Transcript Healthy People: Three Decades Of National Health Goals Edward J. Sondik Director Richard J. Klein Office of Analysis and Epidemiology National Center for Health Statistics.

Healthy People:
Three Decades Of
National Health Goals
Edward J. Sondik
Director
Richard J. Klein
Office of Analysis and Epidemiology
National Center for Health Statistics
Healthy People:
Three Decades Of
National Health Goals
What is Healthy People?
What is Healthy People?
•
National disease
prevention and health
promotion initiative
•
Quantified health
indicators
•
Targets for each
indicator
 Objectives
•
Two broad overarching
national goals
Healthy People 2010
Overarching Goals
• Increase quality and years of
healthy life
• Eliminate health disparities
Examples of Objectives
• Reduce the proportion of
nonsmokers exposed to
environmental tobacco smoke.
(Baseline 65%, 2010 target 45%)
• Increase the proportion of persons
with a usual primary care provider.
(Baseline 77%, 2010 target 85%)
Overweight and Obesity
Baseline data> 1988–94
Tobacco Use
Baseline data> 1990–99
Mental Health
Adults with depression who received treatment
Baseline data 1994–97
Access to Health Care
Baseline data 1997 and 1998
Implications of Healthy People for
National Indicators
•
Topics
• Role of government
• Involvement of the public and
health professionals
• Healthy People infrastucture
• Twin overall focus on goals and
disparities
• Role of data
• Impact – effects of the program
History:
Who Initiated Healthy People?
•
Initiated by the Surgeon General’s
Report on Health Promotion and Disease
Prevention (1979)
•
Contributions from
• Federal, State, and local agencies
• Academic centers
• Providers
• Voluntary health associations
• The public
Philosophy:
Goals, Indicators, and Targets
•
•
Science-based
Indicators with targets = Objectives
• Includes two over-arching goals
•
•
•
•
Measurement!
Public reviews (reports and papers)
Aggressive use of the web
Consensus process for development
Conceptual Framework:
Linkage Between
Objectives and Goals
•
Health: measured by
• Presence or absence of disease
• Quality of life
• Length of life
•
Influenced by risk factors,
interventions, non-health factors
Determinants of Health
Determinants of Health
Determinants of Health
History
Healthy People Editions
•
Three Healthy People initiatives
• Objectives for:
• 1990
• 2000
• 2010
•
Each iteration increased in scope and
complexity
History
Healthy People Editions
•
Three Healthy People initiatives
• Objectives for:
• 1990 (226 objectives)
• 2000 (312 objectives)
• 2010 (467 objectives)
•
Each iteration increased in scope and
complexity
Minimum Dataset per Objective
•
•
•
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Race (5 categories)
Ethnicity (2 categories)
Gender
Socioeconomic status
• Education (3 levels)
• Family income (3 levels)
Implications of Healthy People for
National Indicators
•
Topics
• Role of government
• Involvement of the public and
health professionals
• Healthy People infrastucture
• Twin overall focus on goals and
disparities
• Role of data
• Impact – effects of the program
Implications of Healthy People for
National Indicators
•
•
Role of government
Involvement of the public and health
professionals
• Science-based objectives are
critical
• Government is essential to
initiating and managing the
program
• The public, health professionals
and all levels of government are
partners and customers
Implications of Healthy People for
National Indicators
• Healthy People infrastucture
• Extensive, high level support by
government
• Deputy Assistant Secretary for
Health manages the program
• 28 Federal teams manage
objectives
• National Consortium
Healthy People Consortium
• Over 400 private and national membership
organizations, State and Territorial,
environmental, substance abuse and mental
health departments all using the Healthy
People 2010 objectives
• Listserv/website
• Annual Meetings
• Newsletter
• Independent contributions from members:
• Tools
• Intervention experience
Implications of Healthy People for
National Indicators
• Healthy People infrastucture (more)
• 190 data sources
• Data warehouse under the
National Center for Health
Statistics (Federal Statistical
Agency)
• New data sources for
Developmental Objectives
• State and local data
• Technical guidebook
on the statistics used
for HP2010
• Provides details on
how the objectives
are measured
• Discusses major
statistical issues that
affect interpretation
of data
Implications of Healthy People for
National Indicators
• Healthy People infrastucture (more)
• Research and development
• Analytic methods
–Measuring progress
–Evaluating disparities
–Small area estimates from
National data and multiple
data sources
Implications of Healthy People for
National Indicators
•
Assessing impact
Use by
Federal agencies
State and local agencies
Private and voluntary agencies
The public
Federal Uses
•
Represents the Nation’s disease
prevention, health promotion goals
•
•
Used to build partnerships
•
Identified topics in need of
intervention research and action
Has spawned derivative programs: A
framework and an indicator set for
other health initiatives
State and Local Uses
•
Nearly all States had specific goals and
objectives modeled after Healthy
People 2000
•
23 States have specific goals and
objectives modeled after Healthy
People 2010
• Some select all indicators
• Other adopt select areas and
objectives
•
•
Framework for local health initiatives
Data improvements
Use By the Public
•
•
•
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Health coalition building
•
Use by the media
Introduces a common vocabulary
Increasing focus on prevention
Data and information for health
decisions
Healthy People
Lessons Learned
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Science-based framework
•
Accessible information
Credible data
High level support
Consensus-based measures
Customer-driven and supported
ongoing process
Impact – Progress to Date
2010 Objectives
• Progress Quotient = Most recent value - Baseline
Target value - Baseline
Progress to Date
% of Measures
Achieved Target
Moving Towards Target
6.5
32.3
4.9
14.6
41.8
100.0
No Change
Moving Away from Target
Cannot Assess: Baseline data only