The Institute of Medicine (IOM) has identified 20 key indicators that together “reflect the overall health of the nation and the efficiency and efficacy of U.S. health systems.”

Each of the 20 indicators can be readily measured over time using existing, publicly collected, reasonably high quality data. In addition to supporting nationwide snapshots, they permit drill-down views based on geography, population subgroups, and socioeconomic status.

Here are the IOM’s key indicators:

Health Outcomes:

1. Life Expectancy at Birth (number of years that a newborn is expected to live if current mortality rates continue to apply).

2. Infant Mortality (deaths of infants aged under 1 year per 1,000 live births).

3. Life Expectancy at Age 65 (number of years of life remaining to a person at age 65 if current mortality rates continue to apply).

4. Injury Related Mortality (age-adjusted mortality rates due to intentional and unintentional injuries).

5. Self-Reported Health Status (percentage of adults reporting fair or poor health).

6. Unhealthy Days Physical and Mental (mean number of physically or mentally unhealthy days in past 30 days).

7. Chronic Disease Prevalence (percentage of adults reporting one or more of six chronic diseases [diabetes, cardiovascular disease, chronic obstructive pulmonary disease, asthma, cancer, and arthritis]).

8. Serious Psychological Distress (percentage of adults with serious psychological distress as indicated by a score of > 13 on the K6 scale, with scores ranging from 0-24).

Health Related Behaviors:

9. Smoking (percentage of adults who have smoked > 100 cigarettes in their lifetime and who currently smoke some days or every day).

10. Physical Activity (percentage of adults meeting the recommendation for moderate physical activity [at least 5 days a week for 30 minutes a day of moderate intensity activity or at least 3 days a week for 20 minutes a day of vigorous intensity activity]).

11. Excessive Drinking (percentage of adults consuming four [women] or five [men] or more drinks on one occasion and/or consuming more than an average of one [women] or two [men] drinks per day during the past 30 days)

12. Nutrition (percentage of adults with a good diet [conformance to federal dietary guidance] as indicated by a score of > 80 on the Healthy Eating Index)

13. Obesity (percentage of adults with a body mass index > 30).

14. Condom Use (proportion of youth in grades 9-12 who are sexually active and do not use condoms, placing them at risk for sexually transmitted infections).

Health Systems:

15. Health Care Expenditures (per capita health care spending).

16. Insurance Coverage (percentage of adults without health coverage via insurance or entitlement).

17. Unmet Medical, Dental, and Prescription Drug Needs (percentage of [non-institutionalized] people who did not receive or delayed receiving needed medical services, dental services, or prescription drugs during the previous year).

18. Preventive Services (percentage of adults who are up-to-date with age-appropriate screening services and flu vaccination).

19. Childhood Immunization (percentage of children aged 19-35 months who are up-to-date with recommended immunizations).

20. Preventable Hospitalizations (hospitalization rate for ambulatory care-sensitive conditions).

State of the USA – a new non-profit endeavor developed under the auspices of The National Academy of Sciences and funded by several major foundations – sponsored the IOM project to identify the indicators. The IOM committee of experts was asked to (a) select indicators that, taken together, give “a broad view of health in America, covering health care, health status, and health determinants” and (b) choose only 20 indicators to ensure “maximum clarity and focus.”