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20 Snapshots of America's Well-Being

Photograph by Dung Hoang

20 Snapshots of America's Well-Being

Put 14 public health experts in a room and give them six months to pore over statistics, studies and reports to come up with a snapshot of health in the U.S.

The resulting report is the first step in the inaugural project of State of the USA (SUSA), a nonprofit institution dedicated to providing accurate Web-based data on health, education, the economy and other important topics.

For its focus on health, SUSA commissioned the Institute of Medicine (IOM) of the National Academy of Sciences to convene a panel of health care experts to put together 20 key indicators that define the country’s health care landscape. The panel included David Holtgrave, PhD, chair of Health, Behavior and Society at the Bloomberg School.

“The selection of indicators was informed by the leading causes of death and premature mortality in the U.S.,” Holtgrave says. “If we as a nation can do better on these 20 indicators, then we should be improving on some of the most important aspects of our collective health.” The indicators measure determinants such as childhood immunization rates, health behaviors like smoking, drinking, exercise and diet, major psychological distress and injury-related mortality.

At the outset, SUSA established strict parameters to guide the panel’s work. Each indicator was required to demonstrate: a clear importance to health or health care; the availability of reliable, high-quality data to measure change in indicators over time; and the capability to be broken down geographically and demographically. The panel delivered its recommendations for 20 key indicators to SUSA last year, which published the report in December 2008.

So, what do these indicators say about the current state of American health? Dean Michael J. Klag, MD, MPH ’87, says the data highlight the need for new programs to improve the health of children and also demonstrate the burden of chronic conditions caused by the aging of America. “We need lifestyle interventions at the population level to improve the way we live and work,” says Klag. “We also need to create a health care system built on a primary care base that provides access for both young and old and is flexible enough to deal with the wide range of problems encountered during the life course.”

20 Health Indicators

  • 77.8: life expectancy at birth in 2005
  • 6.9: infant mortality per 1,000 live births from 2002 to 2004
  • 20, 15.2: Years of life remaining at age 65 in white females and black males, respectively (2005 data)
  • 167,000: injury-related deaths in 2004
  • 30: percentage of Americans over 75 who reported fair or poor health in 2005
  • 3.4, 3.5: number of unhealthy days—physical or mental, respectively—reported in the past 30 days in 2001
  • 133 million: number of people with at least one chronic condition in 2005
  • 11.3: percentage of adults with serious psychological distress in 2006
  • 19.7: percentage of adults who smoke
  • <50: percentage of adults who reported engaging in moderate physical activity
  • >15: percentage of adults who engaged in binge drinking in the past 30 days in 2007
  • 10: percentage of U.S. adults with a healthy diet in 2000
  • 34: percentage of adults who are obese (2005 data)
  • 25: percentage of new annual cases of STIs among teens ages 15 to 19 (1998 data)
  • $7,026: Per capita health care expenditures in 2006
  • 45.7 million: Americans who lacked health insurance in 2007
  • 11.6: Percentage of families who did not receive needed health care or were delayed in obtaining care in the previous year (1998 data)
  • 36,000: average annual deaths from influenza from 1990 to 1999
  • 77: percentage of children ages 19 to 35 months with up-to-date recommended childhood vaccines in 2007
  • 12: percentage of hospitalizations in U.S. for potentially avoidable conditions (1997 data)

Sources: State of the USA Health Indicators Report (2008), CDC, WHO, Mental Health Association, U.S. Department of Agriculture, Centers for Medicare & Medicaid Services, Agency for Healthcare Research and Quality.

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