Evaluating public health data systems: a practical approach.

In 1988, the Institute of Medicine published The Future of Public Health (1). According to this report, public health should perform three core functions—assessment, policy development, and assurance. Most of the health data and information activities of public health agencies fall within the assessment function. These information activities provide a basis for policy development and assurance. Since 1988 health data have become more important both in the public and private sectors. Healthy People 2000: National Health Promotion and Disease Prevention Objectives(2) emphasizes the importance of measurable objectives. The National Committee for Quality Assurance developed health indicators for improving the quality, access and utilization of services in Health Maintenance Organizations (HMOs) (3). Most drafts of health care reform legislation recognized the need for health care data and included provisions for health care data systems. There needs to be significant attention, however, to the quality and usefulness of health data. Dr. Manning Feinleib, in an article in the American Journal of Public Health,(4) identified seven characteristics that data must have to be useful: 1) relevancy; 2) coverage; 3) quality; 4) acceptability; 5) timeliness; 6) accessibility; and 7) usability. These characteristics also apply to data collected for public health purposes. The Iowa Department of Public Health responded to these challenges and demands for quality health data in several ways. In October 1992 the Department began the project Enhancement of Capacity to Assess Progress towards Healthy People 2000 Objectives, a five-year cooperative agreement with the National Center for Health Statistics in connection with the CDC Assessment Initiative (5). Iowa is one of seven states to receive funding to enhance state capacity to use data effectively for policy development and assurance. In Iowa the project staff are located administratively in the Division of Substance Abuse and Health Promotion, the division with primary responsibility for coordinating the implementation of the Healthy Iowans 2000 plan. Healthy Iowans 2000 is the result of a broad-based public and private effort to develop year 2000 objectives for Iowa. This comprehensive document addresses components of all 22 priority areas in Healthy People 2000.