High school graduation rates are now officially a public-health metric.
The Health and Human Services Department announced its Leading Health Indicators on Monday, a list of metrics for measuring public-health progress that is adjusted every 10 years. The fourth decade of HHS’s Healthy People campaign will focus on equity, prevention, and the “social determinants” such as education, income, and race that are strongly linked to health.
"We literally need 20/20 vision for a healthier society,” Assistant Secretary for Health Howard Koh told reporters at the American Public Health Association’s annual meeting in Washington.
Oral health made the list for the first time. The new list of leading indicators features many of the mainstays from past lists—albeit tweaked to reflect new trends in public-health thinking and the Obama administration’s health care philosophy. Noticeably absent from the list are metrics tracking increased abstinence in young people, part of the 10 leading health indicators for 2010 that were released in 2000.
The full list: access; clinical preventive services such as childhood immunization and diabetes control; environmental quality; injury and violence; maternal, infant, and child health; mental health; nutrition, physical activity,and obesity; oral health; reproductive and sexual health; social determinants; substance abuse and tobacco.
Koh celebrated the expansion of health care insurance under the 2010 health care law -- a line the audience applauded. He also highlighted first lady Michele Obama’s efforts to combat childhood obesity with her Let’s Move! campaign.
The focus on the larger, social picture surrounding health care outcomes reflects “a new dimension right now in public health,” Koh said, “a paradigm shift with respect to social determinants.”
Koh headed a panel that also included American Public Health Association Executive Director Georges Benjamin, W.K. Kellogg Foundation Vice President Gail Christopher, HHS Chief Technology Officer Todd Park, and Arturo Sanchez, vice president and chief medical officer for BlueCross BlueShield of Texas.
In a question-and-answer session, more than one conference attendee asked the panel how the recession will affect funding for public-health organizations and community health groups.
“We are adamant that we protect those funds,” Benjamin said. He urged members of the audience to meet with "resource allocators" in their communities, including members of Congress. Advocates should argue that public health services are not only vital but that they also create local jobs, he said.
“We need to seize this opportunity to propel the understanding of how the dots connect," Christopher said. She and Sanchez both said that the public-health sector can use this moment to pursue partnerships with the corporate sector.
Overall, the 2020 Healthy People initiative encompasses 42 topics and nearly 600 objectives. New topics include global health, health-care-associated infections, lesbian and gay issues, and problems of the elderly. An interagency working group weighed input from the Institute of Medicine, the HHS Secretary’s Advisory Committee, public-health organizations, and the public.
HHS also released new standards for measuring race, ethnicity, sex, primary language, and disability status, fulfilling a requirement of the 2010 health care law. “With this advance, we as a nation can better understand and target health disparities and ultimately move toward eliminating them,” Koh wrote in a blog post on Monday.