Dec. 8, 2010




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  A committee roster follows.




Christine Stencel, Senior Media Relations Officer

Christopher White, Media Relations Assistant

Office of News and Public Information

202-334-2138; e-mail

Additional resources:

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  Reporters may obtain a copy from the Office of News and Public Information (contacts listed above).


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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

City College

New York City


Steven M. Teutsch, Ph.D., M.D. (vice chair)

Chief Science Officer

Los Angeles County Public Health

Los Angeles


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

Emory University



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

Executive Director

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

Georgetown University

Washington, D.C.


George J. Isham, M.D.

Medical Director and Chief Health Officer

HealthPartners Inc.

Bloomington, Minn.


Robert M. Kaplan, Ph.D.

Distinguished Professor of Health Services and Medicine

David Geffen School of Medicine

University of California

Los Angeles


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

Little Rock


Phyllis D. Meadows, Ph.D., M.S.N., R.N.

Associate Dean for Practice

Office of Public Health Practice, and

Clinical Professor

Health Management and Policy

University of Michigan School of Public Health

Ann Arbor


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

Washington, D.C.


David A. Ross, Sc.D.


Public Health Informatics Institute

Decatur, Ga.


Martin Jose Sepulveda, M.D., F.A.C.P.

IBM Fellow and Vice President Integrated Health Services

IBM Corp.

Somers, N.Y.


Steven H. Woolf, M.D., M.P.H.


Departments of Family Medicine, Epidemiology, and

Community Health

Virginia Commonwealth University






Alina Baciu, Ph.D., M.P.H.

Study Director