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3 The Healthy People 2030 Draft Objectives
Pages 15-28

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From page 15...
... Because the LHI selection criteria begin with "[a] ll core objectives," 1 Italics added for emphasis.
From page 16...
... SOURCE: SAC, 2018. the National Academies committee also reviewed the HP2030 draft objectives available on the HHS Healthy People website and the objective selection criteria (see Box 3-1)
From page 17...
... (The HP2030 draft objectives include a narrow subset of data sources from other federal agencies, such as the Department of Agriculture data pertaining to food security and the Department of Education data pertaining to educational milestones and to disability.) In all cases where new objectives are identified, the data sources from which they are gathered would need to conform to the same stringent quality review as do those currently in use.
From page 18...
...  a. irect impact or influence on health: Does this objective address an D outcome or preventive/risk factor that has a direct impact on population health?
From page 19...
... Achieving health equity requires valuing everyone equally with focused and ongoing societal efforts to address avoidable inequal ities, historical and contemporary injustices, and the elimination of health and healthcare disparities." OMH defines health disparities as, "A particular type of health difference that is closely linked with social or economic disadvantage. Health disparities adversely affect groups of people who have systematically experienced greater social and/or economic obstacles to health and/or a clean environment based on their racial or ethnic group; religion; socioeconomic status; gender; age; mental health; cognitive, sensory, or physical disability; sexual orientation; geographic location; or other characteristics historically linked to discrimination or exclusion." Objectives are also considered for inclu sion, based on the expectation that the data source is able to track the follow ing population level data.
From page 20...
... For example, the ninth meeting of the SAC in May 2018 included an update about the FIW efforts to generate HP2030 draft objectives. A member of the SAC asked how the FIW plans to engage nontraditional health sectors (e.g., agri­ ulture, education, transportation)
From page 21...
... However, on its review of the more than 350 draft core objectives for their suitability as potential LHIs, the committee made four findings. Finding 1: The committee finds that the Healthy People 2030 draft objectives document is missing some key topics necessary to fully reflect the intent of the Healthy People 2030 Framework's vision, mis sion, foundational principles, and overarching goals.6 The draft topics and the objectives nested in each topic demonstrate a disconnection from the aspirations of the HP2030 process reflected in the Framework and the explanatory issue briefs.
From page 22...
... The social determinants of health are primarily organized in one eponymous topic area, with a small number in two to three additional topic areas, but they are not shown and do not operate as a cross-cutting topic, such as social determinants of health that apply to different life stages, or with systematic attention to upstream factors that are linked with several different health states or outcomes. Having topics and objectives that are explicitly aligned with the concept of well-being is not only consistent with the ecological model of health, but it may also help explain the importance of crosssector coordina­ ion and collaboration, and "shared responsibility." This is t a ­ rticulated in the foundational principles of the HP2030 Framework, which state "[h]
From page 23...
... The six core objectives under the social determinants of health topic of the HP2030 draft objectives represent a disparate assortment that includes two objectives related to employment, two on education, one on housing, and one on incarceration and criminal justice. A more systematic approach to each of the social, physical, and economic determinants of health -- as described in the HP2030 Framework and in the issue briefs -- would consider all areas where the evidence is robust or strong, as well as linkages with life stages, among other cross-cutting considerations.
From page 24...
... . Given the modest contribution of medical care to health outcomes, and the robust evidence that factors ranging from income inequality, to adverse childhood experiences, to housing instability considerably influence population health, it is striking that the draft core objectives are largely oriented toward clinical m ­ easures/measures of health states.
From page 25...
... , which contains a review of the draft objectives, and believes that if the SAC's recommendations are implemented, they are likely to strengthen the final set of HP2030 objectives, providing a more well-rounded and HP2030 Framework-aligned complement of core objectives from which to select LHIs. Finding 3: The committee finds that the Healthy People 2030 draft ob jectives document includes too few objectives that allow for making important comparisons to other countries, including to peer nations in the Organisation for Economic Co-operation and Development.
From page 26...
... ON OBJECTIVES FROM OTHER SECTORS IMPORTANT TO HEALTH AND WELL-BEING Although Healthy People 2030 emphasizes that well-being is produced not only by health sectors, but across all sectors of society, we note that only a small subset of the data sources for the HP2030 draft objectives r ­eside outside the health domain. These include data from the Department of Agriculture, Department of Education, Department of Housing and Urban Development, and Department of Transportation.
From page 27...
... For example, several federal departments and agencies list emergency preparedness and response activities in their strategic plans, such as the Department of Homeland Security, Department of the Interior, and the Small Business Administration.15 In terms of the social determinants of health, the Department of Education, Department of Housing and Urban Development, and Department of the Treasury address issues such as educational attainment, sustainable homeownership, housing security, and safety in their strategic plans as well.16 In considering health exposures and outcomes, the language in the strategic plans of the Department of Transportation and the Environmental Protection Agency aligns with HP2030 objectives related to protecting air quality and ensuring clean and safe water, and reducing the number of fatalities and serious injuries, respectively. Another example of an area of alignment may be found in the Depart­ ment of Education highlighting absenteeism as a key metric of educational success.17 Research from the George W
From page 28...
... Richmond, California, has been a pioneer in adopting a health-in-all-policies approach in public–private collaboration involving the city and county;19 the city of Appleton in Wisconsin has enacted a Health in All Policies ordinance; Fairfax County, Virginia, has a health-in-all-policies program and a health-in-all-policies manager that engages with other government agencies in the county; and Kent County, Michigan, has a Health in All Policies learning lab and toolkit.20 19  See https://www.phi.org/uploads/files/Health_in_All_Policies-A_Guide_for_State_ and_Local_Governments.pdf (accessed July 2, 2019)


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