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Volume 7: No. 4, July 2010

ESSAY
Mobilizing Action Toward Community Health (MATCH): Metrics, Incentives, and Partnerships for Population Health

00:00:00

Fran Kritz: Iím Fran Kritz, editor of the Robert Wood Johnson Foundation public health page. Mobilizing Action Toward Community Health, better known as MATCH, is a groundbreaking initiative led by the University of Wisconsin Population Health Institute and funded by the Robert Wood Johnson Foundation.

00:00:16

Kritz: The goal of the project is to serve as a nationwide call to action for improving health. MATCH rolled out its efforts last February with the county health rankings.

00:00:26

Kritz: Weíre talking today with Dr David Kindig, who is professor emeritus at the Population Health Institute at the University of Wisconsin and also the co-principal investigator for the MATCH project.

00:00:37

Kritz: Dr Kindig, welcome.

Dr David Kindig: Thank you for talking to me.

00:00:41

Kritz: We are talking today because thereís a new project and that is the new issue of the CDCís online journal Preventing Chronic Disease, includes several essays that were commissioned by the MATCH project and the Robert Wood Johnson Foundation.

00:00:55

Kritz: Can you highlight some of the key research among the essays in the journal?

Kindig: Sure. We were really privileged to have a number of the nationís experts on metrics contribute essays to the project and coming out next week in the journal.

00:01:13

Kindig: As you mention before, a large part of our MATCH project beyond the county health rankings themselves is essentially to think through and provide advice about taking action and really improving population health.

00:01:26

Kindig: And thereís an old saying that you canít manage what you canít measure and so this first issue focuses on the measurement piece: ways of thinking about outcomes, about disparities, about the different determinants, and so thereís papers on medical care metrics and socioeconomic metrics and environmental metrics.

00:01:51

Kindig: So each of the essay writers has up-to-date, current thinking on current and possibly future metrics.

00:01:59

In addition, thereís a couple of inter, thereís a couple of commentaries that start it out and particularly Linda Bilhiemer from the CDC has a nice piece about how do we evaluate the metrics in terms of their usefulness for improving population health.

00:02:15

Kritz: How might some of the metrics be used in future national county health rankings projects and by individual communities?

00:2:23

Kindig: Sure, well, um, as you know the county health rankings will be done annually and we are hoping to keep the outcomes measures the same, so we can track the overall health of counties over time in a valid way.

00:02:39

Kindig: But as, hopefully as some of your listeners know, we also rank counties on their determinants of health. So metrics about medical care, social factors, environmental factors, and those we will change over time as new measures become available, particularly at the county level. Often we have trouble getting robust best measures for all kinds of small counties. So we will do that.

00:03:03

Kindig: But also, this goes beyond the rankings. I mean, individual states and communities may want to look at things their own way. Some areas may have better data so they can do more than we can do for every county. Iím hopeful that Healthy People 2020 and a lot of the state 2020 projects will look to these as possibilities for useful, for ways they can enhance their own metrics.

00:03:31

Kritz: And health disparity is a key focus, I know. Using metrics to capture health disparity is a focus in some of the essays. Why is that data so pivotal?

00:03:40

Kindig: Well, you know, we talk about two goals of the nation: improving our overall health and reducing disparities. And I think frankly we spend a lot more time talking about the overall health, in metrics at least, and less time on actually careful metrics for health disparities, particularly for overall, um, overall, um, disparity outcomes like mortality, quality of life, and healthy days.

00:04:08

Kindig: And even in the county rankings theyíre a disparity measure in themselves because they compare geographies. But we donít in that exercise explicitly look within counties with disparities issues like race, socioeconomic status or gender.

00:04:26

Kindig: And so thereís a couple of, many of the essay writers talk about that and thereís some overall essays about the critical importance of tracking disparities with exactly the same rigor and vigor that we track, say, overall population health means.

00:04:43

Kritz: Having the data of course requires gathering much of it from individuals, and up until recently the way that that data was typically gathered was through surveys done by landline telephones. Now of course people use landline telephones and cell phones, social media, e-mail for communicating. How does that change how the data is gathered?

00:05:04

Kindig: Ya, well thatís a really important question. A number of the essays touch on it. The one on behavior by Mokdad and Remington specifically talks about that because a lot of the data we have on behaviors like smoking rates, and um, obesity rates and some of those things actually come from phone surveys, a lot of them the Behavioral Risk Factor Surveillance System from the CDC.

00:05:28

Kindig: And some of that data is becoming problematic because of cell phones and other kinds of things. So they point out, and in addition to enhancing those systems and making them as good as they can be, weíre going to have to look at data from other institutional settings, like what you can get from medical records, and health care providers, or in schools, or from employers. All those databases, as well as sort of Internet-based surveys.

00:05:58

Kindig: So there will be, there undoubtedly will be advances in the future on how we learn about these things and measure them.

00:06:08

Kritz: Doctor David Kindig, thank you so much for discussing the upcoming issue of Preventing Chronic Disease.

Kindig: Thanks so much, it was a pleasure talking to you.

Kritz: Iím Fran Kritz for the Robert Wood Johnson Foundation.

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