Leading Health Indicators for Healthy People 2010

First Interim Report

Committee on Leading Health Indicators for Healthy People 2010

Division of Health Promotion and Disease Prevention

INSTITUTE OF MEDICINE

NATIONAL ACADEMY PRESS
Washington, D.C.
1998



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--> Leading Health Indicators for Healthy People 2010 First Interim Report Committee on Leading Health Indicators for Healthy People 2010 Division of Health Promotion and Disease Prevention INSTITUTE OF MEDICINE NATIONAL ACADEMY PRESS Washington, D.C. 1998

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--> NATIONAL ACADEMY PRESS 2101 Constitution Avenue, N.W. Washington, DC 20418 NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance. The Institute of Medicine was chartered in 1970 by the National Academy of Sciences to enlist distinguished members of the appropriate professions in the examination of policy matters pertaining to the health of the public. In this, the Institute acts under the Academy's 1863 congressional charter of responsibility to be an adviser to the federal government and its own initiative in identifying issues of medical care, research, and education. Dr. Kenneth I. Shine is president of the Institute of Medicine. Support for this study was provided by the U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion (contract no. 282-98-0018). The views presented are those of the Institute of Medicine Committee on Leading Health Indicators for Healthy People 2010 and are not necessarily those of the funding organization. Additional copies of this report are available for sale from: National Academy Press 2101 Constitution Avenue, N.W., Box 285 Washington, DC 20055 Call (800) 624-6242 or (202) 334-1318 (in the Washington metropolitan area) or visit the NAP's on-line bookstore at http://www.nap.edu. For more information about the Institute of Medicine, visit the IOM home page at http://www2.nas.edu/iom. Copyright 1998 by the Institute of Medicine. All rights reserved. Printed in the United States of America The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. The image adopted as a logo type by the Institute of Medicine is based on a relief carving from ancient Greece, now held by the Staatliche Musseen in Berlin.

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--> COMMITTEE ON LEADING HEALTH INDICATORS FOR HEALTHY PEOPLE 2010 Roger Bulger, MD, (Chair),* Executive Director, Association of Academic Health Centers, Washington, DC Neal Halfon, MD, MPH, Professor, School of Public Health, School of Public Health, University of California, Los Angeles Barbara S. Hulka, MD, MPH,* Kenan Professor, Department of Epidemiology, Department of Epidemiology, University of North Carolina, Chapel Hill Thomas J. Kean, MPH, President, Strategic Health Concepts, Inc., Englewood, CO Scott C. Ratzan, MD, MPH, Executive Director, Health Communication Technology and Educational Innovation, Academy for Educational Development, Washington, DC Stephen C. Schoenbaum, MD, MPH, Vice President and Regional Medical Director, Harvard Pilgrim Health Care of New England, Providence, RI Mark Smith, MD, MBA, President and CEO, California Health Care Foundation, Oakland Shoshanna Sofaer, DrPH, Schering Plough Professor of Health Policy, Baruch College Robert B. Wallace, MD, Professor of Preventive and Internal Medicine and Director, Cancer Center, Department of Preventive Medicine, University of Iowa Staff Carole A. Chrvala, Study Director Kelly Norsingle, Project Assistant Kathleen R. Stratton, Director, Division of Health Promotion and Disease Prevention Donna D. Duncan, Division Assistant *   Member, Institute of Medicine

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--> Acknowledgments Healthy People has been a product of the efforts of many agencies and individuals during the course of the past two decades. The committee wishes to express its appreciation to the June, 1998 public session presenters for providing an excellent overview of the Leading Health Indicators as they relate to Healthy People 2010. These presentations spoke to many of the issues under consideration by the committee and we appreciated the participants' insights. The presenters were: Edward Sondik, National Center for Health Statistics; Mike Stoto, Institute of Medicine; Ronald Bialek, Public Health Foundation; Thomas Milne, National Association of City and County Health Officers; Laverne Snow; Association for State and Territorial Health Officers; and Olivia Carter-Pokras, Office of Minority Health. The committee would also like to thank Michael McGinnis for providing his summary of Leading Indicators for Health People 2010. This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the NRC's Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making the published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to thank the following individuals for their participation in the review of this report: Erwin Bettinghouse, AMC Cancer Research Center; Ross Brownson, St. Louis University; Paul Frame, Tri-County Family Medicine; Gary Gunderson, Interfaith Health Program; and LaDene Larsen, Utah Public Health Association; and Hugh Tilson, Glaxo Wellcome Company. While the individuals listed above have provided constructive comments and suggestions, it must be emphasized that responsibility for the final content of this report rests entirely with the authoring committee and the institution.

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--> Contents     Executive Summary   1 1   Charge to the Committee   3 2   Historical Overview of Healthy People   5     Methods of Promoting Health   8     Common Elements Among the 15 Strategies   9     Design, Implementation and Evaluation of the Objectives   10     Priority Areas and Objectives for 2000   12     Midcourse Review for Healthy People 2000   12 3   Development of Healthy People 2010   15     Development of Priority Areas and Objectives   15     Proposed Framework for Health People 2010   17 4   Development of Leading Health Indicator Sets   19     Functions of Leading Health Indicators   20     Review of Criteria to Support Selection of Health Indicators   21     Future Directions and Challenges   23     References   25

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