a basis as possible; (6) develop a process for assessing the potential effect of key policy changes on children’s health; and (7) facilitate continued research on children’s health and its influences.

It is necessary for a single federal agency to take responsibility for the measurement of children’s health. The majority of relevant data is collected by HHS, the lead federal agency on health issues. The secretary of HHS should designate and empower a specific unit of HHS and a senior staff person to take steps to make measurement of children’s health, broadly defined, a national priority. Several agencies within HHS have children’s health or data collection within their purview, including the Maternal and Child Health Bureau (MCHB) in the Health Resources and Services Administration, the National Center for Health Statistics (NCHS) and other offices in the Centers for Disease Control and Prevention (CDC), the Agency for Healthcare Research and Quality (AHRQ), the Office of Disease Prevention and Health Promotion and the Office of the Assistant Secretary for Planning and Evaluation in the Office of the Secretary, the National Institute for Child Health and Human Development and other units in the National Institutes of Health, and the Administration for Children and Families. The committee has not identified a preferred agency but stresses the importance of the designated agency having monitoring and promotion of children’s health as a core component of its mandate and having an established leadership role on children’s health in the department and with state and local partners.

The designated agency should be charged with better integration of the existing portfolio of health surveys so that the identified gaps, particularly related to measures of functioning and health potential, can be addressed in a strategic and systematic fashion. Strategies to integrate measures and to compare and contrast data from existing surveys should be developed. Steps are needed to improve the health measures in surveys that do not have a primary health focus, but for which current collection of information about health influences could be substantially augmented by adding a parsimonious set of health measures. Many other federal agencies also fund services or research that affect children’s health, including the departments of Agriculture, Education, Transportation, Housing and Urban Development, Commerce, Labor, and Justice as well as the Environmental Protection Agency. Many of them also collect data on children’s health or its influences. Coordination among these agencies is essential to minimize duplication, improve standardization of data, increase efficiency, and ensure that data collection focuses on the most important variables. The existing Interagency Forum for Child and Family Statistics, if extended beyond its current authorization expiration date of 2007, provides a possible mechanism for this coordination. A lead agency for the multiple relevant HHS agencies will help to facilitate this coordination. Coordination and measurement would also be advanced if the forum adopted a broad conceptualization of health that mandates development of new measures rather than relying solely on existing data.

The committee’s definition and model of health have several important im-



The National Academies | 500 Fifth St. N.W. | Washington, D.C. 20001
Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement