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Children's Health, the Nation's Wealth: Assessing and Improving Child Health (2004)
Institute of Medicine (IOM)
Board on Children, Youth and Families (BOCYF)

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. "Executive Summary." Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press, 2004.

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Children’s Health, The Nation’s Wealth: Assessing and Improving Child Health

Disease Control and Prevention, the Agency for Healthcare Research and Quality, 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. Coordination among these agencies and with the other federal departments who collect data and fund services or research that affect children’s health is essential to minimize duplication, increase efficiency, and ensure that data collection focuses on the most important variables.

Recommendation 2: The secretary of the U.S. Department of Health and Human Services (HHS) should designate a specific HHS unit with a focus on children to address development, coordination, standardization, and validation of data across the multiple HHS data collection agencies, to support state-level use of data, and to facilitate coordination across federal departments. The designated agency’s long-term mission should be to:

  • monitor each of the domains of children’s health (i.e., health conditions, functioning, and health potential) and its influences over time;

  • develop the means to track children’s health and identify patterns (e.g., trajectories) in it over time, both for individual children and for populations and subpopulations of children; and

  • understand the interaction and relative effects of multiple influences on children’s health over time.

The designated unit should (1) translate recommendations on domains, subdomains, and dimensions of health and its influences into improved data collection strategies; (2) identify duplication and gaps in data collection efforts and develop recommendations to make data collection efforts more economical and standardized; (3) ensure that necessary data validation efforts are carried out; (4) ensure that as many data collection activities as possible are usable at the state and substate levels; (5) ensure that thoroughly documented data are released on as timely 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, particularly longitudinal research, on children’s health and its influences.

Improving Children’s Health Measurement

Although numerous national surveys collect relevant data on children’s health, serious gaps remain. Health is not measured in sufficient detail to distinguish the special developmental issues of infants and toddlers (ages 0–3 years), preschool children (4–5), school-age children (6–11), early adolescents (12–14), and older adolescents (15–18). Data on children between toddlerhood and adolescence are especially lacking. Surveys usually do not capture information on

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