April 21, 2004

Dear Chairman Regula and Congressman Obey:

The Friends of the CDC's NCHS appreciate your past support for the National Center for Health Statistics. NCHS's funding is critical in providing data to researchers, policymakers and others needed to improve health care in the United States. NCHS compiles statistical information to help guide public health and health policy decisions. These health statistics allow us to:

• Monitor trends in health status and health care delivery.
• Document the health status of the U.S. population and selected subgroups.
• Provide data to support public policies and programs.
• Evaluate the impact and effectiveness of health policies and programs.
• Identify disparities in health status and use of health care by race/ethnicity, socio-economic status, region, and other population characteristics.
• Document access to the health care system.
• Identify health behaviors and associated risk factors.
• Support biomedical and health services research.

Yet the agency's appropriations have not kept pace with inflation over the past ten years, putting this good work at risk. For the past several years, NCHS has been cutting back the number of people they survey and the numbers of questions asked as well as suspending altogether surveys that give us important information on how the health care system works. This means there is less data on fewer people available when it comes time to make critical decisions on health policy, which may be very shortsighted. As the country becomes more diverse we need to increase not reduce sample sizes.

The President's budget proposal includes a $22 million increase for NCHS, raising this agency's budget to $150 million. This budget increase would be used to restore surveys to their full strength, making it possible to inform policy with accurate information on health trends, disparities, and emerging health issues.  It also provides for progress in updating the way NCHS collects data - such as by supporting electronic systems for birth and death data in the states -

thereby speeding the availability of data. While strongly supporting this increase in the President's budget for NCHS, the Friends of CDC's NCHS believe that an additional of $32 million (for a total of $182 million) is needed to meet the following critical needs:

• Broaden survey content including collecting information on additional health topics such as mental health and obesity.
• Fill data gaps for state and local decision making.
• Better understand racial and ethnic variations.
• Provide detailed data on type of health care provider.
• Accelerate technological improvements to move from paper systems to electronic (e.g.. to fund states to implement electronic birth and death systems developed with 2005 funding).
• Conduct intramural and extramural research on topics such as survey measures, ways to protect the confidentially of health information, health indicators, informed consent, and translating questionnaires into additional languages in order to improve data collection and analytic capabilities.
• Expand data access for researchers and policy makers through a program of Research Data Centers, internet dissemination and other means, to promote data use and address confidentiality constraints.

We urge your support for providing these additional resources to NCHS in FY2005 and thank you again for your past leadership and support.

Sincerely,

Alliance for Continuing Nutrition Monitoring
Ambulatory Pediatric Association
American Academy of Pediatrics
American Association for Dental Research
American Association of Colleges of Nursing
American Association of Colleges of Pharmacy
American Dietetic Association
American Osteopathic Association
American Pediatric Society
American Psychological Association
American Public Health Association
American Society for Clinical Nutrition
American Society for Nutritional Sciences
Arthritis Foundation
Association of American Medical Colleges
Association of Medical School Pediatric Department Chairs
CHADD (Children and Adults with Attention-Deficit/Hyperactivity Disorder)
Coalition for Health Services Research
Consortium of Social Science Associations
Council of Professional Associations on Federal Statistics
Last Acts Partnership
March of Dimes
National Association for Public Health Statistics and Information Systems
National Health Council
National Marfan Foundation
National Mental Health Association
National Osteoporosis Foundation
National Psoriasis Foundation
Osteogenesis Imperfecta Foundation
Population Association of America-Association of Population Centers
Prevent Blindness America
RESOLVE: The National Infertility Association
Shape Up America
Society for Pediatric Research
Trust for America 's Health