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Phase II Update: Contributions of the Committee

Dr. Fielding reminded the Committee of their accomplishments during Phase II of Healthy People 2020 development, which began in December 2008. He noted that the Committee has approved the following five recommendations and reports to-date:

  1. An “Immediate Actions” memo, highlighting issues of particular urgency for population health in light of the economic downturn;
  2. A “System Specifications” report, which provided practical guidance for an approach to developing an interactive, Web-based version of Healthy People 2020;
  3. A “Proposed List of Topic Area Categories,” offering 49 topics that could be used to organize the Healthy People objectives, as well as observations about the function of topic areas in HP2020.
  4. An “Approach to Developing Healthy People 2020 Target-setting Methods,” which recommended using a variety of data sources and processes to set realistic but “aspirational” targets for objectives, incorporating knowledge of effective interventions when it is available.
  5. A letter to the Secretary, emphasizing the need for a Web-based format for Healthy People 2020.

Two items were discussed at previous meetings, but have not yet been formally approved by vote:

  1. The “Implementation Recommendations” was a list of specific strategies that Committee members believed were important to ensure the adoption and effectiveness of Healthy People efforts.
  2. “Evaluating Sources of Knowledge for Evidence-based Actions” offered a realistic but rigorous approach to ensuring that implementation strategies for Healthy People are grounded in science.

II. HHS Update

HHS Response to Committee Recommendations

RADM Penelope Slade-Sawyer explained that all of the Committee’s Phase II recommendations have been delivered to the Secretary. The Federal Interagency Workgroup (FIW) has reviewed system specifications report for an online version of Healthy People 2020, as well as the proposed list of topic area categories and the Committee’s proposed approach to target-setting. As a result of the Committee’s recommendations, several divisions within HHS are working to secure the funding needed for the online, relational database in time for the Healthy People 2020 launch. The Committee’s recommendations for the list of topic area categories guided the FIW’s selection of Healthy People 2020’s topic areas; HHS has built on the existing 2010 focus areas to create the list of 2020 topic areas.

The FIW has used the Committee’s target setting recommendations as a foundation for the Healthy People 2020 target setting guidance. The targets have been set primarily using available science and information, modeling existing policies and laws, and maintaining consistency with other Federal targets or programs. When the information needed to employ these methods is not available, the target will be set using a method of ten percent improvement above baseline. Topic area work groups are required to submit a written justification for the targets to increase transparency and improve the public’s understanding of the process.

FIW Progress and Activities

The public comment period for Healthy People 2020 objectives ended on December 31, 2009. Approximately 8,000 comments were received through the Web site, regular mail, and the public meetings that were held across the country last fall. All comments were reviewed by the appropriate topic area Workgroup Coordinators. Beginning in February and ending in May of this year, the FIW has met to discuss about 180 proposed revisions to the objectives based on public comment. Currently, there is a net increase of approximately 25 measures, and there will be approximately 1,315 measures in Healthy People 2020.

The topic area workgroups are writing introductory material for each topic area, setting targets, and establishing operational definitions that will be used to measure the 2020 objectives. The FIW and its subgroups on social determinants of health, health related quality of life, and the newly formed “Foundations” subgroup, are developing a narrative and specific measures that will underpin all of Healthy People 2020.