Evaluation of the strength of the various indicators revealed premature mortality as the strongest indicator of health status. PMR is widely used as a measure of health because populations with higher rates also report more sickness & more symptoms of illness.
The standardized morbidity/mortality ratio (SMR) based on deaths occurring among individuals aged 0-74 has been identified by several researchers as the best single indicator of health status, capturing the need for health care^5-7. This measure is available in most areas via vital statistics, and when linked to individuals place of residence can be used for longitudinal tracking and/or cross-sectional comparisons between groups.

This measure is also strongly associated with self-assessed health, number of symptoms, self-reported rheumatism and reports of acute illness rates and is recommended as a good proxy for both objective and subjective definitions of ill health.⁸