Making a Difference in Public Health: Healthy People and the Road Ahead

1. Making a Difference in Public Health: Healthy People and the Road Ahead Van S. Hubbard, M.D., Ph.D. Rear Admiral, U.S. Public Health Service and Wendy L. Johnson-Askew, Ph.D., MPH, RD NIH Division of Nutrition Research Coordination

2. Healthy People:What is it? A comprehensive set of national ten-year health objectives A framework for public health priorities and actions

3. Developing Healthy People 2020 Conduct Independent Assessment 10/05-1/07 Charter Advisory Cmte. Convene FIW 2020 Launch Phase I 2020 Launch Phase II 2005 2007/2008 2009 2010 Development of Framework: Vision, Mission, Overarching Goals Development of Objectives Public/Stakeholder Input Public/Stakeholder Input Public/Stakeholder Input Release of Final 2020 Objectives, with baselines, targets, and action steps

4. 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 Healthy People 2020 Phase I:Developing the Framework

5. 13-member panel Advises the Secretary on developing and implementing Healthy People goals and objectives Advises the Secretary about initiatives to occur during the initial implementation phase of the goals and objectives Phase I report submitted Oct. 2008 Recommendations on specific topics in 2009 Jonathan Fielding (chair) Shiriki Kumanyika (vice chair) W. Douglas Evans Vincent Felitti Everold Hosein Lisa Iezzoni Abby King Ronald Manderscheid David Meltzer Eva Moya Patrick Remington David Seigel Adewale Troutman Secretary’s Advisory Committee on National Health Promotion & Disease Prevention Objectives for 2020

6. Healthy People: Federal Collaboration Federal Interagency Workgroup Trans-federal membership 55 members, representing 24 HHS agencies/offices Expanded to include non-HHS Federal partners ED, EPA, DOI, DOJ, HUD, USDA, VA, DOT, and others to come

7. Healthy People 2020 – Phase I Development Milestones: Framework Vision Mission Overarching Goals

9. Draft 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. Phase II: Developing Healthy People 2020 Objectives • 2020 Planning Workgroups • Current Healthy People 2010 subject-area experts • Subject area experts leading new topics • Other Federal and/or non-federal stakeholders • Workgroup Activities • Examining Healthy People 2010 Objectives – retain or drop for 2020 • Determining what new objectives should be included for 2020 • Discussing relevant health determinants that impact the retained and new objectives • Suggest new topic areas • Evidence-based implementation strategies

11. Phase II: Developing Healthy People 2020 Objectives • Topic Areas • Accommodate the different types of objectives (e.g., risk factors, health determinants, diseases, etc.) • Facilitate an organizing and management structure • Objectives • Based on eight criteria developed by the FIW • Important and understandable to a broad audience • Prevention-oriented and achievable through various interventions • Drive action • Useful and reflect issues of national importance • Measurable and address a range of issues • Build on past iterations of Healthy People • Supported with best available scientific evidence • Address population disparities

12. Phase II: Developing Healthy People 2020 Objectives • Data Expectations • Each objective should have: • A valid, reliable, nationally-representative data source (or potential source identified) • Baseline data • Assurance of at least one additional data point throughout the decade • Targets • Each objective will have its own target • Target-setting policies on methods to be used are being discussed

13. Access to Health Services Adolescent Health Children’s Health Genomics Global Health Older Adults Healthcare Acquired Infections Quality of Life Social Determinants of Health Blood Disorders and Blood Safety Healthy Places Preparedness Healthy People 2020 – Phase IINew Topic Areas

14. Healthy People 2020 – Phase II: Objectives/Targets • Significant Issues: • Number of objectives • Data sources • Budget issues • Subpopulation data • Target setting methodology • Aspirational VS achievable targets • Dynamic vs. static processes to accommodate changing priorities

15. Healthy People 2020 Phase II: Tentative Timeline • Healthy People 2010 objectives online for public comment, March 2009 • Workgroups and FIW continue work on objectives throughout, Summer 2009 • Healthy People 2020 objectives online for public comment, Fall 2009 • Public meetings, Fall 2009 • Final set of objectives submitted for Departmental clearance early 2010 • Launch of Healthy People 2020 in 2010

16. New Thoughts about Old Objectives • 19-1 – Healthy Weight • 19-2 – BMI > 30 in adults • 19-3 – BMI > 95th percentile Increase in overweight and obesity prevalence is a result of an energy imbalance, thus modification to assess population energy balance is being considered

17. Thoughts concerning New Objectives • Reduced consumption of solid fats and added sugars • Modification of foods available in schools • Reduction of sodium content of foods • ? Development of policies • ? Upstream determinants

18. Healthy People 2020 Stay Informed Join the Healthy People listserve Check www.healthypeople.gov for updates Healthy People 2020 Regional Meetings Fall 2009

19. US Department of Health and Human ServicesOffice of the Surgeon General of theUnited States of America HHS Childhood Overweight and Obesity Prevention Council

20. HealthyYouth For a Healthy Future

23. A national education program targeting youth, ages 8-13, and their parents and caregivers in home and community settings to meet the overall goal of preventing overweight and obesity.

25. National Collaborative on Childhood Obesity Research (NCCOR) NIH/CDC/RWJF Obesity Collaboration

26. Background Increasing weight in U.S children requires action Effective action requires cooperation and coordination NIH, CDC & RWJF have a long history of collaboration Usually on a project-by-project or topic-by topic basis Believe that we can achieve more by working together Coordinate information, research and dissemination Increase the consistency of messages to the public Speed the research from discovery to implementation Allow for more rapid and responsive funding

27. Foundation:Lessons from Tobacco Control NIH/CDC/RWJF members of this 10+ year collaborative e.g., National Tobacco Cessation Collaborative & Youth Tobacco Cessation Collaborative Use as a model for an obesity collaborative Develop a shared vision and agenda Be action/solution-oriented Do not take on too much or have too a diffuse of an agenda Think carefully about who to involve to build confidence and trust Develop some products to demonstrate collaborative efficacy “De-brand” products so all the organizations share the credit Assign a neutral facilitator Develop subgroups examine particular areas so that participants can address their specific interest areas

28. Obesity Collaborative Goals* Build capacity for integrated research at multiple levels Enhance coordination and reduce redundancy Focus initiatives in the areas of greatest need Translation and dissemination of effective interventions Enhance effectiveness and extend capacity Accelerate the pace of obesity research Special emphasis on children, families and communities Focus on highest risk populations *See the handout for more details regarding the goals

29. Priority Areas • 1: Common measures and methods.  • 2: Evaluating and identifying effective interventions • 3:Rapid assessment of promising policies and environmental changes • 4: Faster applications to speed progress

30. For additional information • http://www.nccor.org/

31. Supplement to Annals of Behavioral Medicine: Anticipate August 09

32. Strategic Plan for NIH Obesity Research • Posted at www.obesityresearch.nih.gov

33. Funding Opportunities - Program Announcements that may interest ASTPHND members: • Community Participation in Research • Community Participation in Research Targeting the Medically Underserved • Behavioral and Social Sciences Research on Understanding and Reducing Health Disparities • Impact of Health Communication Strategies on Dietary Behavior

34. Questions?