desired outcomes for the meeting
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Phase II: Phase II: Update on Phase II Contributions of the Committee & Update on Phase II Contributions of the Committee &
Focus of Activities in Months to ComeFocus of Activities in Months to Come
Secretary’s Advisory Committee on National Health Promotion & 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
April 1, 2010
Desired Outcomes for the MeetingDesired Outcomes for the Meeting
Discuss the connection between HP2020 and health reform Review Phase II progress of the Advisory Committee Obtain feedback and an update from HHS Discuss and vote on recent products of Subcommittee work Hear a summary of the Healthy People 2010 User Study Discuss the Committee’s work for the coming months.
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Opportunities for Innovation: Opportunities for Innovation: Health Promotion & Disease PreventionHealth Promotion & Disease Prevention
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CER Research
Healthy People 2020
Community Health
Data Initiative
ARRA CPPW
Health
Reform
Health Reform: Some Key ComponentsHealth Reform: Some Key Components• Establishment of key national indicators• National Prevention, Health Promotion and Public Health Council
— Within HHS, chaired by the Surgeon General — Members will include Secretaries of HHS, Agriculture, Education, Transportation,
Housing, Director of Domestic Policy Council, Administrator of EPA, and others.
• Advisory Group on Prevention, Health Promotion, and Integrative and Public Health (Advisory group to the Council)— Within HHS, reports to the Surgeon General— No more than 25 non-federal members, to be appointed by the President — Responsible for developing the policy and plans for Council to consider;
• National Prevention and Health Promotion Strategy — Due one year from date of enactment (March 23, 2011) — Developed by the Advisory Group Chairperson, in consultation with the Council— Set goals and objectives for improving the health of the U.S.— Report on Progress would be due on July 1, 2010, and annually thereafter through
January 15, 2015.
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Health Reform…Health Reform… Council’s Report will include :
• List of national priorities on health promotion & disease prevention to address lifestyle behavior modification
• Strategies to achieve Healthy People goals for nutrition, exercise and smoking cessation and 5 leading-disease killers in the U.S.;
• Specific science-based initiatives to achieve the aforementioned measurable goals of Healthy People 2010;
• Specific plans to consolidate Federal health programs & Centers to promote healthy behavior and reduce risk (eliminating those ineffective in meeting priority goals of Healthy People 2010;
• Specific plans to ensure that all public health programs are based on science-based guidelines developed by the CDC;
Periodic Reviews (not less than every 5 years) of federal disease prevention and health promotion programs
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ARRA- ARRA- Communities Putting Prevention to WorkCommunities Putting Prevention to Work
Initiative Funding Level
Community Initiative•Grants to communities•Community and Evaluation Support
$450 M
States and Territories Policy & Env. Change Initiative•Statewide Policy & Environmental Change•Competitive Special Policy & Environmental Change•Tobacco Cessation through Quitlines
$119M
States Chronic Disease Self-Management Initiative $27 M
National Prevention & Media Initiative•National Organization Initiative•National Media Initiative
$40 M
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Community Health Data InitiativeCommunity Health Data Initiativehttp://www.cdc.gov/nchs/data_access/chdi.htmhttp://www.cdc.gov/nchs/data_access/chdi.htm
Collaborative of government & non-government partners Establishes “a network of suppliers and demanders of community
health data, indicators, and interventions.” Purpose is to help Americans understand health and health care
system performance in their communities. Sample Indicator Reports and Initiatives:
• America’s Children: Key Indicators of Well-being, 2009
• Chronic Disease Indicators
• Health, United States, 2009
• Healthy People
• Older Americans 2008
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Committee Recommendations Submitted Committee Recommendations Submitted During Phase IIDuring Phase II
Document Titles and Type Date Submitted
Immediate Actions in Support of Objectives to Improve the Health of the American People [Recommendations to Secretary]
March 2, 2009
System Specifications of Healthy People 2020 Online Version [Recommendations to Secretary]
May 14, 2009
Proposed List of Topic Area Categories[Recommendations to Secretary]
May 15, 2009
Approach to Developing HP2020 Target-Setting Methods[Report to Secretary]
May 23, 2009
Recommendations Underscoring the Need for a Web-based Format for HP2020 [Recommendations to Secretary]
February 17, 2010
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Outstanding Items Outstanding Items Discussed, but not formally approved by Committee voteDiscussed, but not formally approved by Committee vote
Document Titles and Type Date of Last Draft
Recommendations for Implementing Healthy People 2020 [Draft Recommendations to Secretary]
September 3, 2009
Evaluating Sources of Knowledge for Evidence-based Actions in Public Health [Draft Report to Secretary]
September 3, 2009
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Healthy People 2020 UpdateHealthy People 2020 Update
RADM Penelope Slade-SawyerOffice of Disease Prevention and Health Promotion
US Department of Health and Human Services
Secretary’s Advisory CommitteeApril 1, 2010
Update on HHS ActivitiesUpdate on HHS Activities
HHS Response to Committee Recommendations
FIW Progress and Activities Status of the Healthy People 2020
Objectives
Proposed HP 2020 Topic AreasProposed HP 2020 Topic Areas
Access to Health Services
Adolescent Health
Arthritis, Osteoporosis, and Chronic Back Conditions
Blood Disorders and Blood Safety
Cancer
Chronic Kidney Diseases
Dementias, Including Alzheimer’s Disease
Diabetes
Disability and Health
Proposed HP 2020 Topic AreasProposed HP 2020 Topic Areas
Early and Middle Childhood
Educational and Community-Based Programs
Environmental Health
Family Planning
Food Safety
Genomics
Global Health
Health Communication and Health IT
Healthcare-Associated Infections
Proposed HP 2020 Topic AreasProposed HP 2020 Topic Areas Hearing and Other Sensory or Communication Disorders (Ear,
Nose, Throat - Voice, Speech, and Language)
Heart Disease and Stroke
HIV
Immunization and Infectious Diseases
Injury and Violence Prevention
Maternal, Infant and Child Health
Medical Product Safety
Mental Health and Mental Disorders
Nutrition and Weight Status
Proposed HP 2020 Topic AreasProposed HP 2020 Topic Areas Occupational Safety and Health Older Adults Oral Health Preparedness Public Health Infrastructure Physical Activity and Fitness Public Health Infrastructure Quality of Life and Well Being
Proposed HP 2020 Topic AreasProposed HP 2020 Topic Areas
Respiratory Diseases
Sexually Transmitted Diseases
Social Determinants of Health
Substance Abuse
Tobacco Use
Vision
Update on HHS ActivitiesUpdate on HHS Activities
Update on the Launch & Timeline Plans for 2012 National Meeting Guidance to FACA for the Coming Months
Updates on Subcommittee ActivitiesUpdates on Subcommittee Activitiesand Voting on Recommendationsand Voting on Recommendations
Jonathan Fielding, Committee Chair
Status of SubcommitteesStatus of SubcommitteesSubcommittee Meetings to-date
Social Determinants (ad hoc) 10/20; 2/4
Strategic Communications 10/22; 11/3; 1/22; 2/18; 3/16
Priorities 10/30; 2/8; 3/12
Action Steps and Evidence (ad hoc) 2/26; 3/31
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Draft Recommendations to be Draft Recommendations to be Finalized and Approved TodayFinalized and Approved Today
Draft Recommendations Documents
How HHS can shape Healthy People to prompt action on social and environmental determinants of health
Recommendations for priority-setting
Recommendations on Data & IT [from Strategic Communication Subcommittee]
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Ad Hoc Group on Ad Hoc Group on Social Determinants of HealthSocial Determinants of Health
Abby King, PhDAd Hoc Group Chair
Stanford University
Recent Activities of Ad Hoc Group on Social Determinants of Health Met twice (October 2009, February 2010) to
discuss concrete examples that HHS could use to work across topic areas.• The Subcommittee could provide more specific
suggestions directly to the FIW if needed.• Guidance could be developed on how the FIW can
incorporate social determinants of health into implementation strategies for HP2020.
Ad Hoc Group on Social Determinants:Recommendation #1 Encourage and support the FIW’s role in:
• Operationalizing the cross-cutting elements of HP2020 that pertain to physical and social environments and extend beyond the health field.
• Making it a priority to focus on social determinants that will impact multiple determinants of health.
Ad Hoc Group on Social Determinants:Specific Steps to Prompt Action on SDOH
Identify and disseminate planning models that have been adapted to focus on social determinants. • Specify concrete sets of steps for promoting local, state, and
national policies to address social and environmental
determinants of health and eliminate or mitigate determinants
that harm health.
Incorporate planning models from other relevant fields (e.g., public health, education, transportation, housing, law enforcement, etc.) and both the public and private sectors.
Ad Hoc Group on Social Determinants:Recommendation #2 Identify and select specific measures that can be
used to track processes and impacts related to initiatives to influence social determinants.
Such tools should be applicable to both:
• The population at-large, and • Subpopulations that experience health disparities.
Ad Hoc Group on Social Determinants:Recommendation #3 Provide:
• Practical and useful information collection tools related to these identified measures, where available;
• Examples of ways to synthesize the relevant data.
Ad Hoc Group on Social Determinants:Recommendation #4 Wherever possible, give specific examples for
topic areas that demonstrate how programs and policies to affect SDOH can be implemented.
Ad Hoc Group on Social Determinants:Recommendation #5 Evaluate recommendations and activities being
undertaken by other nations in the social and environmental determinants arena.
Next StepsNext Steps
Amendments to recommendations? Vote to approve?
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Subcommittee on PrioritiesSubcommittee on Priorities
David Meltzer, MD, PhDSubcommittee Co-Chair
University of Chicago
Abby King, PhDSubcommittee Co-Chair
Stanford University
Recent Activity, Subcommittee on PrioritiesRecent Activity, Subcommittee on Priorities
Met three times between October and March.
Determined that, given the sheer number of objectives, it is necessary to give users tools to prioritize among them.
• There is an opportunity cost when one does not make choices.
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Recent Activity, Subcommittee on PrioritiesRecent Activity, Subcommittee on Priorities
The Subcommittee has proposed a multi-level approach to priority-setting, based on the following ideas:
• Public health priorities should be set by localities, states, and at the national level;
• Processes used to set priorities should engage civic participation;
• HHS should identify national priorities for the coming decade.
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Proposed Approach to Priority-SettingProposed Approach to Priority-Setting
Priority-setting should be conducted for:
1. Interventions to address specific topic areas (e.g., “Cancer” or “Early and Middle Childhood”);
2. Interventions to address the major risk and protective factors for common diseases;
3. Interventions that address determinants of health outside the traditional health sector.
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Recommendations of the SubcommitteeRecommendations of the Subcommittee
1. Priorities should be set at each level of government—federal, state, and local.
2. Each level should incorporate public input into its priority-setting processes.
3. Priority-setting should be informed by specific criteria (e.g., overall burden, preventability, potential to reduce health disparities, and cost-effectiveness).
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Next StepsNext Steps
Amendments to recommendations? Vote to approve?
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Subcommittee on Strategic Subcommittee on Strategic CommunicationsCommunications
W. Douglas Evans, PhD Subcommittee Chair
George Washington University
Strategic Communications
Five meetings since October Ron Mandersheid, Eva Moya, and Doug
Evans attended from the committee Worked on developing strategic
communication objectives and strategies Started from previous audience matrix Input from ongoing ODPHP/HHS activities
and research
HHS activities and research
Linda Harris presented Healthfinder.gov Reaches health professionals and general
public, includes Twitter account Synthesizes evidence into actionable
information for multiple audiences Offers opportunity for HP2020 communication
research• Who uses it? For what? What is social media
contribution? Does use lead to behavior change?
Other activities
Big ODPHP partnership component Partnerships can be leveraged to build HP2020
awareness and utilization ODPHP audience research Recommendations for Health IT and strategic
communications• Develop HHS plan for public health IT infrastructure• Should include plans for HP2020 strategic
communications capabilities
Example of expanded audience matrix elementsAudience type
User group
What should they know?
Comm Objectives
Channels
Primary audiences
Federal agencies
Uses of HP for planning, program management, development, evaluation
Increase awareness of health in all policies as priority
Get HP 2020 on domestic policy council
agenda
Secondary audiences
General public
How HP can offer guidance for personal
decisions
Develop HP 2020 brand position and promise that shows “What I can do”
Develop network of HP 2020 advocates in communities
Next StepsNext Steps
Amendments to recommendations? Vote to approve?
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Subcommittee on Subcommittee on Action Steps and Evidence Action Steps and Evidence
Jonathan Fielding, MD, MPH, MA, MBA Subcommittee Co-Chair
Los Angeles County Department of Public Health
Steven Teutsch, MD, MPHSubcommittee Co-Chair
Los Angeles County Department of Public Health
Subcommittee on ASE: Charge Subcommittee on ASE: Charge
How can HHS best show HP 2020 stakeholders how to use the exhaustive list of objectives?
How can HHS maximize its adoption and use? What processes can HHS use to ensure that
action steps included in HP 2020 are grounded in solid scientific evidence?
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Subcommittee on ASE: Members Subcommittee on ASE: Members
Martin Fenstersheib, Santa Clara County David Fleming, Seattle King County George Isham, HealthPartners, Inc. Lynn Silver, New York City
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Healthy People 2010 User StudyHealthy People 2010 User Study
[Alternate slide set]
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Summary and Next StepsSummary and Next Steps
Subcommittee charges Future meeting dates and plans
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