Modifications to Objectives and Subobjectives

The following discussion highlights the modifications, including changes, additions, and deletions, to this focus area's objectives and subobjectives as a result of the midcourse review.

As stated in Healthy People 2010: "Most developmental objectives have a potential data source with a reasonable expectation of data points by the year 2004 to facilitate setting 2010 targets in the mid-decade review. Developmental objectives with no baseline at the midcourse will be dropped." Accordingly, at the midcourse review some developmental objectives and subobjectives were deleted due to lack of a data source. However, the U.S. Department of Health and Human Services (HHS) and the agencies that serve as the leads for the Healthy People 2010 initiative will consider ways to ensure these public health issues retain prominence despite their current lack of data.

Among the 10 vision objectives (28-1 through 28-10), only objective 28-4 was measurable at the beginning of the decade. The remaining nine objectives became measurable as data sources were identified. The 2002 National Health Interview Survey (NHIS) provided baseline data for seven of these objectives: dilated eye examinations (28-1), vision screening for children aged 5 years and under (28-2), impairment due to diabetic retinopathy (28-5), impairment due to glaucoma (28-6), impairment due to cataract (28-7), protective eyewear (28-9), and vision rehabilitation services and devices (28-10). Baseline data for impairment due to refractive errors (28-3) were obtained from the 1999–2000 National Health and Nutrition Examination Survey (NHANES). Baseline data sources for occupational eye injuries (28-8) were from the 2002 Annual Survey of Occupational Injuries and Illnesses¹ and the 1999 National Electronic Injury Surveillance System.² Objectives for occupational eye injuries (28-8) and protective eyewear (28-9) were divided into subobjectives to better reflect the data collected.

Of the eight hearing objectives (28-11 through 28-18), one was measurable at the beginning of the decade. Among the remaining seven, one—hearing evaluation and treatment referrals (28-15)—was deleted due to lack of a nationally representative data source, and six became measurable. Four objectives were divided into a total of 12 subobjectives to better reflect the data collected. These objectives included newborn hearing screening, evaluation, and intervention (28-11); hearing aids, assistive listening devices, and cochlear implants (28-13); hearing examination (28-14); and hearing protection (28-16).

Data sources changed for hearing protection (28-16) from NHIS to NHANES. NHIS was dropped for hearing examination (28-14) and noise-induced hearing loss in adults (28-18) because more appropriate data are anticipated from NHANES.

Four hearing objectives were reworded. The change for hearing aids, assistive listening devices, and cochlear implants (28-13) allows for measurement of the most common devices used for rehabilitation of deafness and moderate-to-severe hearing impairment. Hearing protection (28-16) will measure only hearing protection devices used in noisy environments. Revised text for noise-induced hearing loss in adolescents aged 12 to 19 years (28-17) and in adults aged 20 to 69 years (28-18) will measure noise-induced hearing loss that can be tracked over time.

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