Constructing social metrics for health status indexes.

Health status indexes used to make collective decisions satisfying the principles of equality and social minimum must incorporate a social metric for health. Any index or indicator applied to populations for determining health status or to health programs for evaluating outcome must confront the question of who prefers which states of health under which circumstances? Utility models, psychometric scaling, and empirical social decision valuation have been used to measure preferences for states of health. Efforts should be directed toward constructing social metrics for health that are prospective, context-independent, relevant, community-wide, ratio scalled, sensitive, empirically validated, and applicable to program evaluation. These efforts represent the application of normative social theory to research, an important advance in uncovering the mysteries of social action and its consequences.