1. The Road to Healthy People 2020
LT Stacey McBryde
Office of Disease Prevention and Health Promotion
Good morning. My name is LT Stacey McBryde, and I am a Public Health Advisor in the Office of Disease Prevention and Health Promotion (ODPHP). Our office oversees the development of Healthy People 2020, the Dietary Guidelines for Americans, and the Physical Activity Guidelines for Americans. Today’s presentation will highlight ODPHP as a nexus, joining a diverse array of federal and non-federal partners to develop Healthy People. I’ll share with you: 1) the history and background of Healthy People in general; 2) the development of HP2020; 3) what’s new with HP2020; 4) our new HP2020 website; 5) as well as different uses of HP and ways you can get and stay connected. 1

2. Healthy People Background and History
First, let’s review the background and history of Healthy People and the challenges of collaborating with multiple stakeholders.

3. Healthy People: Aligns Strategic Public Health Goals and Efforts Across the Nation
Aligned Effort
Non-Aligned Effort
Random Acts of Innovation
Healthy People
So what are we trying to accomplish? The ultimate outcomes of the initiative are healthier people, healthier communities, and a healthier Nation. There are a lot of public health efforts already going on in communities and across various sectors, and Healthy People serves as a structure or framework to help align them so that we are on the same page aiming for the same things.

4. History of Healthy People
1979—ASH/SG Julius Richmond establishes first national prevention agenda: Healthy People: Surgeon General’s Report on Health Promotion and Disease Prevention
HP 1990—Promoting Health/Preventing Disease: Objectives for the Nation
HP 2000—Healthy People 2000: National Health Promotion and Disease Prevention Objectives
HP 2010—Healthy People 2010: Objectives for Improving Health
Healthy People 2020 – Launched December 2010
For 3 decades, Healthy People has provided a comprehensive set of national 10-year objectives that have served as a framework for public health activities at all levels and across the public health community. Healthy People has evolved as the Nation’s public health priorities have changed. The most recent iteration, HP2020, just launched this past December. 4

5. Evolution of Healthy People
Target Year
1990
2000
2010
2020
Overarching Goals
Decrease mortality: infants–adults
Increase independence among older adults
Increase span of healthy life
Reduce health disparities
Achieve access to preventive services for all
Increase quality and years of healthy life
Eliminate health disparities
Attain high-quality, longer lives free of preventable disease
Achieve health equity; eliminate disparities
Create social and physical environments that promote good health
Promote quality of life, healthy development, healthy behaviors across life stages
# Topic Areas 15 22 28
42*
# Objectives/ Measures
226/NA
312/NA
467/1,000
>580/1200
* 39 With objectives
The number of objectives has increased with each decade. Healthy People 1990 set forth 226 objectives, Healthy People 2000 included 312 objectives, Healthy People 2010 identified 467 objectives with 1,000 measures, and Healthy People 2020 has nearly 600 objectives with 1,200 measures.

6. Key Features of Healthy People
Creates a comprehensive, strategic framework that unites health promotion and disease prevention issues under a single umbrella.
Requires tracking of data-driven outcomes to monitor progress and to motivate, guide, and focus action.
Engages a network of multidisciplinary, multisectoral stakeholders at all levels.
Guides national research, program planning, and policy efforts to promote health and prevent disease.
Establishes accountability requiring all PHS grants to demonstrate support of Healthy People objectives.
Key features of Healthy People include:
It’s a strategic framework for the Nation.
It requires tracking of data to hold us accountable.
It’s stakeholder driven.
It’s a tool for goal-setting for research, program planning and policy.
It establishes accountability for PHS grants. 6

7. Healthy People 2010 Accomplishments and Disappointments
I hoped to share with you today the HP2010 report, but NCHS (National Center for Health Statistics) has not finalized that report yet. It is due to be released this Fall.

8. Healthy People 2020 Development, Framework, Topic Areas, and Objectives
Moving on to the development of HP2020…

9. Federally Led, Stakeholder- Driven Process
HHS
ODPHP
Federal Interagency
Workgroup (28 Federal Agencies)
HHS Secretary’s Advisory Committee
State and Local Governments
(50 State Coordinators)
Community-Based Organizations, Community Health Clinics, Social Service Organizations, etc.
National-Level Stakeholders, Including Members of the Healthy People Consortium (2,200+ Volunteers)
Individuals, Families, and Neighborhoods Across America
Healthy People is led by the Department of Health and Human Services (HHS), with an Advisory Committee (of non-federal subject matter experts from around the country) providing input to the Secretary of HHS. It has been used as strategic management tool by the Federal Government, States, communities, and many other stakeholders. These stakeholders have a direct influence on and provide ongoing input to the Healthy People development and implementation process. So you can see that it is a very inclusive process with stakeholders across the board.

10. Stakeholder Input
Secretary’s Advisory Committee on National Health Promotion and Disease Prevention Objectives for 2020
Public Meetings
Public Comment
Web Site
Healthy People
Consortium
Federal Interagency
Workgroup (FIW)
In addition to the Advisory Committee, public input was sought during a series of nine regional meetings that were held across the country in 2008 and Throughout the development process, input was solicited through formal public comment periods.
Within the Federal government, the Federal Interagency Workgroup (FIW) was charged with drafting the initial framework and objectives. This workgroup includes representatives from across HHS, as well as from other Federal agencies, and still meets monthly on HP issues.

11. This graphic visually depicts the ecological and determinants approach that Healthy People 2020 takes in framing the national health objectives. The concept of determinants describes how the conditions in which we live and work, such our physical and social environments and access to health services, as well as our individual behavior and biology, can have an enormous impact on our health.
The graphic framework attempts to illustrate the fundamental degree of overlap among the determinants of health, as well as emphasize their collective impact and influence on health outcomes and conditions. The framework also underscores a continued focus on population disparities, including those categorized by race/ethnicity, socioeconomic status, gender, age, disability status, sexual orientation, and geographic location.

12. Involving Non-Health Sectors To Address Determinants of Health
Healthy People 2020 will emphasize involving sectors outside health, including:
Education
Housing
Environment
Transportation
Labor
Agriculture
This new emphasis is based on research conducted about Healthy People with various stakeholders from education, housing, environment, transportation, labor and agriculture.

13. Healthy People 2020 Topic Areas
Access to Health Services
Arthritis, Osteoporosis, and Chronic Back Conditions
Cancer
Chronic Kidney Disease
Diabetes
Disability and Health
Educational and Community- Based Programs
Environmental Health
Family Planning
Food Safety
Nutrition and Weight Status
Occupational Safety and Health
Oral Health
Physical Activity
Public Health Infrastructure
HIV
Immunization and Infectious Diseases
Injury and Violence Prevention
Maternal, Infant, and Child Health
Medical Product Safety
Mental Health and Mental Disorders
Health Communication and Health Information Technology
Hearing and Other Sensory or Communication Disorders
Heart Disease and Stroke
Respiratory Diseases
Sexually Transmitted Diseases
Substance Abuse
Tobacco Use
Vision
Here is a list of the 42 topic areas in HP2020.

14. New Healthy People 2020 Topic Areas
Life Stages
Adolescent Health
Early and Middle Childhood
Older Adults
Blood Disorders and Blood Safety
Dementias, including Alzheimer’s Disease
Genomics
Global Health
Healthcare-Associated Infections
Preparedness
Sleep Health
In Development
Lesbian, Gay, Bisexual, and Transgender Health
Health-Related Quality of Life and Well-being
Social Determinants of Health
Topics new in 2020 include Adolescent Health, Early & Middle Childhood, Older Adults… (read list from slide)
Three new topics areas are in development – meaning they do not yet have objectives. Subject-matter-expert workgroups are in process of developing those currently.

15. Sample Objective: Cancer
Objective C–1: Reduce the overall cancer death rate.
Target: deaths per 100,000 population.
Baseline: cancer deaths per 100,000 population occurred in 2007 (age adjusted to the year standard population).
Target Setting Method: 10 percent improvement.
Data Source: National Vital Statistics System (NVSS), CDC, NCHS.
Let’s look at just one of the many objectives within Healthy People “C-1” represents the first objective of the Cancer Topic Area for Healthy People It includes the target to be achieved over the decade, the baseline data, the target setting method (one of several standard methods), and a nationally-represented data source.
Each of the 1200 measures within HP2020 has similar information.

16. Healthy People Web Site Overview
Instead of the phone-book-sized bound copies of Healthy People from the past, we have a “living” document housed on the web at HealthyPeople.gov. We’re very proud of this new website…

17. Redesigned Web Site: www.healthypeople.gov
The Healthy People website was completely redesigned and then launched on December 2, 2010, in conjunction with the HP2020 Launch event. This shows you the homepage.

18. “About Healthy People” Stakeholder Video
The introduction to this section of the Web site, the “About” section, contains a brief video featuring Assistant Secretary of Health Dr. Howard Koh (cue animation), as well as Healthy People stakeholders discussing what Healthy People means to them.

19. Health Disparities Data
Going back to the homepage, a new interactive feature on the site is the Health Disparities tool. (cue animation) The user selects a race/ethnicity, age range, and gender from the menu and clicks “Get Your Results”.
I have selected “Hispanic, years, Female” for this example.

20. Leading Causes of Death
The results are displayed as the 10 leading causes of death from CDC for that particular population group (cue animation 1).
This tool has two intended purposes: 1) to help public health professionals home in on health issues they may wish to address that are impacting a population with whom they work, and 2) to help users explore related Healthy People topic areas.

21. Topic Area A-Z Listing
Here you can see the Index page for all the Healthy People 2020 topic areas. Like I stated earlier, three new topic areas were added for 2020 that focus on life stages (cue animation 1), as well as one on the social determinants of health (cue animation 2).

22. Implementation Strategies
Now let’s review some of the implementation tools in HealthyPeople.gov..

23. Topic Area-Specific Interventions & Resources
For each topic area, evidence-based interventions and recommendations have been provided from the US Preventive Services Task Force Clinical Guide, CDC Community Guide, and healthfinder Quick Guide for Healthy Living, when available (cue animation).

24. Implementing Healthy People
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.

25. Implementing Healthy People
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.

26. How Stakeholders Are Using Healthy People
Data tool for measuring program performance
Framework for program planning and development
Goal setting and agenda building
Teaching public health courses
Benchmarks to compare State and local data
Way to develop nontraditional partnerships
National Opinion Research Center (NORC) has conducted two Users Studies for ODPHP -- one in 2005 and another in 2008.  We know that most stakeholders use HP for goal setting and benchmarking.  Others use it as a data tool.  More and more we are seeing HP 2020 being used as a teaching tool. We are shooting for meaningful use which involves building programs around HP objectives and using the objectives as performance measures.  In order to do this the right way, partnerships are key. HP can bring in your non-traditional partners. 

27. Get Involved!
Now here’s how you can get involved.

28. Ways To Connect With Healthy People
Spread the word about 2020 objectives.
Follow Healthy People on
Connect with Healthy People on LinkedIn.
Join the Healthy People Consortium.
Join the Healthy People listserv.
You can help us spread the work about the HP2020 objectives.
You can follow us on Twitter and LinkedIn.
You can join the Consortium and the listserv.
Or you can always us.

29. Twitter: @GoHealthyPeople
The HP2020 Twitter page has been very popular. Last October, ODPHP celebrated Health Literacy Month with a live twitter chat. The event was a success and the participants wanted to continue the discussion afterwards. They were directed to the HP2020 LinkedIn Group for more discussion in a format that allows for more in-depth interaction.  This offers an interesting example of how to cross-promote within and between different social media platforms, and how they can complement rather than compete with each other. As a result of the continued interest in health literacy, there are now monthly #healthlit chats sponsored by Health Literacy Missouri that cover an array of subjects, with one recent chat covering the Affordable Care Act.
As of my last has 4,258 followers. 29 29

30. Healthy People on LinkedIn
Speaking of LinkedIn… Our office wanted the engaged Healthy People community to become our ambassadors after HP2020 was launched last December. It was a priority to connect with those aware of and involved in HP2020 while expanding into the non-health sector professional arena (such as those working in education, housing and non-profit). Our research found that most people use Facebook for personal interests and interactions with family and friends. But we wanted a platform that tailored to individuals’ professional lives and fostered a professional online community - thus, we chose LinkedIn.
As of my last check, the Healthy People group on LinkedIn has _1,171_ members. (That’s me. I help moderate the group.) This is a very active group that shares insights and strategies – lots of good information, so I encourage you to join if Healthy People interests you. 30 30

31. Join the Consortium
The Healthy People Consortium & Partners section provides a toolkit, including a customizable PowerPoint presentation, and a list of the Healthy People State Coordinators and Consortium Organizations (cue animation 1).
There is also a page to “Stay Connected” with Healthy People by signing up for updates about upcoming webinars and events (cue animation 2).

32. Updates .
And here is the Stay Connected page where you can join the Healthy People listserv. 32 32

33. Healthy People on YouTube
Here is the Healthy People YouTube page.

34. Healthy People 2020: Looking Ahead
Web-based interactive resource to expand reach and usability (
Dynamic system to accommodate changing health needs and priorities.
“Health in All Policies” approach.
Launch of Leading Health Indicators for Healthy People 2020.
2012 National Prevention Summit.
Here are some things coming in the near future:
More resources will be added to the website.
Since HP2020 is web-based, we can adjust throughout the decade as needed (like if we find that a specific target needs to be re-addressed).
Look for HP2020 being referenced in other policies.
Leading Health Indicators should launch in late (The LHI’s are a smaller set of HP2020 high priority indicators that summarize the health of the population.)
And the National Prevention Summit is scheduled for April 2012, and will focus on implementation strategies.

35. Thank you! LT Stacey McBryde Public Health Advisor
Office of Disease Prevention and Health Promotion
1101 Wootton Pkwy, LL-100
Rockville, MD 20852
I thank you for your time this morning. I will open it up for questions during any remaining time we have together.