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Charge to the Committee.

The efforts of this committee are supported by more than 20 years of multi-disciplinary work in collaboration with a wide range of constituencies. The primary focus of these efforts was to evaluate the original Healthy People publication of the Surgeon General in 1979 (U.S. Public Health Service, 1979) and Healthy People 2000, which further expanded upon the Healthy People concept promulgated in 1990. Relevant activities have included annual reviews of progress toward the Healthy People objectives by using diverse datasets, regional workshops, and forums to elicit the opinions of professionals and the public, focus group sessions, public town meetings, and communication through the Healthy People Web site. Most recently, the U.S. Department of Health and Human Services (DHHS) established a working group to prepare an initial report on sentinel objectives for Healthy People 2010. This report, the Leading Indicators for Healthy People 2010: A Report from the HHS Working Group on Sentinel Objectives (U.S. Department of Health and Human Services, 1997b), provided a comprehensive overview of the history of Healthy People activities in public health and generated suggestions for models, criteria, and indicator sets that could reasonably guide the formulation of Healthy People 2010. The content of that report focused on mechanisms to be used to build upon the strengths of previous Healthy People activities and to enhance aspects of the initiative that were considered weak or inadequate in previous efforts.

The Office of Disease Prevention and Health Promotion (ODPHP) of DHHS turned to the Division of Health Promotion and Disease Prevention of the Institute of Medicine (IOM) to convene a committee to consider the issue of leading indicators and to suggest a minimum of two sets of indicators for consideration by the Secretary of Health and Human Services as the leading health indicators for Healthy People 2010. This committee consisted of 10 members with expertise in areas including, but not limited to, public health, health promotion, health communication, epidemiology and biostatistics, health education, health policy, and health performance monitoring. The leading health indicators are meant to accomplish the following. First, such indicators will be leading measures of key health behaviors or outcomes that are known and understandable by the general population and demographic subpopulations and communities. Second, it will be essential that these health indicators be accessible for routine monitoring at the national and state levels, with the potential for the availability of comparable data at the local and community levels for the interval from 2000 to 2010. These indicators will promote positive changes in health behaviors and outcomes and guide the development of policy and action plans at the community level to facilitate



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--> 1 Charge to the Committee. The efforts of this committee are supported by more than 20 years of multi-disciplinary work in collaboration with a wide range of constituencies. The primary focus of these efforts was to evaluate the original Healthy People publication of the Surgeon General in 1979 (U.S. Public Health Service, 1979) and Healthy People 2000, which further expanded upon the Healthy People concept promulgated in 1990. Relevant activities have included annual reviews of progress toward the Healthy People objectives by using diverse datasets, regional workshops, and forums to elicit the opinions of professionals and the public, focus group sessions, public town meetings, and communication through the Healthy People Web site. Most recently, the U.S. Department of Health and Human Services (DHHS) established a working group to prepare an initial report on sentinel objectives for Healthy People 2010. This report, the Leading Indicators for Healthy People 2010: A Report from the HHS Working Group on Sentinel Objectives (U.S. Department of Health and Human Services, 1997b), provided a comprehensive overview of the history of Healthy People activities in public health and generated suggestions for models, criteria, and indicator sets that could reasonably guide the formulation of Healthy People 2010. The content of that report focused on mechanisms to be used to build upon the strengths of previous Healthy People activities and to enhance aspects of the initiative that were considered weak or inadequate in previous efforts. The Office of Disease Prevention and Health Promotion (ODPHP) of DHHS turned to the Division of Health Promotion and Disease Prevention of the Institute of Medicine (IOM) to convene a committee to consider the issue of leading indicators and to suggest a minimum of two sets of indicators for consideration by the Secretary of Health and Human Services as the leading health indicators for Healthy People 2010. This committee consisted of 10 members with expertise in areas including, but not limited to, public health, health promotion, health communication, epidemiology and biostatistics, health education, health policy, and health performance monitoring. The leading health indicators are meant to accomplish the following. First, such indicators will be leading measures of key health behaviors or outcomes that are known and understandable by the general population and demographic subpopulations and communities. Second, it will be essential that these health indicators be accessible for routine monitoring at the national and state levels, with the potential for the availability of comparable data at the local and community levels for the interval from 2000 to 2010. These indicators will promote positive changes in health behaviors and outcomes and guide the development of policy and action plans at the community level to facilitate

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--> the achievement of such changes. These indicators will need to be reasonable in number and based on explicit models of health behavior and outcomes, as well as adhere to a set of criteria specific to these models. The charge to the IOM committee on leading health indicators for Healthy People 2010 is intended to build further upon the efforts of the DHHS working group by eliciting input from experts (1) to select or develop a model(s) to provide a foundation for the identification of necessary criteria and (2) to identify the necessary criteria that will result in the proposal of sets of leading health indicators that will be monitored routinely at the national, state, and, if feasible, local and community levels for the interval from 2000 to 2010. In accomplishing these objectives, the committee will prepare two interim reports, conduct a public forum to receive feedback on candidate sets of leading health indicators, and prepare a final report with recommendations for a minimum of two sets of leading health indicators. This first interim report presents a historical overview of the Healthy People initiative. This is followed by a summary of the proposed Healthy People 2010, including a description of the products of the DHHS work group on leading health indicators. The report concludes with committee commentary on the DHHS work group's discussion of criteria for the indicator sets, the functions of the indicator sets, and future challenges in using such leading health indicator sets for improving the health of the nation.