Transcript Document

Phase II: Approval of
Recommendations to HHS &
Discussion of Topic Areas
Secretary’s Advisory Committee on Health Promotion
and Disease Prevention Objectives for 2020
Committee Chair: Jonathan Fielding, MD, MPH, MA, MBA
Director, Los Angeles County Department of Public Health &
Health Officer, Los Angeles County
Ad Hoc Group on Topic Areas
Group Chair: Patrick Remington, MD, PhD
University of Wisconsin Population Health Institute
Evolution of Healthy People - 1
1990 Health
Objectives
Goals
1.
Reduce mortality among
infants by 35%
2.
Reduce mortality among
children aged
1 to 14 years by 20%
3.
Reduce mortality among
adolescents, young adults
(15 to 24) by 20%
4.
Reduce mortality among
adults by 25%
5.
Increase independence
and quality of life among
older adults (65 and over),
reducing days of restricted
activity
Healthy People 2000
Vision
Healthy People in healthy
communities
Goals
1.
Increase the years of
healthy life for
Americans
2.
Reduce disparities in
health among different
population groups
3.
Achieve access to
preventive health
services for all
Americans
Healthy People 2010†
Vision
Healthy people in healthy
communities
Goals
1.
Increase the quality and
years of healthy life
2.
Eliminate health
disparities
Healthy People 2020
(proposed)
Vision
A society in which all people
live long, health lives
Goals
1. Eliminate
preventable disease,
disability, injury,
and premature
death
2. Achieve health
equity and
eliminate health
disparities
3. Create social and
physical
environments that
promote good
health for all
4. Promote healthy
development and
healthy behaviors at
every life stage
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Evolution of Healthy People - 2
1990 Health
Objectives
Categories
1.
Preventive Services
2.
Health Protection
3.
Health Promotion
Healthy People
2000
Enabling Goals
1.
Preventive Services
2.
Health Protection
3.
Health Promotion
4.
Data and Surveillance
Healthy People
2010†
Enabling Goals
1.
Promote healthy
behaviors
2.
Protect health
3.
Assure access to quality
health care
4.
Strengthen community
prevention
Healthy People
2020 (proposed)
Mission
To improve health through
policy and practice, Healthy
People will:
1. Identify nationwide
health improvement
priorities;
2. Increase public
awareness and
understanding of the
determinants of health,
disease and disability, and
the opportunities for
progress;
3. Provide measurable
objectives and goals that
can be used at the
national, state, and
federal levels;
4. Identify critical research
and data collection needs
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Evolution of Healthy People - 3
Healthy People
2000
1990 Health
Objectives
15 “Priority Areas”
(Preventive Services- 5 )
1. H. blood pressure
control
(Etc.)
(Health Protection-5)
1. Toxic agent and
radiation control
(Etc.)
22 “Priority Areas”
1.
2.
3.
4.
Etc.
(Health Promotion-5)
1. Smoking and health
(Etc.)
Cancer
Clinical Preventive
services
Diabetes and
chronic disabling
conditions
Educational and
community-based
programs
Healthy People
2010†
28 “Focus Areas”
1.
2.
3.
4.
5.
6.
Healthy People
2020 (proposed)
TBD
Access to quality
health services*
Arthritis,
osteoporosis, and
chronic back
conditions
Cancer
Chronic kidney
disease
Diabetes
Disability and
secondary
conditions
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Proposed Definitions for HP 2020
 Vision:
• A single, broad statement of what society will look like in 2020
 Goal:
• The broad result toward which effort is directed
 Focus Area/ Topic Area:
• Points of entry for the community into the healthy people
framework
 Priorities:
• Priorities are given attention before competing alternatives.
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Discussion of Topic Areas
 Thoughts about recommendations for FIW
• Shifting from HP 2010 topic areas to 2020
• Mapping to determinants
 Next steps
• Drafting categories
• Timeline for finalization and approval
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Update on HHS Activities
Rear Admiral Penelope Slade-Sawyer, PT, MSW
Director, Office of Disease Prevention and Health Promotion,
U.S. Department of Health and Human Services
Current Healthy People 2020:
Mission Statement
Vision Statement
A society in which all people live long, healthy lives.
Mission Statement
Healthy People 2020 strives to:
 Identify nationwide health improvement priorities;
 Increase public awareness and understanding of the determinants of health, disease, and disability
and the opportunities for progress;
 Provide measurable objectives and goals that are applicable at the national, state, and local levels;
 Engage multiple sectors to take actions to strengthen policies and improve practices that are driven
by the best available evidence and knowledge;
 Identify critical research, evaluation, and data collection needs
Current Healthy People 2020:
Overarching Goals
Overarching Goals
 Attain high quality, longer lives free of preventable disease, disability, injury, and premature death.
 Achieve health equity, eliminate disparities, and improve the health of all groups.
 Create social and physical environments that promote good health for all.
 [Promote, attain, achieve, realize] quality of life, healthy development and healthy behaviors across
all life stages.
Desired Outcomes for the Meeting
 Recommendations on:
• Immediate HHS Actions in support of the
Health Objectives
• System Specifications for relational database
and User Interface
 Proposed focus/topic area categories
 Finalized charges for subcommittees
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Ad Hoc Group on Immediate
Phase II Recommendations for HHS
Group Chair: Lisa Iezzoni, MD, MSc
Harvard Medical School
[Presented by Dr. Jonathan Fielding]
Recommendations for Immediate
HHS Actions in Support of HP
1.
Maintain and build our nation’s ability to monitor population health
at the local, state, and national levels…
2.
Design and start building an Internet-based public health
information infrastructure…
3.
Improve the evidence base for policies and programs that
can…improve collective health and reduce health disparities.
4.
Assess the health consequences of the economic downturn.
5.
Determine manpower needed to assure a strong public health
infrastructure and to implement evidence-based programs and
policies at the national, state, and local levels.
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Subcommittee on
System Specifications
Subcommittee Chair: Ronald Manderscheid, PhD
SRA International
Report on Outcomes of Subcommittee Work

Purpose of and approach to the report

Changes since the last version (January 7-8, 2009)
•
User-centered design & process

Recommended next steps for the user interface

Issues to be resolved before report is sent to HHS
•
Ready for final vote to approve?
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Charges of the Phase II Subcommittees
Phase II Subcommittees
Charges
Priorities (AK, DM)
• How do we think about priorities at the national, state,
and local level?
Topic Areas & Objectives
(PR)
• Organize the list of HP 2010 objectives into
homogenous categories. Add any that are missing.
Implementation (AT, EM)
• Reflect on the range of potential users at the national,
state, and community levels. What are their needs for
tools, aids, and guidance for communities?
Evidence & Target-Setting
(PR)
• Transparent process for target-setting that
communities can use to set their own objectives.
• Evidence-based public health practices.
Data & IT Issues (RM)
• Interface with NCHS to determine needs/ capabilities.
• Issues related to working with partners for data.
• Longer-term issues re: the role of Health IT.
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Key Dates for Deliverables
 Topic Area categories: March, 2009
 Target-setting Methodology: April, 2009
 Final inclusion criteria for evidence-based
resources: May, 2009
 Implementation strategies: June-July, 2009
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Map of Committee/
Subcommittee Activity for Phase II
Committee Vice-Chair: Shiriki Kumanyika, PhD
University of Pennsylvania School of Medicine
 Healthy People 2020 Mission:
To improve health through strengthening policy and
practice, Healthy People will:
• Identify nationwide health improvement priorities;
• Increase public awareness and understanding of the determinants of
health, disease, and disability and the opportunities for progress;
• Provide measurable objectives and goals that can be used at the
national, state, and local levels;
• Engage multiple sectors to take actions that are driven by the best
available evidence and knowledge;
• Identify critical research and data collection needs.
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“Categories” for HP 2020 Objectives
Mission Statement
Potential “Category”
Identify nationwide health improvement
priorities;
Priorities
Increase public awareness and
understanding of the determinants of
health, disease, and disability and the
opportunities for progress
Determinants
Provide measurable objectives and goals
that can be used at the national, state,
and local levels;
Standards and Tools
Engage multiple sectors to take actions
that are driven by the best available
evidence and knowledge;
Evidence and Knowledge
Identify critical research and data
collection needs.
Data Sources
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Categories as Doorways into Objectives
“Priorities”
Learn about National priorities, or set own priorities at
the state or local level.
“Determinants”
Obtain information about factors contributing to the
disease/ issue of highest priority.
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Categories as Doorways into Objectives
“Standards and Tools”
Obtain standards or tools to set state or local objectives
that are aligned with the national objectives.
“Evidence and Knowledge”
Obtain information about evidence/ knowledge-based
public health practices that can be used to achieve
objectives of interest
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Categories as Doorways into Objectives
“Data Sources”
Link to credible federal, state, or local data sources for
current data for tracking progress on priority issues.
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Subcommittee Activities by Category
Subcommittees’ Phase II Work overlaps and is not siloed.
Potential “Category”
Phase II Subcommittees
Priorities
Priorities (AK, DM)
Determinants
Topic Areas & Objectives (PR)
Standards and Tools
Implementation (AT, EM)
Evidence and Knowledge
Evidence & Target-Setting (PR)
Data Sources
Data & IT Issues (RM)
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Linking Framework to Topic Areas
Components of Action Model
Key Elements
Determinants, broad
Social, economic, cultural;
environmental; health systems; living
and working; social, family, &
community
Individuals across the life course
Individual status
Outcomes
Behavioral; risk factors, diseases,
conditions; injuries; well-being and
QoL; health equity
Assessment, monitoring, evaluation,
dissemination
Interventions
Programs, policies and information
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Discussion and Next Steps
 Remaining work on topic areas
 Next steps for subcommittees
 Next Committee meeting dates
• Thursday, March 26: 12:00-2:00 PM (ET)
• Monday, April 20th: 12:00- 2:00 PM (ET)
• Friday, May 15th: 1:00 PM- 3:00 PM (ET)
 Other issues
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