Building the Prevention Agenda for 2010: Lessons Learned

Healthy People 2000 Consortium Meeting
New York City, November 15, 1996

In her keynote address to the Healthy People 2000 Consortium, Dr. Ilona Kickbusch, Director of the Division of Health Promotion, Education, and Communication of the World Health Organization (WHO), challenged members to address three key questions:

She suggested six principles to guide the development of Healthy People 2010, the next generation of health promotion and disease prevention objectives: the social model of health, investment goals, reduction of gaps and social gradients, policy-relevant indices, partnerships and alliances, and international and sustainable development. Dr. Kickbusch referred to the nations of the world participating in WHO's "Renewing the Health for All" strategy. She emphasized that the United States has a unique opportunity to provide leadership by demonstrating that national prevention objectives can guide policy and strategies for population health improvement.

These remarks set the stage for a stimulating day of discussion and interaction among the 185 Healthy People 2000 Consortium members, invited guests from the business community, and representatives of the Federal Government.

In her opening remarks, Dr. Jo Ivey Boufford, Principal Deputy Assistant Secretary for Health, HHS, reviewed major accomplishments in health promotion and disease prevention during the past year. She cited the President's youth tobacco initiative, improved rates of childhood immunization, and the release of the Dietary Guidelines for Americans and the Surgeon General's Report on Physical Activity and Health.

Healthy People 2000 Progress

Dr. Boufford also provided a summary of progress on the 319 Healthy People 2000 objectives. According to the Healthy People 2000 Review, 1995-6, which was released at the Consortium meeting, 8 percent of the objectives had reached or surpassed the year 2000 targets. Progress had been made toward another 40 percent of the objectives. This good news was offset by the 26 percent of objectives that were either moving away from the year 2000 targets or showed mixed results or no change. Baselines had yet to be set for 19 objectives, or 5 percent of objectives, and 20 percent had no new data with which to evaluate progress.

Dr. Boufford described the new partnerships forming between the health care delivery system and public health community to address these challenges. She also noted that Dr. Philip R. Lee, Assistant Secretary for Health, HHS, had extended invitations to the State substance abuse, mental health, and environmental agencies to be members of the Healthy People 2000 Consortium and welcomed them to this meeting.

A panel led by Dr. Michael McGinnis, Scholar in Residence at the Institute of Medicine (IOM), reviewed the lessons learned over the past 18 years. According to Dr. McGinnis, the most prominent successes of the process included the explicit commitment of the Nation to measurable goals and the recruitment of thousands of people to participate in the development of the Nation's prevention agenda, which made it a truly democratic activity. He stated that the achievement of the 1990 life-stage targets was the most striking success and recalled that targets to reduce mortality by 20 to 25 percent seemed ambitious at the time they were set. Dr. McGinnis said, "To close the gaps in health disparities among racial, economic, geographic, and population groups remains one of the country's most significant challenges."

Panel on Lessons Learned

Michael Stoto, Director of the IOM Division of Health Promotion and Disease Prevention, addressed the difficulties of identifying and funding data systems to track objectives. Dr. Martin Wasserman, Maryland Department of Health and Mental Hygiene Commissioner, described the importance and use of the objectives in forming Healthy Maryland 2000 (for related information, see Focus). In framing the 2010 objectives, he advised, "If it's not broken, don't fix it; build on successes using (Healthy People) 2000 as the foundation; and keep it simple." He also counseled that the new Federal document should promote State and local objectives, particularly in addressing special populations. Jack Elinson, Professor Emeritus, Sociomedical Sciences Department, Columbia School of Public Health, challenged the Consortium to think about building the next decade's prevention objectives based on public opinion polls that would give the American people the opportunity to describe their health priorities.

Worksite Health Promotion

The luncheon address by David Hunnicutt, President of the Wellness Councils of America (WELCOA), outlined how worksite health promotion can help reshape the American prevention agenda. He stressed the importance of maintaining a healthy workforce to improve productivity and employer responsibility to maintain safe workplaces, as well as to empower employees to make sound health decisions. Emphasizing that public-private partnerships are the future of health promotion, Dr. Hunnicutt encouraged businesses to do more in their communities.

An afternoon session focused on the inclusion of business groups in the Consortium. Business associations already are in the Consortium, and the number could be expanded. As for engaging individual employers, there was a variety of viewpoints. Issues included achieving an adequate diversity of minority- and women-owned, small, and large businesses with geographic representation.

State Action as Framework

Dr. Lee led the discussion on State action, using the Healthy People 2000 prevention framework. He noted the importance of building data capacity to support objectives and other performance measurement activity. He also reminded the audience that Healthy People has bipartisan support and is good public health.

In the community action session, Deborah Bohr, Vice President of the Hospital Research and Education Trust, reviewed lessons learned at the outset of the healthy communities movement in the United States. William Powanda, Vice President of Griffen Health Services Corporation, described the Healthy Valley Connecticut initiative as one way to develop a healthy community.

Dr. Claude Earl Fox, Deputy Assistant Secretary for Disease Prevention and Health Promotion, closed the session with an outline of plans for Healthy People 2010 development. That schedule includes the first meeting of the Secretary's Council on Health Promotion and Disease Prevention Objectives for 2010 in spring 1997. The input of Consortium members obtained through focus groups will be used in shaping the proposed framework for the priority areas and the proposed criteria for objectives. In 1997, lead agency work groups will draft objectives. In the fall of 1998, the review copy will be published for public comment. During 1999, public comment will be synthesized, and the 2010 objectives will be released in 2000. Dr. Fox encouraged the support and involvement of all Consortium members in the Healthy People 2010 development process.

ANNOUNCEMENTS

Save the Date!

The 1997 Healthy People 2000 Consortium meeting will be held on November 7 in Indianapolis. The theme, Reducing Health Disparities: How Far Have We Come?, will be the focus of the morning session. In the afternoon, the lead agencies for the Healthy People 2010 Priority Areas will conduct roundtable discussions on proposals for the Healthy People 2010 objectives. This exchange will be an especially valuable opportunity to participate in the development of Healthy People 2010.

Healthy People 2010 Development Guide

Do you want to submit objectives for Healthy People 2010 but do not know how to do so? A national call for Healthy People 2010 objectives will be made in the fall of 1997. This event and others will be described in the forthcoming Healthy People 2010 Development Guide. The guide will help Consortium members and others to participate in the Healthy People process.

This summer, single copies of the Healthy People 2010 Development Guide will be available from the ODPHP Communication Support Center (OCSC). During its initial distribution, this guide will be sent to Consortium members and others currently involved with the Healthy People process. To promote participation and encourage widespread dissemination, photocopying will be encouraged. In addition, concurrent with its printing, the 2010 Guide will be posted on the Internet at the Healthy People home page. (Note that the current Healthy People 2000 web site is http://odphp.osophs.dhhs.gov/pubs/hp2000

(See Etcetera for information on ordering the guide or other material from OCSC.)



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