What indicators could public health use to measure CAMH?
There are a variety of indicators that could be used to measure CAMH. There are data sources available at the federal and/or state level (e.g., National Survey of Children’s Health, National Survey of Drug Use & Health, Youth Risk Behavior Survey, School Health Profiles); however, local decisions more often need to be based on local data. The indicators highlighted in this playbook include 1) school attendance, 2) school disciplinary actions, and 3) school readiness, all of which can be retrieved at the local level.
These indicators have the potential to provide useful information about CAMH. Additionally, they are based on data that are already being collected and are potentially available to health departments to use as a starting point to assess and improve CAMH. These indicators also allow for the monitoring of CAMH at a wide range of child and adolescent ages (e.g., early childhood through high school). Important information about each of these three indicators (e.g., definition, domains, data sources) is detailed in the following sections.
What about the potential for bias?
Like all indicators, the three that are highlighted in this playbook are susceptible to bias. For example, school readiness of children can be influenced by their access to early care and education, and school disciplinary actions might be influenced by race, gender, and disability status 2, 3, 4. Therefore, it is important to recognize the potential for bias when interpreting and using the data. When interpreting data on school attendance, disciplinary actions, and readiness, it can be helpful to incorporate or consider other data that describe population demographics (e.g., race, ethnicity, gender, socioeconomic status) and presence of learning disabilities (e.g., dyslexia, attention deficit/hyperactivity disorder). Data that describe social determinants of health (SDOH) can also be used to better understand populations or subpopulations of interest. SDOH are the conditions in the environments where people are born and live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks5. Taking these extra steps can help capture a more holistic view of the population and assist in the accurate interpretation of indicator data.
These sections include important information about each of the three indicators that are proposed in this playbook as a starting point to assess and improve CAMH. Each of the profiles provides information to help understand the purpose of the indicator, its connection to health, relevant domains, and information about who collects the indicator data, how, and for what purpose. Each profile also suggests ways that health departments and other partner agencies could use the indicators to assess and improve CAMH.