phase ii: approval of recommendations to hhs & discussion of topic areas secretary’s advisory...

Phase II: Approval of Phase II: Approval of Recommendations to HHS & Recommendations to HHS &

Discussion of Topic AreasDiscussion of Topic Areas

Secretary’s Advisory Committee on Health Promotion and Disease Prevention Objectives for 2020

Committee Chair: Jonathan Fielding, MD, MPH, MA, MBA

Director, Los Angeles County Department of Public Health &Health Officer, Los Angeles County

Ad Hoc Group on Topic AreasAd Hoc Group on Topic Areas

Group Chair: Patrick Remington, MD, PhD

University of Wisconsin Population Health Institute

Evolution of Healthy People - 1Evolution of Healthy People - 11990 Health Objectives

Healthy People 2000

Healthy People 2010†

Healthy People 2020 (proposed)

VisionHealthy People in healthy communities

VisionHealthy people in healthy communities

VisionA society in which all people live long, health lives

Goals1.Reduce mortality among infants by 35%2.Reduce mortality among children aged 1 to 14 years by 20%3.Reduce mortality among adolescents, young adults (15 to 24) by 20%4.Reduce mortality among adults by 25%5.Increase independence and quality of life among older adults (65 and over), reducing days of restricted activity

Goals1.Increase the years of healthy life for Americans2.Reduce disparities in health among different population groups3.Achieve access to preventive health services for all Americans

Goals1.Increase the quality and years of healthy life2.Eliminate health disparities

Goals 1. Eliminate

preventable disease, disability, injury, and premature death

2. Achieve health equity and eliminate health disparities

3. Create social and physical environments that promote good health for all

4. Promote healthy development and healthy behaviors at every life stage

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Evolution of Healthy People - 2Evolution of Healthy People - 21990 Health Objectives

Healthy People 2000

Healthy People 2010†

Healthy People 2020 (proposed)

Categories 1.Preventive Services2.Health Protection3.Health Promotion

Enabling Goals 1.Preventive Services2.Health Protection3.Health Promotion4.Data and Surveillance

Enabling Goals 1.Promote healthy behaviors2.Protect health3.Assure access to quality health care4.Strengthen community prevention

MissionTo improve health

through policy and practice, Healthy People will:

1. Identify nationwide health improvement priorities;

2. Increase public awareness and understanding of the determinants of health, disease and disability, and the opportunities for progress;

3. Provide measurable objectives and goals that can be used at the national, state, and federal levels;

4. Identify critical research and data collection needs

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Evolution of Healthy People - 3Evolution of Healthy People - 31990 Health Objectives

Healthy People 2000

Healthy People 2010†

Healthy People 2020 (proposed)

15 “Priority Areas” (Preventive Services- 5 )1.H. blood pressure control(Etc.) (Health Protection-5)1.Toxic agent and radiation control(Etc.)

(Health Promotion-5)1.Smoking and health(Etc.)

22 “Priority Areas” 1.Cancer 2.Clinical Preventive services3.Diabetes and chronic disabling conditions4.Educational and community-based programsEtc.

28 “Focus Areas” 1.Access to quality health services*2.Arthritis, osteoporosis, and chronic back conditions3.Cancer4.Chronic kidney disease5.Diabetes6.Disability and secondary conditions

TBD

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Proposed Definitions for HP 2020Proposed Definitions for HP 2020

Vision: • A single, broad statement of what society will look like in 2020

Goal:• The broad result toward which effort is directed

Focus Area/ Topic Area: • Points of entry for the community into the healthy people

framework

Priorities:• Priorities are given attention before competing alternatives.

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Discussion of Topic AreasDiscussion of Topic Areas

Thoughts about recommendations for FIW• Shifting from HP 2010 topic areas to 2020• Mapping to determinants

Next steps• Drafting categories• Timeline for finalization and approval

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Update on HHS ActivitiesUpdate on HHS Activities

Rear Admiral Penelope Slade-Sawyer, PT, MSW

Director, Office of Disease Prevention and Health Promotion, U.S. Department of Health and Human Services

Current Healthy People 2020: Mission Statement

Vision Statement

A society in which all people live long, healthy lives.

Mission Statement

Healthy People 2020 strives to: 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 sectors 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

Current Healthy People 2020: Overarching Goals

Overarching Goals Attain high quality, longer lives free of preventable disease, disability, injury, and premature death. Achieve health equity, eliminate disparities, and improve the health of all groups. Create social and physical environments that promote good health for all. [Promote, attain, achieve, realize] quality of life, healthy development and healthy behaviors across all life stages.

Desired Outcomes for the MeetingDesired Outcomes for the Meeting

Recommendations on:• Immediate HHS Actions in support of the

Health Objectives• System Specifications for relational database

and User Interface

Proposed focus/topic area categories Finalized charges for subcommittees

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Ad Hoc Group on Immediate Ad Hoc Group on Immediate Phase II Recommendations for HHSPhase II Recommendations for HHS

Group Chair: Lisa Iezzoni, MD, MSc

Harvard Medical School

[Presented by Dr. Jonathan Fielding]

Recommendations for Immediate Recommendations for Immediate HHS Actions in Support of HPHHS Actions in Support of HP1. Maintain and build our nation’s ability to monitor population health

at the local, state, and national levels…

2. Design and start building an Internet-based public health information infrastructure…

3. Improve the evidence base for policies and programs that can…improve collective health and reduce health disparities.

4. Assess the health consequences of the economic downturn.

5. Determine manpower needed to assure a strong public health infrastructure and to implement evidence-based programs and policies at the national, state, and local levels.

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Subcommittee on Subcommittee on System SpecificationsSystem Specifications

Subcommittee Chair: Ronald Manderscheid, PhD

SRA International

Report on Outcomes of Subcommittee WorkReport on Outcomes of Subcommittee Work

Purpose of and approach to the report

Changes since the last version (January 7-8, 2009)

• User-centered design & process

Recommended next steps for the user interface

Issues to be resolved before report is sent to HHS

• Ready for final vote to approve?

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Charges of the Phase II SubcommitteesCharges of the Phase II Subcommittees

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Phase II Subcommittees Charges

Priorities (AK, DM) • How do we think about priorities at the national, state, and local level?

Topic Areas & Objectives (PR)

• Organize the list of HP 2010 objectives into homogenous categories. Add any that are missing.

Implementation (AT, EM) • Reflect on the range of potential users at the national, state, and community levels. What are their needs for tools, aids, and guidance for communities?

Evidence & Target-Setting (PR)

• Transparent process for target-setting that communities can use to set their own objectives.

• Evidence-based public health practices.

Data & IT Issues (RM) • Interface with NCHS to determine needs/ capabilities. • Issues related to working with partners for data.• Longer-term issues re: the role of Health IT.

Key Dates for Deliverables Key Dates for Deliverables

Topic Area categories: March, 2009

Target-setting Methodology: April, 2009

Final inclusion criteria for evidence-based resources: May, 2009

Implementation strategies: June-July, 2009

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Map of Committee/ Map of Committee/ Subcommittee Activity for Phase IISubcommittee Activity for Phase II

Committee Vice-Chair: Shiriki Kumanyika, PhD

University of Pennsylvania School of Medicine

Healthy People 2020 Mission: Healthy People 2020 Mission: To improve health through strengthening policy and practice, Healthy People will:•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 can be used at the national, state, and local levels;

•Engage multiple sectors to take actions that are driven by the best available evidence and knowledge;

•Identify critical research and data collection needs.

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““Categories” for HP 2020 ObjectivesCategories” for HP 2020 ObjectivesMission Statement Potential “Category”

Identify nationwide health improvement priorities;

Priorities

Increase public awareness and understanding of the determinants of health, disease, and disability and the opportunities for progress

Determinants

Provide measurable objectives and goals that can be used at the national, state, and local levels;

Standards and Tools

Engage multiple sectors to take actions that are driven by the best available evidence and knowledge;

Evidence and Knowledge

Identify critical research and data collection needs.

Data Sources

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Categories as Doorways into Categories as Doorways into ObjectivesObjectives

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“Priorities”Learn about National priorities, or set own priorities at the state or local level.

“Determinants”Obtain information about factors contributing to the disease/ issue of highest priority.

Categories as Doorways into Categories as Doorways into ObjectivesObjectives

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“Standards and Tools”Obtain standards or tools to set state or local objectives that are aligned with the national objectives.

“Evidence and Knowledge”Obtain information about evidence/ knowledge-based public health practices that can be used to achieve objectives of interest

Categories as Doorways into Categories as Doorways into ObjectivesObjectives

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“Data Sources”Link to credible federal, state, or local data sources for current data for tracking progress on priority issues.

Subcommittee Activities by CategorySubcommittee Activities by Category

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Potential “Category” Phase II Subcommittees

Priorities Priorities (AK, DM)

Determinants Topic Areas & Objectives (PR)

Standards and Tools Implementation (AT, EM)

Evidence and Knowledge Evidence & Target-Setting (PR)

Data Sources Data & IT Issues (RM)

Subcommittees’ Phase II Work overlaps and is not siloed.

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Linking Framework to Topic AreasLinking Framework to Topic Areas

Components of Action Model Key Elements

Determinants, broad Social, economic, cultural; environmental; health systems; living and working; social, family, & community

Individuals across the life course Individual status

Outcomes Behavioral; risk factors, diseases, conditions; injuries; well-being and QoL; health equity

Assessment, monitoring, evaluation, dissemination

Interventions Programs, policies and information

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Discussion and Next StepsDiscussion and Next Steps

Remaining work on topic areas Next steps for subcommittees Next Committee meeting dates

• Thursday, March 26: 12:00-2:00 PM (ET) • Monday, April 20th: 12:00- 2:00 PM (ET)• Friday, May 15th: 1:00 PM- 3:00 PM (ET)

Other issues

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