The Past, Present and Future of Health Risk Assesment

A conversation with the man who wrote the book on HRA tools - literally.

Geoff Alexander, the author of two chapters of the “Society of Prospective Medicine  Handbook of Health Assessment Tools,” spent 20 years developing the computations and translating the science behind Health Risk Assessments (HRAs). These days, Alexander holds Gordian’s coolest job title: Chief Science Officer. He oversees the development of new content for all of Gordian’s stock HRAs, along with all the custom health assessments Gordian creates for clients. About 90 percent of clients customize their HRA, depending on how they plan to use it. For example, a client may add functional status assessment and health and productivity questions. Others may add questions specific to the work environment with emphasis on repetitive motion or safety issues.

The first step toward improving the health of a group is assessing the current health and risk factors of the population in question— health plans, employer groups or communities. The HRA is commonly used in integrated health management (IHM) to measure the effect of a wide range of risk factors on an equally broad range of health outcomes, such as cancer, heart disease or diabetes. HRAs can measure the probability of mortality in the presence of certain risk factors, and are used to estimate the likelihood of disease within a specified time frame. For instance, an individual who smokes and has a family history of cancer will have a higher relative risk of dying of lung cancer in the next 10 years than someone without those risk factors.