clude a question about the overall rating of a child’s health, this information may not always be obtained from someone with the same relationship to the child. In some surveys it is answered by a respondent who may not be the child’s primary caretaker and in others by a parent or the person who is most knowledgeable about the child’s health. Questions about the child’s functioning have inconsistent wording across surveys. When wording is inconsistent over a period of time, it is difficult to know to what extent changing rates of identification are a result of those changes (Newacheck et al., 2003).

It has been recognized for some time that data could be collected and used more efficiently if they were better coordinated across agencies. The U.S. Department of Health and Human Services Data Council, responsible to the secretary of health and human services, was intended to accomplish this, but it has not focused on the need for new approaches to the conceptualization of children’s health or on the consequent appropriate data collection and dissemination.

National Data Syntheses

There have been several national efforts to use secondary national data to produce annual reports on the health or well-being of children (see Box 4-2). These reports are used by policy makers at the federal, state, and local levels and by others interested in children’s health issues to understand trends. Although they can be useful tools to monitor specific indicators over time, they do not enable understanding of the dynamics of children’s health or the interaction of influences and health.

For the past 15 years, the MCHB has published an annual report entitled Child Health USA that includes data on child health indicators, as well as state-specific data on selective indicators. It also includes trends and progress toward

BOX 4-2
National Data Syntheses

America’s Children and the Environment

America’s Children: Key National Indicators of Well-Being

Child Health USA


Child Trends Data Bank

NOTE: See Appendix C for web links for these syntheses and examples of the indicators tracked.

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