[Federal Register Volume 62, Number 172 (Friday, September 5, 1997)]
[Notices]
[Pages 46975-46977]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-23567]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Office of the Secretary
Health Promotion and Disease Prevention Objectives for 2010
AGENCY: DHHS/OS/Office of Public Health and Science, Office of Disease
Prevention and Health Promotion (ODPHP).
ACTION: Call for (1) comments on the proposed structure for Healthy
People 2010 national health objectives for the year 2010 and (2)
proposed objectives.
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SUMMARY: The Department of Health and Human Services is soliciting
comments on the proposed structure for Healthy People 2010, the third
set of decade-long national health promotion and disease prevention
objectives. The Department is also soliciting proposed objectives for
2010. Guidance for comments is provided in the DHHS publication
Developing Objectives for 2010. During the fall of 1997, individuals
and organizations are encouraged to submit (1) comments on the proposed
framework envisioned for 2010 (see Appendix to this Notice) and/or (2)
objectives for 2010. In the fall of 1998, a draft document of Healthy
People 2010 objectives will be made available for public review and
comment.
DATES: The comment and submission period is September 15 through
December 15, 1997.
ADDRESSES: By mail, comments postmarked no later than December 15 can
be submitted to--Office of Disease Prevention and Health Promotion,
Attention: Healthy People 2010 Objectives, Department of Health and
Human Services, Room 738-G Hubert H. Humphrey Building, 200
Independence Avenue, SW., Washington, DC. 20201. Comments sent by
courier service will be accepted until 5 p.m. EST on December 15.
Comments may also be submitted electronically through the Healthy
People Home Page--http://web.health.gov/healthypeople.
FOR FURTHER INFORMATION CONTACT:
Office of Disease Prevention and Health Promotion, Room 738-G Hubert H.
Humphrey Building, 200 Independence Avenue, SW., Washington, DC 20201,
(202) 205-8583.
SUPPLEMENTARY INFORMATION:
Background
In 1979, the Department of Health and Human Services began an
initiative to use health promotion and disease prevention objectives to
improve the health of people living in the United States. The first set
of national health targets was published that year in Healthy People:
The Surgeon General's Report on Health Promotion and Disease
Prevention, which included five goals to be achieved by 1990 to reduce
mortality among four different age groups and increase independence
among older adults. The goals were supported by objectives that were
released in 1980, also with 1990 targets.
Healthy People 2000, the second and current national prevention
initiative, reflects the progress and experience of ten years, as well
as an expanded science base and surveillance system. With the
collaboration of an extensive network of voluntary and professional
organizations, businesses, and individuals, the framework of Healthy
People 2000 was designed with three broad goals--increasing the span of
healthy life, reducing health disparities, and achieving access to
clinical preventive services. To help meet these goals, 319 objectives
and 319 special population targets, organized into 22 priority areas,
aim to achieve improvements in health status, risk reduction, and
service delivery.
Structure of Healthy People 2010
The healthy People 2010 process will build on Healthy People 2000.
To ensure that the year 2010 goals and objectives address the needs of
their many stakeholders, your input is requested. ODPHP is soliciting
public assessment and comments on a preliminary framework (see Appendix
to this Notice), which was developed with the assistance of focus
groups composed of representatives from Healthy People 2000 Consortium
member organizations. This draft framework includes a vision statement
``Healthy People in Healthy Communities.'' Two overarching goals for
the Nation are proposed: (1) Increase years of healthy life, and (2)
eliminate health disparities. This first goal continues the year 2000
goal with an emphasis on increasing quality life years, not just life
expectancy. The second goal strengthens the Healthy People 2000 goal of
reducing health disparities by calling for the elimination of those
disparities. Four proposed enabling goals accompany the overarching
ones. Their purpose is to provide strategies to achieve the overarching
goals by: (Promoting healthy behaviors; (2) protecting health; (3)
assuring access to quality health care; and (4) strengthening community
prevention activities.
The proposed focus areas are analogous to, and for the most part
use the same names as, Healthy People 2000 priority areas. The term
``focus area'' was chosen to avoid any implication of prioritization.
New focus areas have been suggested in response to changes in health
care and public health during the last 10 years and those anticipated
over the next decade. These include mental and physical impairment and
disability, and public health infrastructure. Since one of the
overarching goals is to eliminate health disparities, specific special
population focus areas--low income, race/ethnicity, gender, age, and
people with disabilities--are under consideration to address this goal.
In each of these focus areas, special population objectives would
target the most significant
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disparities in health status, health risk, and service delivery.
Comments on the framework are invited to address (1) The proposed
framework in its entirety; (2) the proposed vision statement; (3) the
two proposed overarching goals; (4) the four proposed enabling goals;
(5) the proposed focus areas; (6) the proposed arrangement of focus
areas; or (7) entirely new proposals. For each heading addressed, the
commenter should consider the appropriateness and usefulness of the
proposed approach and/or offer alternative approaches. After the close
of the comment period, the framework will be reconsidered and recast on
the basis of comments received. A revised framework will be included in
the draft 2010 document and a notice calling for public comment on the
draft will be published in the Federal Register in the fall of 1998.
Objectives for Healthy People 2010
Objectives for Healthy People 2010 can be updated or modified
Healthy People 2000 objectives or entirely new ones submitted by
commenters. The proposed approach for Healthy People 2010 calls for two
broad types of objectives--measurable and developmental objectives.
Recommendations for both types will be accepted during the comment
period.
Measurable objectives provide direction for action. They have
baselines that use valid and reliable data derived from currently
established, nationally recognized data systems. These baseline data
provide the point from which a 2010 target can be set. Whenever
possible, objectives should be measured with national systems that
either build on, or are comparable with, state and local data systems.
However, state data are not a prerequisite for developing an objective.
Proxy data may be used when national data are not available or when
regional data provide better measurability. When providing an idea for
a measurable objective, please cite the data source. An example of a
measurable objective is ``Reduce the infant mortality rate by (XX)
percent to no more than (X) per 1,000 live births.'' The current
Healthy People 2000 baseline is 10.1 per 1,000 live births in 1987, as
recorded by National Vital Statistics System, the data source.
Developmental objectives describe a desired outcome or achieved
health status. However, current surveillance systems do not provide
data on these objectives. The purposes of developmental objectives is
to identify areas that are important and to stimulate the development
of data systems to measure them. An example of a developmental
objective is ``Increase to at least 90 percent the proportion of
pregnant women and infants who receive risk-appropriate care.''
Baseline data to measure such an objective are not currently available.
Proposals for 2010 objectives received by ODPHP will be assigned
for consideration to lead agencies of DHHS, which will select proposed
objectives for inclusion in the draft 2010 document. This draft will be
available for public review and comment from October to December 1998.
A listing of lead agencies is contained in the DHHS publication
Developing Objectives for Healthy People 2010. This publication is for
sale by the U.S. Government Printing Office, stock #017-001-00530-4;
the price is $18, which includes shipping and handling. All orders must
be prepaid. To order, call (202) 512-1800; FAX (202) 512-2250; or send
orders to--Superintendent of Documents P0 Box 371954, Pittsburgh, PA
15250-7954.
Information about the Healthy People initiative as well as many
publications relating to it are available electronically on the Healthy
People Home Pages--http://odphp.osophs.dhhs.gov/pubs/hp2000 and http://
web.health.gov/healthy people
Dated: August 29, 1997.
John M. Eisenberg,
Acting Assistant Secretary for Health.
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