Advancing States' Child Indicator Initiatives: Promotional Indicators Forum . A Draft List of 20 Critical Objectives


  • Mortality 10-14, 15-19, 20-24 year-olds
  • Motor vehicle fatalities
  • Alcohol/drug-related motor vehicle fatalities and injuries
  • Safety belt use
  • Riding with a drinking driver
  • Suicides
  • Injurious suicide attempts
  • Homicides
  • Physical fighting
  • Weapon carrying
  • Binge drinking
  • Use of marijuana
  • Feeling sad, unhappy, or depressed
  • Pregnancies 15-17 year-olds
  • HIV infection
  • Chlamydia
  • Abstinence or used condoms at last intercourse
  • Used any tobacco product
  • Overweight/obese
  • Vigorous physical activity

On November 4, 1998, the Surgeon General convened a National Interactive Television Conference with State Health Departments. It featured participation by representatives of key state societal institutions, who reviewed national progress in attaining more than 70 of the Healthy People 2000 objectives and also reviewed draft critical objectives for the year 2010. During the conference, participants discussed what each of the societal institutions could do to support these efforts. A conference videotape is available.

Draft Strategies of the National Initiative to Improve Adolescent Health by the year 2010

  • Publish every two years state progress on critical health objectives
  • Publish state adolescent health performance measures (this would be similar to a community report card)
  • Convene all state adolescent health coordinators every year
  • Increase state core capacity in adolescent health program and service delivery
  • Identify best policies, practices, and partners to attain critical health objectives
  • Publish annual review of state health policies
  • Develop on-line database of funding sources for adolescent health programs (this is in progress)
  • Implement and apply findings from Healthy Futures: Community-based Longitudinal Study of Adolescent Health
  • Broadcast live to state departments of health the national Healthy People 2010 progress reviews on adolescents and young adults
  • Develop a "companion document" on the National Initiative to Improve Adolescent Health by the Year 2010

Possible Partners


Association of Maternal & Child Health Programs
Association of State & Territorial Health Officials
National Association of County & City Health Officials
State Adolescent Health Coordinators Network

Centers for Disease Control & Prevention
Health Resources & Services Administration
National Institutes of Health
Office of Disease Prevention & Health Promotion
Office of Minority Health
Office of the Solicitor General
Office of Women's Health

National Nongovernmental
American Academy of Pediatrics
American Medical Association
Institute of Medicine
Society for Adolescent Medicine

Kristen Teipel, State Adolescent Health Coordinator Network

Kristin Teipel, Adolescent Health Coordinator in the Family Health Division of the Minnesota Department of Health, talked about the State Adolescent Health Coordinator Network. The Network's purposes include trying to ease cooperation between states and their communities and bringing national attention to adolescent health concerns.

The Network takes a strengths-based approach to adolescent health and operates from a practice-oriented and population-oriented perspective. It held a January meeting focused on the uses of data and included a look at the possibility of developing intermediate indicators.

Ms. Teipel said that she recently spoke with 400 Minnesota young people about health issues. She asked them to define health and the issues they mentioned included "self-confidence." In identifying factors that interfere with health they mentioned challenges such as drugs, but also "lack of support."

Martha Moorehouse, ASPE

Martha Moorehouse of the Office of the Assistant Secretary for Planning and Evaluation (ASPE) of the U.S. Department of Health and Human Services, sketched ongoing federal data collection projects that focus on state-level data and identified some ways in which those data can be applied to the indicators projects. She noted that a usual purpose of federal data collections was to yield state-level, not community-level, estimates. In part, this makes federal data collections a guide and a point of comparison for states, not a source of data relevant to communities. (Nevertheless, state data needs are influencing federal data collections in ways that can be useful in community-level work. Examples include changes being made to the Youth Risky Behavior Survey (YRBS).)

Useful Data Sources

Moorehouse began by detailing two data collections — the State and Local Area Integrated Telephone Survey (SLAIT) conducted by the National Center for Health Statistics of the Center for Disease Control and Prevention and the American Community Survey (ACS). Both were detailed on overheads (reproduced below). ACS is designed to collect information of the type collected on the Census long form, but to collect it annually. Goals of the ACS include to:

  • Provide federal, state, and local governments with an information base for the administration and evaluation of government programs
  • Improve the 2010 Census
  • Provide data users with timely demographic, housing, social, and economic data, updated every year, that can be compared across states, communities, and population groups

Although data from the ACS will be available more frequently than every decade, as is currently the case with Census long-form data, samples in small areas, such as Census tracts, will require more than a single year's data collection to yield analyzable samples. Full implementation of the ACS is slated for 2003. More information on the ACS can be found at

Moorehouse's American Community Survey Overhead

What is the American Community Survey (ACS)?

The ACS is:

A way to provide data communities need every year instead of every decade.

An on-going survey that the Census Bureau plans will replace the long form in the 2010 Census.

The ACS will provide estimates of demographic, housing, social, and economic characteristics every year for all states, as well as for all cities, counties, metropolitan areas, and population groups of 65,000 people or more. For smaller areas, it will take 2 to 5 years to accumulate sufficient sample to produce data for areas as small as census tracts.

Goals of the Program

The goals of the American Community Survey are to:

Provide federal, state, and local governments an information base for the administration and evaluation of government programs.

Improve the 2010 Census.

Provide data users with timely demographic, housing, social, and economic data updated every year that can be compared across states, communities, and population groups.


The American Community Survey is being implemented in three parts:

Demonstration period 1996-1998

Comparison sites 1999-2002

Full implementation nationwide starting in 2003 in every county of the U.S.

Data Dissemination

ACS goals

To provide data to the users within six months of the end of a collection or calendar year.

For states, populous counties, and other governmental units or population groups with a population of 65,000 or more, the American Community Survey can provide direct estimates for each year.

For smaller governmental units or population groups (those with a population of less than 65,000), estimates can be provided each year through refreshed multi-year accumulations of data.

Next, Moorehouse suggested meeting participants investigate the information found on the web site of the Federal Interagency Forum on Child and Family Statistics (

Moorehouse's SLAITS Overhead

New Directions for the State and Local Area Integrated Telephone Survey (SLAITS)

Originally designed by NCHS to generate high-quality state-level data for tracking and monitoring current and emerging health and welfare policy-related issues.

Its design and approach is based upon the telephone survey used by the National Immunization Program.

Current SLAITS Projects

1. Survey of children with special health care needs (funded by HRSA) Goal: Provide baseline estimates for federal and state performance measures, year 2010 national prevention objectives, and data for each state's Title V five-year needs assessment.

  • Includes 50 states and D.C.
  • Will screen 3300 households with children per state
  • Will complete 750 interviews in each state on children with special health care needs
  • A control sample of children without special health care needs will receive health insurance questions
  • Data collection is in July 2000-July 2001;
  • Five minute screener to identify special health care needs children and 15 minute survey
  • Survey content: severity of ongoing condition, medical home, access and barriers to care, care coordination, satisfaction with care, health insurance adequacy of health care coverage, impact on family.

2. Survey of pediatric care (funded by American Academy of Pediatrics). Goal: Provide data on the characteristics of pediatric care of children age 4-35 months.

  • Will include 2000 families including 800 minority families.

Contact: Marcie Cynamon at or (301) 458-4174.

Influencing Federal Data Collections

The National Institute of Child Health and Human Development (NICHD) has made a grant to Child Trends, Inc., to explore what topics might be added to federal data collections, including a look at whether measures from the Adolescent Health Study might be added to other surveys.

School Readiness

As an example, Moorehouse noted that the National Center for Education Statistics has a measure of early literacy drawn from a study of early childhood experiences. She is among government staff encouraging NCES not to use this measure as the sole measure of school readiness, arguing that readiness also includes a number of asset-linked and environmental measures. More complete school readiness measures might be found in the measures that Head Start has developed. Its measures of social competence are similar to the objectives found in the national education goals for this population.

Balancing Traditional and Promotional Indicators

Moorehouse said that there are particular roles for both traditional (or deficit-focused) indicators and promotional (asset-focused) indicators. Traditional indicators can galvanize attention — including the attention of policy makers — regarding a particular topic in ways that asset-based indicators can not. Many in government believe that it is government's role to address particular problems, not to craft promotional strategies. Moorehouse advised meeting participants to develop a strategy balancing both types of indicators, exploiting the strengths of each type.