Secretary's Council on Health Promotion and Disease Prevention Objectives for 2010

DR. BOUFFORD: Okay. Before we sort of open up the floor, let me go back and give you very brief highlights of where the Healthy People process has come over the last couple decades. I mentioned about the Consortium being much more extensive than initially, continuing to grow.

The Healthy People 2000 Steering Committee now does include all of the operating divisions across the Department and many of the staff divisions in the Secretary's office. There are still regular progress reviews chaired by the ASH, which are a vehicle not only to bring together leadership within the Department, but also in the private sector and State leadership. These cross-cutting initiatives and sessions have been very important. We have one on Hispanic Americans scheduled for next Tuesday, and 2 weeks ago had one on environmental health, and they are very lively. After each of these meetings, a sort of progress report and newsletter is published and disseminated to members of the Consortium.

We had an active midcourse review which looked at 5 years in on Healthy People 2000. I think a copy of that was provided in the material that you received. While building on a pretty strong foundation, I think one of the concerns for today is the sense that the Healthy People 2000 process is still largely in the domain of the public health professionals around the country, and we really want to look at the opportunities for broadening the awareness and broadening the use of Healthy People to really engage intersectorally, if you will, other parts of the government than the health sector, as well as both at the federal, State and local level, and also the private sector and community-based organizations.

Three of the sort of technical issues we will talk about, just to touch on them again--one is the scope of the initiative. This has largely been a prevention initiative. There are obviously questions as to whether Healthy People ought to move beyond prevention into quality measurement, into dealing with treatment objectives, or cost containment issues. These are sort of various pulls and tugs, so that's one of our substantive questions.

A second one is the structure, this issue of should we expand the goals, the numbers of goals and objectives, should they contract, should they be structured differently in the presentation.

A final issue, which is tied very importantly to the material that I think Ed Sondik is going to share with us later on data, is the issue of how we bring better attention to the disparities between groups in our population that suffer a greater burden of illness than the average population. We have set targets in the past, yet in a sense, if you will, we could be seen as accepting a gap rather than putting the same target down for all populations and then dealing with perhaps more energy and more of a targeted set of initiatives to address the gap. So this is one of the issues we need to discuss today.

Without much more delay, unless there's any particular questions, we would like to really open the session to the Assistant Secretaries for sort of giving us their reflections on Healthy People. I think it might also be interesting for each of them to just reflect on where this fit in their overall agenda when they were in the role, as well as sort of how they see it having evolved since that time. It seems proper to probably start with you, Dr. Richmond, if you don't mind.

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