The Goal of Adequate Data

" Timely and reliable data are an essential component of public health assessment, policy development , and assurance at all levels of government. " — Institute of Medicine, The Future of the Public's Health Responsible decision making requires adequate data — and the Institute of Medicine (IOM) report is 1 of several reports and initiatives that look forward to a new era of timely, high-quality information on health brought about by an improved data infrastructure in public health. Although we have excellent sources of information at the national level in the National Health Interview Survey and the National Health and Nutrition Examination Survey, and at the state and county levels in the Behavioral Risk Factor Surveillance System, each source has inherent limitations. More serious, however, are the issues raised by the 2002 report from the National Committee on Vital and Health Statistics (NCVHS) (1). That report emphasized the need for sufficient data to address the health needs of minority groups and, in particular, to account for various influences on our population's health. Among these influences are community attributes, including the economy and aspects of the built environment; contextual variables from the natural environment to the political context; social determinants of health; and influences of place and time. The NCVHS analysis noted an " uneven-ness in the [data] enterprise's capacity to provide data on all influences on population health " and identified a " shortage of state and local data, especially survey data " (1, p. ix) as one of the causes. Another recommendation for strengthening the information base for public health is establishment of a " uniform national data set. .. that will permit valid comparison of local and state health data with those of the nation and of other states and localities and that will facilitate progress toward national health objectives and implementation " (2). The Community Health Status Indicators (CHSI) project (3) is a sign of such progress, bringing together data from multiple sources and multiple domains to aid in county-level decision making. Like the CHSI project, other efforts on the horizon could change our data sources and meet the needs outlined by the NCVHS and the IOM. For example: Community indicators. The National Academy of Sciences and other organizations are involved in developing a set of key national indicators for the United States. These indicators would include health as one of their dimensions. Although this project is …