Health Promotion and Disease Prevention Objectives for 2010

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Office of the Secretary

Health Promotion and Disease Prevention Objectives for 2010

AGENCY: DHHS/OS/Office of Public Health and Science, Office of Disease

Prevention and Health Promotion (ODPHP).

ACTION: Call for (1) comments on the proposed structure for Healthy

People 2010 national health objectives for the year 2010 and (2)

proposed objectives.

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SUMMARY: The Department of Health and Human Services is soliciting

comments on the proposed structure for Healthy People 2010, the third

set of decade-long national health promotion and disease prevention

objectives. The Department is also soliciting proposed objectives for

2010. Guidance for comments is provided in the DHHS publication

Developing Objectives for 2010. During the fall of 1997, individuals

and organizations are encouraged to submit (1) comments on the proposed

framework envisioned for 2010 (see Appendix to this Notice) and/or (2)

objectives for 2010. In the fall of 1998, a draft document of Healthy

People 2010 objectives will be made available for public review and

comment.

DATES: The comment and submission period is September 15 through

December 15, 1997.

ADDRESSES: By mail, comments postmarked no later than December 15 can

be submitted to--Office of Disease Prevention and Health Promotion,

Attention: Healthy People 2010 Objectives, Department of Health and

Human Services, Room 738-G Hubert H. Humphrey Building, 200

Independence Avenue, SW., Washington, DC. 20201. Comments sent by

courier service will be accepted until 5 p.m. EST on December 15.

Comments may also be submitted electronically through the Healthy

People Home Page--http://web.health.gov/healthypeople.

FOR FURTHER INFORMATION CONTACT:

Office of Disease Prevention and Health Promotion, Room 738-G Hubert H.

Humphrey Building, 200 Independence Avenue, SW., Washington, DC 20201,

(202) 205-8583.

SUPPLEMENTARY INFORMATION:

Background

In 1979, the Department of Health and Human Services began an

initiative to use health promotion and disease prevention objectives to

improve the health of people living in the United States. The first set

of national health targets was published that year in Healthy People:

The Surgeon General's Report on Health Promotion and Disease

Prevention, which included five goals to be achieved by 1990 to reduce

mortality among four different age groups and increase independence

among older adults. The goals were supported by objectives that were

released in 1980, also with 1990 targets.

Healthy People 2000, the second and current national prevention

initiative, reflects the progress and experience of ten years, as well

as an expanded science base and surveillance system. With the

collaboration of an extensive network of voluntary and professional

organizations, businesses, and individuals, the framework of Healthy

People 2000 was designed with three broad goals--increasing the span of

healthy life, reducing health disparities, and achieving access to

clinical preventive services. To help meet these goals, 319 objectives

and 319 special population targets, organized into 22 priority areas,

aim to achieve improvements in health status, risk reduction, and

service delivery.

Structure of Healthy People 2010

The healthy People 2010 process will build on Healthy People 2000.

To ensure that the year 2010 goals and objectives address the needs of

their many stakeholders, your input is requested. ODPHP is soliciting

public assessment and comments on a preliminary framework (see Appendix

to this Notice), which was developed with the assistance of focus

groups composed of representatives from Healthy People 2000 Consortium

member organizations. This draft framework includes a vision statement

``Healthy People in Healthy Communities.'' Two overarching goals for

the Nation are proposed: (1) Increase years of healthy life, and (2)

eliminate health disparities. This first goal continues the year 2000

goal with an emphasis on increasing quality life years, not just life

expectancy. The second goal strengthens the Healthy People 2000 goal of

reducing health disparities by calling for the elimination of those

disparities. Four proposed enabling goals accompany the overarching

ones. Their purpose is to provide strategies to achieve the overarching

goals by: (Promoting healthy behaviors; (2) protecting health; (3)

assuring access to quality health care; and (4) strengthening community

prevention activities.

The proposed focus areas are analogous to, and for the most part

use the same names as, Healthy People 2000 priority areas. The term

``focus area'' was chosen to avoid any implication of prioritization.

New focus areas have been suggested in response to changes in health

care and public health during the last 10 years and those anticipated

over the next decade. These include mental and physical impairment and

disability, and public health infrastructure. Since one of the

overarching goals is to eliminate health disparities, specific special

population focus areas--low income, race/ethnicity, gender, age, and

people with disabilities--are under consideration to address this goal.

In each of these focus areas, special population objectives would

target the most significant

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disparities in health status, health risk, and service delivery.

Comments on the framework are invited to address (1) The proposed

framework in its entirety; (2) the proposed vision statement; (3) the

two proposed overarching goals; (4) the four proposed enabling goals;

(5) the proposed focus areas; (6) the proposed arrangement of focus

areas; or (7) entirely new proposals. For each heading addressed, the

commenter should consider the appropriateness and usefulness of the

proposed approach and/or offer alternative approaches. After the close

of the comment period, the framework will be reconsidered and recast on

the basis of comments received. A revised framework will be included in

the draft 2010 document and a notice calling for public comment on the

draft will be published in the Federal Register in the fall of 1998.

Objectives for Healthy People 2010

Objectives for Healthy People 2010 can be updated or modified

Healthy People 2000 objectives or entirely new ones submitted by

commenters. The proposed approach for Healthy People 2010 calls for two

broad types of objectives--measurable and developmental objectives.

Recommendations for both types will be accepted during the comment

period.

Measurable objectives provide direction for action. They have

baselines that use valid and reliable data derived from currently

established, nationally recognized data systems. These baseline data

provide the point from which a 2010 target can be set. Whenever

possible, objectives should be measured with national systems that

either build on, or are comparable with, state and local data systems.

However, state data are not a prerequisite for developing an objective.

Proxy data may be used when national data are not available or when

regional data provide better measurability. When providing an idea for

a measurable objective, please cite the data source. An example of a

measurable objective is ``Reduce the infant mortality rate by (XX)

percent to no more than (X) per 1,000 live births.'' The current

Healthy People 2000 baseline is 10.1 per 1,000 live births in 1987, as

recorded by National Vital Statistics System, the data source.

Developmental objectives describe a desired outcome or achieved

health status. However, current surveillance systems do not provide

data on these objectives. The purposes of developmental objectives is

to identify areas that are important and to stimulate the development

of data systems to measure them. An example of a developmental

objective is ``Increase to at least 90 percent the proportion of

pregnant women and infants who receive risk-appropriate care.''

Baseline data to measure such an objective are not currently available.

Proposals for 2010 objectives received by ODPHP will be assigned

for consideration to lead agencies of DHHS, which will select proposed

objectives for inclusion in the draft 2010 document. This draft will be

available for public review and comment from October to December 1998.

A listing of lead agencies is contained in the DHHS publication

Developing Objectives for Healthy People 2010. This publication is for

sale by the U.S. Government Printing Office, stock #017-001-00530-4;

the price is $18, which includes shipping and handling. All orders must

be prepaid. To order, call (202) 512-1800; FAX (202) 512-2250; or send

orders to--Superintendent of Documents P0 Box 371954, Pittsburgh, PA

15250-7954.

Information about the Healthy People initiative as well as many

publications relating to it are available electronically on the Healthy

People Home Pages--http://odphp.osophs.dhhs.gov/pubs/hp2000 and http://

web.health.gov/healthy people

Dated: August 29, 1997.

John M. Eisenberg,

Acting Assistant Secretary for Health.

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