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Leading Health Indicators Development and Framework

Leading Health Indicators Development and Selection Process

The process of selecting the Leading Health Indicators (LHIs) mirrored the extensive collaborative efforts undertaken to develop Healthy People 2020. The process was led by the Healthy People 2020 Federal Interagency Workgroup, with approximately 50 members from across the U.S. Department of Health and Human Services (HHS) and other Federal departments.

Reports by the Institute of Medicine of the National Academy of Sciences and the Secretary’s Advisory Committee on National Health Promotion and Disease Prevention Objectives for 2020 provided several recommendations for HHS to consider in developing the final set of LHIs. In addition, consideration was given to other indicator sets, such as the National Prevention Strategy mandated by the Affordable Care Act, as well as to key priorities of the secretary and the assistant secretary for health, to ensure alignment among the various prevention initiatives within HHS and across the Federal government.

Leading Health Indicators Framework

The Healthy People 2020 LHIs were selected and organized using a Health Determinants and Health Outcomes by Life Stages conceptual framework. This approach is intended to draw attention to both individual and societal determinants that affect the public’s health and contribute to health disparities from infancy through old age, thereby highlighting strategic opportunities to promote health and improve quality of life for all Americans.

  • Determinants of Health and Health Disparities
    Biological, social, economic, and environmental factors—and their interrelationships—influence the ability of individuals and communities to make progress on these indicators. Addressing these determinants is key to improving population health, eliminating health disparities, and meeting the overarching goals of Healthy People 2020.

  • Health Across Life Stages
    LHIs are being examined using a life stages perspective. This approach recognizes that specific risk factors and determinants of health vary across the life span. Health and disease result from the accumulation (over time) of the effects of risk factors and determinants. Intervening at specific points in the life course can help reduce risk factors and promote health. The life stages perspective addresses 1 of the 4 overarching goals of Healthy People 2020: “Promote quality life, healthy development, and health behaviors across all life stages.”