Leading Health Indicators for Healthy People 2020 - Letter Report
For the past three decades, the Department of Health and Human Services (HHS) has issued a national agenda aimed at improving the health of all Americans over each 10-year span. Under each of these Healthy People initiatives, HHS established health targets and monitored how well people were reaching them over time. Healthy People 2020 lays out the proposed agenda for the current decade, which will end in 2020.
As Healthy People 2020 is in its early days, HHS asked the Institute of Medicine (IOM) to review the objectives and recommend leading health indicators that could help sharpen the focus of the agenda. The IOM convened a committee of experts to respond to its charge. The committee’s report, Leading Health Indicators for Healthy People 2020, considered, among other resources, the work of another IOM committee that examined how a private, nonprofit group called State of the USA was developing reliable indicators that measure the nation’s health.
National Mission of Improving Health
As envisioned by HHS, the mission of Healthy People 2020 is broad in scope. It will identify nationwide health improvement priorities; increase public awareness and understanding of determinants of health, disease, disability, and understanding of opportunities for progress; provide measurable objectives and goals applicable at national, state, and local levels; engage multiple sectors to take actions to strengthen policies and improve practices that are driven by the best available evidence and knowledge; and identify critical needs for research evaluation and data collection. The agenda’s overarching goals include enabling the nation to achieve health equity and eliminate disparities; create social and physical environments that promote good health; and promote quality of life, healthy development, and healthy behaviors across life stages.
Defining Critical Health Terms
Healthy People 2020, like previous versions, is structured to identify a number of topics and objectives that collectively provide a blueprint for improving the nation’s health. With the steady advance of science and medicine, each decade’s agenda has grown increasingly detailed. Healthy People 2020 lists 42 topics and nearly 600 objectives. By comparison, Healthy People 2000 listed 15 topics and 226 objectives. As part of its charge, the IOM committee was asked to develop 12 key indicators and 12 topics as well as to selectively identify 24 objectives that are critical to the nation’s health needs.
As a first step, the committee refined the definitions of the four terms. A topic is defined as a general category relevant to health; for example, chronic illness. An indicator is defined as a measurement; for example, prevalence of cardiovascular disease. An indicator could relate to multiple topics; for example, the indicator percentage of adults with a body mass index—BMI—equal to or greater than 30 could relate to the topics of chronic disease and health behaviors. Leading health indicators are measurements of health-related concepts that reflect major public health concerns. Finally, an objective is defined as a statement of movement in an indicator toward a quantitative target; for example, reducing the prevalence of cardiovascular disease by 10 percent.