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 due to lack of a data source. However, 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.

Four developmental objectives and one developmental subobjective became measurable: childbirth classes (16-7), developmental disabilities―autism spectrum disorder (16-14c), fetal alcohol syndrome (FAS) (16-18), hospitalization for sickle cell disease among children (16-21), and medical homes for children with special health care needs (16-22).

The age range of objective 16-21 was revised from children aged 4 years and under to children aged 9 years and under. Modifications were made to subobjectives 16-20a and b. The mechanism for ensuring that all newborns are screened at birth for conditions mandated by their State-sponsored newborn screening programs (16-20a) was added to the objective: matching the number screened by the State to birth certificate information. Objective 16-20b was revised to "ensure that followup testing for screened positives is performed within an appropriate time period by monitoring the period from time of birth to initial diagnosis." Objective 16-23 was revised from "the proportion of Territories and States with service systems for children with special health care needs" to "the proportion of children with special health care needs who receive care in family-centered, comprehensive, and coordinated systems."

Four subobjectives were deleted because of a lack of nationally representative data sources: ectopic pregnancies (16-5b), post partum complications (16-5c), developmental disability―epilepsy (16-14d), and appropriate newborn referral to services (16-20c).

Two new subobjectives were added to breastfeeding (16-19): breastfeeding exclusively through 3 months (16-19d) and breastfeeding exclusively through 6 months (16-19e). These two new subobjectives are consistent with recommendations from the American Academy of Pediatrics and the World Health Organization and are based on the recent availability of data on exclusive breastfeeding. Research-based evidence has shown significant declines in infections among infants who are exclusively breastfed.⁷

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