strategies to better understand the influence of various factors on health outcomes. A measurement system for children’s health, building on what has already been achieved, should be able to:

  • Measure and monitor important trends in health and its influences. These measures would span the developmental stages of childhood and be gathered from important subgroups defined by ethnicity, income, geographic region, and special needs (e.g., children with chronic conditions, in foster care, in special education).

  • Provide a surveillance and early warning capacity for the detection of significant changes in health, as well as increase the capacity to forecast the effect of changing influences on children’s health and anticipate the need for specific services and interventions.

  • Improve understanding of the mechanisms of children’s development and determine how changes in behavior, new health practices, and new policy interventions affect children’s health.

  • Measure the performance of the personal medical care system, relevant community service systems, and the broader public health system and how they affect children’s health. Such activities would not only measure the quality of services, but also encourage the improvement of the integration and coordination of personal, community, and public health services.

CONCLUSIONS AND RECOMMENDATIONS

The committee identified five action areas to move toward a comprehensive children’s health measurement system:

  1. establishing a definition and framework for children’s health;

  2. establishing children’s health as a national priority;

  3. improving measurement of children’s health;

  4. increasing state and local leadership and use of data; and

  5. promoting research to better understand children’s health and its influences.

This report is intended to provide a foundation and a framework for children’s health measurement rather than specific measures to monitor children’s health. Appendix B provides a review of the approaches taken by key national surveys, and Appendix C summarizes many of the indicators used in national monitoring efforts.

Definition and Framework

Few existing definitions of health are specific to children, and none accounts fully for issues particularly salient to them: the developmental process; how bio-



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