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Leading Health Indicators for Healthy People 2010: Final Report (1999)

Chapter: 2 Approach to Development of Leading Health Indicator Sets

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Suggested Citation:"2 Approach to Development of Leading Health Indicator Sets." 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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    1.  

    Development of criteria for suitable indicators,

    2.  

    Development of potential conceptual organizing frameworks and indicator categories, and

    3.  

    Selection of final candidate indicator sets.

    The committee completed a number of activities to support the process of reaching consensus on the recommendations for three candidate sets of leading health indicators. Briefly, these activities included:

      1.  

      clarification and acceptance of the charge to the committee,

      2.  

      review of relevant literature, especially alternative efforts focused on health report cards and indicators considered to be representative of the health and well-being of communities,

      3.  

      development of a set(s) of essential criteria against which selection of potential leading health indicators could be assessed,

      4.  

      participation in regional meetings convened by the U.S. Department of Health and Human Services to elicit commentary on the selection of leading health indicators for Healthy People 2010,

      5.  

      consideration of public comments submitted to the Institute of Medicine and the Department of Health and Human Services concerning leading health indicators,

      6.  

      evaluation of 11 conceptual frameworks to guide the development of leading health indicator sets,

      7.  

      preparation of two interim reports describing the committee's process and efforts,

      Suggested Citation:"2 Approach to Development of Leading Health Indicator Sets." 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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        8.  

        conduct of a public hearing during July 1998 and January 1999, respectively, to elicit further comments on leading health indicator sets, and

        9.  

        final selection of conceptual frameworks and candidate indicator sets.

        A brief description of each of these activities is provided in the following narrative.

        Charge to Committee

        The committee received its charge from the U.S. Department of Health and Human Services and had several opportunities for periodic review and clarification. The initial charge emphasized that candidate leading health indicator sets should (1) elicit interest and awareness among the general population and diverse population groups, (2) motivate these diverse population groups to undertake activities to improve the status of specific indicators and thereby improving the overall health of the nation, (3) provide ongoing feedback to these populations and the members of the public and private health care communities concerning progress toward achieving sustained improvements in the indicators. In subsequent discussions with staff from the U.S. Department of Health and Human Services, the committee came to understand that the charge also included the development of suggestions for communications and dissemination strategies to promote awareness of the leading health indicators and galvanize actions to improve the status of those indicators. It was also established that clear linkages should be demonstrated between the proposed indicator sets and the full draft of Healthy People 2010, including the two overarching goals, four enabling goals and 26 focus areas. Finally, additional clarification about the committee charge included the recommendation that the candidate indicator sets should contain no more than 10 indicators and that any proposed indicator set should be supported by a conceptual framework around which the specific indicators could be organized.

        Review of Relevant Literature

        The committee reviewed and discussed a wide array of previous work related to the concept of leading health indicators and suggested candidate indicators for inclusion in a set of such indicators. Prominent among these was work from the two previous decades of Healthy People and the March 1998 report from the Working Group on Sentinel Health Objectives (U.S. Public Health Service, 1979; U.S. Department of Health and Human Services, 1980, 1986, 1998a; National Center for Health Statistics, 1992, 1994, 1995, 1996, 1997) Included in the Working Group report were five organizing frameworks for leading health indicators, suggestions of specific indicators, and a proposal for nine criteria to be used to guide the committee's final selection of indicators. In addition, the committee gave careful consideration to the Healthy Communities 2000 project in which communities across the nation developed indicators to monitor the health of their populations and provided feedback concerning progress toward achieving indicator objectives (American Public Health Association, 1991). Another source used by the committee was the work of the Coalition for Healthier Cities, and Communities, and particularly the publication of Community Indicators: An Inventory (1997). The committee also familiarized itself with the literature on community health report cards.

        Suggested Citation:"2 Approach to Development of Leading Health Indicator Sets." 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:"2 Approach to Development of Leading Health Indicator Sets." 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:"2 Approach to Development of Leading Health Indicator Sets." 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:"2 Approach to Development of Leading Health Indicator Sets." 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:"2 Approach to Development of Leading Health Indicator Sets." 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:"2 Approach to Development of Leading Health Indicator Sets." 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:"2 Approach to Development of Leading Health Indicator Sets." 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:"2 Approach to Development of Leading Health Indicator Sets." 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:"2 Approach to Development of Leading Health Indicator Sets." Institute of Medicine. 1999. Leading Health Indicators for Healthy People 2010: Final Report. Washington, DC: The National Academies Press. doi: 10.17226/9436.
        ×
        Page 19
        Suggested Citation:"2 Approach to Development of Leading Health Indicator Sets." Institute of Medicine. 1999. Leading Health Indicators for Healthy People 2010: Final Report. Washington, DC: The National Academies Press. doi: 10.17226/9436.
        ×
        Page 20
        Suggested Citation:"2 Approach to Development of Leading Health Indicator Sets." Institute of Medicine. 1999. Leading Health Indicators for Healthy People 2010: Final Report. Washington, DC: The National Academies Press. doi: 10.17226/9436.
        ×
        Page 21
        Suggested Citation:"2 Approach to Development of Leading Health Indicator Sets." Institute of Medicine. 1999. Leading Health Indicators for Healthy People 2010: Final Report. Washington, DC: The National Academies Press. doi: 10.17226/9436.
        ×
        Page 22
        Suggested Citation:"2 Approach to Development of Leading Health Indicator Sets." Institute of Medicine. 1999. Leading Health Indicators for Healthy People 2010: Final Report. Washington, DC: The National Academies Press. doi: 10.17226/9436.
        ×
        Page 23
        Suggested Citation:"2 Approach to Development of Leading Health Indicator Sets." 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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        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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