Phase II: Phase II: Update on Phase II Contributions of the Committee & Update on Phase II Contributions of the Committee &

Focus of Activities in Months to ComeFocus of Activities in Months to Come

Secretary’s Advisory Committee on National Health Promotion & Disease Prevention

Objectives for 2020

Committee Chair: Jonathan Fielding, MD, MPH, MA, MBA

Director, Los Angeles County Department of Public Health & Health Officer, Los Angeles County

April 1, 2010

Desired Outcomes for the MeetingDesired Outcomes for the Meeting

Discuss the connection between HP2020 and health reform Review Phase II progress of the Advisory Committee Obtain feedback and an update from HHS Discuss and vote on recent products of Subcommittee work Hear a summary of the Healthy People 2010 User Study Discuss the Committee’s work for the coming months.

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Opportunities for Innovation: Opportunities for Innovation: Health Promotion & Disease PreventionHealth Promotion & Disease Prevention

3

CER Research

Healthy People 2020

Community Health

Data Initiative

ARRA CPPW

Health

Reform

Health Reform: Some Key ComponentsHealth Reform: Some Key Components• Establishment of key national indicators• National Prevention, Health Promotion and Public Health Council

— Within HHS, chaired by the Surgeon General — Members will include Secretaries of HHS, Agriculture, Education, Transportation,

Housing, Director of Domestic Policy Council, Administrator of EPA, and others.

• Advisory Group on Prevention, Health Promotion, and Integrative and Public Health (Advisory group to the Council)— Within HHS, reports to the Surgeon General— No more than 25 non-federal members, to be appointed by the President — Responsible for developing the policy and plans for Council to consider;

• National Prevention and Health Promotion Strategy — Due one year from date of enactment (March 23, 2011) — Developed by the Advisory Group Chairperson, in consultation with the Council— Set goals and objectives for improving the health of the U.S.— Report on Progress would be due on July 1, 2010, and annually thereafter through

January 15, 2015.

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Health Reform…Health Reform… Council’s Report will include :

• List of national priorities on health promotion & disease prevention to address lifestyle behavior modification

• Strategies to achieve Healthy People goals for nutrition, exercise and smoking cessation and 5 leading-disease killers in the U.S.;

• Specific science-based initiatives to achieve the aforementioned measurable goals of Healthy People 2010;

• Specific plans to consolidate Federal health programs & Centers to promote healthy behavior and reduce risk (eliminating those ineffective in meeting priority goals of Healthy People 2010;

• Specific plans to ensure that all public health programs are based on science-based guidelines developed by the CDC;

Periodic Reviews (not less than every 5 years) of federal disease prevention and health promotion programs

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ARRA- ARRA- Communities Putting Prevention to WorkCommunities Putting Prevention to Work

Initiative Funding Level

Community Initiative•Grants to communities•Community and Evaluation Support

$450 M

States and Territories Policy & Env. Change Initiative•Statewide Policy & Environmental Change•Competitive Special Policy & Environmental Change•Tobacco Cessation through Quitlines

$119M

States Chronic Disease Self-Management Initiative $27 M

National Prevention & Media Initiative•National Organization Initiative•National Media Initiative

$40 M

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Community Health Data InitiativeCommunity Health Data Initiativehttp://www.cdc.gov/nchs/data_access/chdi.htmhttp://www.cdc.gov/nchs/data_access/chdi.htm

Collaborative of government & non-government partners Establishes “a network of suppliers and demanders of community

health data, indicators, and interventions.” Purpose is to help Americans understand health and health care

system performance in their communities. Sample Indicator Reports and Initiatives:

• America’s Children: Key Indicators of Well-being, 2009

• Chronic Disease Indicators

• Health, United States, 2009

• Healthy People

• Older Americans 2008

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Committee Recommendations Submitted Committee Recommendations Submitted During Phase IIDuring Phase II

Document Titles and Type Date Submitted

Immediate Actions in Support of Objectives to Improve the Health of the American People [Recommendations to Secretary]

March 2, 2009

System Specifications of Healthy People 2020 Online Version [Recommendations to Secretary]

May 14, 2009

Proposed List of Topic Area Categories[Recommendations to Secretary]

May 15, 2009

Approach to Developing HP2020 Target-Setting Methods[Report to Secretary]

May 23, 2009

Recommendations Underscoring the Need for a Web-based Format for HP2020 [Recommendations to Secretary]

February 17, 2010

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Outstanding Items Outstanding Items Discussed, but not formally approved by Committee voteDiscussed, but not formally approved by Committee vote

Document Titles and Type Date of Last Draft

Recommendations for Implementing Healthy People 2020 [Draft Recommendations to Secretary]

September 3, 2009

Evaluating Sources of Knowledge for Evidence-based Actions in Public Health [Draft Report to Secretary]

September 3, 2009

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Healthy People 2020 UpdateHealthy People 2020 Update

RADM Penelope Slade-SawyerOffice of Disease Prevention and Health Promotion

US Department of Health and Human Services

Secretary’s Advisory CommitteeApril 1, 2010

Update on HHS ActivitiesUpdate on HHS Activities

HHS Response to Committee Recommendations

FIW Progress and Activities Status of the Healthy People 2020

Objectives

Proposed HP 2020 Topic AreasProposed HP 2020 Topic Areas

Access to Health Services

Adolescent Health

Arthritis, Osteoporosis, and Chronic Back Conditions

Blood Disorders and Blood Safety

Cancer

Chronic Kidney Diseases

Dementias, Including Alzheimer’s Disease

Diabetes

Disability and Health

Proposed HP 2020 Topic AreasProposed HP 2020 Topic Areas

Early and Middle Childhood

Educational and Community-Based Programs

Environmental Health

Family Planning

Food Safety

Genomics

Global Health

Health Communication and Health IT

Healthcare-Associated Infections

Proposed HP 2020 Topic AreasProposed HP 2020 Topic Areas Hearing and Other Sensory or Communication Disorders (Ear,

Nose, Throat - Voice, Speech, and Language)

Heart Disease and Stroke

HIV

Immunization and Infectious Diseases

Injury and Violence Prevention

Maternal, Infant and Child Health

Medical Product Safety

Mental Health and Mental Disorders

Nutrition and Weight Status

Proposed HP 2020 Topic AreasProposed HP 2020 Topic Areas Occupational Safety and Health Older Adults Oral Health Preparedness Public Health Infrastructure Physical Activity and Fitness Public Health Infrastructure Quality of Life and Well Being

Proposed HP 2020 Topic AreasProposed HP 2020 Topic Areas

Respiratory Diseases

Sexually Transmitted Diseases

Social Determinants of Health

Substance Abuse

Tobacco Use

Vision

Update on HHS ActivitiesUpdate on HHS Activities

Update on the Launch & Timeline Plans for 2012 National Meeting Guidance to FACA for the Coming Months

Updates on Subcommittee ActivitiesUpdates on Subcommittee Activitiesand Voting on Recommendationsand Voting on Recommendations

Jonathan Fielding, Committee Chair

Status of SubcommitteesStatus of SubcommitteesSubcommittee Meetings to-date

Social Determinants (ad hoc) 10/20; 2/4

Strategic Communications 10/22; 11/3; 1/22; 2/18; 3/16

Priorities 10/30; 2/8; 3/12

Action Steps and Evidence (ad hoc) 2/26; 3/31

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Draft Recommendations to be Draft Recommendations to be Finalized and Approved TodayFinalized and Approved Today

Draft Recommendations Documents

How HHS can shape Healthy People to prompt action on social and environmental determinants of health

Recommendations for priority-setting

Recommendations on Data & IT [from Strategic Communication Subcommittee]

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Ad Hoc Group on Ad Hoc Group on Social Determinants of HealthSocial Determinants of Health

Abby King, PhDAd Hoc Group Chair

Stanford University

Recent Activities of Ad Hoc Group on Social Determinants of Health Met twice (October 2009, February 2010) to

discuss concrete examples that HHS could use to work across topic areas.• The Subcommittee could provide more specific

suggestions directly to the FIW if needed.• Guidance could be developed on how the FIW can

incorporate social determinants of health into implementation strategies for HP2020.

Ad Hoc Group on Social Determinants:Recommendation #1 Encourage and support the FIW’s role in:

• Operationalizing the cross-cutting elements of HP2020 that pertain to physical and social environments and extend beyond the health field.

• Making it a priority to focus on social determinants that will impact multiple determinants of health.

Ad Hoc Group on Social Determinants:Specific Steps to Prompt Action on SDOH

Identify and disseminate planning models that have been adapted to focus on social determinants. • Specify concrete sets of steps for promoting local, state, and

national policies to address social and environmental

determinants of health and eliminate or mitigate determinants

that harm health.

Incorporate planning models from other relevant fields (e.g., public health, education, transportation, housing, law enforcement, etc.) and both the public and private sectors.

Ad Hoc Group on Social Determinants:Recommendation #2 Identify and select specific measures that can be

used to track processes and impacts related to initiatives to influence social determinants.

Such tools should be applicable to both:

• The population at-large, and • Subpopulations that experience health disparities.

Ad Hoc Group on Social Determinants:Recommendation #3 Provide:

• Practical and useful information collection tools related to these identified measures, where available;

• Examples of ways to synthesize the relevant data.

Ad Hoc Group on Social Determinants:Recommendation #4 Wherever possible, give specific examples for

topic areas that demonstrate how programs and policies to affect SDOH can be implemented.

Ad Hoc Group on Social Determinants:Recommendation #5 Evaluate recommendations and activities being

undertaken by other nations in the social and environmental determinants arena.

Next StepsNext Steps

Amendments to recommendations? Vote to approve?

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Subcommittee on PrioritiesSubcommittee on Priorities

David Meltzer, MD, PhDSubcommittee Co-Chair

University of Chicago

Abby King, PhDSubcommittee Co-Chair

Stanford University

Recent Activity, Subcommittee on PrioritiesRecent Activity, Subcommittee on Priorities

Met three times between October and March.

Determined that, given the sheer number of objectives, it is necessary to give users tools to prioritize among them.

• There is an opportunity cost when one does not make choices.

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Recent Activity, Subcommittee on PrioritiesRecent Activity, Subcommittee on Priorities

The Subcommittee has proposed a multi-level approach to priority-setting, based on the following ideas:

• Public health priorities should be set by localities, states, and at the national level;

• Processes used to set priorities should engage civic participation;

• HHS should identify national priorities for the coming decade.

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Proposed Approach to Priority-SettingProposed Approach to Priority-Setting

Priority-setting should be conducted for:

1. Interventions to address specific topic areas (e.g., “Cancer” or “Early and Middle Childhood”);

2. Interventions to address the major risk and protective factors for common diseases;

3. Interventions that address determinants of health outside the traditional health sector.

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Recommendations of the SubcommitteeRecommendations of the Subcommittee

1. Priorities should be set at each level of government—federal, state, and local.

2. Each level should incorporate public input into its priority-setting processes.

3. Priority-setting should be informed by specific criteria (e.g., overall burden, preventability, potential to reduce health disparities, and cost-effectiveness).

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Next StepsNext Steps

Amendments to recommendations? Vote to approve?

35

Subcommittee on Strategic Subcommittee on Strategic CommunicationsCommunications

W. Douglas Evans, PhD Subcommittee Chair

George Washington University

Strategic Communications

Five meetings since October Ron Mandersheid, Eva Moya, and Doug

Evans attended from the committee Worked on developing strategic

communication objectives and strategies Started from previous audience matrix Input from ongoing ODPHP/HHS activities

and research

HHS activities and research

Linda Harris presented Healthfinder.gov Reaches health professionals and general

public, includes Twitter account Synthesizes evidence into actionable

information for multiple audiences Offers opportunity for HP2020 communication

research• Who uses it? For what? What is social media

contribution? Does use lead to behavior change?

Other activities

Big ODPHP partnership component Partnerships can be leveraged to build HP2020

awareness and utilization ODPHP audience research Recommendations for Health IT and strategic

communications• Develop HHS plan for public health IT infrastructure• Should include plans for HP2020 strategic

communications capabilities

Example of expanded audience matrix elementsAudience type

User group

What should they know?

Comm Objectives

Channels

Primary audiences

Federal agencies

Uses of HP for planning, program management, development, evaluation

Increase awareness of health in all policies as priority

Get HP 2020 on domestic policy council

agenda

Secondary audiences

General public

How HP can offer guidance for personal

decisions

Develop HP 2020 brand position and promise that shows “What I can do”

Develop network of HP 2020 advocates in communities

Next StepsNext Steps

Amendments to recommendations? Vote to approve?

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Subcommittee on Subcommittee on Action Steps and Evidence Action Steps and Evidence

Jonathan Fielding, MD, MPH, MA, MBA Subcommittee Co-Chair

Los Angeles County Department of Public Health

Steven Teutsch, MD, MPHSubcommittee Co-Chair

Los Angeles County Department of Public Health

Subcommittee on ASE: Charge Subcommittee on ASE: Charge

How can HHS best show HP 2020 stakeholders how to use the exhaustive list of objectives?

How can HHS maximize its adoption and use? What processes can HHS use to ensure that

action steps included in HP 2020 are grounded in solid scientific evidence?

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Subcommittee on ASE: Members Subcommittee on ASE: Members

Martin Fenstersheib, Santa Clara County David Fleming, Seattle King County George Isham, HealthPartners, Inc. Lynn Silver, New York City

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Healthy People 2010 User StudyHealthy People 2010 User Study

[Alternate slide set]

45

Summary and Next StepsSummary and Next Steps

Subcommittee charges Future meeting dates and plans

46