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Improving Health in the Community: A Role for Performance Monitoring (1997)
Institute of Medicine (IOM)

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. "5 Measurement Tools for a Community Health Improvement Process." Improving Health in the Community: A Role for Performance Monitoring. Washington, DC: The National Academies Press, 1997.

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Improving Health in the Community: A Role for Performance Monitoring

able. Field model domains: disease, genetics, individual behavior, social environment, health care, health and function, well-being, and prosperity. Data sources: state or local disease surveillance systems.

  1. Births to adolescents (ages 10–17) as a proportion of total live births.

    This indicator is included in the consensus set recommended by CDC (1991) for use by all states and communities. Births to young women of school age are usually unplanned and often unwanted. The pregnancy can have a negative impact on the health and well-being of the mother, father, grandparents, and child. Lack of economic and social support can manifest in various diseases and health conditions. Field model domains: individual behavior, social environment, well-being, and prosperity. Data sources: state or local vital records.

  2. Number and rate of confirmed abuse and neglect cases among children.

    This indicator is included among the priority data needs to augment the consensus indicators recommended by CDC (1991) for use by all states and communities. Children are the most vulnerable population in a community. Most abuse and neglect cases involve young children who cannot defend or choose for themselves; thus, a community response is required. Child abuse and neglect are thought to be underreported, and inconsistencies in reporting and confirmation practices make it difficult to assess changes in incidence (NRC, 1993). Field model domains: disease, individual behavior, social environment, physical environment, health care, and well-being. Data sources: state or local child protection agency.

  3. Proportion of 2-year-old children who have received all age-appropriate vaccines, as recommended by the Advisory Committee on Immunization Practices.

    This indicator is included among the priority data needs to augment the consensus indicators recommended by CDC (1991) for use by all states and communities. The immunization rate reflects the effectiveness of the public health system and personal health care providers in delivering immunization services. It also reflects the impact of family decisions, which can be influenced by personal circumstances, economic factors, and factors affecting access to services. The current series of immunizations recom-

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