The Subcommittee on Topic Areas proposed that Healthy People 2020 topic area categories might be organized under the four elements of the Mission Statement (see Appendix 1). The topic areas could build on earlier iterations of the initiative to offer some continuity, and add a new focus on health equity and determinants of health in the social and physical environment. Dr. Remington said the Subcommittee views topic areas as important “doors of entry” into the relational database. A remaining task would be to link the objectives together to show the logic for how a health outcome relates across the continuum of the framework—whether focused on diseases/health outcomes, or on determinants/programs and policies.
Dr. Fielding suggested that the Subcommittee develop a list of specific topic area categories for review by the Committee. Dr. Shiriki Kumanyika, Committee Vice-Chair, said it is important to link the topic areas to the framework to ensure that the areas in the framework are covered (especially the broad determinants and the life course issues). Dr. Remington concurred, and said the challenge would be to coordinate the overlap in areas where groups may be working on determinants as well as program and policy issues.
A Committee member asked whether topic areas would be assigned to a single Healthy People 2020 goal. She argued against doing this because, for example, not all disabilities are preventable. Another member responded that the Subcommittee on System Specifications had been using relational thinking to outline the mechanisms by which people will enter the Healthy People database. A dynamic approach to addressing topics from multiple entry points suggests that topics will be interrelated. The notion that a topic area would match up with a single goal is inconsistent with the trajectory of this thinking. Dr. Fielding summarized by saying that the table presented by the Subcommittee was helpful to ensure that no important issues are omitted, but that the Committee should not suggest that the topics would only fit into the four categories of the Mission Statement.
Dr. Fielding asked RADM Penelope Slade-Sawyer, Deputy Assistant Secretary for Health for Disease Prevention and Health Promotion, to provide an update on the progress of the U.S. Department of Health and Human Services (HHS) in developing Healthy People 2020. RADM Slade-Sawyer explained that the Federal Interagency Workgroup (FIW) was making final edits to the vision, mission, and overarching goals. She reviewed changes that the FIW has proposed for each of these elements of the framework, and then gave an overview of the timeline for developing a draft set of objectives by the summer. From March through June of 2009, HHS workgroups and the FIW would be convening to develop and review specific objectives for Healthy People 2020. From June through July, HHS staff would recommend specific knowledge-based interventions for achieving the proposed Healthy People 2020 objectives.
II. HHS Update
RADM Slade-Sawyer stressed that HHS will accept public comments through a variety of means throughout the objective development process, including the Internet and public meetings. In coming weeks, the Healthy People 2020 public comment Web site (www.healthypeople.gov) will be updated to allow submission of comments on the current Healthy People 2010 objectives. In the summer, a draft set of objectives for Healthy People 2020 will be posted for public comment. ODPHP is also planning to solicit comments through regional meetings that will be open to the public. (Dates and locations for those meetings have not yet been announced.) RADM Slade-Sawyer explained that, to meet the goal of launching Healthy People 2020 in early 2010, HHS would like to receive feedback from the Advisory Committee on the following issues:
- Healthy People 2020 topic areas (by March, 2009)
- Target-setting methodologies (by April, 2009)
- Criteria for selecting knowledge-based strategies (by May, 2009)
- Recommendations for implementation strategies (by June, 2009).