records, and federal surveys that summarize population health outcomes (NCVHS, 2010).1

Helping communities to understand the local conditions for health and outcomes is a necessary (but not sufficient) precursor of the work of improving unfavorable socioeconomic and physical environments. Accurate, timely, locally relevant information is crucial for the implementation of population-focused interventions of established effectiveness and for implementing and evaluating promising new strategies. In the pages that follow, the committee discusses three sets of challenges, endeavors in which changes are warranted to strengthen the population health statistics and information system: adopting the determinants-of-health perspective at a fundamental level (to complement the health system’s predominantly biomedical orientation); enhancing responsiveness to the needs of end users; and coordination and cross-sector collaboration at the national level, beginning with the primary federal health-statistics agency—the National Center for Health Statistics (NCHS)—and with federal health data and statistics activities in general.2 An additional, overarching challenge, and one to which the committee intends to return in its later report on funding, is the extreme inadequacy of resources available for statistical and data-gathering activities of governmental public health agencies at all levels in general (Friedman and Parrish, 2009b; HHS et al., 2002) and NCHS in particular (NCHS, 2008, 2009; Population Association of America, 2010).

Several related terms are used to describe concepts in the field of health statistics and information. In common professional usage, the terms statistics and measures are often used interchangeably to refer to an aggregate data point (or set of data points) about a phenomenon, such as disease-specific mortality in a particular age group over a given period. (Statistic is also used in the field to indicate a type of measure, such as a mean, a median, or a proportion.) A specific statistic or measure is commonly called an indicator when it is widely acknowledged to be useful for monitoring something of concern to policy-makers or to the public. Examples include the monthly unemployment rate and the annual poverty rate as indicators of the health of the national economy. Such indicators can be simple statistics or can be quite complex; for example, many data sources go into the


The system includes 57 vital registration jurisdictions in the United States and the entities represented by the National Association for Public Health Statistics and Information Systems (Schwartz, 2008).


The Department of Health and Human Services (HHS) Data Council plays a key role in facilitating intradepartment coordination on data and statistics issues. The council has supported the development of the HHS Gateway to Data and Statistics (HHS, 2010d), which represents one of several HHS efforts to make federal health data more available and accessible. The council’s role in coordinating HHS data systems has also been discussed in a meeting of the HHS secretary’s Advisory Committee on National Health Promotion and Disease Prevention Objectives for 2020 (HHS, 2009).

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