1. Phase II: Approval of Recommendations to HHS & Discussion 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

2. Ad Hoc Group on Topic Areas
Group Chair: Patrick Remington, MD, PhD
University of Wisconsin Population Health Institute

3. Evolution of Healthy People - 1
1990 Health Objectives
Healthy People 2000
Healthy People 2010†
Healthy People 2020 (proposed)
Vision
Healthy People in healthy communities
Healthy people in healthy communities
A society in which all people live long, health lives
Goals
Reduce mortality among infants by 35%
Reduce mortality among children aged 1 to 14 years by 20%
Reduce mortality among adolescents, young adults (15 to 24) by 20%
Reduce mortality among adults by 25%
Increase independence and quality of life among older adults (65 and over), reducing days of restricted activity
Increase the years of healthy life for Americans
Reduce disparities in health among different population groups
Achieve access to preventive health services for all Americans
Increase the quality and years of healthy life
Eliminate health disparities
Eliminate preventable disease, disability, injury, and premature death
Achieve health equity and eliminate health disparities
Create social and physical environments that promote good health for all
Promote healthy development and healthy behaviors at every life stage

4. Evolution of Healthy People - 2
1990 Health Objectives
Healthy People 2000
Healthy People 2010†
Healthy People 2020 (proposed)
Categories
Preventive Services
Health Protection
Health Promotion
Enabling Goals
Data and Surveillance
Promote healthy behaviors
Protect health
Assure access to quality health care
Strengthen community prevention
Mission
To 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

5. Evolution of Healthy People - 3
1990 Health Objectives
Healthy People 2000
Healthy People 2010†
Healthy People 2020 (proposed)
15 “Priority Areas”
(Preventive Services- 5 )
H. blood pressure control
(Etc.)
(Health Protection-5)
Toxic agent and radiation control
(Health Promotion-5)
Smoking and health
22 “Priority Areas”
Cancer
Clinical Preventive services
Diabetes and chronic disabling conditions
Educational and community-based programs
Etc.
28 “Focus Areas”
Access to quality health services*
Arthritis, osteoporosis, and chronic back conditions
Chronic kidney disease
Diabetes
Disability and secondary conditions
TBD

6. Proposed 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.

7. Discussion 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

8. Update 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

9. 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

10. Current Healthy People 2020: 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.

11. Desired 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

12. Ad Hoc Group on Immediate Phase II Recommendations for HHS
Group Chair: Lisa Iezzoni, MD, MSc
Harvard Medical School
[Presented by Dr. Jonathan Fielding]

13. Recommendations for Immediate HHS Actions in Support of HP
Maintain and build our nation’s ability to monitor population health at the local, state, and national levels…
Design and start building an Internet-based public health information infrastructure…
Improve the evidence base for policies and programs that can…improve collective health and reduce health disparities.
Assess the health consequences of the economic downturn.
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.

14. Subcommittee on System Specifications
Subcommittee Chair: Ronald Manderscheid, PhD
SRA International

15. Report 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?

16. Charges of the Phase II Subcommittees
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.

17. 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

18. Map of Committee/ Subcommittee Activity for Phase II
Committee Vice-Chair: Shiriki Kumanyika, PhD
University of Pennsylvania School of Medicine

19. 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.

20. “Categories” for HP 2020 Objectives
Mission 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

21. Categories as Doorways into Objectives
“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.

22. Categories as Doorways into Objectives
“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

23. Categories as Doorways into Objectives
“Data Sources”
Link to credible federal, state, or local data sources for current data for tracking progress on priority issues.

24. Subcommittee Activities by Category
Subcommittees’ Phase II Work overlaps and is not siloed.
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)

26. Linking 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

27. Discussion 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