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 because they lacked 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.

Outdoor air quality. The developmental subobjective within alternative modes of transportation—proportion of population telecommuting (8-2d)—became measurable with the availability of baseline data through the U.S. Department of Transportation National Household Travel Survey.

Water quality. With baseline data now available through the EPA Office of Water, the objectives regarding surface water safe for fishing and recreation (8-8), beaches open and safe for swimming (8-9), and fish contamination (8-10) became measurable. Objectives related to surface water safe for fishing and recreation (8-8) and fish contamination (8-10) were divided into subobjectives to monitor the quality of rivers and streams separately from lakes, ponds, and reservoirs. The beaches open and safe for swimming objective (8-9) was modified to "increase the proportion of days that beaches are open and safe for swimming." The revised language made the objective consistent with the EPA Office of Water data source.

Toxics and waste. The toxic pollutants reduction objective (8-14) remained developmental at the midcourse. For compatibility with EPA monitoring,¹ the objective was divided into two subobjectives to monitor separately the "Green Index" (reductions in toxics release inventory [TRI] chemicals in production-related wastes) generated by the business sector per unit of production) and the "Clean Index" (reductions in TRI chemical releases to the environment). Data to measure progress toward this objective are anticipated by the end of the decade.²

Healthy homes and healthy communities. The units of measurement for monitoring reductions in indoor German cockroach allergens (8-16c) and substandard housing (8-23) were revised for consistency with the data sources. Availability of additional data for indoor allergens (8-16) will depend on whether a second National Survey of Lead and Allergens in Housing is conducted by the National Institutes of Health (NIH). Baseline data for monitoring school policies to protect students and staff from environmental hazards (8-20) were obtained from the 2000 School Health Policies and Programs Study,³ and objective 8-20 became measurable. Baseline data for monitoring State disaster preparedness plans and protocols (8-21) were obtained from the Centers for Disease Control and Prevention's (CDC's) Division of State and Local Preparedness, and this objective became measurable.

Infrastructure and surveillance. The subobjective to reduce 1-naphthol (carbaryl) (8-24a) was deleted because the chemical measured is not an indicator for carbaryl exposure. Within States monitoring environmentally related diseases (8-27), subobjectives for skin cancer (8-27l), malignant melanoma (8-27m), and other skin cancer (8-27n) were deleted because they are monitored by the Healthy People 2010 cancer objectives (Focus Area 3). The objective related to local agencies' use of surveillance data for vector control (8-28) was deleted due to lack of a data source. CDC's National Biomonitoring Program⁴ made baseline data available for exposure to heavy metals and selected environmental chemicals (8-25). This objective has 19 subobjectives that will monitor exposures to 4 groups of environmental chemicals: heavy metals, pesticides, persistent chemicals, and organochlorine compounds. With data available for subobjectives 8-25b, c, e, g, m, and o through s, these subobjectives became measurable. Baseline data are anticipated in the second half of the decade to establish baselines for subobjectives 8-25a, d, f, h through l, and n. Information systems used for environmental health (8-26) became measurable using data from CDC's National Environmental Public Health Tracking program.⁵

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