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1 Introduction
Pages 13-27

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From page 13...
... In recent years, there has been an increased focus on issues that affect chi dren and on improving their hea th. Chi dren have begun to be recognized not only for who they are today but for their future roles in creating fami ies, powering the workforce, and making American democracy work Mounting evidence that hea th during childhood sets the stage for adult hea th not only reinforces this perspective, but a so creates an important ethics, social, and economic imperative to ensure that all children are as hea thy as they can be.
From page 14...
... . Fewer adolescents are havmg babies—in 1999, the teenage pregnancy rate reached the lowest recorded rate since 1976 (Child Trends, 2003)
From page 15...
... The current and future prospects of these children, and the prospects of the eat on as a whole, are reduced as a resu t The nation needs to consider the sigmficance of statistics such as these and adopt prudent policies to improve children's hea th if it is to successfully maximize the potentia of all its children and ensure the future hea th of the nation. Even more distressing than the absolute numbers are the sustained and marked disparities between white children and racia and ethnic minority children, and between children in poorer families and wealthier families.
From page 16...
... . Measurement systems that consider the re ationship of various factors in the fami y, community, and physica environments a so serve as early warning systems about thnngs like toxic neighborhoods, risky family situations, and poor school environments.
From page 17...
... assess the adequacy of currently available methods for assess no risks to children, identify scientific uncertainties associated with these methods, and develop a prioritized research agenda to reduce such uncertainties and Improve risk assessment for children's hea th and safety." The Board on Children, Youth, and Fami ies of the Nationa Research Council and institute of Medicine in consultation with the Department of Hea th and Human Services and expert advisers developed a statement of task that erp mded this basic charge. The Committee on Eva uation of Children's Hea th: Measures of Risk, Protective, and Promotiona Factors for Assessing Child Hea th In the Community was formed to en ammo kq issues regarding the deEmition and measurement of children's hea th, influences that affect children's hea th, and the optima use of data on children's hea th.
From page 18...
... The committee heard from a range of stakeholders active in various aspects of the fie d to benefit from a wider range of viewpoints and to obtain inp at on our charge. The committee's Bust tasks were to (1)
From page 19...
... They a so must consider mu tiple influences that interact over time in different ways as children develop and ch mge. The committee proposes a new deEmition of chi dren's hea th that embraces hea th conditions, functioning, and hea th potentia in a new conceptua mode that considers multiple interrelated factors as influences.
From page 20...
... As used in this report, the term "hea th" therefore inherently embraces hea th-related aspects of well-being. Risk, Protective, and Promotional Factors (In'duences on Children's Health)
From page 21...
... Data and Methods Numerous federal, state, and loca surveys and administrative data sources are used to inform policy and programmatic decisions. In specifying available data sources, the committee chose to focus on nations data sources or state-level sources that are avai able m a I or most states.
From page 22...
... Therefore, it is inappropriate to assume that what enhances or impedes adult heath translates direcdy intn chidren's heath. Whie many factors may be relevant to both child and adu t hea th, a wide range of factors affect them differentially.
From page 23...
... While autonomy increases with growth and development, during most of their chi dhood chi dren are fundamenta Iy dependent on the ado ts on their environment for the prevent on of disease and the prompt on and protect on of their hea th and development Different Manifestations of Poor Health The distribution of disease in childhood and the nature and types of hea th threats that affect children are different than in adu ts. Chi dren have a lower preva ence than adu ts of chronic illnesses that require expensive, high-tech interventions and a higher preva ence of repeated acute illness.
From page 24...
... At each stage, previous hea th affects current and future hea th, and the cumulative effects of early differences in hea th may resu t in profound differences in later hea th (see Keating and Hertzm m, 1999)
From page 25...
... This report addresses the questions of whether what is measured is what ought to be measured; whether it is being measured in an appropriate manner; and whether information is being used m a way that wi I optimize chi dren's hea th. THE COMMITTEE'S VISION A though the committee views the findings m this report as re evant to multiple audiences, federa, state, md loca decision makers are considered to be the primary audience.
From page 26...
... Given the rapid strides in the deve opment of new technologies, such as electronic information systems and the Human Genome Project, the committee has addressed future information needs both in terms of specific types of indicators as well as the types of systems and infrastructures necessary to make better data avai able at national, state, and loca levels. Where indicators, measurement tools, and measurement systems are not available, the committee has identified research to address gaps m knowledge.
From page 27...
... Appendix A provides short descriptions of existing core datasets for measurmg children's hea th and compares them based on periodicity, age, and geographic leve surve,ved. Appendix B exam nes the extent to which current major surveys capture data on children's hea th and its influences and provides a comparison across surveys in both narrative and tabular form.


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