An initiative called 100 Million Healthier Lives has created a new community healthcare measurement framework to guide policy, compare results across initiatives, and drive improvement.
The Well-Being in the Nation (WIN) Measurement Framework: Measures for Improving Health, Well-Being, and Equity Across Sectors was created by 100 Million Healthier Lives, which was convened by the Institute for Healthcare Improvement (IHI), and in partnership with the National Committee on Vital and Health Statistics (NCVHS), an advisory committee to the U.S. Secretary of Health and Human Services.
The measures include high school graduation rates, child poverty rates, community walkability, and how people feel about their own lives and their future.
“The degree to which people engage in civic life, good jobs are available, housing is affordable, the environment enables people to connect with one another, and the culture of the community is inclusive — all of these relate to whether a community might thrive,” said Somava Saha, M.D., M.S., vice president of IHI and executive lead for the 100 Million Healthier Lives initiative, in a prepared statement. “The WIN report recognizes that these elements — the well-being of people and the well-being of places — are interconnected and relate to the systems and conditions that perpetuate health inequities.”
The WIN framework is the culmination of work begun in 2015 by NCVHS to identify key factors that impact population and community health and well-being. After NCVHS arrived at initial findings, they invited 100 Million Healthier Lives to expand the work and to test a preliminary set of measures with others.
100 Million Healthier Lives brought together more than 100 stakeholders, including organizations and agencies working at both the state and federal levels on health, housing, education, transportation, and the environment. The final WIN framework draws from existing resources, such as US News & World Report’s Healthiest Communities, County Health Rankings and Roadmaps, and City Health Dashboard. Recommendations from across the sectors and communities represented also helped everyone see certain indicators of health and well-being in a new light.
Saha noted that while traditional healthcare performance measures can be useful, they are actually only a small part of the picture of what is needed to improve the health and well-being of the nation. The WIN measures help us see the whole picture — including the social conditions that people and places need to thrive.
Together, the stakeholder groups identified more than 500 measures, which were narrowed down to nine core measures mentioned above, as well as 54 leading indicators across 12 domains and 30 subdomains, such as food, health, housing, education and transportation. In addition, the groups identified a number of innovative measures that could over time help organizations and communities better understand the nontraditional factors influencing health and well-being, such as perception of everyday discrimination and school absences.
Dozens of local and national agencies, communities and states that worked on the measures have already begun to put them to use, including the American Heart Association, the Delaware Substance Abuse and Mental Health Agency, the National Council on Aging, US News & World Report, and the Well Being Trust. These organizations and others have formed a Well-Being in the Nation Measurement Cooperative to continue to learn from one another.
