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Leading Health Indicators 2030: Advancing Health, Equity, and Well-Being Committee on Informing the Selection of Leading Health Indicators for Healthy People 2030 Board on Population Health and Public Health Practice Health and Medicine Division A Consensus Study Report of PREPUBLICATION COPY: UNCORRECTED PROOFS
THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001 This activity was supported by a contract between the National Academy of Sciences and the Department of Health and Human Services (HHSP233201400020B). Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project. International Standard Book Number-13: 978-0-309-XXXXX-X International Standard Book Number-10: 0-309-XXXXX-X Digital Object Identifier: https://doi.org/10.17226/25682 Additional copies of this publication are available from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu. Copyright 2020 by the National Academy of Sciences. All rights reserved. Printed in the United States of America Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2020. Leading Health Indicators 2030: Advancing health, equity, and well-being. Washington, DC: The National Academies Press. https://doi.org/10.17226/25682. PREPUBLICATION COPY: UNCORRECTED PROOFS
The National Academy of Sciences was established in 1863 by an Act of Congress, signed by President Lincoln, as a private, nongovernmental institution to advise the nation on issues related to science and technology. Members are elected by their peers for outstanding contributions to research. Dr. Marcia McNutt is president. The National Academy of Engineering was established in 1964 under the charter of the National Academy of Sciences to bring the practices of engineering to advising the nation. Members are elected by their peers for extraordinary contributions to engineering. Dr. John L. Anderson is president. The National Academy of Medicine (formerly the Institute of Medicine) was established in 1970 under the charter of the National Academy of Sciences to advise the nation on medical and health issues. Members are elected by their peers for distinguished contributions to medicine and health. Dr. Victor J. Dzau is president. The three Academies work together as the National Academies of Sciences, Engineering, and Medicine to provide independent, objective analysis and advice to the nation and conduct other activities to solve complex problems and inform public policy decisions. The National Academies also encourage education and research, recognize outstanding contributions to knowledge, and increase public understanding in matters of science, engineering, and medicine. Learn more about the National Academies of Sciences, Engineering, and Medicine at www.nationalacademies.org. PREPUBLICATION COPY: UNCORRECTED PROOFS
Consensus Study Reports published by the National Academies of Sciences, Engineering, and Medicine document the evidence-based consensus on the studyâs statement of task by an authoring committee of experts. Reports typically include findings, conclusions, and recommendations based on information gathered by the committee and the committeeâs deliberations. Each report has been subjected to a rigorous and independent peer-review process, and it represents the position of the National Academies on the statement of task. Proceedings published by the National Academies of Sciences, Engineering, and Medicine chronicle the presentations and discussions at a workshop, symposium, or other event convened by the National Academies. The statements and opinions contained in proceedings are those of the participants and are not endorsed by other participants, the planning committee, or the National Academies. For information about other products and activities of the National Academies, please visit www.nationalacademies.org/about/whatwedo. PREPUBLICATION COPY: UNCORRECTED PROOFS
COMMITTEE ON INFORMING THE SELECTION OF LEADING HEALTH INDICATORS FOR HEALTHY PEOPLE 2030 GEORGE J. ISHAM (Chair), Senior Fellow, HealthPartners Institute L. EBONY BOULWARE, Professor of Medicine; Chief, Division of General Internal Medicine; Vice Dean, Translational Science; Associate Vice Chancellor, Translational Research, School of Medicine, Duke University GILBERT GEE, Professor, Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles MARTHE R. GOLD, Senior Scholar, The New York Academy of Medicine SHERI JOHNSON, Director, Population Health Institute, Associate Professor, Department of Population Health Sciences, School of Medicine and Public Health, University of WisconsinâMadison PAULA LANTZ, Associate Dean for Academic Affairs, Professor of Public Policy, Gerald R. Ford School of Public Policy, University of Michigan DARCY PHELAN-EMRICK, Chief Epidemiologist, Baltimore City Health Department; Associate Scientist, Bloomberg School of Public Health, Johns Hopkins University JONATHAN S. SKINNER, James O. Freedman Presidential Professor in Economics, Department of Economics, Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College Study Staff ALINA B. BACIU, Study Director CARLA S. ALVARADO, Program Officer ANNA W. MARTIN, Administrative Assistant ROSE MARIE MARTINEZ, Senior Director, Board on Population Health and Public Health Practice PREPUBLICATION COPY: UNCORRECTED PROOFS v
Reviewers This Consensus Study Report was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published report as sound as possible and to ensure that it meets the institutional standards for quality, 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 thank the following individuals for their review of this report: John Auerbach, Trust for Americaâs Health Ana Diez Roux, Drexel University Cynthia Haq, University of California, Irvine Jewell Mullen, University of Texas at Austin Dell Medical School Steven M. Teutsch, University of California, Los Angeles, and University of Southern California JosÃ© A. Pagan, New York University Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations of this report nor did they see the final draft before its release. The review of this report was overseen by Eric B. Larson, Kaiser Permanente Washington, and James S. House, University of Michigan. They were responsible for making certain that an independent examination of this report was carried out in accordance with the standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the authoring committee and the National Academies. PREPUBLICATION COPY: UNCORRECTED PROOFS vii
Contents Summary S-1 1 Introduction 1-1 2 The Process for Identifying Candidate Leading Health Indicators 2-1 3 Details of the Top-Down Procedure 3-1 4 Results of the Bottom-Up Procedure: Gaps in the Draft Objectives 4-1 5 Conclusion 5-1 References R-1 Appendixes A Committee Member Biosketches A-1 B Public Information-Gathering Meeting Agendas B-1 C Two Social Determinants of Health Frameworks C-1 D Leading Health Indicator Contender Form D-1 E Department of Health and Human Services Proposed Objectives for Inclusion in Healthy People 2030 E-1 PREPUBLICATION COPY: UNCORRECTED PROOFS ix