 30 mentally unhealthy days is assigned the maximum of 30 unhealthy days.

Healthy days are the positive complementary form of unhealthy days. Healthy days estimates the number of recent days when a person's physical and mental health was good (or better) and is calculated by subtracting the number of unhealthy days from 30 days.


  • Americans said they feel unhealthy (physically or mentally) about 6 days per month.

  • Americans said they feel "healthy and full of energy" about 19 days per month.

  • Almost one-third of Americans say they suffer from some mental or emotional problem every month—including 10 percent
    who said their mental health was not good for 14 or more days a month.

  • Younger American adults, aged 18–24 years, suffered the most mental health distress.

  • Older adults suffered the most poor physical health and activity limitation.

  • Native Americans and Alaska Natives have reported the highest levels of unhealthy days among American race/ethnicity groups.

  • Adults with the lowest income or education reported more unhealthy days than did those with higher income or education.

  • Americans with chronic diseases or disabilities reported high levels of unhealthy days.

Disease Specific Findings from the National Center for
Chronic Disease Prevention and Health Promotion



Arthritis . . . A recent cross-sectional study of almost 10,000 adults found adults reporting arthritis pain said they had on average 5 more unhealthy days per month vs adults without arthritis pain. strive hard to always eat healthy foodsAmong adults with chronic osteoarthritis, the largest number of unhealthy days was experienced by women (much more vs reported by men), and persons with less than a college education.

Breast Cancer . . . Findings revealed that over 300,000 women surveyed, women with breast cancer diagnosis reported experiencing 8 unhealthy days per month vs 6 unhealthy days per month for women without breast cancer.

Cardiovascular Disease . . . Findings revealed more than 50,000 persons in over 20 states, reported having had a heart attack, heart disease, atherosclerotic cardiovascular disease, or a stroke reported an average of 10 un-healthy days for the previous month vs 5 poor-health days reported among persons not having had one of the conditions.

Diabetes . . . Findings revealed that of more than 500,000 adults surveyed, adults with diabetes reported experiencing 10 unhealthy days per month compared to 5.1 unhealthy days per month for adults without diabetes.

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