Author: Columbia University Mailman School of Public Health
Author Contact: columbia.edu
Published: 10th Mar 2023
Peer-Reviewed Publication: Yes
Additional References: Sexual Health Information Publications
Summary: The study proposes sexual health indicators to document public health needs and assess progress.
The World Health Organization (WHO) defines sexual health as a state of physical, emotional, mental, and social well-being about sexuality; it is not merely the absence of disease, dysfunction, or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships and the possibility of having pleasurable and safe sexual experiences free of coercion, discrimination, and violence. Sexual health is fundamental to the overall health and well-being of individuals, couples, and families, and to the social and economic development of communities and countries.
Sexual Health Indicators for The United States: Measuring Progress and Documenting Public Health Needs - Frontiers in Public Health.
Moving away from a focus on the risk of disease to a more positive, holistic, and health-promoting approach to sexual health is critical to improving health outcomes, according to a new study led by a researcher from Columbia University Mailman School of Public Health. The study, which proposes indicators to assess broad progress in sexual health outcomes, appears in the open-access journal Frontiers in Public Health.
Rates of sexually transmitted infections (STIs) have increased substantially throughout the COVID-19 pandemic, aided by delays in treatment and surveillance. STIs are the most reported infectious disease in the United States; reproductive tract cancers affect hundreds of thousands of people annually, and almost half of all pregnancies are unintended. Adverse health outcomes are costly, with the direct medical costs of STIs estimated at $16 billion annually and the estimated annual costs of unintended pregnancies at $9 billion.
Within the United States, public health researchers have largely focused on sexual health challenges like these one at a time. Yet many of these outcomes occur in the same individuals and subpopulations, creating syndemics (overlapping epidemics of two or more health-related issues) stemming from social conditions like poverty, stigma, and structural violence. However, in recent years, other countries have moved towards a more holistic approach to evaluating sexual health outcomes, aligned with the World Health Organization's definition of sexual health, which the researchers used as a framework for their study.
The research team worked with the Centers for Disease Control and Prevention (CDC) experts to identify key sexual health indicators to measure long-term outcomes, focused on the general population, and aligned with existing government goals. Indicators were selected that fit into one of four objectives:
The study identifies 23 indicators tied to these objectives. They write that their efforts were more successful at identifying indicators for traditional public health measures like clinical services and adverse outcomes (for example, new HIV infections among adolescents and adults) and less so for measures of attitudes and relationships related to sexual health (example: percentage of people who report being very happy in marriage).
The researchers envision these core sexual health indicators would be published as an index publicly available and updated frequently. These sexual health indicators could be used for ongoing monitoring and to guide related research, programming, and policy development to help promote sexual health in the coming years. They hope the proposed indicators will be reviewed and revised to ensure usefulness.
"While there have been calls for a more positive, holistic focus on sexual health, this paper takes those calls a step further and nails down the importance of measurement," says study author Jessie V. Ford, Ph.D., assistant professor of sociomedical sciences at Columbia Mailman School. "Imagine if the U.S. had a publicly available scorecard where we could easily track our sexual health. It would help us think about where to celebrate our wins and where to make changes and invest resources. We envision this paper as a baseline to build even better measures and surveillance in the future."
The study's co-authors are Megan B. Ivankovich from the Population Reference Bureau and Eli Coleman from the University of Minnesota Twin Cities Institute for Sexual and Gender Health. The Population Reference Bureau employed Megan B. Ivankovich, but the other study authors declare no conflict of interest.
Sexual Health Progress Score Card | Columbia University Mailman School of Public Health (columbia.edu). SexualDiversity.org makes no warranties or representations in connection therewith. Content may have been edited for style, clarity or length.
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• (APA): Columbia University Mailman School of Public Health. (2023, March 10). Sexual Health Progress Score Card . SexualDiversity.org. Retrieved March 22, 2025 from www.sexualdiversity.org/sexuality/health/1157.php
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