Today’s health statistics are the product of an enormous national investment over the past century. Most health statistics systems were designed decades ago to address the pressing health questions of the day using the technology, resources, and structures then available. Their evolution has been shaped by a variety of institutional and public health pressures.(4)
Individually, these health statistics systems¾such as data on AIDS and sexually transmitted diseases, registries on cancer and other diseases, birth and death records, household health surveys, and provider records¾generally meet the needs they were created for, albeit with room for improvement. But collectively, as a national system of information on the health of the U.S. population, they are deficient. Because they were not planned as a unified system, they are a patchwork of data collection systems, both duplicative and full of gaps. Although rich national health data are collected, they often cannot be broken down to provide information on states or localities. Also, because they are collected using different methods and definitions, it is often not possible to combine health statistics from different states and localities to form a national picture, nor to compare states. Local, state, and national data systems cannot be combined into a coherent whole.
These limitations make it difficult, for example, to answer such basic questions as these:
- Do preventive health measures and medical care have their intended effects for individuals, communities, and the nation?
- How are society’s economic and racial inequities affecting the health of communities and individuals?
- How are environmental hazards affecting local and national health?
- Who is benefiting most from medical care, and how? Who has been left out, and why? What do we need to know and do to include the excluded?
- What mix of public health measures (e.g., screening, education, attention to food and water safety) and medical care would maximize improvements in the population’s health?