Leading Health Indicators for Healthy People 2010 Final Report (1999) / Chapter Skim
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Executive Summary
Executive Summary
Pages 1-10
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Similar to the five key measures in the first decade of Healthy People and the 47 sentinel indicators established for Healthy People 2000, Healthy People 2010 may benefit from a small set of leading health indicators that will be of interest, importance and relevance to the general public, non-health organizations, and traditional public and private health organizations. Leading health indicators can focus on a small number of key health and social issues that can be brought to the attention of the nation, motivate actions to exert positive influences over these leading health indicators and provide feedback concerning progress toward achieving the targets set for each indicator.
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Specifically, the committee was informed that the charge also included the development of potential dissemination strategies to promote the leading health indicators to the lay public and traditional public and private health care communities. It was also established that clear linkages should be demonstrated between the proposed indicators and the existing full draft of Healthy People 2010, including the two overarching goals, four enabling goals and 26 focus areas.
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DESCRIPTION OF PROPOSED INDICATOR SETS Health Determinants and Health Outcomes Set The Health Determinants and Health Outcomes Set is based on extensive research supporting the field model of determinants of health at the individual and population levels (Evans and Stoddart, 19921. In this conceptual framework, determinants of health are also considered predictors of health behaviors and health outcomes.
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Prevention-Oriented Set The third proposed set of leading health indicators is based on the Prevention Model, which relies on four basic constructs: current health status, primary prevention, secondary prevention, and tertiary prevention. The Prevention-Oriented Set uses a simple and conventional structure that encompasses both individual and community-based health activities and the prevention and disease management activities of the health care delivery system.
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The specific indicators include: disability, and preventable deaths as measures of current health status; poverty, tobacco use and childhood immunizations as primary prevention strategies; cancer screening end hypertension screening as representative of secondary prevention, and diabetes management and health care access as measures of tertiary prevention. LINKAGE OF INDICATOR SETS TO HEALTHY PEOPLE 2010 The three proposed leading health indicator sets reflect a shift in emphasis away from simple mortality measures toward a more complex array that includes health-related quality-of- life, protective health behaviors, risk behaviors, social, and environmental factors consistent with one of two overarching goals of Healthy People 2010: to increase the quality and years of healthy life.
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The committee encourages particular attention be given to data quality limitations of self-reported data, data validity and reliability, periodicity and timeliness of data availability, representativeness of data and small-area analyses. DISSEMINATION STRATEGIES Experience with leading health indicators during the first two decades of Healthy People suggests that traditional methods of communication and dissemination are unlikely to be successful in communicating to the general public and motivating public actions to improve the status of specific indicators.
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This will provide ongoing feedback about the successes and failures of specific dissemination strategies for diverse population groups and will support modification of these strategies, if necessary, during the full course of Healthy People 2010. CONCLUSIONS AND RECOMMENDATIONS Chapter 3 of this report recommends three sets of leading health indicators for consideration by the U.S.
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c and thereby improving the health of the nation. Dissemination Strategies ~~~ =~~~ -- or -- -- -= ~ ^ ~ v A comprehensive plan for communication and dissemination of information related to the leading health indicators should be responsive to the needs of diverse population groups and include both traditional and innovative communication and health behavior change strategies.
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This report contains a number of recommendations and suggestions for the Department of Health and Human Services that address issues relevant to the composition of leading health indicator sets, data collection, data analysis, effective dissemination strategies, health disparities, and application of the indicators across multiple jurisdictional levels. These recommendations and suggestions also reflect the committee's belief that achievement of the overarching and enabling goals of Healthy People 2010 is possible only when national, state, and local health agencies establish collaborative partnerships with members and organizations representative of a wide array of diverse population groups and communities.
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