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1. Healthy People 2020
Promoting Health and Preventing Disease Throughout the Nation
Debra Nichols, MD, MPH
Office of Disease Prevention and Health Promotion
Debra.nichols@hhs.gov
3. What is Healthy People?
■ A National agenda that communicates a
vision for improving the population’s health
and achieving health equity.
■ A set of specific, measurable objectives with
targets to be achieved by the year 2020.
These objectives are organized within
distinct topic areas.
4. Why Do We Need a National Set
of Health Objectives?
1. Creates a comprehensive, strategic
framework.
2. Requires tracking of data-driven
outcomes.
3. Engages a network of stakeholders.
4. Guides national research, program
planning, and policy efforts.
5. Establishes accountability.
5. Evolution of Healthy People
Target Year 1990 2000 2010 2020
Overarching Decrease Increase span Increase Attain high quality, longer
mortality: of healthy life quality and lives free of preventable
Goals infants-adults years of disease
Reduce health healthy life
disparities Achieve health equity;
eliminate disparities
Increase
independence Achieve access Eliminate
Create social and physical
among older to preventive health
environments that promote
adults services for all disparities
good health
Promote quality of life,
healthy development,
healthy behaviors across
life stages
# Topic Areas 15 22 28 42
# Objectives/ 226/na 312/na 467/969 >1,194/1,194
Measures
8. Healthy People 2020 Mission
■ 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 stakeholders 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.
12. Why are the determinants of
health important?
The rationale for focusing on determinants
includes:
■ The need to move beyond controlling
disease to address factors that are root
causes of disease;
■ The importance of achieving health equity;
and
■ Practical considerations related to national
prosperity and security.
13. Multi-Sectoral Efforts are
Needed
■ Health is created through the conditions of
our daily lives
■ The commitment of all is needed:
– To implement evidence-based strategies to
improve health, and
– To build the evidence base for such strategies.
14.
15. Social determinants of health:
A new area of focus for HP2020
■ A video on Social Determinants of Health is
viewable on the Healthy People 2020 website
at:
http://healthypeople.gov/2020/about/DOHAbout.aspx
■ A new topic area narrative explaining social
determinants of health is available on the
Healthy People 2020 website.
■ New objectives addressing social determinants
of health are under development for Healthy
People 2020.
17. Healthy People 2020 Topic Areas
From Healthy People 2010
■ Access to Health Services ■ Immunization and Infectious
■ Arthritis, Osteoporosis, and Diseases
Chronic Back Conditions ■ Injury and Violence Prevention
■ Cancer ■ Maternal, Infant, and Child
■ Chronic Kidney Disease Health
■ Diabetes ■ Medical Product Safety
■ Disability and Health ■ Mental Health and Mental
■ Educational and Community- Disorders
Based Programs ■ Health Communication and
■ Environmental Health Health Information Technology
■ Family Planning ■ Hearing and Other Sensory or
■ Food Safety Communication Disorders
■ Nutrition and Weight Status ■ Heart Disease and Stroke
■ Occupational Safety and Health ■ Respiratory Diseases
■ Oral Health ■ Sexually Transmitted Diseases
■ Physical Activity ■ Substance Abuse
■ Public Health Infrastructure ■ Tobacco Use
■ HIV ■ Vision
18. New Healthy People 2020
Topic Areas
■ Life Stages ■ Healthcare-Associated
– Adolescent Health Infections
– Early and Middle Childhood ■ Preparedness
– Older Adults ■ Sleep Health
■ Blood Disorders and ■ In Development
Blood Safety – Lesbian, Gay, Bisexual, and
Transgender Health
■ Dementias, including – Health-Related Quality of
Alzheimer’s Disease Life and Well-being
■ Genomics – Social Determinants of
Health
■ Global Health
19. Healthy People 2020 Objectives
■ Represent quantitative values to be achieved
over the decade.
■ Organized within the Topic Areas.
■ Managed by lead Federal agencies.
■ Supported by scientific evidence.
■ Address population disparities.
■ Data driven and prevention oriented.
27. Implementation and
Communication Strategies
■ Provide interventions for each objective
– Preventive Services Task Force recommendations
– Federal government reports
– Pilot studies, interventions research
– Promising practices
■ Healthy People content syndication:
http://healthfinder.gov/contentsyndication/index.
aspx
■ Webinars
■ App Challenge
■ Companion documents
28. “Who’s Leading the Leading
Health Indicators?”
■ Monthly series, “Who’s Leading the Leading
Health Indicators?”
■ Highlight organizations using evidence-based
approaches to address one of the Healthy
People 2020 Leading Health Indicator (LHI)
topics.
29. What are the Leading Health
Indicators (LHIs)?
Leading Health Indicators are:
■ Critical health issues that, if addressed appropriately,
will dramatically reduce the leading causes of
preventable deaths and illnesses.
■ Linked to specific Healthy People objectives.
■ Intended to motivate action to improve the health of
the entire population.
30. Leading Health Indicator Topics
■ Access to Health Services
■ Clinical Preventive Services
■ Environmental Quality
■ Injury and Violence
■ Maternal, Infant, and Child Health
■ Mental Health
■ Nutrition, Physical Activity, and Obesity
■ Oral Health
■ Reproductive and Sexual Health
■ Social Determinants
■ Substance Abuse
■ Tobacco
31. State and Community Awards
■ Twenty-four new Healthy People 2020 state, tribal
and territorial projects.
■ Projects were initiated on June 1, 2011 and will be
completed by May 31, 2012.
■ 91 Community Innovations Projects funded December
1, 2011 will be complete May 31,2012.
■ CBOs awarded up to $10,000 to address one or more
HP2020 topic areas, with special emphasis on
Environmental Justice, Health Equity, or Healthy
Behaviors Across All Life Stages.
32. Ways To Connect With Healthy
People
■ Spread the word about 2020 objectives.
■ Follow Healthy People on Twitter @gohealthypeople.
■ Connect with Healthy People on LinkedIn.
■ Join the Healthy People listserv.
■ Join the Healthy People Consortium.
■ E-mail: healthypeople@nhic.org
■ Sign up for e-mail updates at the website.
33. Healthy People 2020:
In Summary
■ Web-based interactive resource to expand reach and
usability (www.healthypeople.gov)
■ Dynamic system to accommodate changing health
needs and priorities
■ “Who’s Leading the Leading Health Indicators?”
monthly series
■ Eat Healthy • Be Active Community Workshops
(www.health.gov/dietaryguidelines)
■ Will be available online April 23, 2012
The number of objectives has increased with each decade. Healthy People 1990 released 226 objectives, Healthy People 2000 included 312 objectives, Healthy People 2010 identified 467 objectives with 1,000 measures, and Healthy People 2020 has almost 1,200 measures.As you can see, the objectives for Healthy People 2020 are described differently. That’s because we have adopted a new system of nomenclature to make things easier for everyone. In the past we had objectives and subobjectives. Now, we describe anything with a target as being an objective. This decade’s expansion for Healthy People 2020 occurred because both our Advisory Committee (made up of public health experts) and our Federal Interagency Workgroup felt that our Internet capabilities have vastly improved and can handle the load. And the larger number of objectives allows us to relate to more issues and stakeholders.
As note earlier, the social determinants of health have been an important focus of Healthy People 2020 since the early stages of its development…
The impact of interventions such as policies, programs, and information on determinants of health at multiple levels (e.g., individual; social, family and community; living and working conditions; and broad social, economic, cultural, health, and environmental conditions) to improve outcomes. The results of such interventions can be demonstrated through assessment, monitoring, and evaluation. Through dissemination of evidence-based practices and best practices, these findings would feed back to intervention planning to enable the identification of effective prevention strategies in the future.
Achieving health requires more than just controlling disease. It requires us to assure conditions in which people can be healthy. Health results from the choices that people are able to make in response to the options that they have. Conditions in the social and physical environments determine the range of options that are available, their attractiveness, and their relative ease or difficulty of use. Extensive evidence points to ways that environmental factors influence health.A close examination of the underlying causes of specific diseases reveals many of the same factors are at play and, over time, can result in physiologic changes that exacerbate chronic disease. Therefore, focusing on these common underlying determinants has the potential to impact many different health and disease outcomes. Because the effects of determinants begin to take hold well before disease processes appear on the clinical horizons, addressing these factors can offer an opportunity to prevent or delay the development of disease.
For three decades, the Healthy People initiative has led efforts to educate the nation that health is about more than the absence of disease, and is created through the conditions of our daily lives—not at the doctor’s office. Healthy People has long provided a vehicle for channeling diverse and distinct disease prevention and health promotion efforts throughout the U.S. toward the common goal of improving the nation’s health. It has offered an undergirding structure for tracking and monitoring health and disease, and has sought to inspire action by setting science-based targets for progress. As we begin a new decade, Healthy People 2020 re-energizes this long-standing vision, infusing it with a new focus on creating a society in which all people live long and healthy lives. Yet this vision cannot become reality without the active and deep engagement of many sectors of our society.Healthy People 2020 can be used as a tool to convene partners from across sectors—including housing, urban planning, education, transportation, and the environment— to improve the health of the nation. Indeed, examples of the type of multi-sectoral efforts needed to accomplish the goals of Healthy People and improve the health of the nation, are already occurring. An important example is the National Prevention Council, whose members include the Secretaries of the Departments of Agriculture, Education, Transportation, the FTC, the Environmental Protection Agency, the Department of Homeland Security, and others.
The goals and objectives of Healthy People 2020 are intended to be aspirational, yet achievable. Translating noble aspirations into tangible progress will require the commitment of all to implementing evidence-based strategies to improve health, and to build the evidence base for such actions where it does not currently exist. A key focus of these efforts must be on addressing the social and physical environmental factors that affect population health.
The Healthy People 2020 redesigned Web site was launched in December 2010.
Here you can see the Index page for all the Healthy People 2020 topic areas. New topic areas that were added for 2020 are indicated by the “new” icon in red – including three life stages topic areas, social determinants of health, LGBT health, preparedness and others.
Let’s look at the Tobacco Use topic area as an example. Each topic area contains 3 tabs: a narrative overview which is displayed here, objectives, and interventions and resources for that area.
Here is the objectives page for Tobacco Use. Each objective contains baseline and target values, a target-setting method, and a data source (unless they are developmental). When you click on the “more information” link, it takes you to the HHS Health Indicators Warehouse…
…where you can access all kinds of information about the data for each objective.
For each topic area we currently have listed evidence-based interventions and recommendations from the US Preventive Services Task Force Clinical Guide, CDC Community Guide, and healthfinder Quick Guide for Healthy Living, when available (cue animation).
The Implementing section of the Web site provides examples of implementation, planning and funding resources, links to State Healthy People plans, and the MAP-IT framework, which provides step-by-step guidance for developing an implementation plan.Each step of the MAP-IT process contains downloadable, printer-friendly tools and real-life examples from people using Healthy People (cue animation). The entire Implementation section will become more robust over the coming months and years.
In summation, HHS has sought to engage stakeholders in a number of ways and make Healthy People 2020 a useful initiative. Interventions are provided on the web siteWebinars provide more in depth information on particular interventions or Topic AreaThe LHI App Challenge is an opportunity for public health to engage new stakeholders: programmers and developers. Developers and public health experts must co-design an application that makes the leading health indicators customizable and easy to use. This challenge is open through March 9, 2012. Companion documents are being developed to help focus efforts on specific areas or populations, e.g., Healthy Youth and Rural Healthy People
