Healthy People: The Role for Measurement, Data, and Evaluation to Inform Policies Aimed at Improving Health and Equity in Communities Angela McGowan, JD, MPH Project Director, Office of Disease Prevention and Health Promotion, U.S. Department of Health and Human Services Twitter: @angiemcgowan February 11, 2020 | Law and Health Policy
Healthy People Initiative and Developing Healthy People 2030 Law and Health Policy |
What Is Healthy People? • Provides a strategic framework for a national prevention agenda that communicates a vision for improving health and achieving health equity • Identifies science-based , measurable objectives with targets to be achieved by the end of the decade • Requires tracking of data-driven outcomes to monitor progress and to motivate, guide, and focus action • Offers a model for international, state, and local program planning 3 Law and Health Policy |
Evolution of Healthy People and Health Equity Across the Decades Target Year 1990 2000 2010 2020 2030 • • • • • Decrease Increase span Increase quality Attain high-quality, longer Attain healthy, thriving lives and well- Overarching Goals mortality: of healthy life and years of lives free of preventable being, free of preventable disease, • infants – adults Reduce health healthy life disease disability, injury and premature death. • • • • Increase disparities Eliminate Achieve health equity; Eliminate health disparities, achieve • independence Achieve access health eliminate disparities health equity, and attain health literacy • among older to preventive disparities Create social and physical to improve the health and well-being of adults services for all environments that all. • promote good health Create social, physical, and economic • Promote quality of life, environments that promote attaining healthy development, full potential for health and well-being healthy behaviors across for all. • life stages Promote healthy development, healthy behaviors and well-being across all life stages. • Engage leadership, key constituents, and the public across multiple sectors to take action and design policies that improve the health and well-being of all. Leading Health 10 topics 12 topics TBD Indicators 22 indicators 26 indicators Topic Areas 15 22 28 42 40 Objectives 226 319 ~1,000 >1,200 355 * Law and Health Policy | 4
Streamlining Objectives • Objective Selection Criteria Healthy People 2020: o Baseline data from 2016 or later ~1,200 o Collection of at least 2 data points in addition to the baseline by 2030 Stage I & II o Address health concerns of Assessment: ~500 national importance FIW o Identification of at least 1 evidence-based intervention Review: o Considerations related to health ~400 disparities and health equity 355* * Number of Objectives Submitted for Public Comment 5 Law and Health Policy |
Healthy People 2030 Objective Types Core Objectives • Must address all of the core inclusion criteria • Targets will be set Developmental Objectives • Focus on need to develop data sources and data collection • Represent high priority issues that do not have reliable baseline data, but for which evidence-based interventions have been identified Research Objectives • Focus on need to advance research and develop evidence-base interventions in an area • Represent significant opportunities for advancement in areas with limited research, a high degree of health or economic burden (preventable or otherwise), or evidence of substantial disparities between populations 6 Law and Health Policy |
Role for the Social Determinants of Health and Health Equity 7 Law and Health Policy |
Healthy People’s Social Determinants of Health Framework and Key Issue Areas Objectives should seek to reduce health disparities and increase health equity as much as possible, including addressing social determinants of health Poverty High school Access to health Quality of Social cohesion graduation rates services housing Employment Discrimination Enrollment in Access to Crime and Housing stability Civic higher education primary care violence participation Food insecurity Early childhood Health literacy Environmental Incarceration education and conditions development Access to healthy Language and foods literacy Law and Health Policy |
Health Equity Issue Brief Health equity is “attainment of the highest level of health for all people” • To achieve health equity, we must recognize that multiple determinants of health and well-being interact with each other across the life span. • The ability of Healthy People 2030 to measure its success in achieving health equity will depend on ongoing surveillance of health inequalities between more and less advantaged social groups. Law and Health Policy |
Healthy People Data and Disparities Resources Law and Health Policy |
Law and Policy in Healthy People and Tools and Resources to Identify and Evaluate Evidence-Based Laws and Policies Law and Health Policy | 11
Why Use Law and Policy to Help Meet Healthy People Goals? Private Federal Entities Tribal Businesses Non- Local Profits Religious Groups State Statutes & Case Law Licensure Regulations Ordinances Law and Policy Actions Handbooks Accreditation Guidance Contract Budgets Documents Language 12 Law and Health Policy |
Law and Policy in Healthy People, 1990 – 2020 Topic Areas Objectives with Law Decade Related to Relevant Topic Areas and Policy Law and Policy Objectives Healthy People 4 of 226 3 of 15 Toxic Agent and Radiation Control, Smoking and Health, Nutrition 1990 objectives topic areas Tobacco, Substance Abuse: Alcohol and Other Drugs, Violent and Abusive Behavior, Unintentional Injuries, Occupational Safety and Healthy People 27 of 319 10 of 22 Health, Environmental Health, Food and Drug Safety, Cancer, 2000 objectives * topic areas Diabetes and Chronic Disabling Conditions, Immunization and Infectious Diseases Environmental Health, Injury and Violence Prevention, Physical Healthy People 23 of ~1,000 6 of 28 Activity and Fitness, Public Health Infrastructure, Substance Abuse, 2010 objectives ^ topic areas Tobacco Use Adolescent Health, Early and Middle Childhood, Environmental Healthy People 59 of >1,200 10 of 42 Health, Injury and Violence Prevention, Maternal, Infant, and Child 2020 objectives ^ topic areas Health, Nutrition and Weight Status, Physical Activity, Preparedness, Substance Abuse, Tobacco Use • In HP2000, some objectives were included under more than one topic area. These duplicate objectives were given more than one objective number (e.g., 3.11 and 10.18) . For this exercise, these objectives are counted twice to reflect they are in both topic areas. ˄ In HP2010 and HP2020, some objectives are grouped under a main objective "header." The sub -objectives are the measurable objectives. The number of relevant objectives reflects all measurable objectives that are related to law and policy. 13 Law and Health Policy |
Law and Health Policy Project Reports and Related Products • Reports and community “Bright Spots” Webinar Series • Focused on specific Healthy People 2020 topics • Shares community examples of innovative uses of law and policy to improve health outcomes Supporting the Development of Healthy People 2030 (HP2030) • HP2030 Listening Session: 2018 Public Health Law Conference For more information: www.healthypeople.gov/2020/law- and-health-policy 14 Law and Health Policy |
Law and Policy effectively serve as the nation’s primary structural engineer, responsible for its foundation, its most important design features, and its resiliency. ~ Healthy People 2030 Law and Policy Subcommittee Law and Health Policy |
Law and Policy Issue Brief: Law and Policy as Determinants of Health Can be direct responses to health-harming social conditions and deficiencies Perpetuate social conditions that can be harmful to health and well-being Law and Legal Policy Are Sometimes applied selectively based on biases that Critical affect distributions of health and well-being Determinants Are hollow without regulations, funding, and effective of Health enforcement Can affect health and well-being based on how they are interpreted by the courts 16 Law and Health Policy |
Evaluation of Laws and Policies Law and Health Policy | 17
What Works: Evidence-Based Interventions to Protect and Promote Public Health 18 Law and Health Policy |
What Works: The Role of Evidence-based Law and Policy in Evidence-Based • Laws and policies as public health interventions • Laws and policies that support public health interventions and practices 19 Law and Health Policy |
Leading Health Indicator: Injury Deaths Approaches to Prevent Evidence-Based Legal and Policy Strategies Fatal Injuries IVP 1-1: Injury Deaths Helmet laws, seatbelt laws, laws and ordinances to promote complete streets and Motor vehicle injury holistic safe transit systems, policies to reduce drunk and impaired driving, and prevention graduated driver licensing systems School-based violence Anti-bullying legislation and policies, dating abuse policies prevention 20 Law and Health Policy |
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