Healthy People : Three Decades Of National Health Goals

1. 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

2. Healthy People:Three Decades Of National Health Goals

3. What is Healthy People?

4. What is Healthy People? • National disease prevention and health promotion initiative • Quantified health indicators • Targets for each indicator  Objectives • Two broad overarching national goals

5. Healthy People 2010Overarching Goals • Increase quality and years of healthy life • Eliminate health disparities

6. 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%)

7. Overweight and Obesity Baseline data> 1988–94

8. Tobacco Use Baseline data> 1990–99

9. Mental Health Adults with depression who received treatment Baseline data 1994–97

10. Access to Health Care Baseline data 1997 and 1998

11. 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

12. 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

13. 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

14. 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

15. Determinants of Health

16. Determinants of Health

17. Determinants of Health

18. HistoryHealthy People Editions • Three Healthy People initiatives • Objectives for: • 1990 • 2000 • 2010 • Each iteration increased in scope and complexity

19. HistoryHealthy People Editions • Three Healthy People initiatives • Objectives for: • 1990 (226 objectives) • 2000 (312 objectives) • 2010 (467 objectives) • Each iteration increased in scope and complexity

20. Minimum Dataset per Objective • Race (5 categories) • Ethnicity (2 categories) • Gender • Socioeconomic status • Education (3 levels) • Family income (3 levels)

21. 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

22. 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

23. 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

24. 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

25. 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

27. 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

28. 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

29. Implications of Healthy People for National Indicators • Assessing impact Use by Federal agencies State and local agencies Private and voluntary agencies The public

30. Federal Uses • Represents the Nation’s disease prevention, health promotion goals • Used to build partnerships • Has spawned derivative programs: A framework and an indicator set for other health initiatives • Identified topics in need of intervention research and action

31. 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

32. Use By the Public • Health coalition building • Introduces a common vocabulary • Increasing focus on prevention • Data and information for health decisions • Use by the media

33. Healthy People Lessons Learned • Science-based framework • Credible data • High level support • Consensus-based measures • Customer-driven and supported ongoing process • Accessible information

35. Impact – Progress to Date2010 Objectives • Progress Quotient = Most recent value - Baseline Target value - Baseline