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For the Public’s Health: The Role of Measurement in Action and Accountability
and breadth of the information available)—makes the utility of the system’s combined efforts less than it should be.
Many of the data sets described in Chapter 2 are built from core data elements that have been static for many years and reflect the sum of the health of individuals with few data on measures of the health of a community. The committee’s vision of measurement includes both a reconsideration of the use of older measures that may be less amenable to local action and accountability and the building of new measures and potentially new measurement systems that report on more recently recognized loci for intervention.
NCHS’s current mission is “to provide statistical information that will guide actions and policies to improve the health of the American people. As the Nation’s principal health statistics agency, NCHS leads the way with accurate, relevant, and timely data” (CDC, 2009). Although recognizing the statutory underpinnings of its mission, the committee believes that the current implementation of the NCHS mission is too limited (e.g., to conducting surveys). The 2002 HHS document Developing a 21st Century Vision forHealth Statistics states that the NCHS vision should (HHS, 2002)
Reflect all manifestations of health and health care delivery.
Encompass population health, transactions between the population and the health care delivery system, and the health care delivery system.
Address the relationship and potential synergy between public and private health data sets and national, state, and locally maintained data.
Those three points are congruent with the committee’s findings about the statistics and information system’s needs, gaps, and opportunities. NCHS’s current mission statement and the committee’s understanding of the agency’s scope of work suggest that its current role consists primarily of conducting several major surveys on population health, as well as managing the nation’s vital statistics system and managing surveys of nursing homes, hospitals, outpatient facilities, and other clinical care providers (NRC, 2009). The committee believes that NCHS can and should play a broader leadership role in the population health information system, expanding its analytic capabilities, its research activities, its ability to collaborate with those who use its data, and its ability to help to modernize and integrate the system. Transforming the way the mission of NCHS is implemented could broaden the array of activities in which NCHS engages beyond surveys and basic statistical work and toward activities that facilitate and provide guidance for the “translation” of data into information and knowledge that decision-makers and communities can use.
Facilitating a more highly integrated data system and a national popula-