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 Wu301-443-8687swu@hrsa.gov