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Phase I Report
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Appendix 13.
The Multi-Level Nature of Health
Determinants:
Strategies for Healthy People 2020
- A separate, introductory 'chapter' should be included in Healthy
People 2020 that discusses the rationale for and definitions related to the
multi-level nature of health determinants.
- The multi-level framework that is discussed in
this introductory chapter should be applied throughout the entire Healthy
People enterprise.
- Healthy People users should be encouraged to apply/capture as
many levels as possible in developing interventions in each health
area.
- Specific and potentially measurable social and physical
environmental indicators should be identified and described across
categories of Healthy People objectives. (Such indicators could be broken out
by subpopulation, region of the country, etc. as relevant.)
- Identify and establish surveillance of selected indicators
of healthful social and physical environments. Include physical and social
environmental areas of emerging prominence (e.g., 'virtual environments'
occurring on the Web and through other technological advances).
To
accomplish this, we recommend that health departments at all levels (local,
state, regional) enhance geographical information systems (GIS) capabilities
and work to standardize this type of information across the U.S. so that
physical environmental factors (including specific settings, such as schools,
worksites, and health care settings as well as larger-scale settings such as
neighborhoods and communities) could be more consistently evaluated and tracked
regarding health-relevant attributes. Access to place-specific GIS data is an
essential component of identifying areas at risk and developing multi-level
interventions.
- Review and/or provide links to evidence-based interventions
consisting of multi-level as well as social and environmental interventions
(for different subpopulations, regions, health areas as available).
- Facilitate the translation and dissemination of effective
interventions throughout the U.S.
- Establish surveillance systems to track the implementation of
evidence-based interventions
- Describe sample model programs occurring in multi-level as
well as social and physical environmental and policy domains that could benefit
from further evaluation.
- Identify relevant types of multi-level social environment and
physical environment interventions that could merit further scientific
exploration.
- Recommend areas for which comprehensive reviews of relevant
interventions (e.g., the U.S. Preventive Services Taskforce, Community
Guide) as well as relevant assessment tools should be undertaken to
support/supplement the Healthy People endeavor in these arenas.
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Continue to Appendix 14. Explanation of
Prioritization Criteria for Sorting Objectives
Back to
Appendix 12. The Multi-Level Nature of Health
Determinants: Dimensions for Intervention
Return to Phase I Report Table of Contents
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