Leading Health Indicators for Healthy People 2010: Second Interim Report (1999)
Chapter: 2 Criteria for Leading Health Indicators
2
Criteria for Leading Health Indicators
The original publication, Leading Indicators for Healthy People 2010: A Report from the HHS Working Group on Sentinel Objectives (U.S. Department of Health and Human Services, 1997) outlined 9 criteria considered necessary and essential for the development of leading indicator sets for Healthy People 2010 (see Table 2-1).
Table 2-1 Original Set of Criteria for Leading Health Indicators
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The IOM committee generally concurs with these 9 criteria, although modifications and additions have been made as efforts to develop leading health indicator sets have evolved. Specifically, the committee believes that it is of utmost importance that the general public, selected population groups, and opinion leaders find the indicators interpretable and understandable. Members of the health and medical community should already have a higher level understanding of health statistics and information, and will monitor progress toward achieving the goals of Healthy
People 2010 through changes in the objectives and subobjectives in each of the 26 focus areas. In addition, the committee chose to expand the scope of the fifth criterion to include measures that are reliable, as well as valid, and representative of multiple population groups to permit community-level analyses. Criterion 6 is of diminished importance, and can be eliminated as an essential criterion in light of the commitment by DHHS to ensure data collection for new and existing indicators. However, the committee suggests that annual, and especially biennial, data summaries will probably fail to meet the needs of the public health community and those of the public if there is truly a desire to educate and motivate changes in health and related behaviors at the individual and community levels. Data collection systems will have to support real-time reporting of changes in indicators for the general public or selected population groups. The committee wholeheartedly supports the 3 remaining criteria of the original 9.
In the first interim report, 2 additional criteria were recommended by the IOM committee. First, it was recognized that effective indicator sets must be catalytic in nature to motivate actions across multiple sociodemographic groups within the general population. Second, the committee considered it essential to have dissemination plans drafted for each potential indicator set in order to ensure that messages would be appropriate for diverse populations, that the frequency of these messages would be sufficient to provoke changes in knowledge and behaviors, and to ensure the use of multi disciplinary strategies would be used for communication and intervention.
As the work of the committee has progressed, 4 additional criteria were added to ensure that the leading health indicator sets were congruent with the charge placed on the committee. As noted above, it is expected that potential leading health indicators will address primary, secondary, and tertiary prevention issues as well as environmental and socio-cultural determinants of health. Furthermore, the Healthy People 2010 vision of eliminating health disparities and improving the number and quality of years of healthy life must be integrated within each potential set of leading health indicators. Of greatest importance however, is the selection of a limited number of priority areas that will affect positive changes in knowledge and promote behavior change by encouraging and supporting involvement of the general public and selected population groups that will, in turn, result in significant and sustained changes in health outcomes. Finally, acceptable indicator sets will establish and maintain a level of credibility and support from individuals, groups, organizations, health professionals, and others involved in the delivery of health care education and services to the general public and selected population groups. The complete set of 14 revised criteria are listed in Table 2-2. These criteria will be used as one evaluation mechanism for potential sets of leading health indicators and their specific measures, described in Chapter 5.
Table 2-2 Final Criterion for Selection of Leading Health Indicators
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