7: No. 4, July 2010
Mobilizing Action Toward Community Health (MATCH): Metrics, Incentives, and Partnerships for Population Health
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.
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
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.
Kritz: Dr Kindig, welcome.
Dr David Kindig: Thank you for talking to me.
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
Kritz: Can you highlight some of the key research among the essays in the
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
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.
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
Kindig: So each of the essay writers has up-to-date, current thinking on
current and possibly future metrics.
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
Kritz: How might some of the metrics be used in future national county health
rankings projects and by individual communities?
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.
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
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.
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?
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
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.
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.
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?
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.
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.
Kindig: So there will be, there undoubtedly will be advances in the future on
how we learn about these things and measure them.
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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