National Academies Press: OpenBook
Suggested Citation:"Front Matter." Institute of Medicine. 1999. Leading Health Indicators for Healthy People 2010: Final Report. Washington, DC: The National Academies Press. doi: 10.17226/9436.
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Suggested Citation:"Front Matter." Institute of Medicine. 1999. Leading Health Indicators for Healthy People 2010: Final Report. Washington, DC: The National Academies Press. doi: 10.17226/9436.
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Suggested Citation:"Front Matter." Institute of Medicine. 1999. Leading Health Indicators for Healthy People 2010: Final Report. Washington, DC: The National Academies Press. doi: 10.17226/9436.
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Suggested Citation:"Front Matter." Institute of Medicine. 1999. Leading Health Indicators for Healthy People 2010: Final Report. Washington, DC: The National Academies Press. doi: 10.17226/9436.
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Suggested Citation:"Front Matter." Institute of Medicine. 1999. Leading Health Indicators for Healthy People 2010: Final Report. Washington, DC: The National Academies Press. doi: 10.17226/9436.
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Suggested Citation:"Front Matter." Institute of Medicine. 1999. Leading Health Indicators for Healthy People 2010: Final Report. Washington, DC: The National Academies Press. doi: 10.17226/9436.
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i Leading Health Indicators for Healthy People 2010 Final Report Carole A. Chrvala and Roger J. Bulger, Editors Committee on Leading Health Indicators for Healthy People 2010 Division of Health Promotion and Disease Prevention INSTITUTE OF MEDICINE NATIONAL ACADEMY OF SCIENCES Washington, D.C. 1999

ii Institute of Medicine 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 mem- bers 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 pro- fessions in the examination of policy matters pertaining to the health of the public. In this, the Institute acts under the Academy's 1863 con- gressional 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 Office of Disease Prevention and Health Promotion, U.S. Department of Health and Human Ser- vices, (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 in limited quantities from: Division of Health Promotion and Disease Prevention 2101 Constitution Avenue, N.W. Washington, DC 20418 Call (202) 334-2383 for more information. 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 1999 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 logotype by the Institute of Medicine is based on a relief carving from ancient Greece, now held by the Staatliche Musseen in Berlin. ISBN 0-309-06539-9

iii Committee on Leading Health Indicators for Healthy People 2010 Roger Bulger, MD (Chair),Association of Academic Health Centers, Washington, DC Susan Allan, MD, JD, MPH,Department of Human Services, Public Health Services, Arlington, VA Neal Halfon, MD, MPH,School of Medicine, and School of Public Health, University of California, Los Angeles Barbara S. Hulka, MD, MPH,Department of Epidemiology, University of North Carolina, Chapel Hill Thomas J. Kean, MPH,Strategic Health Concepts, Inc., Englewood, CO Scott C. Ratzan, MD, MPA, MA,Academy for Educational Development, Washington, DC Stephen C. Schoenbaum, MD, MPH,Harvard Pilgrim Health Care of New England, Providence, RI Mark Smith, MD, MBA,California Health Care Foundation, Oakland Shoshanna Sofaer, DrPH,Baruch College, New York, NY Robert B. Wallace, MD,Department of Preventive Medicine, University of Iowa, Iowa City 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

ACKNOWLEDGMENTS iv 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 expresses its appreciation to the presenters at the June 1998 public session for providing an excellent overview of the leading health indicators as they relate to Healthy People 2010. The pre- senters addressed many of the issues under consideration by the committee, and the committee appreciates the participants' insights. The presenters were: Edward Sondik, National Center for Health Statistics; Mike Stoto, Department of Epidemiology, George Washington University; Ronald Bialek, Public Health Foundation; Thomas Milne, National Association of City and County Health Officials; Laverne Snow; Association for State and Territorial Health Officers; and Olivia Carter-Pokras, Office of Minority Health. The committee also thanks Michael McGinnis for providing the committee with his summary of leading health indicators for Healthy Peo- ple 2010. This report has been reviewed by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council's Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the authors and the Institute of Medicine in making the published report as sound as possible and to ensure that the report meets insti- tutional standards for objectivity, evidence, and responsiveness to the study charge. The content of the review comments and draft manuscripts remain confidential to protect the integrity of the deliberative process. The committee thanks the following individuals for their participation in the review of this report: Ross Brownson, St. Louis University; Ezra Davidson, Charles R. Drew University of Medicine and Science; Paul Frame, Tri- County Family Medicine; Randolph Gordon, Bon Secours Richmond Health Systems; Maureen Henderson, Uni- versity of Washington; LaDene Larsen, Utah Public Health Association; Anthony Robbins, Tufts University; Susan Scrimshaw, University of Illinois at Chicago; and Hugh Tilson, Glaxo Wellcome Company. Although the individuals listed above have provided many constructive comments and suggestions, respon- sibility for the final content of this report rests solely with the authoring committee and the Institute of Medicine.

Contents Executive Summary CONTENTS v

4 Linkage with Healthy People 2010 CONTENTS vi

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Healthy People is the nation's agenda for health promotion and disease prevention. The concept, first established in 1979 in a report prepared by the Office of the Surgeon General, has since been revised on a regular basis, and the fourth iteration, known as Healthy People 2010 will take the nation into the 21st century. Leading Health Indicators for Healthy People 2010: Final Report contains a number of recommendations and suggestions for the Department of Health and Human Services that address issues relevant to the composition of leading health indicator sets, data collection, data analysis, effective dissemination strategies, health disparities, and application of the indicators across multiple jurisdictional levels.

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