ing state or local demonstration projects, standardization of data elements, and technical assistance.
Both federal and state governments should assist local efforts to measure trends in children’s health and development and to address disparities in children’s health, health influences, and access to and use of health services. Of greatest use to health planners are the collection and public distribution of data on health and health influences at neighborhood, community, county, and state levels. State web sites with aggregated data hold particular promise as ways of disseminating information inexpensively to large numbers of users without breaching confidentiality. Web sites designed for use by the public as well as public and private researchers with more sophisticated skills have greater usefulness.
Because there are likely to be common technical, methodological, and measurement challenges at the state and local levels, the federal government has an obvious role in convening and supporting efforts to reengineer state and local health information systems. Collaborative strategies to identify and implement promising data system reform strategies should be supported by the federal agencies.
Federal agencies—including but not limited to the CDC, the NCHS, the MCHB, and the AHRQ, operating under the auspices of the newly designated lead HHS agency—should assist states in their effort to improve and create more systematic approaches to measure children’s health. They should provide preferential funds for model demonstrations that use standardized data collection methods, aggregate data by local geographic units, and disseminate aggregated data on web sites designed with two to three levels of complexity to meet the needs of the public and researchers while simultaneously protecting confidentiality. Federal guidance and assistance are necessary but not sufficient for states and localities to realize the potential of records data to inform health policy and research. States and communities should establish a process for using the data on children in the allocation of limited resources, policy development, and the evaluation of strategies.
Several areas of children’s health measurement are ripe for efforts to integrate data across age ranges, child service sectors, and geographic levels. Several of these areas would build on or be responsive to important and emerging children’s health issues that are supported under a range of different federal and state initiatives.
In building and improving the function of data collection systems, it is also useful to institute data integration strategies that capture aspects of health across developmental stages. For example, a possible measure of health potential is profiles of school readiness that can be measured at school entry. Measures of school readiness usually capture several aspects of functioning, such as physical, social, emotional, cognitive, and language functions. Currently, some states and com-