The department of Health and Human Services has meet each decade since 1979 to set forth a published document that creates a set of national public health objectives. This is known as Healthy People and these objectives are targeted to a variety of audiences such as health care agencies, policy makers, states, educational institutions and the general public. A draft document for Healthy People 2020 has been created by a technical expert panel (TEP) and ‘the public’. This document was released and a public comment period has ensued. By attending the regional meeting to participate in the public comment period was my objective.
Topic Areas to organize the objectives are:
1. Physical activity
2. Nutrition
3. Tobacco use
4. Alcohol and substance abuse
5. Sexual and reproductive health
6. Mental health
7. Injury and violence prevention
8. Occupational safety and health
9. Environmental health
10. Oral health
11. Emerging issues
12. Preventative services (by life stages)
The guidelines require topic area networks to consider four issues that cut across topic areas:
1. Strengthening public health infrastructure
2. Taking an ecological approach to health promotion
3. Eliminating health disparities
4. Promoting health throughout life stages.
Some important points to consider
‘National data is not sufficient for driving health policy” –Richard Klein
A users panel was introduced and given time to introduce the ideas of this program.
Speaker -Vincent Phillete
-Bio-Psych-Social is involved. We are gathered to make a proposal. The ‘Framingham study’ WWII showed us how behavior is a factor in health. The most commonly sold street drug is methamphetamine. Amphetamine was the most potent known anti-depressant until the 1940’s. Is there a connection? Why do people self-medicate in this way? Traumatic life experiences- concealed by shame and a society that does not politely talk about those things. The GOAL of all public health work? To promote optimum development of ALL the nation’s children.
Speaker- Linette Scott
Dept. of Public Health in California
-costs of chronic disease and emergency preparedness
using the objectives of HPHP2010 as a focal point for future funding. Grant applications –use the objectives of having a shared target to make comparisons with on measures of progress.
Solutions and root causes –we must bridge the gap between them.
The biggest thing missing in HP2010 is how to deal with ‘emergencies’ and ‘emerging’ or ‘reemerging’ diseases. Preparedness needs to be a part of the conversation.
The hands on level is at the county and other local jurisdictions. At the state it is all about the funding priorities. Funding streams are divided up
-risk factors
-infrastructure
-environment
health IT is crucial to making sense of these elements and make better use of the data. GOALS for department surfacing in 2020. Equality in the workforce. Business –professionalization- hiring the ‘best’ people. Workforce development and training.
Speaker -Linda Bailey
Quit line consortium (phoenix)
Telephone based counseling services to help people stop smoking.
-data sets -how to be effective in this effort
-best practices
20% of those served
Challenges –behavioral services as a part of health care (reimbursement?)
How to integrate with services that we partner with. Community based.
Letting people know how to access –excess objectives?-
We need a small set that we can ALL get behind.
We need to mature HPHP in a healthy way
Health care system change
Insurance –electronic medical records
Surveillance- feds have to be accountable (data tracking)
Process –technology create virtual communities that allow for more check-in than once a decade.
Speaker -Jude VanB
Epidem. Pub. Health
We stretch and pull ourselves up by our bootstraps. People (in the government) want to know what you are producing with the money they give you in funding. Tracking the changes that are being made making realistic steps things that can happen. Infection rate reporting. –required in many states. People want you to show WHY this is happening and what is being done about it.
How to keep essential programs is the question. Report cards. –comparing the accomplishments to the goals. Accountability with the government is targeted/demanded. But it is VERY difficult to ‘control’ things –like obesity- but the squeeze has helped.
If you don’t have a vision you can’t get there.
Public health is doing a good job, but how do we show that? We can’t count bodies.
But there is a set of measurements to use. State level data is needed. Engaging the public health community –young people –out of the box, fresh thinkers to get us there.
Q&A
-What can be done about the perverse incentives for health care? –prevention programs run by hospitals end up costing them a loss of revenue and get cancelled. Panel thoughts are that business leads the way to get out of this. BIRD –CEO of Safeway has workforce issues with making the investment per employee. What is the initiative how much education is required in medical schools? There needs to be more outreach and looking at small victories along the way to getting these grand goals met.
-inherently what we do in public health is create partnerships
-evidence based practice in prevention/pubic health sphere is lacking –this is a problem-
we need more data collection to create best practice development.
Public comments:
Each person who signed up to speak was given three minutes to do so. Some people came as a part of an organized effort. Some people seemed to have just wandered in and said whatever came to mind. It was an interesting session. If anyone is interested, contact me and I will send you the full list of topics that were brought up in this session. After this comment period, we went into smaller themed breakout sessions to do some brainstorming on the method for handling these big topic areas more effectively.
The take home message for me was that the broad goals of our national public health institution, centered on prevention, environment, and lifestyle are all things that are a reflection of naturopathic principles and that ND’s are leading the way in terms of developing specific models reflecting these principles. So really, we should be applying for and getting all the public health R&D, as well as program money that is out there.
http://wonder.cdc.gov/data2010
www.cdc.gov/nchs/hphome
