Health care in the United States is in crisis. Medical spending is the highest of all industrialized countries, but it has obvious shortcomings. These gaps include how health information is collected and the lack of global agreement on the best indicators. These have the effect of hindering efforts to improve the system (Johnson, 2011). Measuring progress in public health involves measuring what is important (Koh, 2011). This measure has typically been accomplished through disease surveillance or special reports summarizing disease trends, reported by race/ethnicity or another variable (Koh, 2011). This is why it is crucial that health measures track social determinants. Health is always present in daily life. This not only happens in a doctor's office when your blood pressure is measured, but also in our homes, schools, jobs, and churches (Koh, 2011). Even the World Health Organization defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease” (Koh, 2011). However, the United States does not have a systematic national strategy to identify and address all of the problems. the social and environmental determinants of health that are most responsible for health outcomes (IOM report, 2010). As a nation, we lag behind our counterparts in Canada and Britain, who have been collecting socioeconomic data for decades. In the past, limited efforts have been made to resolve this problem. In 2009, the CDC, in its Behavioral Risk Factor Surveillance System, introduced a “social context” module that was subsequently used by 12 states to assess civic engagement. Questions were asked as part of the assessment on food, housing and job security (IOM report, 2010). In the 1960s, several efforts were made to prepare a national document...... middle of paper ...... on public health agencies and medical care systems. Likewise, local agencies must be more effective in educating the public. The report recommends the development of local performance reports. These reports will be used to describe the overuse, underuse, and misuse of these interventions, including preventive and diagnostic tests, procedures, and treatments. These reports should then be made available to the public (IOM report, 2010). The hope is that the reports can better educate the public and local community health agencies to better target indicators and outcomes specific to their population of origin. Finally, the IOM report makes clear that the government must be held accountable to engage communities and policy makers in understanding, monitoring and improving the contributions of various health system partners (IOM report)., 2010).