Focus Area 28: Vision and Hearing: Objectives and Subobjectives

As a result of the Healthy People 2010 Midcourse Review, changes were made to the Healthy People 2010 objectives and subobjectives. These changes are specific to the following situations:

Changes in the wording of an objective to more accurately describe what is being measured.
Changes to reflect a different data source or new science.
Changes resulting from the establishment of a baseline and a target (that is, when a formerly developmental objective or subobjective became measurable).
Deletion of an objective or subobjective that lacked a data source.
Correction of errors and omissions in Healthy People 2010.

Revised baselines and targets for measurable objectives and subobjectives do not fall into any of the above categories and, thus, are not considered a midcourse review change.¹

When changes were made to an objective, three sections are displayed:

In the Original Objective section, the objective as published in Healthy People 2010 in 2000 is shown.
In the Objective With Revisions section, strikethrough indicates text deleted, and underlining is used to show new text.
In the Revised Objective section, the objective appears as revised as a result of the midcourse review.

Details of the objectives and subobjectives in this focus area, including any changes made at the midcourse, appear on the following pages.

¹See Technical Appendix for more information on baseline and target revisions.

Vision

ORIGINAL OBJECTIVE
28-1.	(Developmental) Increase the proportion of persons who have a dilated eye examination at appropriate intervals. Potential data source: National Health Interview Survey (NHIS), CDC, NCHS.
OBJECTIVE WITH REVISIONS
28-1.	~~(Developmental)~~ Increase the proportion of persons who have a dilated eye examination at appropriate intervals. Target: 58 percent of persons aged 18 years and older. Baseline: 55 percent of persons aged 18 years and older had a dilated eye examination within the past 2 years in 2002 (age adjusted to the year 2000 standard population). Target setting method: Better than the best. ~~Potential d~~Data source: National Health Interview Survey (NHIS), CDC, NCHS.
REVISED OBJECTIVE
28-1.	Increase the proportion of persons who have a dilated eye examination at appropriate intervals. Target: 58 percent of persons aged 18 years and older. Baseline: 55 percent of persons aged 18 years and older had a dilated eye examination within the past 2 years in 2002 (age adjusted to the year 2000 standard population). Target setting method: Better than the best. Data source: National Health Interview Survey (NHIS), CDC, NCHS.

ORIGINAL OBJECTIVE
28-2.	(Developmental) Increase the proportion of preschool children aged 5 years and under who receive vision screening. Potential data source: National Health Interview Survey (NHIS), CDC, NCHS.
OBJECTIVE WITH REVISIONS
28-2.	~~(Developmental)~~ Increase the proportion of preschool children aged 5 years and under who receive vision screening. Target: 52 percent of preschool children aged 5 years and under. Baseline: 36 percent of children aged 5 years and under had ever had their vision screened in 2002. Target setting method: Better than the best. ~~Potential d~~Data source: National Health Interview Survey (NHIS), CDC, NCHS.
REVISED OBJECTIVE
28-2.	Increase the proportion of preschool children aged 5 years and under who receive vision screening. Target: 52 percent of preschool children aged 5 years and under. Baseline: 36 percent of children aged 5 years and under had ever had their vision screened in 2002. Target setting method: Better than the best. Data source: National Health Interview Survey (NHIS), CDC, NCHS.

ORIGINAL OBJECTIVE
28-3.	(Developmental) Reduce uncorrected visual impairment due to refractive errors. Potential data source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.
OBJECTIVE WITH REVISIONS
28-3.	~~(Developmental)~~ Reduce uncorrected visual impairment due to refractive errors. Target: 92.9 per 1,000 persons aged 12 years and older. Baseline: 110.7 per 1,000 persons aged 12 years and older had uncorrected visual impairment due to refractive errors in 1999–2000 (age adjusted to the year 2000 standard population). Target setting method: Better than the best. ~~Potential d~~Data source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.
REVISED OBJECTIVE
28-3.	Reduce uncorrected visual impairment due to refractive errors. Target: 92.9 per 1,000 persons aged 12 years and older. Baseline: 110.7 per 1,000 persons aged 12 years and older had uncorrected visual impairment due to refractive errors in 1999–2000 (age adjusted to the year 2000 standard population). Target setting method: Better than the best. Data source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.

NO CHANGE IN OBJECTIVE
(Data updated and footnoted)

28-4.

Reduce blindness and visual impairment in children and adolescents aged 17 years and under.

Target: 18¹ per 1,000 children and adolescents aged 17 years and under.

Baseline: 24² per 1,000 children and adolescents aged 17 years and under were blind or visually impaired in 1997.

Target setting method: Better than the best.

Data source: National Health Interview Survey (NHIS), CDC, NCHS.

¹ Target revised from 20 because of baseline revision after November 2000 publication.
² Baseline revised from 25 after November 2000 publication.

ORIGINAL OBJECTIVE
28-5.	(Developmental) Reduce visual impairment due to diabetic retinopathy. Potential data source: National Health Interview Survey (NHIS), CDC, NCHS.
OBJECTIVE WITH REVISIONS
28-5.	~~(Developmental)~~ Reduce visual impairment due to diabetic retinopathy. Target: 40.9 per 1,000 persons aged 18 years and older with diabetes. Baseline: 45.8 per 1,000 persons aged 18 years and older with diabetes had trouble seeing and diabetic retinopathy in 2002 (age adjusted to the year 2000 standard population). Target setting method: Better than the best. ~~Potential d~~Data source: National Health Interview Survey (NHIS), CDC, NCHS.
REVISED OBJECTIVE
28-5.	Reduce visual impairment due to diabetic retinopathy. Target: 40.9 per 1,000 persons aged 18 years and older with diabetes. Baseline: 45.8 per 1,000 persons aged 18 years and older with diabetes had trouble seeing and diabetic retinopathy in 2002 (age adjusted to the year 2000 standard population). Target setting method: Better than the best. Data source: National Health Interview Survey (NHIS), CDC, NCHS.

ORIGINAL OBJECTIVE
28-6.	(Developmental) Reduce visual impairment due to glaucoma. Potential data source: National Health Interview Survey (NHIS), CDC, NCHS.
OBJECTIVE WITH REVISIONS
28-6.	~~(Developmental)~~ Reduce visual impairment due to glaucoma. Target: 10.7 per 1,000 persons aged 45 years and older. Baseline: 13.5 per 1,000 persons aged 45 years and older had trouble seeing and glaucoma in 2002 (age adjusted to the year 2000 standard population). Target setting method: Better than the best. ~~Potential d~~Data source: National Health Interview Survey (NHIS), CDC, NCHS.
REVISED OBJECTIVE
28-6.	Reduce visual impairment due to glaucoma. Target: 10.7 per 1,000 persons aged 45 years and older. Baseline: 13.5 per 1,000 persons aged 45 years and older had trouble seeing and glaucoma in 2002 (age adjusted to the year 2000 standard population). Target setting method: Better than the best. Data source: National Health Interview Survey (NHIS), CDC, NCHS.

ORIGINAL OBJECTIVE
28-7.	(Developmental) Reduce visual impairment due to cataract. Potential data source: National Health Interview Survey (NHIS), CDC, NCHS.
OBJECTIVE WITH REVISIONS
28-7.	~~(Developmental)~~ Reduce visual impairment due to cataract. Target: 91.4 per 1,000 persons aged 65 years and older. Baseline: 119.3 per 1,000 persons aged 65 years and older reported they had trouble seeing and cataracts in 2002 (age adjusted to the year 2000 standard population). Target setting method: Better than the best. ~~Potential d~~Data source: National Health Interview Survey (NHIS), CDC, NCHS.
REVISED OBJECTIVE
28-7.	Reduce visual impairment due to cataract. Target: 91.4 per 1,000 persons aged 65 years and older. Baseline: 119.3 per 1,000 persons aged 65 years and older reported they had trouble seeing and cataracts in 2002 (age adjusted to the year 2000 standard population). Target setting method: Better than the best. Data source: National Health Interview Survey (NHIS), CDC, NCHS.

ORIGINAL OBJECTIVE

28-8.

(Developmental) Reduce occupational eye injury.

Potential data sources: Annual Survey of Occupational Injuries and Illnesses (ASOII), U.S. Department of Labor, Bureau of Labor Statistics; National Electronic Injury Surveillance System (NEISS), CPSC, and NIOSH.

OBJECTIVE WITH REVISIONS

28-8.

~~(Developmental)~~ Reduce occupational eye injury.

Target and baseline:

Objective	Reduction in Occupational Eye Injury	2002 Baseline (unless noted) Per 10,000 Full-Time Workers	2010 Target Per 10,000 Full-Time Workers
28-8a.	Occupational eye injuries resulting in lost work days	4.8	3.4
28-8b.	Occupational eye injuries treated in emergency departments	21.0 (1999)	14.7

Target setting method: 30 percent improvement.

~~Potential d~~Data sources: ~~Annual~~ Survey of Occupational Injuries and Illnesses (ASOII), U.S. Department of Labor, Bureau of Labor Statistics; National Electronic Injury Surveillance System (NEISS), CPSC and CDC, NIOSH.

REVISED OBJECTIVE

28-8.

Reduce occupational eye injury.

Target and baseline:

Objective	Reduction in Occupational Eye Injury	2002 Baseline (unless noted) Per 10,000 Full-Time Workers	2010 Target Per 10,000 Full-Time Workers
28-8a.	Occupational eye injuries resulting in lost work days	4.8	3.4
28-8b.	Occupational eye injuries treated in emergency departments	21.0 (1999)	14.7

Target setting method: 30 percent improvement.

Data sources: Survey of Occupational Injuries and Illnesses (SOII), U.S. Department of Labor, Bureau of Labor Statistics; National Electronic Injury Surveillance System (NEISS), CPSC and CDC, NIOSH.

ORIGINAL OBJECTIVE

28-9.

(Developmental) Increase the use of appropriate personal protective eyewear in recreational activities and hazardous situations around the home.

Potential data source: National Health Interview Survey (NHIS), CDC, NCHS.

OBJECTIVE WITH REVISIONS

28-9.

~~(Developmental)~~ Increase the use of ~~appropriate~~ personal protective eyewear in recreational activities and hazardous situations around the home.

Target and baseline:

Objective	Increase in Use of Personal Protective Eyewear at Home	2002 Baseline Percent	2010 Target Percent
28-9a.	Children aged 6 to 17 years	15	20
28-9b.	Adults aged 18 years and older	33*	37

* Age adjusted to the year 2000 standard population.

Target setting method: Better than the best.

~~Potential d~~Data source: National Health Interview Survey (NHIS), CDC, NCHS.

REVISED OBJECTIVE

28-9.

Increase the use of personal protective eyewear in recreational activities and hazardous situations around the home.

Target and baseline:

Objective	Increase in Use of Personal Protective Eyewear at Home	2002 Baseline Percent	2010 Target Percent
28-9a.	Children aged 6 to 17 years	15	20
28-9b.	Adults aged 18 years and older	33*	37

* Age adjusted to the year 2000 standard population.

Target setting method: Better than the best.

Data source: National Health Interview Survey (NHIS), CDC, NCHS.

ORIGINAL OBJECTIVE

28-10.

(Developmental) Increase vision rehabilitation.

28-10a. Increase the use of rehabilitation services by persons with visual impairments.

28-10b. Increase the use of visual and adaptive devices by persons with visual impairments.

Potential data source: National Health Interview Survey (NHIS), CDC, NCHS.

OBJECTIVE WITH REVISIONS

28-10.

~~(Developmental)~~ Increase vision rehabilitation.

~~28-10a.~~ ~~Increase the use of rehabilitation services by persons with visual~~ ~~impairments.~~

~~28-10b.~~ ~~Increase the use of visual and adaptive devices by persons with visual~~ ~~impairments.~~

Target and baseline:

Objective	Increase in Vision Rehabilitation	2002 Baseline Per 1,000 Population	2010 Target Per 1,000 Population
28-10a.	Use of vision rehabilitation services by visually impaired persons aged 18 years and older (age adjusted to the year 2000 standard population)	14.0	15.5
		Percent	Percent
28-10b.	Use of visual and adaptive devices by visually impaired persons aged 18 years and older (age adjusted to the year 2000 standard population)	22	26

Target setting method: For 28-10a, 10 percent improvement; for 28-10b, better than the best.

~~Potential d~~Data source: National Health Interview Survey (NHIS), CDC, NCHS.

REVISED OBJECTIVE

28-10.

Increase vision rehabilitation.

Target and baseline:

Objective	Increase in Vision Rehabilitation	2002 Baseline Per 1,000 Population	2010 Target Per 1,000 Population
28-10a.	Use of vision rehabilitation services by visually impaired persons aged 18 years and older (age adjusted to the year 2000 standard population)	14.0	15.5
		Percent	Percent
28-10b.	Use of visual and adaptive devices by visually impaired persons aged 18 years and older (age adjusted to the year 2000 standard population)	22	26

Target setting method: For 28-10a, 10 percent improvement; for 28-10b, better than the best.

Data source: National Health Interview Survey (NHIS), CDC, NCHS.

Hearing

ORIGINAL OBJECTIVE

28-11.

(Developmental) Increase the proportion of newborns who are screened for hearing loss by age 1 month, have audiologic evaluation by age 3 months, and are enrolled in appropriate intervention services by age 6 months.

Potential data sources: State-based Early Hearing Detection and Intervention (EHDI) Program Network, CDC and/or specific State data.

OBJECTIVE WITH REVISIONS

28-11.

~~(Developmental)~~ Increase the proportion of newborns who are screened for hearing loss by age 1 month, have audiologic evaluation by age 3 months, and are enrolled in appropriate intervention services by age 6 months.

Target and baseline:

Objective	Increase in Newborn Screening, Audiologic Evaluation, and Enrollment in Appropriate Intervention Services	2001 Baseline Percent	2010 Target Percent
28-11a.	Screening for hearing loss before age 1 month	66	90
28-11b.	Receipt of audiologic evaluation before age 3 months among infants with possible hearing loss	56	70
28-11c.	Enrollment of infants with confirmed hearing loss for intervention services before age 6 months	57	85

Target setting method: For 28-11a, 36 percent improvement; for 28-11b, 25 percent improvement; for 28-11c, 49 percent improvement.

~~Potential d~~Data sources: State-based Early Hearing Detection and Intervention (EHDI) Program Network, CDC and/or specific State data.

REVISED OBJECTIVE

28-11.

Increase the proportion of newborns who are screened for hearing loss by age 1 month, have audiologic evaluation by age 3 months, and are enrolled in appropriate intervention services by age 6 months.

Target and baseline:

Objective	Increase in Newborn Screening, Audiologic Evaluation, and Enrollment in Appropriate Intervention Services	2001 Baseline Percent	2010 Target Percent
28-11a.	Screening for hearing loss before age 1 month	66	90
28-11b.	Receipt of audiologic evaluation before age 3 months among infants with possible hearing loss	56	70
28-11c.	Enrollment of infants with confirmed hearing loss for intervention services before age 6 months	57	85

Target setting method: For 28-11a, 36 percent improvement; for 28-11b, 25 percent improvement; for 28-11c, 49 percent improvement.

Data sources: State-based Early Hearing Detection and Intervention (EHDI) Program Network, CDC and/or specific State data.

NO CHANGE IN OBJECTIVE

28-12.

Reduce otitis media in children and adolescents.

Target: 294 visits per 1,000 children and adolescents under age 18 years.

Baseline: 344.7 visits per 1,000 children and adolescents under age 18 years were for otitis media in 1997.

Target setting method: Better than the best.

Data sources: National Ambulatory Medical Care Survey (NAMCS), CDC, NCHS; National Hospital Ambulatory Medical Care Survey (NHAMCS), CDC, NCHS.

ORIGINAL OBJECTIVE

28-13.

(Developmental) Increase access by persons who have hearing impairments to hearing rehabilitation services and adaptive devices, including hearing aids, cochlear implants, or tactile or other assistive or augmentative devices.

Potential data sources: National Health Interview Survey (NHIS), CDC, NCHS; National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.

OBJECTIVE WITH REVISIONS

28-13.

~~(Developmental)~~ Increase the proportion of persons with hearing impairments who have ever used a hearing aid or assistive listening devices or who ~~access~~ ~~by persons who have hearing impairments to hearing rehabilitation services and~~ ~~adaptive devices, including hearing aids, cochlear implants, or tactile or other~~ ~~assistive or augmentative devices~~have cochlear implants.

Target and baseline:

Objective	Increase in Use of Hearing Aids, Cochlear Implants, or Assistive Listening Devices Among Persons With Hearing Loss	2001 Baseline Per 1,000	2010 Target Per 1,000
28-13a.	Adults aged 20 to 69 years with hearing loss who have ever used a hearing aid	149.6	155.0
		Per 10,000	Per 10,000
28-13b.	Persons who are deaf or very hard of hearing and who have new cochlear implants	51	56
28-13c.	Adults aged 70 years and older with hearing loss who have ever used a hearing aid	Developmental	Developmental
28-13d.	Adults aged 70 years and older with hearing loss who use assistive listening devices	Developmental	Developmental

Target setting method: For 28-13a, better than the best; for 28-13b, 10 percent improvement.

~~Potential d~~Data sources: National Health Interview Survey (NHIS), CDC, NCHS; National Health and Nutrition Examination Survey (NHANES), CDC, NCHS; Healthcare Cost and Utilization Project (HCUP), AHRQ.

REVISED OBJECTIVE

28-13.

Increase the proportion of persons with hearing impairments who have ever used a hearing aid or assistive listening devices or who have cochlear implants.

Target and baseline:

Objective	Increase in Use of Hearing Aids, Cochlear Implants, or Assistive Listening Devices Among Persons With Hearing Loss	2001 Baseline Per 1,000	2010 Target Per 1,000
28-13a.	Adults aged 20 to 69 years with hearing loss who have ever used a hearing aid	149.6	155.0
		Per 10,000	Per 10,000
28-13b.	Persons who are deaf or very hard of hearing and who have new cochlear implants	51	56
28-13c.	Adults aged 70 years and older with hearing loss who have ever used a hearing aid	Developmental	Developmental
28-13d.	Adults aged 70 years and older with hearing loss who use assistive listening devices	Developmental	Developmental

Target setting method: For 28-13a, better than the best; for 28-13b, 10 percent improvement.

Data sources: National Health Interview Survey (NHIS), CDC, NCHS; National Health and Nutrition Examination Survey (NHANES), CDC, NCHS; Healthcare Cost and Utilization Project (HCUP), AHRQ.

ORIGINAL OBJECTIVE

28-14.

(Developmental) Increase the proportion of persons who have had a hearing examination on schedule.

Potential data sources: National Health Interview Survey (NHIS), CDC, NCHS; National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.

OBJECTIVE WITH REVISIONS

28-14.

~~(Developmental)~~ Increase the proportion of persons who have had a hearing examination on schedule.

Target and baseline:

Objective	Increase in Hearing Examinations	1999–2000 Baseline Percent	2010 Target Percent
28-14a.	Adults aged 20 to 69 years who have had a hearing examination in the past 5 years (age adjusted to the year 2000 standard population)	29	34
28-14b.	Adults aged 70 years and older who have had a hearing examination in the past 5 years	37	40
28-14c.	Adolescents aged 12 to 19 years who have had a hearing examination in the past 5 years	Developmental	Developmental

Target setting method: Better than the best.

~~Potential d~~Data sources: ~~National Health Interview Survey (NHIS), CDC, NCHS;~~ National Health and Nutrition Examination Survey (NHANES).

REVISED OBJECTIVE

28-14.

Increase the proportion of persons who have had a hearing examination on schedule.

Target and baseline:

Objective	Increase in Hearing Examinations	1999–2000 Baseline Percent	2010 Target Percent
28-14a.	Adults aged 20 to 69 years who have had a hearing examination in the past 5 years (age adjusted to the year 2000 standard population)	29	34
28-14b.	Adults aged 70 years and older who have had a hearing examination in the past 5 years	37	40
28-14c.	Adolescents aged 12 to 19 years who have had a hearing examination in the past 5 years	Developmental	Developmental

Target setting method: Better than the best.

Data source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.

OBJECTIVE DELETED
28-15.	(Objective deleted due to lack of data source) (Developmental) Increase the number of persons who are referred by their primary care physician for hearing evaluation and treatment.

ORIGINAL OBJECTIVE

28-16.

(Developmental) Increase the use of appropriate ear protection devices, equipment, and practices.

Potential data source: National Health Interview Survey (NHIS), CDC, NCHS.

OBJECTIVE WITH REVISIONS

28-16.

~~(Developmental)~~ Increase the use of ~~appropriate~~ ear protection devices~~, equipment, and practices~~.

Target and baseline:

Objective	Increase in Use of Ear Protection Devices	1999–2000 Baseline Per 1,000 Population	2010 Target Per 1,000 Population
28-16a.	Adults aged 20 to 69 years who have ever used hearing protection devices (ear plugs, ear muffs) when exposed to loud sounds or noise (age adjusted to the year 2000 standard population)	457.0	487.0
28-16b.	Adolescents aged 12 to 19 years who have ever used hearing protection devices (ear plugs, ear muffs) when exposed to loud sounds or noise	Developmental	Developmental

Target setting method: Better than the best.

~~Potential d~~Data source: National Health and Nutrition Examination Survey (NHANES)~~National Health Interview Survey (NHIS),~~ CDC, NCHS.

REVISED OBJECTIVE

28-16.

Increase the use of ear protection devices.

Target and baseline:

Objective	Increase in Use of Ear Protection Devices	1999–2000 Baseline Per 1,000 Population	2010 Target Per 1,000 Population
28-16a.	Adults aged 20 to 69 years who have ever used hearing protection devices (ear plugs, ear muffs) when exposed to loud sounds or noise (age adjusted to the year 2000 standard population)	457.0	487.0
28-16b.	Adolescents aged 12 to 19 years who have ever used hearing protection devices (ear plugs, ear muffs) when exposed to loud sounds or noise	Developmental	Developmental

Target setting method: Better than the best.

Data source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.

ORIGINAL OBJECTIVE
28-17.	(Developmental) Reduce noise-induced hearing loss in children and adolescents aged 17 years and under. Potential data source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.
OBJECTIVE WITH REVISIONS
28-17.	~~(Developmental)~~ Reduce ~~noise-induced hearing loss in children and adolescents aged 17 years and~~the proportion of adolescents who have elevated hearing thresholds, or audiometric notches, in high frequencies (3, 4, or 6 kHz) in both ears, signifying noise-induced hearing loss. ~~under.~~ Target: 34.7 per 1,000 adolescents aged 12 to 19 years. Baseline: 46.4 per 1,000 adolescents aged 12 to 19 years had noise-induced hearing loss in the period 1988–94. Target setting method: Better than the best. ~~Potential d~~Data source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.
REVISED OBJECTIVE
28-17.	Reduce the proportion of adolescents who have elevated hearing thresholds, or audiometric notches, in high frequencies (3, 4, or 6 kHz) in both ears, signifying noise-induced hearing loss. Target: 34.7 per 1,000 adolescents aged 12 to 19 years. Baseline: 46.4 per 1,000 adolescents aged 12 to 19 years had noise-induced hearing loss in the period 1988–94. Target setting method: Better than the best. Data source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.

ORIGINAL OBJECTIVE
28-18.	(Developmental) Reduce adult hearing loss in the noise-exposed public. Potential data sources: National Health Interview Survey (NHIS), CDC, NCHS; National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.
OBJECTIVE WITH REVISIONS
28-18.	~~(Developmental)~~ Reduce ~~adult hearing loss in the noise-exposed public~~ the proportion of adults who have elevated hearing thresholds, or audiometric notches, in high frequencies (3, 4, or 6 kHz) in both ears, signifying noise-induced hearing loss. Target: 78.3 per 1,000 adults aged 20 to 69 years. Baseline: 117.0 per 1,000 adults aged 20 to 69 years had noise-induced hearing loss in the period 1999–2000 (age adjusted to the year 2000 standard population). Target setting method: Better than the best. ~~Potential d~~Data sources: ~~National Health Interview Survey (NHIS), CDC, NCHS;~~ National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.
REVISED OBJECTIVE
28-18.	Reduce the proportion of adults who have elevated hearing thresholds, or audiometric notches, in high frequencies (3, 4, or 6 kHz) in both ears, signifying noise-induced hearing loss. Target: 78.3 per 1,000 adults aged 20 to 69 years. Baseline: 117.0 per 1,000 adults aged 20 to 69 years had noise-induced hearing loss in the period 1999–2000 (age adjusted to the year 2000 standard population). Target setting method: Better than the best. Data source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.

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