State of the
Committee on the State of the
Available online at: http://www.nap.edu/catalog.php?record_id=12534
“………..Policymakers, the media, and the public should focus on 20 specific health indicators as "yardsticks" to measure the overall health and well-being of Americans, says a new report from the
By providing information that can be compared over time, these 20 indicators will also help Americans track the nation's progress on improving our health and the effectiveness of public health and care systems.
The indicators are intended for the health section of a new Web site that the nonprofit State of the USA Inc. (SUSA) http://stateoftheusa.org/ is building as a tool for measuring and monitoring the nation on several fronts. The site will aim to help people become more-informed and active participants in national discussions about important topics — such as health, education, and the environment — by giving them a way to measure national progress from year to year and to compare it to that of other countries. Until recently, only researchers and academics have had the capacity for this kind of analysis.
The 20 proposed indicators together provide a broad picture of Americans' health and the nation's health systems. They reflect a range of factors that determine well-being, including how many individuals engage in certain risky or healthy behaviors, how well patients fare from the care they receive, and to what extent health professionals and facilities are meeting specific goals.
Social and environmental factors — such as income, race and ethnicity, education level, and pollution — also influence people's health, noted the committee that wrote the report. The SUSA Web site will have sections devoted to education and the environment as well as other topics. Given the interconnectedness of health and these other areas, the committee urged
IOM's Proposed Health Indicators
Health Outcomes
• Life Expectancy at Birth — number of years that a newborn is expected to live if current mortality rates continue
• Infant Mortality — number of deaths of infants less than 1 year old per 1,000 live births
• Life Expectancy at Age 65 — number of years of life remaining to a person at age 65 if current mortality rates continue
• Injury-Related Mortality — age-adjusted mortality rates due to intentional and unintentional injuries
• Self-Reported Health Status — percent of adults reporting fair or poor health
• Unhealthy Days, Physical and Mental — mean number of physically or mentally unhealthy days in past 30 days
• Chronic Disease Prevalence — percent of adults reporting one or more of six chronic diseases: diabetes, cardiovascular disease,
chronic obstructive pulmonary disease, asthma, cancer, and arthritis
• Serious Psychological Distress — percent of adults with serious psychological distress as indicated by a score of 13 or higher on the K6 scale
Health-Related Behaviors
• Smoking — percent of adults who have smoked 100 or more cigarettes in their lifetime and who currently smoke some days or every day
• Physical Activity — percent of adults meeting the recommendations for moderate physical activity, which are 30 minutes of
moderate intensity activity at least five days a week or 20 minutes of vigorous intensity activity at least three days per week
• Excessive Drinking — percent of adults consuming 4 (women) or 5 (men) or more drinks on one occasion and/or consuming
more than an average of 1 (women) or 2 (men) drinks per day during the past 30 days
• Nutrition — percent of adults eating a good diet as indicated by a score of 80 or more on the Healthy Eating Index
• Obesity — percent of adults with a body mass index of 30 or more
• Condom Use — proportion of youth in grades 9 through 12 who are sexually active and do not use condoms, placing them at risk
for sexually transmitted infections
Health Systems
• Health Care Expenditures — per capita health care spending
• Insurance Coverage — percentage of adults without health coverage via insurance or entitlement
• Unmet Medical, Dental, and Prescription Drug Needs — percent of non-institutionalized people who did not receive or
delayed receiving needed medical services, dental services, or prescription drugs during the previous year
• Preventive Services — percent of adults who are up-to-date with age-appropriate screening services and flu vaccination
• Preventable Hospitalizations — hospitalization rate for ambulatory care-sensitive conditions
• Childhood Immunization — percent of children between 19 and 35 months old who are up-to-date with recommended immunizations
The study was sponsored by State of the USA Inc., the F.B. Heron Foundation, and William and Flora Hewlett Foundation. Established in 1970 under the charter of the National Academy of Sciences, the
George J. Isham, M.D., M.S. (chair) Medical Director and Chief Health Officer Health Partners Inc.
Ron Bialek, M.P.P. President Public Health Foundation Washington, D.C.
Norman M. Bradburn, Ph.D. Tiffany and Margaret Blake Distinguished Service Professor Emeritus; and Senior Fellow National Opinion Research Center
Caroline Fichtenberg, Ph.D. Chief Epidemiologist Baltimore City Health Department
Jessie Gruman, Ph.D.
David Holtgrave, Ph.D. Professor and Chair Department of Health, Behavior, and
Cara V. James, Ph.D. Senior Policy Analyst Henry J. Kaiser Family Foundation
David A. Kindig, M.D., Ph.D. Professor Emeritus of Population Health Sciences, and Emeritus Vice Chancellor for
Lisa Lang, M.P.P. Head National Information Center on Health Services Research and Health Care Technology, and Assistant Director Health Services Research Information, National Library of Medicine Bethesda, Md.
David R. Nerenz, Ph.D. Director of Outcomes Research Neuroscience Institute, and
James D. Reschovsky, Ph.D.
Steven M. Teutsch, M.D., Ph.D. Executive Director U.S. Outcomes Research Merck and Co. Inc.
David R. Williams, Ph.D., M.P.H. Florence & Laura Norman Professor of Public Health, and Professor of African and African American Studies and of Sociology Department of Society, Human Development, and Health School of Public Health Harvard University Boston
Alan M. Zaslavsky, Ph.D. Professor of Statistics Department of
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