tion health measurement strategy requires both governance and a high level of scientific guidance. In this chapter, the committee believes that NCHS, as the lead national health-statistics agency, must be strengthened to improve its ability to lead a system-wide effort toward better coordination and, as discussed below, enhanced information capacities for the health system. It is important to note here the roles of two federal advisory committees affiliated with NCHS: the Board of Scientific Counselors, which provides advice to NCHS, and the National Committee on Vital and Health Statistics (NCVHS), which is chartered to advise the secretary of HHS but is staffed in NCHS and closely identified with its work. NCVHS also has a population health subcommittee.2

The committee recognizes that two provisions of the Affordable Care Act (ACA)3 have potential pertinence to strengthening the nation’s population health information system. First, and most important, the new National Prevention, Health Promotion, and Public Health Council (NPHPPHC)—comprised of twelve cabinet secretaries and agency heads, under the leadership of the Surgeon General (Public Law 111-148)—offers an unprecedented opportunity for all sectors of government to come together around a de facto Health in All Policies effort. In recent years, there have been efforts around the country to examine the ramifications of all types of policy decisions on health outcomes, by using such tools as health impact assessments, as part of an approach called Health in All Policies, which calls for considering the health effects of all government policies and is internationally used (for example, in the European Union) (CDC, 2010b; Koivusalo, 2010). The council is to make “recommendations to the President and the Congress concerning the most pressing health issues confronting the United States and changes in Federal policy to achieve national wellness, health promotion, and public health goals, including the reduction of tobacco use, sedentary behavior, and poor nutrition” (Congressional Research Service, 2010).

The executive order establishing the council creates a forum for collaboration and coordination among twelve federal departments and agencies that have roles with implications for population health. For the purposes of enhancing the nation’s population health information system, the council’s composition (for example, the inclusion of other agencies) could provide an independent or fresh perspective from outside HHS that could be useful in supporting the department and NCHS (in addition to ensuring that the transformation of NCHS takes place as a primary requirement for meeting


The Subcommittee focuses on both “(1) population-based data such as vital statistics and health surveys concerning the U.S. population generally and (2) data about specific vulnerable groups within the population which are disadvantaged by virtue of their special health needs, economic status, race and ethnicity, disability, age, or area of residence” (NCVHS, 2008).


The Patient Protection and Affordable Care Act and the Health Care and Education Affordability Reconciliation Act, known jointly as the Affordable Care Act (ACA).

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