Health People 2020

HEALTHY PEOPLE 2020: MAKING SURE THE USLCA VOICE IS HEARD

OVERVIEW

Healthy People provides science-based, 10-year national objectives for promoting health and preventing disease. Since 1979, Healthy People has set and monitored national health objectives to meet a broad range of health needs, encourage collaborations across sectors, guide individuals toward making informed health decisions, and measure the impact of prevention activity. Every 10 years, the U.S. Department of Health and Human Services (HHS) revises these objectives to better meet the changing health needs of the nation. Healthy People 2020 will reflect assessments of major risks to health and wellness, changing public health priorities, and emerging issues related to our nation's health preparedness and prevention. It is crucial that breastfeeding be given a higher priority in terms of its potential in disease prevention. HHS is conducting regional meetings across the US that provide a venue for public input. Please read the reports from the first meetings and consider attending one of the remaining meetings near you. These objectives are what gets funded! Breastfeeding should be a leading health indicator as it provides the health foundation for a lifetime.

Timeline (from the Healthy People 2020 website):

Healthy People 2020 will be launched in two phases. The organizing framework, including the vision, mission and overarching goals, will be issued in late 2008 or early 2009. The specific objectives, accompanied by strategies for achieving them, will be launched in 2010.

Changes in the Goal-Setting Process for 2020

A number of changes in the process are being made since the Healthy People 2010 goals were set a decade ago.  Among the most important—especially for those of you considering attending a meeting and/or making an oral or written comment—include:

• A refocus from a disease-oriented framework (i.e., diabetes, heart attack, etc.) to a health promotion and disease prevention approach.
• The number of Topic Areas, organized by health determinants and risks, is streamlined from the current 28 to approximately 15. (See topic list below)
• The number of objectives is limited from the current 467 to approximately 150.
• Processes for narrowing and selecting objectives are grounded in scientific evidence, but integrate best practices, qualitative evidence, and opportunities for public comment.

[from NORC Assessment of the Healthy People Objective-setting Framework and Process DRAFT, January 2007]

Potential Topic Area Categories to Organize the 2020 National Health Objectives

In the Draft version, there are 12 topic areas suggested:

• Physical Activity
• Nutrition
• Tobacco Use
• Alcohol and Substance Abuse
• Sexual and Reproductive Health
• Mental Health
• Injury and Violence Prevention
• Occupational Safety and Health
• Environmental Health
• Oral Health
• Emerging Issues
• Preventative Services (by life stages)

Certainly breastfeeding is an obvious component of at least nutrition, sexual and reproductive health, and preventative services.  In addition, “preventative services” could open the door for objectives that urge professional and lay support for breastfeeding mothers—IBCLCs, LLL Leaders, WIC breastfeeding counselors, etc.

Cross-Cutting Issues

In addition to the Topic Areas, four “cross-cutting issues” have been identified:

• Health Disparities: Population-specific differences in the presence of disease, health outcomes, or access to health care.
• Life Stages: A framework for health goals adopted by the CDC in Fiscal Year 2004.
• Ecological Model: Acknowledges that independent but interrelated elements within systems (including social and environmental factors) impact health.
• Public Health Initiatives: Resources for public health organizations to deliver essential services to every community—including workforce, communications systems, and data collection and dissemination.

[from NORC Assessment of the Healthy People Objective-setting Framework and Process DRAFT, January 2007]

While it should be obvious to those in the position of finalizing the topic areas, cross-cutting issues, and specific goals that breastfeeding goals—including initiation, duration (in general and exclusivity), and providing adequate support from lay and professional sources—deserve to play a major role in the health of the nation, we can’t afford to take this for granted, especially given that the number of objectives will be reduced to a third of what they were before. It is vitally important that we have adequate representation at each of the remaining meetings, and that we encourage as many pro-breastfeeding written comments as possible.

For further reading:

http://www.healthypeople.gov/hp2020/default.asp  Healthy People home page

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