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What Gets Measured Gets Fixed, so Measure the Right Things

scorecard.jpg Editor's Note: Sightline Institute just released their third annual Cascadia Scorecard, a publication reporting on the state of human and environmental health in the Pacific Northwest. Through seven key indicators, they examine present concerns, and offer practical vision for a prosperous future. Last year, we published an excerpt from their Sprawl & Health chapter, and one year later we're returning to the topic to see what this year's findings can tell us about the evolution of health and the environment, regionally and beyond. The following is an excerpt from the Introduction and Health chapters of Cascadia Scorecard 2007.

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contributed by Sightline Institute

What if your bathroom scale has been wrong all along? Day after day, you step on, and take comfort—or sigh with disappointment—at the reading. But what if it's been telling you the poundage of some other person? Or, perhaps, the average of 30 strangers, picked seemingly at random? You might try to exchange your scale for one that works; or you might just toss it in the trash. Regardless, you'd certainly stop consulting it.

Now consider the Dow Jones industrial average. The Dow is the king of stock indicators—the bathroom scale of the global economy. Yet the Dow is a lousy scale, the least meaningful of the major market indices. Its outdated methods serve as a reminder of the computational limits of the late nineteenth century: by simply averaging stock prices, while ignoring the number of shares of each stock in circulation, the Dow provides a distorted view of the market's ups and downs.

Worse, its roster of 30 companies (out of more than 3,600 companies whose stocks are traded on the New York Stock Exchange, and perhaps ten times that number traded globally) is chosen without any particular methodology; two Dow Jones employees simply pick them. By now, with superior indices a mouse click away, using the Dow to gauge the market's mood is like using The Old Farmer's Almanac to predict the weather.

But through the power of repetition, our society has come to regard the Dow as a reliable scale not only for stock markets but for society's progress more generally.

The Dow, as misleading an indicator as it is, attracts attention in part because of convention. In a complicated world, the Dow is simple and familiar. It also attracts attention because it is mercurial. It can fluctuate widely from month to month, or even day to day, which makes its variations a perfect fit for the nightly news.

But while our minds gravitate toward the fast-changing news, our daily lives are far more affected by trends that move with almost imperceptible slowness—trends for which we do not have reliable bathroom scales. The gradual warming that has already occurred passed virtually unnoticed; forests, farmland, fisheries, hydropower, and even coastal lowlands now hang in the balance. We've been measuring the wrong things in the wrong ways.

By tracking and measuring what we truly care about, we can better assess the world that we are creating for our children and focus on what we need to do improve that world, both today and for tomorrow. Fundamentally, we don't care about the economy for its own sake but because it helps provide us with things we truly value: security, meaningful work, and the opportunity to pursue our interests and passions. These are the measurements that matter.

1. HEALTH

The Score: 11 years behind targets

The Trend: Improving steadily

The Story: Health, as measured by life expectancy, is the Scorecard’s best-performing indicator. Lifespans now average 79.5 years in Cascadia, compared with 81.3 years for the Scorecard model. To accelerate progress, Cascadians can increase access to preventive medical care, design neighborhoods for safety and exercise, and improve the economic prospects of our neediest residents.

After surging in 2004, life expectancy in Cascadia improved only modestly in 2005, the most recent year for which regionwide data are available. Given prevailing patterns of mortality, a baby born in 2005 could expect 79 years and 6 months of life, up by about a month from the previous year (see Figure 3). That’s one-fifth of the improvement logged in 2004, when average lifespans shot up by 7 months in Washington and 8 months in Idaho. But the trend is consistently positive. By the Scorecard’s reckoning, Cascadia is only 11 years away from achieving the “model” performance chosen at the Scorecard’s inception (Japan’s life expectancy as of 2001), if we make steady progress each year.

Good health is important in its own right, and is also a sign that other aspects of our lives are going well. If our air and water grow more polluted, our lives more stressful, our society more dangerous, or our economy less able to meet our needs, then our health is likely to deteriorate as well.

The Cascadia Scorecard measures health through life expectancy, probably the globe’s most common yardstick of population health. Technically, life expectancy is the average number of years a newborn can expect to live, given current patterns of mortality. It is a reliable health gauge because it integrates all maladies that can shorten lives, from infant mortality to heart disease to traffic accidents to cancer. Moreover, national and international comparisons show striking correlations between life expectancy and other measures of health, such as the number of years people live free of disability and even people’s satisfaction with their own health.

Life expectancy has grown slowly but steadily for decades in Cascadia. At the dawn of the twentieth century, a resident of the region could expect to reach the age of about 50. But 100 years later, average lifespans had stretched to nearly 79 years: more growth in a single century than in all of prior human history. And the growth of life expectancy shows little sign of abating: over the most recent decade, average lifespans increased by nearly 2 years, as the toll from virtually every major cause of death declined.
Gains in health have been uneven, however. British Columbia remains far and away the healthiest jurisdiction in Cascadia. Provincial residents can expect 81.1 years of life—topping all other North American states and provinces. In fact, if British Columbia were an independent nation, it would rank second in the world in life expectancy, trailing only Japan. If recent trends continue, the province may match or exceed the Scorecard model within two years.

Within British Columbia, the healthiest areas are in the south (see map, page 24.) The healthiest jurisdiction in British Columbia, and Cascadia overall, is the suburban city of Richmond, where lifespans exceed 83 years—higher than Japan’s, and also higher than those of any major county in the United States. Jurisdictions within the Northwest states don’t fare as well. The Northwest counties with the longest lifespans, Washington County, Oregon, and King County, Washington, aren’t even standouts among populous US counties. To look for leadership in improving health, residents of the Northwest states should cast their gaze northward.

British Columbians’ success in leading long, healthy lives is the result not of one cause but of many. While the province’s health care system certainly has its detractors, none of its inhabitants goes without health insurance—unlike the 1 in 7 residents of the Northwest states who go without such insurance each year. British Columbia also has lower rates of violent deaths: fewer homicides and also fewer fatal car crashes, the latter largely due to compact communities that allow residents to drive less than their neighbors to the south. Even economics may play a role. On average, residents of the province aren’t as wealthy as their American counterparts, but the income and wealth gaps between the rich and the poor are narrower. Around the world, an unequal economic structure tends to be associated with poor health. Other factors—including lower rates of severe obesity, compared with the Northwest states—may also play a role in the province’s exceptional record.

In the Northwest states, improving access to preventive medical care—as Washington did in 2007 for lower-income children—could be a boon to lifespans. But medical care is only part of the solution to better health. Just as important are more systemic changes that keep us healthy without medical intervention. Redesigning our neighborhoods so that we can walk more and drive less, for example, would help promote regular exercise while limiting deaths and injuries from car crashes. Similarly, taking steps to reduce poverty could alleviate economic and social strains that contribute to poor health.


Find more information, including maps, solutions, and a pdf of the entire report here.

Sightline Institute is a Seattle-based research and communication center—a think tank—that aims to bring about sustainability, a healthy, lasting prosperity grounded in place.

IMAGE: Temperature Increase in Cascadia 1950-2003 (map) from Scorecard 2007

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Comments

Thanks for an excellent example of key metrics and results in the use of a scorecard. We are working on the initial ideas and resources for a book to apply the balanced scorecard tools to planetary wellbeing. We plan to include objectives, measures and exemplary initiatives at multiple levels, ranging from planetary to regional/national, organizational and individual. WE WELCOME INPUT, SUGGESTIONS, IDEAS AND COMMENTS on objectives, measures and strategic initiatives for applying balanced scorecard methodology to critical areas of concern, especially the environment and energy. We will appreciate suggestions in other areas, as well. Plz forward to irvb@sh163.net.


Posted by: Irv Beiman on 1 Jul 07



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