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Suggested Citation:"Front Matter." Institute of Medicine. 2011. A Nationwide Framework for Surveillance of Cardiovascular and Chronic Lung Diseases. Washington, DC: The National Academies Press. doi: 10.17226/13145.
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A NATIONWIDE FRAMEWORK
FOR SURVEILLANCE OF
CARDIOVASCULAR AND
CHRONIC LUNG DISEASES

Committee on a National Surveillance System for Cardiovascular and Select Chronic Diseases

Board on Population Health and Public Health Practice

INSTITUTE OF MEDICINE
              OF THE NATIONAL ACADEMIES

THE NATIONAL ACADEMIES PRESS

Washington, D.C.

www.nap.edu

Suggested Citation:"Front Matter." Institute of Medicine. 2011. A Nationwide Framework for Surveillance of Cardiovascular and Chronic Lung Diseases. Washington, DC: The National Academies Press. doi: 10.17226/13145.
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THE NATIONAL ACADEMIES PRESS      500 Fifth Street, N.W.      Washington, DC 20001

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.

This study was supported by contracts between the National Academy of Sciences and the Department of Health and Human Services (N01-OD-4-2139). Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project.

International Standard Book Number-13: 978-0-309-21216-8
International Standard Book Number-10: 0-309-21216-2

Additional copies of this report are available from The National Academies Press, 500 Fifth Street, N.W., Lockbox 285, Washington, DC 20055; (800) 624-6242 or (202) 334-3313 (in the Washington metropolitan area); Internet, http://www.nap.edu.

For more information about the Institute of Medicine, visit the IOM home page at: www.iom.edu.

Copyright 2011 by the National Academy of Sciences. 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 serpent adopted as a logotype by the Institute of Medicine is a relief carving from ancient Greece, now held by the Staatliche Museen in Berlin.

Suggested citation: IOM (Institute of Medicine). 2011. A Nationwide Framework for Surveillance of Cardiovascular and Chronic Lung Diseases. Washington, DC: The National Academies Press.

Suggested Citation:"Front Matter." Institute of Medicine. 2011. A Nationwide Framework for Surveillance of Cardiovascular and Chronic Lung Diseases. Washington, DC: The National Academies Press. doi: 10.17226/13145.
×

Knowing is not enough; we must apply.
Willing is not enough; we must do.
”      

                                                —Goethe

image

INSTITUTE OF MEDICINE
              OF THE NATIONAL ACADEMIES

Advising the Nation. Improving Health.

Suggested Citation:"Front Matter." Institute of Medicine. 2011. A Nationwide Framework for Surveillance of Cardiovascular and Chronic Lung Diseases. Washington, DC: The National Academies Press. doi: 10.17226/13145.
×

THE NATIONAL ACADEMIES

Advisers to the Nation on Science, Engineering, and Medicine

The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences.

The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Charles M. Vest is president of the National Academy of Engineering.

The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine.

The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. Charles M. Vest are chair and vice chair, respectively, of the National Research Council.

www.national-academies.org

Suggested Citation:"Front Matter." Institute of Medicine. 2011. A Nationwide Framework for Surveillance of Cardiovascular and Chronic Lung Diseases. Washington, DC: The National Academies Press. doi: 10.17226/13145.
×

COMMITTEE ON A NATIONAL SURVEILLANCE SYSTEM FOR
CARDIOVASCULAR AND SELECT CHRONIC DISEASES

Elizabeth Barrett-Connor (Chair), Distinguished Professor and Chief, Division of Epidemiology, University of California San Diego

John Z. Ayanian, Professor of Medicine and Health Care Policy, Harvard Medical School; Professor of Health Policy and Management, Harvard School of Public Health; Director, Harvard Medical School Fellowship in General Medicine and Primary Care; Director, Harvard Catalyst Health Disparities Research Program, Harvard Medical School

E. Richard Brown, Professor of Health Services and Community Health Sciences, School of Public Health, University of California Los Angeles; Director, UCLA Center for Health Policy Research; Principal Investigator, California Health Interview Survey

David B. Coultas, Vice President for Clinical and Academic Affairs; Professor and Chair, Department of Medicine, University of Texas Health Science Center at Tyler

Charles K. Francis, Clinical Professor of Medicine, Cardiology Division, Department of Medicine, Robert Wood Johnson Medical School

Robert J. Goldberg, Professor and Director, Division of Epidemiology of Chronic Diseases and Vulnerable Populations, University of Massachusetts Medical School

Lawrence O. Gostin, Linda D. and Timothy J. O’Neill Professor of Global Health Law, Georgetown University; Director, World Health Organization Collaborating Center on Public Health Law and Human Rights

Thomas E. Kottke, Medical Director for Evidence-Based Health, HealthPartners; Senior Clinical Investigator, HealthPartners Research Foundation; Professor of Medicine, University of Minnesota; Cardiologist, Regions Hospital Heart Center, HealthPartners Medical Group

Elisa T. Lee, George Lynn Cross Research Professor of Biostatistics and Epidemiology; Director, Center for American Indian Health Research, University of Oklahoma Health Sciences Center

David M. Mannino, Professor and Director, Pulmonary Epidemiology Research Laboratory, University of Kentucky College of Public Health

K. M. Venkat Narayan, Ruth and O.C. Hubert Professor of Global Health and Epidemiology, Rollins School of Public Health, Emory University; Professor of Medicine, School of Medicine, Emory University

Sharon-Lise T. Normand, Professor of Health Care Policy (Biostatistics), Department of Health Care Policy, Harvard Medical School; Professor of Biostatistics, Department of Biostatistics, Harvard School of Public Health

David J. Pinsky, J. Griswold Ruth, M.D., & Margery Hopkins Ruth Professor of Internal Medicine; Professor of Molecular and Integrative Physiology; Chief, Cardiovascular Medicine; Director, Cardiovascular Center, University of Michigan

Lorna Thorpe, Associate Professor and Program Director, Epidemiology and Biostatistics Program, City University of New York School of Public Health at Hunter College

William M. Tierney, Chancellor’s Professor and Sam Regenstrief Professor of Health Services Research, Indiana University School of Medicine; President and CEO, Regenstrief Institute, Inc.

Paul J. Wallace, The Lewin Group, Senior Vice President and Director, Center for Comparative Effectiveness Research

Study Staff

Lyla M. Hernandez, Staff Director

Nora Hennessy, Associate Program Officer

Suzanne Landi, Senior Project Assistant (until November 1, 2010)

Angela Martin, Senior Project Assistant (beginning November 1, 2010)

Rose Marie Martinez, Director, Board on Population Health and Public Health Practice

Suggested Citation:"Front Matter." Institute of Medicine. 2011. A Nationwide Framework for Surveillance of Cardiovascular and Chronic Lung Diseases. Washington, DC: The National Academies Press. doi: 10.17226/13145.
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Suggested Citation:"Front Matter." Institute of Medicine. 2011. A Nationwide Framework for Surveillance of Cardiovascular and Chronic Lung Diseases. Washington, DC: The National Academies Press. doi: 10.17226/13145.
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Reviewers

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 National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its 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 process. We wish to thank the following individuals for their review of this report:

 

Robert Califf, Duke University Medical Center

Paul Citron, Retired, Medtronic, Inc.

Kevin A. Fiscella, University of Rochester School of Medicine and Dentistry

Lewis H. Kuller, University of Pittsburgh

Elizabeth Martinez, Massachusetts General Hospital

James Mold, University of Oklahoma Health Science Center

Jonathan Samet, University of Southern California

Stephen Sidney, Kaiser Permanente

 

Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the final draft of the report before its release. The review of this report was overseen by Patricia Buffler, University of California, Berkeley. Appointed by the Institute of Medicine, she was responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the authors and the institution.

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Acknowledgments

This report was made possible by support of the sponsors of this study, the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health and the Division for Heart Disease and Stroke Prevention of the Centers for Disease Control and Prevention (CDC). The committee wishes to express special appreciation to Jean Olson of NHLBI and Robert Merritt of CDC who unfailingly responded to numerous questions and requests for information.

The work of the committee was aided by the valuable testimony and advice of many knowledgeable and experienced individuals. These individuals are: Manal J. Aboelata, Prevention Institute; Toni Alterman, National Institute for Occupational Safety and Health; R. Graham Barr, Columbia University; Diane Bild, NHLBI; Gerard Criner, Temple University Hospital; Alfredo Czerwinski, J. Glynn & Company; Helen Darling, National Business Group on Health; Majid Ezzati, Harvard University; Lark Galloway-Gilliam, Community Health Councils; David Goff, Wake Forest University; Lisa Harris, National Association of Public Hospitals and Health Systems; Anne Kelsey Lamb, Public Health Institute; Elizabeth Lancet, American Lung Association; Ali Mokdad, University of Washington; Thomas Reilly, Centers for Medicare & Medicaid Services; Steve Sidney, Kaiser Permanente; Tyler Smith, Department of Defense; Edward Sondik, National Center for Health Statistics; Paul Varosy, University of Colorado; Mark Veazie, Indian Health Service; and Janet Wright, American College of Cardiology.

The committee also wishes to thank the individuals who graciously responded to requests for information about data collection systems. These individuals are: Sonia Angell, New York City Department of Health and Mental Hygiene; Alice Arnold, University of Washington; Susie Baldwin, Los Angeles County Department of Health; Jennifer Cartland, Children’s Memorial Research Center; Nathaniel Cobb, Indian Health Service; Peter Damiano, University of Iowa; Ann Elixhauser, Agency for Healthcare Research and Quality; Paul Garbe, National Center for Environmental Health; Linda Geiss, CDC; Suzanne Hallquist, University of North Carolina; Ken Huelskamp, American College of Cardiology; Susan Jack, National Center for Health Statistics; Laura Kann, CDC; Nora Keenan, CDC; Russell Luepker, University of Minnesota; Greg Pawlson, National Committee for Quality Assurance; Sharina Person, University of Alabama; Randel Plant, COPD Foundation; Veronique Roger, Mayo Clinic College of Medicine; Wayne Rosamond, University of North Carolina; Esta Shindler, Framingham Heart Study; Jane Sisk, National Center for Health Statistics; and Paula Yoon, CDC.

While we have tried to list all the individuals who provided input, it is possible that we have overlooked someone and, if that is so, we apologize.

Suggested Citation:"Front Matter." Institute of Medicine. 2011. A Nationwide Framework for Surveillance of Cardiovascular and Chronic Lung Diseases. Washington, DC: The National Academies Press. doi: 10.17226/13145.
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Chronic diseases are common and costly, yet they are also among the most preventable health problems. Comprehensive and accurate disease surveillance systems are needed to implement successful efforts which will reduce the burden of chronic diseases on the U.S. population. A number of sources of surveillance data--including population surveys, cohort studies, disease registries, administrative health data, and vital statistics--contribute critical information about chronic disease. But no central surveillance system provides the information needed to analyze how chronic disease impacts the U.S. population, to identify public health priorities, or to track the progress of preventive efforts.

A Nationwide Framework for Surveillance of Cardiovascular and Chronic Lung Diseases outlines a conceptual framework for building a national chronic disease surveillance system focused primarily on cardiovascular and chronic lung diseases. This system should be capable of providing data on disparities in incidence and prevalence of the diseases by race, ethnicity, socioeconomic status, and geographic region, along with data on disease risk factors, clinical care delivery, and functional health outcomes. This coordinated surveillance system is needed to integrate and expand existing information across the multiple levels of decision making in order to generate actionable, timely knowledge for a range of stakeholders at the local, state or regional, and national levels.

The recommendations presented in A Nationwide Framework for Surveillance of Cardiovascular and Chronic Lung Diseases focus on data collection, resource allocation, monitoring activities, and implementation. The report also recommends that systems evolve along with new knowledge about emerging risk factors, advancing technologies, and new understanding of the basis for disease. This report will inform decision-making among federal health agencies, especially the Department of Health and Human Services; public health and clinical practitioners; non-governmental organizations; and policy makers, among others.

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