Healthy People Consortium Meeting
"Implementing Healthy People 2010"
November 11, 2000

Summary of Breakout Group Discussion Concerning:
Respiratory Diseases

Background -- Overview

The Respiratory Diseases focus area is new to the Healthy People document. Although in the past Respiratory Diseases had been a part of the Healthy People agenda, it had not been compiled into one chapter. The Respiratory Diseases focus area is naturally relatively comprehensive and has been developed through stakeholders in government, private sectors, academia, and public health organizations. This year there were numerous public comments and, in conjunction with work group additions, the Respiratory Diseases chapter expanded to nearly 35 objectives and then later had to be refined to the current 12 objectives. The Respiratory Diseases chapter is divided into three sections: asthma, chronic obstructive pulmonary disease, and obstructive sleep apnea. 

1. What does implementing Healthy People mean to you?

• Stimulating activities to address reduction in utilization issues such as emergency department (ED) visits and hospitalizations.
• Programs such as the ALA is implementing in New York State--six asthma coalitions.
• Getting people together from a variety of perspectives to address asthma at school, home, etc.
• Addressing issues such as indoor air quality, which have an impact on conditions such as asthma.
• When implementing Healthy People, States typically focus on the objectives most important to them, with an eye toward resources.
• Implementing Healthy People also means collecting and tracking data.
• For many, implementing Healthy People meant facilitating community partnerships among all public health stakeholders. 

2. How do you suggest we work with local community groups in implementing the Healthy People 2010 objectives?

• Creative and innovative outreach such as the use of the BreathMobile, which is now operating or soon to be operating in the following locations: Phoenix, Baltimore, Chicago, and Washington, DC. The BreathMobile is a mobile clinic that provides asthma treatment and education.
• Working through such groups as the ALA, AAFA, and Mothers of Asthmatics, which have relationships with Federal agencies such as CDC and NIH.
• Working with community groups such as schools, media, and health practitioners is very important to acquire resources and, by explaining the significance of Healthy People activities at the local level, will help to involve more local groups.
• Educate health professionals (including practitioners and health educators) and help provide them tools for action.
• Work to create alliances with business and other private organization stakeholders.
• Advertise the objectives to physicians, senior citizen centers, and social services.
• Meet with local health groups on a regular basis and cultivate the importance of Respiratory Diseases objectives within their communities.
• Work with Healthy People groups such as the "Healthy Communities Group"; healthy community Web site: http://www.healthycommunities.org/.
• Work with community-based groups that focus on particular issues in their towns (e.g., groups that specifically work to reduce indoor air pollution).
• Continue having regional and national conferences that focus on States and locales. 

3. What are the challenges/barriers to meeting the Healthy People 2010 objectives? And how do you suggest we work to overcome them?

• Getting proper attention using patient advocacy.
• State and local laws that govern indoor and outdoor air quality.
• Emission control and its impact on asthma control.
• Liability issues.
• Work to achieve the correct diagnosis.
• Need for continuity of care.
• Disseminate information that helps to reduce the lack of information and lack of organization.
• Need more resources, especially funding.
• Establishing partnerships with private industry and business can be difficult yet also critical because of the assistance they can provide.
• Other barriers include identifying where money can be provided, lack of technical resources, and lack of technical assistance.
• By combining similar departments and personnel, barriers are sometimes broken. 
• The more coordinated and integrated State and local health agencies there are, the more likely their chances of success.
• In some instances the challenge is simply lack of awareness of the problems involved. 
• Educating community practitioners to educate legislators is particularly useful in developing legislation and policy toward accomplishing Healthy People objectives.

4. What can we do to support the elimination of health disparities among racial and ethnic population groups?

• Focus attention on groups with greatest disparity. ALA is conducting a conference in Washington that will address community-based "best practices" that can used to develop strategies at the local community level. The recommendations from this meeting may be useful in developing activities to address disparities in asthma.
• Making alliances with grassroots organizations. This approach also supplies information to those populations that in all probability need it the most.
• Providing data to legislators on the issues and extent of health disparities among their constituents gives them a powerful tool to actively develop legislation and provide funding to local agencies that combat disparities. Similarly, offering and translating data to the State and local media provide another avenue to break down barriers.

5. How do we measure the progress of Healthy People 2010 in the future? And what is progress?

• Continuing to measure the objectives through the use of data seems to be the best method. Nonetheless, there seems to be some inherent problems with various objectives that cause them to be difficult to measure at the State level. If a better system could be developed of compiling data at the State level as well as refining the objectives so they better correspond to State data collecting systems, then better progress could be made. 

6. How can we work more effectively with the media in implementing the Healthy People 2010 objectives?

• Community-level leaders should work with editors and media groups to make the objectives more visible to the public and to increase awareness.
• Educate the stakeholders who are involved as to the importance of the objectives regarding health outcomes.
• Educate the media (get the right message across) in translating data and how to refine messages about Healthy People into "plain" language that motivates the audience.
• Start small--at the districts level--and work up to State level.
• Help to translate and transmit the data to the media and encourage editors and other media authorities to become involved in the process.

Participants List

Rob Fulwood
NIH/NHLBI
fulwoodr@nih.gov

Marion Harnois
MA DEP
marion.harnois@state.ma.us

Bill Jirles
NIH/NIEHS
jirles@niehs.nih.gov 

Alan S. Pernick
DEY L.P.
aspern@banet.net

Sorensen Ramirez
Carson-Tahoe Hospital
norasorensen@cth.hbocvan.van

Martina V. Taylor,
NIH-OD
martinav@nih.gov

Ron White
American Lung Association
rwhite@lungusadc.org

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