intervention, and health promotion activities. Improving the availability of data at the neighborhood, community, or regional level can improve the ability of a local community to target their own efforts and institute community-specific interventions.

Environmental data are valuable in and of themselves, but they also enhance the value of survey and records information. For example, survey-based reports of poor children’s health can be related to neighborhood socioeconomic conditions, or crime, or local or state policies regarding health care or welfare reform. Records-based data on substantiated reports of child abuse can be examined to see if cases cluster in certain neighborhood “hot spots.” But the geographic dimension can be exploited only if subjects’ locations (e.g., homes, schools, workplace addresses) have been coded with geographic identifiers. With proper safeguards, data collectors should make efforts to make these geocodes, which facilitate geographic linkages or the linked data themselves, more available to the planning and research communities.

Balancing Confidentiality with Public Health Needs

Recommendation 7: Administrators of survey and records-based sources of health information should take all necessary legal, ethical, and technical steps to ensure respondent or subject confidentiality while also promoting the availability of needed data to the research and planning communities.

The committee recognizes the importance of maintaining the confidentiality and privacy of data, perhaps especially for children: data can follow them through various programs and systems and be perceived as potentially affecting the provision of benefits and services, and facilitating geographic analysis threatens subject anonymity. Administrative data can be integrated in a manner that prohibits the identification of specific children. Safeguards include obtaining appropriate parental consent for the collection and sharing of data, limiting access to integrated data, ensuring that data security protocols are in place, and in some instances reporting only aggregated data. The committee is encouraged by the many surveys and records systems that have developed geographic identifiers that both safeguard data and make them available to the research and planning communities. However, much more needs to be done to make data, such as that collected by the NCHS, readily accessible to the research and planning communities.

Facilitating State and Local Use of Data

Recommendation 8: The U.S. Department of Health and Human Services should formulate strategies to improve the capacity of state and local communities to monitor children’s health and its influences, including fund-

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