Download - Importance of Data: Connecting the Dots Between Healthy People 2020 and Affordable Care Act
Importance of Data: Importance of Data: Connecting the Dots Between Connecting the Dots Between
Healthy People 2020 and Healthy People 2020 and Affordable Care ActAffordable Care Act
USPHS Scientific & Training Symposium New Orleans, LA
June 21, 2011
CDR Samuel Wu, Pharm.D.Senior Public Health Advisor
Office of Special Health AffairsOffice of Health Equity
Objectives
• Describe what is Healthy People 2020
• Describe how data are the foundation in creating and supporting public health initiatives
• Describe how law is implemented through the process of review and feedback of various workgroups
Healthy People
What is Healthy People
• A national agenda that communicates a vision for improving health and achieving health equity
• A set of specific, measurable objectives with targets to be achieved over the decade
• Objectives are organized within distinct Topic Areas
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
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 226 312 467 > 580
Evolution of Healthy People
*39 Topic areas with objectives
Key Features of Healthy People
• Creates a comprehensive health promotion and disease strategic framework
• Tracks data-driven outcomes to monitor progress
• Engages a network of 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
State & 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+ organizations)
Federal Interagency Workgroup (28 federal agencies)
Federally Led, Stakeholder-Driven
Individuals, Families, & Neighborhoods across America
HHS Secretary’s Advisory Committee
Aligns Strategic Public HealthGoals and Efforts Across the Nation
Healthy People
Non-Aligned EffortRandom Acts of Innovation
Aligned EffortStrategic Goals
How Stakeholders Use Healthy People
• Data tool for measuring program performance
• Framework for program planning & development
• Goal setting and agenda building
• Teaching public health courses
• Benchmarks to compare national, state, and local data
• Way to develop nontraditional partnerships
Healthy People 2020
Healthy People 2020 Vision
A society in which all people live long, healthy lives
Healthy People 2020 Mission
• 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
Focus on Determinants of Health
A renewed focus on identifying, measuring, tracking, and reducing
health disparities through a determinants of health approach
Health Disparity
A particular type of health difference that is closely linked with social, economic, and/or environmental
disadvantage. Health disparities adversely affect groups of people who have systematically experienced greater
obstacles to health based on their racial or ethnic group; religion; socioeconomic status; gender; age;
mental health; cognitive, sensory, or physical disability; sexual orientation or gender identity; geographic
location; or other characteristics historically linked to discrimination or exclusion.
Healthy Equity
Attainment of the highest level of health for all people. Achieving health equity requires valuing everyone
equally with focused and ongoing societal efforts to address avoidable inequalities, historical and
contemporary injustices, and the elimination of health and health care disparities.
What’s New in Healthy People 2020
• New Topic Areas (13)• Focus on determinants of health• Web-based• Data linked to the Health Indicators Warehouse
Healthy People 2020 Topic Areas
1. Access to Health Services
2. Adolescent Health*
3. Arthritis, Osteoporosis, and Chronic Back Conditions
4. Blood Disorders and Blood Safety*
5. Cancer
6. Chronic Kidney Disease
7. Dementias, Including Alzheimer’s Disease*
8. Diabetes
9. Disability and Health
10. Early and Middle Childhood*
11. Educational and Community-Based Programs
12. Environmental Health
13. Family Planning
14. Food Safety
* New for 2020
Healthy People 2020 Topic Areas (continued)
15. Genomics*16. Global Health*17. Healthcare-Associated
Infections*18. Health Communication and
Health Information Technology
19. Health-Related Quality of Life*
20. Hearing and Other Sensory or Communication Disorders
21. Heart Disease and Stroke22. HIV23. Immunization and
Infectious Diseases24. Injury and Violence
Prevention25. Lesbian, Gay, Bisexual and
Transgender Health Issues*26. Maternal, Infant and Child
Health27. Medical Product Safety
* New for 2020
Healthy People 2020 Topic Areas (continued)
28. Mental Health and Mental Disorders
29. Nutrition and Weight Status
30. Occupational Safety and Health
31. Older Adults*
32. Oral Health
33. Physical Activity
34. Preparedness*
35. Public Health Infrastructure
36. Respiratory Diseases
37. Sexually Transmitted Diseases
38. Sleep Health*
39. Social Determinants of Health*
40. Substance Abuse
41. Tobacco Use
42. Vision
* New for 2020
New Topic Areas• Adolescent Health• Blood Disorders and
Blood Safety• Dementias, including
Alzheimer’s Disease• Early and Middle
Childhood• Genomics• Global Health• Healthcare-Associated
Infections
• Health-Related Quality of Life and Well-Being
• Lesbian, Gay, Bisexual, and Transgender Health
• Older Adults• Preparedness• Sleep Health• Social Determinants of
Health
About the Data…
Data Source
• A national census of events (like the National Vital Statistics System)
• Nationally representative sample surveys (like the National Health Interview Survey)
Data Collection Instruments
• Surveys• Federal
― National Health Interview Survey (NHIS)― National Health and Nutrition Examination Survey
(NHANES)― National Survey on Family and Growth (NSFG)
• State― Behavioral Risk Factor Surveillance System (BRFSS)― Youth Risk Behavior Surveillance System (YRBSS)― California Health Interview Survey (CHIS)
Affordable Care Act
Section 4302Understanding Health Disparities:
Data Collection and Analysis
Section 4302
• Calls for the Secretary to develop standards for uniform data collection on:― Race― Ethnicity― Sex― Primary language― Disability
• Empowers Secretary to require inclusion of additional demographic data on departmental surveys and health data collection activities
• To be implemented “not later than 2 years” after the enactment
4302 Implementation Process
• ACA Prevention Implementation Workgroup― Oversaw implementation of Section 4302
• ACA Prevention Implementation Section 4302 Subgroup― Charged with producing the recommendations
• HHS Data Council― Proposed recommended data standards under the
request of 4302 Subgroup• Section 4302 Standards Workgroup
― Led the task of developing standards
4302 Implementation Process (continued)
• Public listening sessions• LGBT Public Engagement Listening Session• Public Health/Academia Listening Session• Minority Stakeholders Listening Sessions
• IOM Report• Race, Ethnicity, and Language Data: Standardization for
Health Care Quality Improvement (2009)
4302 Recommendations Report
• Draft report with OASH for submission to the Secretary
• Public comment
• Review of comments and revision of standards
• Implementation agenda• Timeline• Funding considerations
Connecting the Dots
• Affordable Care Act’s Section 4302 provides an opportunity to collect granular data on all federal surveys
• These data can be used to support additional or new measurable objectives in Healthy People 2020
Data alone cannot reduce disparities, but it can serve as a foundation to our efforts to
understand the causes, design effective responses, and evaluate our progress.
Questions?
Acknowledgements
Office of Disease Prevention and Health PromotionOffice of Minority Health
CAPT Magda Barini-Garcia, MD, MPHCAPT Deborah Willis-Fillinger, MD
CDR Samuel [email protected]