CENTERS FOR DISEASE CONTROL AND PREVENTION
Volume 16 • Number 2/3 • Winter/Spring/Summer 2004

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Oregon

Benchmarking Oregon

In 1991 the Oregon State Legislature created the Oregon Progress Board (OPB) and tasked it with implementing Oregon Shines, a first-in-the-nation attempt at defining, measuring, and improving statewide quality of life. The Board responded with the Oregon Benchmarks, 90 measures of the economy, education, civic engagement, social support, public safety, community development, and environment of Oregon. The biannual Oregon Benchmark Performance Report not only measures current conditions, but also sets a target for improvement in each category, giving policy makers, public health officials, and all Oregonians clear goals for improving quality of life in their state.

The benchmarks are not standards of performance but indicators that measure diverse quality of life issues including net job growth, adult literacy, water quality, and perceived health status. As stated in the 2003 Benchmark Performance Report, “Oregon Shines is based on the assumption that the social and economic well-being of Oregonians depends on the interconnectedness of quality jobs, a sustainable environment, and caring communities” (Figure 1).

Figure 1.
Circle of Prosperity

Oregon has proven the worth of using benchmarks to track and improve quality of life of an entire state’s population. In 2002, the Institute for Government Innovation, part of the John F. Kennedy School of Government at Harvard University, recognized the Oregon Progress Board and its benchmarks as one of the 15 most effective public sector programs of the previous 15 years. In a statement announcing the award, Executive Director Gail Christopher said, “The Oregon Benchmarks model has been replicated by other states and has informed both practice and policy debates at the federal level of government and within nonprofit and private sectors.”

One key area of overall QOL is health. In the dozen years since their inception, the benchmarks have gained respect and legitimacy. Kathy Pickle, Oregon’s Behavioral Risk Factor Surveillance Survey Coordinator, says, “There is value in benchmarks. Health care isn’t just an abstract thing. Not only are people getting screened, but what happens next? What should be done for individuals?” Benchmark data give policy makers, health care providers, civic and business leaders, and all Oregonians a report card on and a guide to improving quality of life.

Challenges to Health-Related Quality of Life
As with most broad measures of large groups of people, over time some categories improve, some hold steady, and some worsen. Although Oregonians’ self-rated health is at the national average, the 2003 benchmark report indicates that those who consider their health very good or excellent has fallen from 63% in 1993 to 55% in 2001. Targets for this measure are 65% by 2005 and 72% by 2010.

Oregon is using its Behavioral Risk Factor Surveillance System to track HRQOL for people with chronic conditions such as diabetes, arthritis, and asthma. “We use [the data] to understand which of our populations are bearing the greatest burdens from these conditions and to help tease out some of the causes and related factors,” said Nancy Clark, Health Systems Liaison in the Oregon Department of Human Services. “We are performing surveillance on those things that affect quality of life.”

One program working to reverse the downward health trend is the Oregon Diabetes Program (ODP). The number of Oregonians reporting diagnosed diabetes increased from 4% in 1995 to 6% in 2001. People over age 65 are particularly at risk: 14% have diagnosed diabetes. The ODP uses the Healthy Days measures to compare the HRQOL of Oregonians with diabetes to that of Oregonians without diabetes. The 2002 Report Card of the Oregon Diabetes Program indicates that in the previous 30 days Oregonians with diabetes had 5 fewer physically healthy days and one less mentally healthy day than Oregonians without diabetes.

The 2001 Oregon Behavioral Risk Factor Surveillance Survey indicates that 36% of Oregonians have some type of arthritis. Those with arthritis were also more likely to report being inactive and obese.

Oregon asthma programs are also using HRQOL research. “In the asthma program, we have made an effort to look specifically in surveys among people with asthma to determine if their limited activity is, in their view, a consequence of their asthma,” said Richard Leman, MD, Oregon’s Chronic Disease Epidemiologist. “Our role is to educate, to conduct surveillance, and we feel it is useful to look at quality of life and degree of disability. The next part of our role is education of people who can do something about that. It’s part of the partnership between the public health department and people in the community.”

Benchmarking Smaller Populations
Benchmarking at the state level has proven so useful that local government and business leaders are applying the concept to counties and cities. An example is the Portland Multnomah Progress Board (PMRB), modeled after Oregon’s Progress Board. The PMRB benchmarks the city of Portland and its surrounding county, Multnomah. The PMRB’s mission statement summarizes their goals: “The Portland Multnomah Progress Board identifies, monitors, and reports on indicators (named Benchmarks) for important community-wide goals. The Board identifies major trends in the community and acts as a catalyst for government, business, and community groups to improve the performance of the benchmarks.”

Oregonians take their benchmarks seriously and intend them to be drivers of change, rather than just more compiled data. A Brief History of the Portland Multnomah Progress Board states, “Benchmarks place a priority on measuring results, such as adult literacy, rather than efforts. Community indicators are more meaningful signs of achievement than are the expenditures on programs. They tell us whether our strategies are working to get results. By focusing on and monitoring the outcomes, community leaders and citizens can reset priorities and adapt and modify programs as they learn what works.”

Benchmarking the Future
Oregon is proving the benchmark concept useful in monitoring and trying to improve HRQOL. “We report HRQOL data for advocacy, to show we need to do more as a community and state. We need to find ways to deal with health problems so they don’t interfere with people’s activities,” says Dr. Leman. “We use the data as a tool to educate health care providers and others about how much these issues affect people, and to promote coalitions in the community to improve quality of life.”

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This page last reviewed August 10, 2004

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