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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. Healthy People : Three Decades Of National Health Goals. What is Healthy People ?. What is Healthy People ?.
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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
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 2010Overarching 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
HistoryHealthy People Editions • Three Healthy People initiatives • Objectives for: • 1990 • 2000 • 2010 • Each iteration increased in scope and complexity
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
Minimum Dataset per Objective • 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 • Has spawned derivative programs: A framework and an indicator set for other health initiatives • Identified topics in need of intervention research and action
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 • Health coalition building • Introduces a common vocabulary • Increasing focus on prevention • Data and information for health decisions • Use by the media
Healthy People Lessons Learned • Science-based framework • Credible data • High level support • Consensus-based measures • Customer-driven and supported ongoing process • Accessible information
Impact – Progress to Date2010 Objectives • Progress Quotient = Most recent value - Baseline Target value - Baseline