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2 The Process for Identifying Candidate Leading Health Indicators
Pages 13-26

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From page 13...
... That is because the HP2030 objectives had not been finalized at the time the committee began its work and were not expected to be completed until much later. Thus, instead of obtaining a list of LHI candidates based on evaluating and rating each of the 355 draft core objectives, the committee used two approaches that integrated all LHI selection criteria (see Table 2-1)
From page 14...
... Closing Gaps the health and well- • Balance: common • Health disparities being of the nation upstream root causes • Health equity • Magnitude of the health and high-priority health • Health literacy disparity and the degree states to which health equity • Amenable to Cultivating Healthier would be achieved if the interventions of Environments target were met different types (policy, • Physical environments • The degree to which the environmental, • Social environments objective is a sentinel or systems) at all levels • Economic environments bellwether (e.g., national, state, • Actionability local, and for the Increasing Knowledge and purpose of, including Action informing international • Shared responsibility across comparisons)
From page 15...
...  ties and/or support achieving health equity. Health equity and disparities have been an important part of the Healthy People initiative since Healthy People 2000.
From page 16...
... The committee's present work builds on the first report on criteria for LHI selection (see Box 2-2 for the report's findings and recommendations) .1 This report proposes LHIs -- and where appropriate, new topics and objectives related to LHIs for which there were no extant draft core objectives -- that reflect the intent of all components of the HP2030 Framework and criteria for core objective selection.
From page 17...
... Finding 2: The committee finds that the draft objectives do not offer an appropri ately balanced and comprehensive range from which to derive Leading Health In dicators (LHIs) that also reflect the intent of the Healthy People 2030 Framework's vision, mission, foundational principles, and overarching goals.
From page 18...
... AHR = America's Health Rankings; AHRQ = Agency for Healthcare Research and Quality; BARHII = Bay Area Regional Health Inequities Indicators; CDC = Centers for Disease Control and Prevention; CHR = County Health Rankings; HHS HP2020 = Healthy People 2020
From page 19...
... . Prevention OECD OECD Institute IOM WHO HUD Healthy Health Social Health Vital 100 Communities IOM at a at a Equity Signs Health Index HP2020 Glance Glance Indicators Report Core WIN X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X LHIs; HUD HCI = Department of Housing and Urban Development Healthy Communities Index; IOM HP2020 = 2011 IOM report on the HP2020 Leading Health Indicators; OECD = Organisation for Economic Co-operation and Development; Vital Signs = 2015 IOM Vital Signs report; WHO 100 Core = World Health Organization 100 Core Measures; WIN = Wellbeing in the Nation.
From page 20...
... Health disparities, however, refer to health differences that are based on or originate in social disadvantages. A recent National Academies study defined health equity as "the state in which everyone has the opportunity to attain full health potential and no one is disadvantaged from achieving this potential because of social position or any other socially defined circumstance" (NASEM, 2017, p.
From page 21...
... . This suggests the importance not only of monitoring health data disaggregated by different demographic groups but also of monitoring the social and structural inequities that affect health.
From page 22...
... . Well-being and health are seen as interactive concepts whereby health influences overall well-being, and wellbeing affects future health (WHO, 2012)
From page 23...
... . FIVE STEPS TO SELECT CANDIDATE LEADING HEALTH INDICATORS Overview The committee undertook two separate approaches resulting in five total steps in its effort to identify a slate of LHI candidates to recommend to the Department of Health and Human Services (HHS)
From page 24...
... The committee applied the objective selection criteria to committee-proposed LHI candidates not found on the HHS list of draft objectives to ensure that proposed measures qualified (see Box 2-1 for the objective selection criteria)
From page 25...
... Level 3, or "strong" evidence, rests on nonsystematic reviews published by the federal government and nonsystematic reviews published in peer-reviewed journals. Level 2, seen as "moderate" evidence, emerges from journal articles of individual studies, published intervention research, and published pilot studies.
From page 26...
... 26 LEADING HEALTH INDICATORS 2030 well-being do not necessarily have the same links to an evidence base that health measures do. The LHIs the committee proposes are supported either by evidence that specific interventions will improve outcomes or by evidence that the LHI is itself a marker of better health or well-being.


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