The Assistant Secretary for Health has charged this National Academies of Sciences, Engineering, and Medicine committee with assisting
in the development of Leading Health Indicators (LHIs) for Healthy People 2030. The committee will develop (1) recommendations regarding the criteria for selecting LHIs and (2) a slate of LHIs that will serve as options for the Healthy People Federal Interagency Workgroup to consider as they develop the final criteria and set of LHIs for Healthy People 2030. The committee may identify gaps and may recommend new objectives for LHI consideration that meet the core objective criteria.
This brief report responds to the first part of the task. The committee reviewed past and current Healthy People materials, both those developed by the Department of Health and Human Services (HHS) and the current Secretary’s Advisory Committee on National Health Promotion and Disease Prevention Objectives for 2030 (SAC), and prior National Academies reports. The committee’s information-gathering activities included three open meetings: two were online and consisted of presentations from HHS and the leadership of the SAC and its relevant subcommittees, and one meeting took place at the Keck Center of the National Academies in Washington, DC.
In this report, the committee makes four findings and two recommendations based on its review of relevant materials and information.
Finding 1: The committee finds that the Healthy People 2030 draft objectives document is missing some key topics necessary to fully reflect the intent of the Healthy People 2030 Framework’s vision, mission, foundational principles, and overarching goals.1
Finding 2: The committee finds that the draft objectives do not offer an appropriately balanced and comprehensive range from which to derive Leading Health Indicators that also reflect the intent of the Healthy People 2030 Framework’s vision, mission, foundational principles, and overarching goals.
Finding 3: The committee finds that the Healthy People 2030 draft objectives document includes too few objectives that allow for making important comparisons to other countries, including to peer nations in the Organisation for Economic Co-operation and Development.
Finding 4: The committee finds that if the existing criteria for Leading Health Indicator (LHI) selection were applied to the existing Healthy People 2030 draft objectives, the resulting LHI set would not be aligned with the Healthy People 2030 Framework—it would not tell a coherent story about the nation’s (or communities’) health, well-being, and the state of health equity.
Recommendation 1: The committee recommends that the Department of Health and Human Services and the Federal Interagency Workgroup add to the Healthy People 2030 objectives topics or implement a structural reorganization (with additional topics) that will yield more core objectives that reflect the Healthy People 2030 Framework and could lead to better Leading Health Indicators. Cross-cutting topics (i.e., topics that refer to or link with multiple health states, life stages, systems, and all dimensions of health) should include health equity; the social, physical, and economic determinants of health; shared responsibility and multiple sectors; and all levels of government.
Recommendation 2: The committee recommends a three-phase process should be used for Leading Health Indicator (LHI) selection from the Healthy People 2030 objectives. A new phase would precede the existing two, and it would apply the Healthy People 2030
1 Refers to the topic categories under which lists of objectives are nested beginning with Adolescent Health and concluding with Vision.
Framework (especially the vision, mission, foundational principles, and overarching goals) in consideration of additional objectives and in selecting LHIs.