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Date:  Dec. 17, 2008

Contacts:  Christine Stencel, Media Relations Officer

Alison Burnette, Media Relations Assistant

Office of News and Public Information

202-334-2138; e-mail <>







WASHINGTON — 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 Institute of Medicine.  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 report says. 


The indictors are intended for the health section of a new Web site that the nonprofit State of the USA Inc. (SUSA) 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. 


SUSA asked IOM to recommend no more than 20 indicators of health, each with a substantial body of high-quality data behind it.  Reputable organizations are generating new data on each of these markers annually, providing a reliable means to track changes over time.  The data can be sorted by population subgroups or geographic region, allowing detailed analyses and comparisons.  For example, one could use the data to compare current rates of obesity in different race and ethnic groups or to track whether the national obesity rate goes up or down over the next five years. 


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 SUSA to create links between the different sections that will enable visitors to see and explore these relationships.


"This report takes an important step of capturing the health of the American people with a few key indicators," said committee chair George J. Isham, medical director and chief health officer, HealthPartners Inc., Bloomington, Minn.  "Given the gap between the relatively low performance and high costs of our health care system, data that is readily accessible on the Internet will be of great value in devising strategies to close this gap.  We believe this set of measures, as deployed by the State of the USA project, can help move the nation toward better health."


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 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.  A committee roster follows.

Copies of State of the USA Health Indicators 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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[ This news release and report are available at ]



Board on Population Health and Public Health Practice


Committee on the State of the USA Health Indicators


George J. Isham, M.D., M.S. (chair)

Medical Director and Chief Health Officer

Health Partners Inc.

Bloomington, Minn.


Ron Bialek, M.P.P.


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

University of Chicago



Caroline Fichtenberg, Ph.D.

Chief Epidemiologist

Baltimore City Health Department



Jessie Gruman, Ph.D.

Executive Director

Center for the Advancement of Health

Washington, D.C.


David Holtgrave, Ph.D.

Professor and Chair

Department of Health, Behavior, and Society

Bloomberg School of Public Health

Johns Hopkins University



Cara V. James, Ph.D.

Senior Policy Analyst

Henry J. Kaiser Family Foundation

Washington, D.C.


David A. Kindig, M.D., Ph.D.

Professor Emeritus of Population Health Sciences, and

Emeritus Vice Chancellor for Health Sciences

School of Medicine

University of Wisconsin



Lisa Lang, M.P.P.


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


Center for Health Services Research

Henry Ford Health System



James D. Reschovsky, Ph.D.

Senior Health Researcher

Center for Studying Health System Change

Washington, D.C.


Steven M. Teutsch, M.D., Ph.D.

Executive Director

U.S. Outcomes Research

Merck and Co. Inc.

West Point, Pa.


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



Alan M. Zaslavsky, Ph.D.

Professor of Statistics

Department of Health Care Policy

Harvard Medical School





Lyla Hernandez, M.P.H.

Study Director