be equally important to identify alternate sources of similar information that will accurately support local level analyses and to develop new data collection efforts that will be conducted as local or community-based surveys with effective linkages to data management systems for the leading health indicators. Some mechanisms that can address these limitations and that can handle requests for data about specific leading health indicators from local jurisdictions and interest groups include the following:

    1.  

    federal support and technical assistance for efforts to conduct national surveys that are relevant to the leading health indicator sets at the state, local, and community levels and for diverse population groups;

    2.  

    federal support and technical assistance for identification of and statistical improvements to existing state, local, and community risk factor, vital records, or survey data that might be relevant to one or more indicators;

    3.  

    provision of indicator information from geographically, socially, or demographically similar population surveys;

    4.  

    development and dissemination of statistical "tool kits" that would assist state, local, and community health authorities and interested groups to extrapolate national statistical information to the demography of the local population; and

    5.  

    education in analytic techniques that would support summarization of existing state, local, and community information over longer but more statistically secure intervals, such as "rolling averages."

    To summarize, significant work needs to be undertaken by the U.S. Department of Health and Human Services following selection of a set of leading health indicators for Healthy People 2010. First, data sets that will be appropriate for the measurement of each of the indicators within the chosen set must be selected and evaluated on the basis of a number of dimensions including the quality of the data, limitations of self-reported data, data validity and reliability, periodicity and timeliness of data availability, the representativeness of the data, and the ability of the data to be used for small-area analyses. Of equal importance will be the determination of appropriate intervals for collection, methods of analysis, and frequency of reporting on results for each of the indicators. It would be best if the collection of data on each of the indicators were to occur on an ongoing basis rather than to be tied to surveys that obtain data at only a simple point in time. Furthermore, methods of data analysis should be defined at the outset and should be adhered to during the course of implementation of the selected leading health indicator set. Consistency of analysis will help to ensure that the same information about each indicator is available to be reported to the public. Finally, careful consideration of the appropriate time intervals of reporting on the indicators to the public will be required. Reporting at intervals that are too frequent may make it difficult for the public to perceive any significant or meaningful change in the indicators. In contrast, delayed reporting on the indicators to every 1 or 2 years may increase the likelihood that the public will lose awareness of the indicators and motivation to act on them.



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