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 because they lacked a data source. However, the U.S. Department of Health and Human Services (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.

Several subobjectives were deleted, and others were modified to reflect methodological changes in data sources. Changes also included revision of text and division of objectives into subobjectives. Five objectives remained developmental.

Objective 26-1, alcohol- and drug-related motor vehicle deaths and injuries, was modified to reflect current data collection practices. Subobjectives addressing alcohol- and drug-related injuries as well as drug-related deaths were deleted (26-1b, c, and d), because reliable data were not available. However, objective 26-1a, alcohol-related motor vehicle crash deaths, was retained. This objective now tracks the number of traffic deaths in which drivers had a .08 percent blood alcohol concentration (BAC) or higher.

Objective 26-8, lost productivity due to alcohol and drug abuse, was revised and became measurable. The objective was split into two subobjectives: lost productivity due to alcohol abuse (26-8a) and lost productivity due to drug abuse (26-8b). Objective 26-18, treatment for illicit drug and alcohol problems, became measurable and was reworded and subdivided to more accurately reflect the identified data source and treatment populations covered under the objective. Subobjective 26-18a tracks persons who need treatment for drug problems; 26-18b tracks persons who need treatment for both alcohol and illicit drug abuse.

The National Household Survey on Drug Abuse underwent several methodological changes during the period from 1999 to 2001. The survey name was also changed to the National Survey on Drug Use and Health. As a result, new 2002 baselines and revised targets were established for adolescent alcohol or illicit drug use (26-10a), adult illicit drug use (26-10c), adult binge drinking (26-11c), adolescent binge drinking (26-11d), adolescent inhalant use (26-15), and adolescents' perception of risk associated with alcohol and drug use (26-17a, b, and c). New 2002 baselines were established for average age at first alcohol use (26-9a), average age at first marijuana use (26-9b), and adolescent marijuana use (26-10b).

Treatment for alcohol abuse (26-21) became measurable. The objective was reworded to more accurately reflect the data source.

Data sources were identified, and baseline data are anticipated before the end of the decade for the following five developmental objectives: alcohol-related hospital emergency department visits (26-5), intentional injuries from alcohol- and drug-related violence (26-7), substance abuse treatment in correctional facilities (26-19), hospital emergency department referrals for alcohol or drug programs and suicide attempts (26-22), and community partnerships and coalitions to prevent substance abuse (26-23). Because data sources are anticipated by the end of the decade but no data were available at the time of the midcourse review, these objectives are still categorized as developmental.

Objective 26-22 was revised to provide two subobjectives: persons referred for followup care for alcohol problems, drug problems after diagnosis, or emergency department treatment for one of these conditions (26-22a) and persons referred for followup care for suicide attempts after diagnosis or treatment in an emergency department (26-22b).

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