Dec. 8, 2010
FOR IMMEDIATE RELEASE
IOM Report Recommends Changes in How U.S. Tracks Health Trends And Measures Health Outcomes
WASHINGTON — Social and environmental factors are the most powerful shapers of life expectancy and health-related quality of life, yet the United States lacks a cohesive national strategy and appropriate measurement tools to track and respond to these critical influences, says a new report from the Institute of Medicine.
Deficiencies in the completeness, timeliness, and relevance of health information being collected and lack of agreement on the best indicators to measure progress are hindering efforts to improve the health of Americans, whose life expectancy ranks 49th among all nations. Moreover, the absence of a benchmark report on nonmedical care-related factors that influence health leaves the public in the dark about the true state of the nation's well-being and the types of efforts that are most likely to improve health outcomes.
"Although the United States invests over 17 percent of its Gross Domestic Product on medical care — far more than any other nation — we lag behind other countries in several measures of health," said Marthe Gold, chair of the committee that wrote the report and Arthur C. Logan Professor and Chair of Community Health and Social Medicine, Sophie Davis School of Biomedical Education, City College of New York, New York City. "Our understanding of more effective and efficient strategies for improving health is hampered by inadequacies in the current system."
The U.S. Department of Health and Human Services should provide greater leadership, coordination, and guidance to the population health information and statistics system, the report says. Strengthened capabilities and coordination within HHS could facilitate efforts to harmonize and integrate population health data collection, analysis, and reporting; provide guidance on developing and selecting health indicators; and analyze the effects of various determinants of health over time.
HHS also should lead development of a standardized, core set of indicators focused on priority health outcomes to improve the relevance and usefulness of data collection and reporting. The numerous health indicator sets developed in recent years and deployed in different contexts make assessment and comparison difficult for policymakers and other decision makers by highlighting similar information in different ways. A standardized set of indicators should reflect and support a convergence of national, state, and local priorities and enable realistic comparisons of jurisdictions.
The nation also should adopt a single summary measure of population health to serve as the GDP equivalent for the health sector. The United States and many other nations have long used death rates as the standard measure of population health, but life expectancy by itself is too blunt an indicator to capture information about the health-related quality of life associated with chronic illnesses and injuries. Summary measures of population health, such as health-adjusted life expectancy, encapsulate an overall picture of the well-being of communities and countries and support monitoring of health status, forecasting, and priority-setting.
HHS also should issue an annual report on the social and environmental factors that influence the population's health as a means of helping Americans better understand what shapes their well-being at the local, state, and national levels. A report of this kind would also potentially galvanize action that leads to better outcomes.
The report, sponsored by the Robert Wood Johnson Foundation, is the first of a series on public health strategies to improve health. Established in 1970 under the charter of the National Academy of Sciences, the Institute of Medicine provides independent, objective, evidence-based advice to policymakers, health professionals, the private sector, and the public. The National Academy of Sciences, National Academy of Engineering, Institute of Medicine, and National Research Council make up the National Academies. For more information, visit http://national-academies.org. A committee roster follows.
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Report in Brief
Pre-publication copies of For the Public’s Health: The Role of Measurement in Action and Accountability are available from the National Academies Press; tel. 202-334-3313 or 1-800-624-6242 or on the Internet at http://www.nap.edu. Reporters may obtain a copy from the Office of News and Public Information (contacts listed above).
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INSTITUTE OF MEDICINE
Board on Population Health and Public Health Practice
Committee on Public Health Strategies to Improve Health
Marthe R. Gold, M.D., M.P.H. (chair)
Professor and Chair
Department of Community Health and Social Medicine
Sophie Davis School of Biomedical Education
New York City
Steven M. Teutsch, Ph.D., M.D. (vice chair)
Chief Science Officer
Los Angeles County Public Health
Leslie Beitsch, M.D., J.D.
Associate Dean for Health Affairs and Director
Center for Medicine and Public Health
College of Medicine
Florida State University
Joyce D.K. Essien, M.D., M.B.A.
Center for Public Health Practice
Rollins School of Public Health
David W. Fleming, M.D.
Director and Health Officer
Department of Public Health - Seattle King County
Thomas Getzen, Ph.D.
Professor of Risk, Insurance, and Health Management
Fox School of Business
Temple University, and
International Health Economics Association
Lawrence O. Gostin, J.D.
Linda and Timothy O'Neill Professor of Global Health Law and
O’Neill Institute for National and Global Health Law
George J. Isham, M.D.
Medical Director and Chief Health Officer
Robert M. Kaplan, Ph.D.
Distinguished Professor of Health Services and Medicine
David Geffen School of Medicine
University of California
Wilfredo Lopez, J.D.
General Counsel Emeritus
New York City Department of Health
New York City
Glen P. Mays, Ph.D., M.P.H.
Professor and Chairman
Department of Health Policy and Management
Fay W. Boozman College of Public Health
University of Arkansas for Medical Sciences
Phyllis D. Meadows, Ph.D., M.S.N., R.N.
Associate Dean for Practice
Office of Public Health Practice, and
Health Management and Policy
University of Michigan School of Public Health
Mary Mincer Hansen, R.N., Ph.D.
Master of Public Health Program
Adjunct Associate Professor and Department of Global Health
Des Moines University
Des Moines, Iowa
Poki S. Namkung, M.D., M.P.H.
Chief Medical Officer
Santa Cruz County Health Services Agency
Santa Cruz, Calif.
Margaret E. O’Kane, M.H.S.
National Committee for Quality Assurance
David A. Ross, Sc.D.
Public Health Informatics Institute
Martin Jose Sepulveda, M.D., F.A.C.P.
IBM Fellow and Vice President Integrated Health Services
Steven H. Woolf, M.D., M.P.H.
Departments of Family Medicine, Epidemiology, and
Virginia Commonwealth University
Alina Baciu, Ph.D., M.P.H.