Shaping a Vision for 21st Century Health Statistics. Socioeconomic, demographic, and environmental factors


Perhaps the strongest theme of the discussions to date has been the need for a broad definition of health, and the need to look further than the presence of disease or the pursuit of medical care in order to understand the health of the population. This means understanding the effects and interactions of the cultural, socio-economic, and environmental domains in which we all live. What trends in these domains are likely to shape future needs and opportunities? What will we want to know about them with respect to health?(9)

Key demographic factors include an aging population(10) and changes in household composition (e.g., there are fewer children, more single parents, and more single-sex households).(11) Important socio-economic factors in the U.S. include growing gaps between the resources available to the wealthy and to the non-wealthy, greater differentials in economic and social status, more self-employment and less job security, and an increase in the percentage of the population that is poor, including the working poor.(12)

Other significant trends are the increasing racial and ethnic complexity of American life,(13) with wide ethnic variations in health status within racial groups (e.g., among Cambodians, Japanese, and Vietnamese) and the growing percentage of multi-racial families; the resurgence of attention to social support as important to health and health statistics; and a rising awareness (and possibly growing presence) of environmental threats to health.

Knowledge Gaps

To address these socioeconomic, demographic, and environmental trends, we need to close the following knowledge gaps, among others, at all geographic levels:

  • Ongoing data on economic status, education, language, immigrant status, the availability of social supports, and the relation of each to health status
  • Socio-economic and health data on various racial and ethnic groups
  • Data on specific environmental factors such as lead and ozone and their impact on health
  • Mechanisms for collecting longitudinal data to help us understand emerging trends and threats to the population’s health, and mechanisms for sharing and linking information, with adequate privacy protections
  • Better ways to characterize the complex interactions among the factors that affect health