Healthy People 2000 Consortium Meeting

November 7, 1997


Summary of Breakout Group Discussion Concerning
Adolescent Health


I. Special Populations

 The Adolescent Work Group members were supportive of the concept of setting health outcomes at the same level for all subpopulations. However, specific program goals might need to be different in order to most effectively reach different population groups. Two additional issues were raised: (1) If all targets are set at the same level, what would effect would this have on chapters on special populations? (2) Much of the disparity across groups is related to socioeconomic status. How should this be addressed in the HP 2010 objectives?

Because data collection is often driven by the objectives, there still should be a focus on collecting and reporting data specific to the different subpopulations in order to describe differences in health problems across these groups. If the data are consolidated, we will miss important differences across groups.

II. Healthy People 2010 Structure

 The Healthy People 2010 structure and the graphic used to depict this structure should be user friendly, i.e., simple and easily understood. Because the overarching goals are long-term, ongoing goals that will become constant aspects of improving the health of the Nation, they might be better described as foundational, underlying goals, In fact, they are depicted as such in the current graphic. In addition, the group suggested depicting special populations in a band the cuts across all focus areas. The group concurred with the concept of coordinating/collaborating across objectives that address HIV, STD, and unintended pregnancy.

III. Duplicate Objectives

 The work group agreed that there should not be duplicate objectives, but also felt that the concept of having only one focus area "home" was not clear. How will shared objectives be indicated?

The work group also agreed that there should be an attempt to limit the total number of objectives and that this limit should be reflected equally across all focus areas, which would enforce priority setting within each focus area. Limiting the number of objectives equally in each focus area and priority setting should be implemented early in this process.

IV. Measurable and Developmental Objectives

 The work group supported the concept of establishing both measurable and developmental objectives. Developmental objectives could provide a means to describe important issues and ideals for the Nation, even in the absence of existing means to measure progress toward meeting those objectives.

V. Healthy People 2010 Objectives

 General comments from the group concerned the age ranges addressed by the Child Health Work Group and the Adolescent Health Work Group. Why are there separate workgroups? What age ranges will be addressed by each group? Will there be an overlap between the groups and how will this overlap be handled?

The group felt that this work group should encompass objectives for adolescents and young adults, with subobjectives addressing age categories as follows:

Puberty is starting earlier, especially among girls, and initiation of sexual activity is occurring earlier among youth. In addition, drug use is starting at earlier ages than ever before. Including these younger age levels within this focus area is critical. This raises the question, then, of whether surveys that measure the initiation of risk behaviors should be administered to younger age groups, e.g., starting at age 10.

In addition, an analysis should be done to determine if the school health objectives should be included in this work group. Some school health objectives were included in the current breakdown of Healthy People 2000 adolescent objectives (e.g., education about alcohol and tobacco use prevention). Relevant school health objectives should be included in the other focus areas as well (e.g., Objectives 2.17, 2.19, 14.10)

The work group reviewed the list of Healthy People 2000 Objectives for Adolescents and Young Adults by priority area. The comments for each priority area are listed below:

A. Nutrition

Add an objective to address reducing eating disorders among youth.

B. Tobacco

An analysis should be done to assess whether an objective on tobacco cessation programs in schools should be included.

C. Substance Abuse: Alcohol and Other Drugs

Should Objective 4.6 (cocaine use) be split to address crack cocaine and other forms of cocaine with different subobjectives?

D. Family Planning

Should HP 2010 address reducing the number of abortions in the adolescent age group?

Objectives 5.8 and 5.10 should be operationalized more clearly so that these objectives can be measured with validity and reliability.

An objective on reducing the percent of youths who have sex before age 13 should be added.

E. Mental Health and Mental Disorders

Consider adding measures of: (1) adolescent quality of life; (2) clinical depression, (3) attention deficit disorder, and (4) perceptions of stress among youth?

F. Educational and Community-Based Programs

Consider adding an objective that address performance measures for the Education Goals for the year 2000.

Is Objective 8.5 being measured? If so, to what extent?

It is not clear why Objectives 8.10 and 8.13 were included in the adolescent health breakdown of HP 2000 objectives.

G. Occupational Safety and Health

Should there be an index of occupational injuries sustained by adolescents?

H. Environmental Health

Should there be a measure of asthma incidence and prevalence, or a measure of number of school days missed due to asthma? For example, reduce the number of school days missed due to asthma?

I. Cancer

Consider adding an objective on reducing exposure to UV rays.

J. Diabetes and Chronic Disabling Conditions

Because diabetes management and control is difficult in young people and may add to life expectancy, consider adding an objective to increase the proper control of diabetes among adolescents who have diabetes, including providing education in schools for students with diabetes and their family members.

K. Immunization and Infectious Diseases

A subobjective for Hepatitis B should be added to Objective 20.1.

L. Clinical Preventive Services

Consider adding objectives related to school health services for children and adolescents and to providing all adolescents access to primary and preventive health care services.

Participants

Lloyd Kolbe, Facilitator, Centers for Disease Control and Prevention
John Moore, Centers for Disease Control and Prevention
Anita Sturgeon, National Association of School Nurses



Breakout Session List