affiliates (the Council for State and Territorial Epidemiologists, the National Association of Public Health Statistics and Information Systems), the National Association of County and City Health Officials, the Association of State and Territorial Health Officers, the Association of Schools of Public Health, and the Association of Teachers of Maternal and Child Health. The National Action Alliance has advocated for better maternal and child health data and information systems, increased opportunities for field-based capacity building, sufficient well-trained people in the field, as well as increased communication and opportunities for research and evidence-based practice.

Concerns About Data Linkage: Territoriality and Competing Sectors

Data linkage raises concerns as more information becomes available about specific individuals. Parents may be reluctant to have their children’s data in a linked system. Government agencies, health providers, health insurers, and even legislators may oppose data linkage because of the accountability issues it raises. Data are very important for ensuring accountability, but not everyone welcomes accountability with the same enthusiasm. Competing private entities may have concerns about how data will be collected, analyzed, utilized, and reported and may fear that negative data could be presented in a manner that threatens the stability and future of a facility, organization, company, or community.

Geographically Coded and Valid Data for Smaller Geographic Units

Geographically coded data can help communities understand children’s health and its influences in their communities. They provide communities with an efficient method for determining what or where their problems are and allow them to compare their community with other similar communities. Most data now are geographically coded at the state and county level, and some public health data, such as cancer data, includes geocodes. However, few communities have data other than decennial census data available at smaller geographic levels, such as the census tract level. In some cases, administrative data sets that incorporate geocodes do not retain multiple geocodes, which negates geographic tracking over time.

Geocoded data can also assist states and communities in their efforts to target limited resources to meet the greatest need, forcing communities to recognize problems that they might not acknowledge without data to apply to them. For example, although a state may recognize that it has a higher incidence of youth alcohol and drug use or juvenile arrests than surrounding states or the nation, communities can deny that the problem relates to them if there are no data specific for their community. Rural communities may be surprised at their incidence of specific social and health problems because they have associated these problems with urban areas (e.g., drug abuse). Middle and upper income commu-



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