# 7 {#section .Chapter-#}

# Educational and Community-Based Programs

#### School Setting

7-1 High school completion

7-2 School health education

7-2a All components

7-2b Unintentional injury

7-2c Violence

7-2d Suicide

7-2e Tobacco use and addiction

7-2f Alcohol and other drug use

7-2g Unintended pregnancy, HIV/AIDS, and STD infection

7-2h Unhealthy dietary patterns

7-2i Inadequate physical activity

7-2j Environmental health

7-3 Health-risk behavior information for college and university students

7-4 School nurse-to-student ratio

7-4a All middle, junior high, and senior high schools

7-4b Senior high schools

7-4c Middle and junior high schools

7-4d Elementary schools

#### Worksite Setting

7-5 Worksite health promotion programs

7-5a Worksites with fewer than 50 employees

7-5b Worksites with 50 or more employees

7-5c Worksites with 50 to 99 employees

7-5d Worksites with 100 to 249 employees

7-5e Worksites with 250 to 749 employees

7-5f Worksites with 750 or more employees

7-6 Participation in employer-sponsored health promotion activities

#### Health Care Setting

7-7 Patient and family education

7-8 Satisfaction with patient education

7-9 Health care organization sponsorship of community health promotion

> activities

#### Community Setting and Select Populations

7-10 Community health promotion programs

7-11 Culturally appropriate and linguistically competent community
health promotion programs

7-11a Access to quality health services

7-11b Arthritis, osteoporosis, and chronic back conditions

7-11c Cancer

7-11d Chronic kidney disease

7-11e Diabetes

7-11f Disability and secondary conditions

7-11g Educational and community-based programs

7-11h Environmental health

7-11i Family planning

7-11j Food safety

7-11k Medical product safety

7-11l Health communication

7-11m Heart disease and stroke

7-11n HIV

7-11o Immunizations and infectious diseases

7-11p Injury and violence prevention

7-11q Maternal, infant (and child) health

7-11r Mental health (and mental disorders)

7-11s Nutrition and overweight

7-11t Occupational safety and health

7-11u Oral health

7-11v Physical activity and fitness

7-11w Public health infrastructure

7-11x Respiratory diseases

7-11y Sexually transmitted diseases

7-11z Substance abuse (alcohol and other drugs)

7-11aa Tobacco use

7-11bb Vision and hearing

7-12 Older adult participation in community health promotion activities

###  {#section-1 .unnumbered}

### School Setting

+---------------------+------------------------------------------------+
| 7-1. Increase high  |                                                |
| school completion.  |                                                |
+---------------------+------------------------------------------------+
| **National Data     | Current Population Survey (CPS), U.S.          |
| Source**            | Department of Commerce, U.S. Bureau of the     |
|                     | Census.                                        |
+---------------------+------------------------------------------------+
| **State Data        | Current Population Survey (CPS), U.S.          |
| Source**            | Department of Commerce, U.S. Bureau of the     |
|                     | Census.                                        |
+---------------------+------------------------------------------------+
| **Healthy People    | 8.2 (Educational and Community-Based           |
| 2000 Objective**    | Programs).                                     |
+---------------------+------------------------------------------------+
| **Measure**         | Percent.                                       |
+---------------------+------------------------------------------------+
| **Baseline**        | 85 (1998).                                     |
+---------------------+------------------------------------------------+
| **Numerator**       | Number of persons 18 to 24 years old not       |
|                     | currently enrolled in high school who report   |
|                     | that they have received a high school diploma  |
|                     | or its equivalent.                             |
+---------------------+------------------------------------------------+
| **Denominator**     | Persons aged 18 to 24 years.                   |
+---------------------+------------------------------------------------+
| **Population        | U.S. civilian, noninstitutionalized            |
| Targeted**          | population.                                    |
+---------------------+------------------------------------------------+
| **Questions Used To | From the 1998 Current Population Survey:       |
| Obtain the National |                                                |
| Data**              |                                                |
+---------------------+------------------------------------------------+
|                     | -   Is ([Person]{.underline}) attending or     |
|                     |     enrolled in regular school?                |
+---------------------+------------------------------------------------+
|                     | -   What grade or year is                      |
|                     |     ([Person]{.underline}) attending?          |
+---------------------+------------------------------------------------+
|                     | -   Was ([Person]{.underline}) attending or    |
|                     |     enrolled in a regular school or college in |
|                     |     October, 199\_, that is, October of last   |
|                     |     year?                                      |
+---------------------+------------------------------------------------+
|                     | -   What grade or year was                     |
|                     |     ([Person]{.underline}) attending last      |
|                     |     year?                                      |
+---------------------+------------------------------------------------+
|                     | -   What is the highest level of school        |
|                     |     ([Person]{.underline}) has completed or    |
|                     |     the highest degree\...has received?        |
+---------------------+------------------------------------------------+
| **Expected          | Annual.                                        |
| Periodicity**       |                                                |
+---------------------+------------------------------------------------+
| **Comments**        | High school completion is the proportion of    |
|                     | persons aged 18 to 24 years not currently      |
|                     | enrolled in high school who report that they   |
|                     | have received a high school diploma or the     |
|                     | equivalent (such as a General Education        |
|                     | Development (GED) certificate), regardless of  |
|                     | the type of credential.                        |
+---------------------+------------------------------------------------+
|                     | States are able to report in 3-year averages   |
|                     | only. For States with small populations, the   |
|                     | 3-year estimates may be unreliable.            |
+---------------------+------------------------------------------------+
|                     | See Appendix A for focus area contact          |
|                     | information.                                   |
+---------------------+------------------------------------------------+

7-2. Increase the proportion of middle, junior high, and senior high
schools that provide school health education to prevent health problems
in the following areas: unintentional injury; violence; suicide; tobacco
use and addiction; alcohol and other drug use; unintended pregnancy,
HIV/AIDS, and STD infection; unhealthy dietary patterns; inadequate
physical activity; and environmental health.

+---------------------+------------------------------------------------+
| 7-2a. All           |                                                |
| components          |                                                |
+---------------------+------------------------------------------------+
| **National Data     | School Health Policies and Programs Study      |
| Source**            | (SHPPS), CDC, NCCDPHP.                         |
+---------------------+------------------------------------------------+
| **State Data        | School Health Education Profiles (SHEPS), CDC, |
| Source**            | NCCDPHP.                                       |
+---------------------+------------------------------------------------+
| **Healthy People    | Adapted from 8.4 (Educational and              |
| 2000 Objective**    | Community-Based Programs).                     |
+---------------------+------------------------------------------------+
| **Measure**         | Percent.                                       |
+---------------------+------------------------------------------------+
| **Baseline**        | 28 (1994).                                     |
+---------------------+------------------------------------------------+
| **Numerator**       | Number of middle, junior, and senior high      |
|                     | schools that provide health education on all   |
|                     | key behavior and content areas.                |
+---------------------+------------------------------------------------+
| **Denominator**     | Number of middle, junior, and senior high      |
|                     | schools.                                       |
+---------------------+------------------------------------------------+
| **Population        | Middle, junior, and senior high schools.       |
| Targeted**          |                                                |
+---------------------+------------------------------------------------+
| **Questions Used To | From the 1994 School Health Policies and       |
| Obtain the National | Programs Study:                                |
| Data**              |                                                |
+---------------------+------------------------------------------------+
|                     | -   Now I'd like to ask which health education |
|                     |     [topics]{.underline} are taught in [any of |
|                     |     the required courses that we've            |
|                     |     listed]{.underline}. Please give me the    |
|                     |     numbers of the topics your school teaches  |
|                     |     at some time in required courses.          |
|                     |                                                |
|                     |     1\. None of these topics\                  |
|                     |     2. Alcohol and other drug use prevention\  |
|                     |     3. Conflict resolution/violence            |
|                     |     prevention\                                |
|                     |     4. Dietary behaviors and nutrition\        |
|                     |     5. Environmental health\                   |
|                     |     6. HIV prevention\                         |
|                     |     7. Injury prevention and safety\           |
|                     |     8. Physical activity and fitness\          |
|                     |     9. Pregnancy prevention\                   |
|                     |     10. Sexually transmitted disease (STD)     |
|                     |     prevention\                                |
|                     |     11. Suicide prevention\                    |
|                     |     12. Tobacco use prevention\                |
|                     |     13. Other (List additional topics here):   |
|                     |     \_\_\_\_\_\_\_\_\_\_                       |
+---------------------+------------------------------------------------+
| **Expected          | Periodic.                                      |
| Periodicity**       |                                                |
+---------------------+------------------------------------------------+
| **Comments**        | A school is considered to provide health       |
|                     | education on key risk behavior and content     |
|                     | areas if they report having required courses   |
|                     | on all the topics listed in the question       |
|                     | above.                                         |
+---------------------+------------------------------------------------+
|                     | This objective is adapted from a measure in    |
|                     | Healthy People 2000 objective 8.4, which       |
|                     | tracked the proportion of elementary and       |
|                     | secondary schools that included instruction in |
|                     | six key behavioral areas (unintentional and    |
|                     | intentional injury, tobacco use, alcohol and   |
|                     | other drug use, sexual behaviors, unhealthy    |
|                     | dietary behaviors, physical inactivity) in     |
|                     | their health education program. The 2010       |
|                     | measure tracks middle, junior, and senior high |
|                     | schools: it excludes elementary schools. The   |
|                     | 2010 measure also includes environmental       |
|                     | health.                                        |
+---------------------+------------------------------------------------+
|                     | See Part C for a description of SHPPS and      |
|                     | Appendix A for focus area contact information. |
+---------------------+------------------------------------------------+

  ---------------------- ------------------------------------------------
  7-2b. Unintentional    
  injury.                

  **National Data        School Health Policies and Programs Study
  Source**               (SHPPS), CDC, NCCDPHP.

  **State Data Source**  School Health Education Profiles (SHEPS), CDC,
                         NCCDPHP.

  **Healthy People 2000  Adapted from 8.4 (Educational and
  Objective**            Community-Based Programs).

  **Measure**            Percent.

  **Baseline**           66 (1994).

  **Numerator**          Number of middle, junior, and senior high
                         schools that provide health education on injury
                         prevention and safety.

  **Denominator**        Number of middle, junior, and senior high
                         schools.

  **Population           Middle, junior, and senior high schools.
  Targeted**             

  **Questions Used To    See Questions Used To Obtain the National Data
  Obtain the National    provided with 7-2a.
  Data**                 

  **Expected             Periodic.
  Periodicity**          

  **Comments**           A school is considered to provide health
                         education on key risk behavior and content areas
                         if they report having a required course on
                         injury prevention and safety.

                         See Comments provided with objective 7-2a for
                         more information.
  ---------------------- ------------------------------------------------

  -----------------------------------------------------------------------
  7-2c. Violence.        
  ---------------------- ------------------------------------------------
  **National Data        School Health Policies and Programs Study
  Source**               (SHPPS), CDC, NCCDPHP.

  **State Data Source**  School Health Education Profiles, (SHEPS), CDC,
                         NCCDPHP.

  **Healthy People 2000  Adapted from 8.4 (Educational and
  Objective**            Community-Based Programs).

  **Measure**            Percent.

  **Baseline**           58 (1994).

  **Numerator**          Number of middle, junior, and senior high
                         schools that provide health education on
                         conflict resolution/violence prevention.

  **Denominator**        Number of middle, junior, and senior high
                         schools.

  **Population           Middle, junior, and senior high schools.
  Targeted**             

  **Questions Used To    See Questions Used To Obtain the National Data
  Obtain the National    provided with 7-2a.
  Data**                 

  **Expected             Periodic.
  Periodicity**          

  **Comments**           A school is considered to provide health
                         education on key risk behavior and content areas
                         if they report having a required course on
                         conflict resolution/ violence prevention.

                         See Comments provided with objective 7-2a for
                         more information.
  -----------------------------------------------------------------------

  ---------------------- ------------------------------------------------
  7-2d. Suicide.         

  **National Data        School Health Policies and Programs Study
  Source**               (SHPPS), CDC, NCCDPHP.

  **State Data Source**  School Health Education Profiles (SHEPS), CDC,
                         NCCDPHP.

  **Healthy People 2000  Adapted from 8.4 (Educational and
  Objective**            Community-Based Programs).

  **Measure**            Percent.

  **Baseline**           58 (1994).

  **Numerator**          Number of middle, junior, and senior high
                         schools that provide health education on suicide
                         prevention.

  **Denominator**        Number of middle, junior, and senior high
                         schools.

  **Population           Middle, junior, and senior high schools.
  Targeted**             

  **Questions Used To    See Questions Used To Obtain the National Data
  Obtain the National    provided with 7-2a.
  Data**                 

  **Expected             Periodic.
  Periodicity**          

  **Comments**           A school is considered to provide health
                         education on key risk behavior and content areas
                         if they report having a required course on
                         suicide prevention.

                         See Comments provided with objective 7-2a for
                         more information.
  ---------------------- ------------------------------------------------

  ---------------------- ------------------------------------------------
  7-2e. Tobacco use and  
  addiction.             

  **National Data        School Health Policies and Programs Study
  Source**               (SHPPS), CDC, NCCDPHP.

  **State Data Source**  School Health Education Profiles (SHEPS), CDC,
                         NCCDPHP.

  **Healthy People 2000  Adapted from 8.4 (Educational and
  Objective**            Community-Based Programs).

  **Measure**            Percent.

  **Baseline**           86 (1994).

  **Numerator**          Number of middle, junior, and senior high
                         schools that provide health education on tobacco
                         use prevention.

  **Denominator**        Number of middle, junior, and senior high
                         schools.

  **Population           Middle, junior, and senior high schools.
  Targeted**             

  **Questions Used To    See Questions Used To Obtain the National Data
  Obtain the National    provided with 7-2a.
  Data**                 

  **Expected             Periodic.
  Periodicity**          

  **Comments**           A school is considered to provide health
                         education on key risk behavior and content areas
                         if they report having a required course on
                         tobacco use prevention.

                         See Comments provided with objective 7-2a for
                         more information.
  ---------------------- ------------------------------------------------

  ---------------------- ------------------------------------------------
  7-2f. Alcohol and      
  other drug use.        

  **National Data        School Health Policies and Programs Study
  Source**               (SHPPS), CDC, NCCDPHP.

  **State Data Source**  School Health Education Profiles (SHEPS), CDC,
                         NCCDPHP.

  **Healthy People 2000  Adapted from 8.4 (Educational and
  Objective**            Community-Based Programs).

  **Measure**            Percent.

  **Baseline**           90 (1994).

  **Numerator**          Number of middle, junior, and senior high
                         schools that provide health education on alcohol
                         and other drug use prevention.

  **Denominator**        Number of middle, junior, and senior high
                         schools.

  **Population           Middle, junior, and senior high schools.
  Targeted**             

  **Questions Used To    See Questions Used To Obtain the National Data
  Obtain the National    provided with 7-2a.
  Data**                 

  **Expected             Periodic.
  Periodicity**          

  **Comments**           A school is considered to provide health
                         education on key risk behavior and content areas
                         if they report having a required course on
                         alcohol and other drug use prevention.

                         See Comments provided with objective 7-2a for
                         more information.
  ---------------------- ------------------------------------------------

  ---------------------- ------------------------------------------------
  7-2g. Unintended       
  pregnancy, HIV/AIDS,   
  and STD infection.     

  **National Data        School Health Policies and Programs Study
  Source**               (SHPPS), CDC, NCCDPHP.

  **State Data Source**  School Health Education Profiles (SHEPS), CDC,
                         NCCDPHP.

  **Healthy People 2000  Adapted from 8.4 (Educational and
  Objective**            Community-Based Programs).

  **Measure**            Percent.

  **Baseline**           65 (1994).

  **Numerator**          Number of middle, junior, and senior high
                         schools that provide health education on
                         (unintended) pregnancy prevention, HIV (AIDS)
                         prevention, and sexually transmitted disease
                         (STD) prevention.

  **Denominator**        Number of middle, junior, and senior high
                         schools.

  **Population           Middle, junior, and senior high schools.
  Targeted**             

  **Questions Used To    See Questions Used To Obtain the National Data
  Obtain the National    provided with 7-2a.
  Data**                 

  **Expected             Periodic.
  Periodicity**          

  **Comments**           A school is considered to provide health
                         education on key risk behavior and content areas
                         if they report having a required course on
                         (unintended) pregnancy prevention, HIV (AIDS)
                         prevention, and sexually transmitted disease
                         (STD) prevention.

                         See Comments provided with objective 7-2a for
                         more information.

  7-2h. Unhealthy        
  dietary patterns.      

  **National Data        School Health Policies and Programs Study
  Source**               (SHPPS), CDC, NCCDPHP.

  **State Data Source**  School Health Education Profiles (SHEPS), CDC,
                         NCCDPHP.

  **Healthy People 2000  Adapted from 8.4 (Educational and
  Objective**            Community-Based Programs) and 2.19 (Nutrition).

  **Measure**            Percent.

  **Baseline**           84 (1994).

  **Numerator**          Number of middle, junior, and senior high
                         schools that provide health education on dietary
                         behaviors and nutrition.

  **Denominator**        Number of middle, junior, and senior high
                         schools.

  **Population           Middle, junior, and senior high schools.
  Targeted**             

  **Questions Used To    See Questions Used To Obtain the National Data
  Obtain the National    provided with 7-2a.
  Data**                 

  **Expected             Periodic.
  Periodicity**          

  **Comments**           A school is considered to provide health
                         education on key risk behavior and content areas
                         if they report having a required course on
                         dietary behaviors and nutrition.

                         This objective is adapted from measures in
                         Healthy People 2000 objective 8.4, which tracked
                         the proportion of elementary and secondary
                         schools that included instruction in six key
                         behavioral areas (unintentional and intentional
                         injury, tobacco use, alcohol and other drug use,
                         sexual behaviors, unhealthy dietary behaviors,
                         physical inactivity) in their health education
                         program; and Healthy People 2000 objective 2.19,
                         which tracked the proportion of elementary and
                         secondary schools that included instruction in
                         nutrition information. The 2010 measure tracks
                         middle, junior, and senior high schools: it
                         excludes elementary schools. The 2010 measure
                         also includes environmental health.
  ---------------------- ------------------------------------------------

+---------------------+------------------------------------------------+
| 7-2i. Inadequate    |                                                |
| physical activity.  |                                                |
+---------------------+------------------------------------------------+
| **National Data     | School Health Policies and Programs Study      |
| Source**            | (SHPPS), CDC, NCCDPHP.                         |
+---------------------+------------------------------------------------+
| **State Data        | School Health Education Profiles (SHEPS), CDC, |
| Source**            | NCCDPHP.                                       |
+---------------------+------------------------------------------------+
| **Healthy People    | Adapted from 8.4 (Educational and              |
| 2000 Objective**    | Community-Based Programs).                     |
+---------------------+------------------------------------------------+
| **Measure**         | Percent.                                       |
+---------------------+------------------------------------------------+
| **Baseline**        | 78 (1994).                                     |
+---------------------+------------------------------------------------+
| **Numerator**       | Number of middle, junior, and senior high      |
|                     | schools that provide health education on       |
|                     | physical activity and fitness.                 |
+---------------------+------------------------------------------------+
| **Denominator**     | Number of middle, junior, and senior high      |
|                     | schools.                                       |
+---------------------+------------------------------------------------+
| **Population        | Middle, junior, and senior high schools.       |
| Targeted**          |                                                |
+---------------------+------------------------------------------------+
| **Questions Used To | See Questions Used To Obtain the National Data |
| Obtain the National | provided with 7-2a.                            |
| Data**              |                                                |
+---------------------+------------------------------------------------+
| **Expected          | Periodic.                                      |
| Periodicity**       |                                                |
+---------------------+------------------------------------------------+
| **Comments**        | A school is considered to provide health       |
|                     | education on key risk behavior and content     |
|                     | areas if they report having a required course  |
|                     | on physical activity and fitness.              |
+---------------------+------------------------------------------------+
|                     | See Comments provided with objective 7-2a for  |
|                     | more information.                              |
+---------------------+------------------------------------------------+
|                     | See Part C for a description of SHPPS and      |
|                     | Appendix A for focus area contact information. |
+---------------------+------------------------------------------------+
| 7-2j. Environmental |                                                |
| health.             |                                                |
+---------------------+------------------------------------------------+
| **National Data     | School Health Policies and Programs Study      |
| Source**            | (SHPPS), CDC, NCCDPHP.                         |
+---------------------+------------------------------------------------+
| **State Data        | School Health Education Profiles (SHEPS), CDC, |
| Source**            | NCCDPHP.                                       |
+---------------------+------------------------------------------------+
| **Healthy People    | Adapted from 8.4 (Educational and              |
| 2000 Objective**    | Community-Based Programs).                     |
+---------------------+------------------------------------------------+
| **Measure**         | Percent.                                       |
+---------------------+------------------------------------------------+
| **Baseline**        | 60 (1994).                                     |
+---------------------+------------------------------------------------+
| **Numerator**       | Number of middle, junior, and senior high      |
|                     | schools that provide health education on       |
|                     | environmental health.                          |
+---------------------+------------------------------------------------+
| **Denominator**     | Number of middle, junior, and senior high      |
|                     | schools.                                       |
+---------------------+------------------------------------------------+
| **Population        | Middle, junior, and senior high schools.       |
| Targeted**          |                                                |
+---------------------+------------------------------------------------+
| **Questions Used To | See Questions Used To Obtain the National Data |
| Obtain the National | provided with 7-2a.                            |
| Data**              |                                                |
+---------------------+------------------------------------------------+
| **Expected          | Periodic.                                      |
| Periodicity**       |                                                |
+---------------------+------------------------------------------------+
| **Comments**        | A school is considered to provide health       |
|                     | education on key risk behavior and content     |
|                     | areas if they report having a required course  |
|                     | on environmental health.                       |
+---------------------+------------------------------------------------+
|                     | See Comments provided with objective 7-2a for  |
|                     | more information.                              |
+---------------------+------------------------------------------------+
|                     |                                                |
+---------------------+------------------------------------------------+
| 7-3. Increase the   |                                                |
| proportion of       |                                                |
| college and         |                                                |
| university students |                                                |
| who receive         |                                                |
| information from    |                                                |
| their institution   |                                                |
| on each of the six  |                                                |
| priority            |                                                |
| health-risk         |                                                |
| behavior areas.     |                                                |
+---------------------+------------------------------------------------+
| **National Data     | National College Health Risk Behavior Survey   |
| Source**            | (NCHRBS), CDC, NCCDPHP.                        |
+---------------------+------------------------------------------------+
| **State Data        | Not identified.                                |
| Source**            |                                                |
+---------------------+------------------------------------------------+
| **Healthy People    | 8.5 (Educational and Community-Based           |
| 2000 Objective**    | Programs).                                     |
+---------------------+------------------------------------------------+
| **Measure**         | Percent.                                       |
+---------------------+------------------------------------------------+
| **Baseline**        | 6 (1995).                                      |
+---------------------+------------------------------------------------+
| **Numerator**       | Number of undergraduate students who report    |
|                     | that they have received information from their |
|                     | college or university on each of the six       |
|                     | priority health-risk behavior areas.           |
+---------------------+------------------------------------------------+
| **Denominator**     | Number of undergraduate college students in    |
|                     | post-secondary institutions.                   |
+---------------------+------------------------------------------------+
| **Population        | Undergraduate college students.                |
| Targeted**          |                                                |
+---------------------+------------------------------------------------+
| **Questions Used To | From the 1995 National College Health Risk     |
| Obtain the National | Behavior Survey:                               |
| Data**              |                                                |
+---------------------+------------------------------------------------+
|                     | -   On which health topics have you ever       |
|                     |     received information from your college or  |
|                     |     university?                                |
|                     |                                                |
|                     |     1\. Tobacco use prevention\                |
|                     |     2. Alcohol and other drug use prevention\  |
|                     |     3. Violence prevention\                    |
|                     |     4. Injury prevention and safety\           |
|                     |     5. Suicide prevention\                     |
|                     |     6. Pregnancy prevention\                   |
|                     |     7. Sexually transmitted disease (STD)      |
|                     |     prevention\                                |
|                     |     8. AIDS or HIV infection prevention\       |
|                     |     9. Dietary behaviors and nutrition\        |
|                     |     10. Physical activity and fitness          |
+---------------------+------------------------------------------------+
| **Expected          | Periodic.                                      |
| Periodicity**       |                                                |
+---------------------+------------------------------------------------+
| **Comments**        | Students were considered as receiving          |
|                     | information on each of the six priority        |
|                     | health-risk behavior areas if they responded   |
|                     | positively to [all]{.underline} of the topics  |
|                     | listed in the question above.                  |
+---------------------+------------------------------------------------+
|                     | The six priority health-risk behaviors are:    |
|                     | injuries (intentional and unintentional),      |
|                     | tobacco use, alcohol and illicit drug use,     |
|                     | sexual behaviors that cause unintended         |
|                     | pregnancies and sexually transmitted diseases, |
|                     | dietary patterns that cause disease, and       |
|                     | inadequate physical activity.                  |
+---------------------+------------------------------------------------+
|                     | Postsecondary institutions include 2- and      |
|                     | 4-year community colleges, private colleges,   |
|                     | and universities.                              |
+---------------------+------------------------------------------------+
|                     | See Appendix A for focus area contact          |
|                     | information.                                   |
+---------------------+------------------------------------------------+

7-4. Increase the proportion of the Nation's elementary, middle, junior
high, and senior high schools that have a nurse-to-student ratio of at
least 1:750.

+---------------------+------------------------------------------------+
| 7-4a. All middle,   |                                                |
| junior high, and    |                                                |
| senior high         |                                                |
| schools.            |                                                |
+---------------------+------------------------------------------------+
| **National Data     | School Health Policies and Programs Study      |
| Source**            | (SHPPS), CDC, NCCDPHP.                         |
+---------------------+------------------------------------------------+
| **State Data        | Not identified.                                |
| Source**            |                                                |
+---------------------+------------------------------------------------+
| **Healthy People    | Not applicable.                                |
| 2000 Objective**    |                                                |
+---------------------+------------------------------------------------+
| **Measure**         | Percent.                                       |
+---------------------+------------------------------------------------+
| **Baseline**        | 28 (1994).                                     |
+---------------------+------------------------------------------------+
| **Numerator**       | Number of middle, junior high, and senior high |
|                     | schools that have a nurse-to-student ratio of  |
|                     | at least 1:750.                                |
+---------------------+------------------------------------------------+
| **Denominator**     | Number of middle, junior, and senior high      |
|                     | schools.                                       |
+---------------------+------------------------------------------------+
| **Population        | Middle, junior high, and senior high schools.  |
| Targeted**          |                                                |
+---------------------+------------------------------------------------+
| **Questions Used To | From the 1994 School Health Policies and       |
| Obtain the National | Programs Study:                                |
| Data**              |                                                |
+---------------------+------------------------------------------------+
|                     | -   Are there any RN/LPNs who work in the      |
|                     |     school?                                    |
|                     |                                                |
|                     |     \[If yes:\]                                |
|                     |                                                |
|                     |     -   Please tell me [how many]{.underline}  |
|                     |         RNLPNs work in your school, [which     |
|                     |         days of the week]{.underline} each RN  |
|                     |         is here, and [how many                 |
|                     |         hours]{.underline} each RN/LPN is      |
|                     |         usually here on those days.            |
+---------------------+------------------------------------------------+
|                     | \[If an RN/LPN doesn't have a regular          |
|                     | schedule, ask:\]                               |
|                     |                                                |
|                     | -   How many [total hours per                  |
|                     |     week]{.underline} is this RN/LPN usually   |
|                     |     in your school?                            |
+---------------------+------------------------------------------------+
| **Expected          | Periodic.                                      |
| Periodicity**       |                                                |
+---------------------+------------------------------------------------+
| **Comments**        | The nurse-to-student ratio is the number of    |
|                     | school nurses divided by the total student     |
|                     | enrollment. One school nurse is defined as 30  |
|                     | nurse-hours per week per school.               |
+---------------------+------------------------------------------------+
|                     | Total student enrollment of all the schools    |
|                     | included in SHPPS is obtained from the Quality |
|                     | Education Data (QED) database. QED's National  |
|                     | Education Database covers all educational      |
|                     | institutions in the United States and Canada.  |
|                     | See http://www.qeddata.com/ for more           |
|                     | information.                                   |
+---------------------+------------------------------------------------+
|                     | See Part C for a description of SHPPS and      |
|                     | Appendix A for focus area contact information. |
+---------------------+------------------------------------------------+

  ---------------------- ------------------------------------------------
  7-4b. Senior high      
  schools.               

  **National Data        School Health Policies and Programs Study
  Source**               (SHPPS), CDC, NCCDPHP.

  **State Data Source**  Not identified.

  **Healthy People 2000  Not applicable.
  Objective**            

  **Measure**            Percent.

  **Baseline**           26 (1994).

  **Numerator**          Number of senior high schools that have a
                         nurse-to-student ratio of at least 1:750.

  **Denominator**        Number of senior high schools.

  **Population           Senior high schools.
  Targeted**             

  **Questions Used To    See Questions Used To Obtain the National Data
  Obtain the National    provided with 7-4a.
  Data**                 

  **Expected             Periodic.
  Periodicity**          

  **Comments**           See Comments provided with 7-4a for more
                         information.

                         Total student enrollment of the senior high
                         schools included in SHPPS is obtained from the
                         Quality Education Data (QED) database. QED's
                         National Education Database covers all
                         educational institutions in the United States
                         and Canada. See http://www.qeddata.com/ for more
                         information.
  ---------------------- ------------------------------------------------

  ---------------------- ------------------------------------------------
  7-4c. Middle and       
  junior high schools.   

  **National Data        School Health Policies and Programs Study
  Source**               (SHPPS), CDC, NCCDPHP.

  **State Data Source**  Not identified.

  **Healthy People 2000  Not applicable.
  Objective**            

  **Measure**            Percent.

  **Baseline**           32 (1994).

  **Numerator**          Number of middle and junior high schools that
                         have a nurse-to-student ratio of at least 1:750.

  **Denominator**        Number of middle and junior high schools.

  **Population           Middle and junior high schools.
  Targeted**             

  **Questions Used To    See Questions Used To Obtain the National Data
  Obtain the National    provided with 7-4a.
  Data**                 

  **Expected             Periodic.
  Periodicity**          

  **Comments**           See Comments provided with 7-4a for more
                         information.

                         Total student enrollment of the middle and
                         junior high schools included in SHPPS is
                         obtained from the Quality Education Data (QED)
                         database. QED's National Education Database
                         covers all educational institutions in the
                         United States and Canada. See
                         http://www.qeddata.com/ for more information.

  7-4d. (Developmental)  
  Elementary schools.    

  **Comments**           An operational definition could not be specified
                         at the time of publication.

                         The expected national data source is the School
                         Health Policies and Programs Study (SHPPS), CDC,
                         NCCDPHP.

                         The expected numerator is the number of
                         elementary schools that have a nurse-to-student
                         ratio of at least 1:750.

                         The expected denominator is the number of
                         elementary schools.

                         The nurse-to-student ratio is the number of
                         school nurses divided by the total student
                         enrollment. One school nurse is defined as 30
                         nurse hours per week per school.

                         Total student enrollment of the elementary
                         schools included in SHPPS will be obtained from
                         the Quality Education Data (QED) database. QED's
                         National Education Database covers all
                         educational institutions in the United States
                         and Canada. See http://www.qeddata.com/ for more
                         information.

                         See Part C for a description of SHPPS and
                         Appendix A for focus area contact information.
  ---------------------- ------------------------------------------------

### Worksite Setting

7-5. Increase the proportion of worksites that offer a comprehensive
employee health promotion program to their employees.

  ----------------------- -----------------------------------------------
  7-5a. (Developmental)   
  Worksites with fewer    
  than 50 employees       

  **Comments**            An operational definition could not be
                          specified at the time of publication.

                          The proposed national data source is the 1999
                          National Worksite Health Promotion Survey
                          (NWHPS), Association for Worksite Health
                          Promotion (AWHP).

                          A comprehensive worksite health promotion
                          program contains all of the following elements:

                          \(1\) health education that focuses on skill
                          development and lifestyle behavior change in
                          addition to information dissemination and
                          awareness building, preferably tailored to
                          employees interests and needs;

                          \(2\) supportive social and physical
                          environments, including established norms for
                          healthy behavior and policies that promote
                          health and reduce risk of disease, such as
                          worksite smoking policies, healthy nutrition
                          alternatives in the cafeteria and vending
                          machines, and opportunities for obtaining
                          regular physical activity;

                          \(3\) integration of the worksite program into
                          the organization's structure;

                          \(4\) related programs, such as employee
                          assistance programs; and

                          \(5\) screening programs, preferably linked to
                          medical care delivery to ensure follow-up and
                          appropriate treatment as necessary and to
                          encourage adherence.

                          This objective is adapted from a measure in
                          Healthy People 2000 objective 8.6, which
                          tracked worksites with less than 50 employees,
                          50 or more employees, as well as medium and
                          large companies. It measured the proportion
                          that offered any health promotion activity for
                          their employees, preferably as part of a
                          comprehensive employee health promotion
                          program. This measure tracks the proportion of
                          worksites with less than 50, 50 to 99, 100-249,
                          250 to 749, and 750 or more employees who offer
                          a comprehensive (as defined above) health
                          promotion program to both full- and part-time
                          employees.

                          See Part C for a description of NWHPS and
                          Appendix A for focus area contact information.
  ----------------------- -----------------------------------------------

-   

+-----------------------+-----------------------------------------------+
|                       |                                               |
+-----------------------+-----------------------------------------------+
|                       |                                               |
+-----------------------+-----------------------------------------------+
| 7-5b. Worksites with  |                                               |
| 50 or more employees. |                                               |
+-----------------------+-----------------------------------------------+
| **National Data       | 1999 National Worksite Health Promotion       |
| Source**              | Survey (NWHPS), Association for Worksite      |
|                       | Health Promotion (AWHP).                      |
+-----------------------+-----------------------------------------------+
| **State Data Source** | Not identified.                               |
+-----------------------+-----------------------------------------------+
| **Healthy People 2000 | Adapted from 8.6 (Educational and             |
| Objective**           | Community-Based Programs).                    |
+-----------------------+-----------------------------------------------+
| **Measure**           | Percent.                                      |
+-----------------------+-----------------------------------------------+
| **Baseline**          | 34 (1999).                                    |
+-----------------------+-----------------------------------------------+
| **Numerator**         | Number of worksites with 50 or more employees |
|                       | that offer a comprehensive health promotion   |
|                       | program.                                      |
+-----------------------+-----------------------------------------------+
| **Denominator**       | Number of worksites with 50 or more           |
|                       | employees.                                    |
+-----------------------+-----------------------------------------------+
| **Questions Used To   | From the 1999 National Worksite Health        |
| Obtain the National   | Promotion Survey:                             |
| Data**                |                                               |
+-----------------------+-----------------------------------------------+
|                       | \[NUMERATOR:\]                                |
|                       |                                               |
|                       | \[Component 1: Health Education\]             |
|                       |                                               |
|                       | -   During the last 12 months, did you offer  |
|                       |     ([Insert Program Type]{.underline}) to    |
|                       |     your employees at the worksite?           |
|                       |                                               |
|                       |     \(a\) Physical activity and/or fitness    |
|                       |     programs or activities\                   |
|                       |     (b) Nutrition or cholesterol education\   |
|                       |     (c) Weight management classes or          |
|                       |     counseling\                               |
|                       |     (d) Smoking management classes or         |
|                       |     counseling\                               |
|                       |     (e) Stress management classes or          |
|                       |     counseling\                               |
|                       |     (f) Alcohol or drug abuse support         |
|                       |     programs\                                 |
|                       |     (g) Back injury prevention programs\      |
|                       |     (h) Maternal or prenatal programs\        |
|                       |     (i) Education on balancing work and       |
|                       |     family\                                   |
|                       |     (j) HIV or AIDS education\                |
|                       |     (k) Workplace violence prevention         |
|                       |     programs                                  |
+-----------------------+-----------------------------------------------+
|                       | -   Did your worksite offer Health Awareness  |
|                       |     Information such as lectures or           |
|                       |     informational brochures about smoking or  |
|                       |     other health issues during the last 12    |
|                       |     months?                                   |
+-----------------------+-----------------------------------------------+
|                       | -   Did your worksite offer Lifestyle         |
|                       |     Behavior Change Programs such as ongoing  |
|                       |     meetings, sessions or counseling for      |
|                       |     weight management or to quit smoking      |
|                       |     during the last 12 months?                |
+-----------------------+-----------------------------------------------+
|                       | -   Do you currently offer ([Insert           |
|                       |     Program/service]{.underline}) either      |
|                       |     through the company, through one or ore   |
|                       |     employee health plans, or not at all?     |
+-----------------------+-----------------------------------------------+
|                       | \(a\) Self Care Books or Tools\               |
|                       | (b) Nurse Advice Lines\                       |
|                       | (c) Diabetes Management Programs\             |
|                       | (d) Asthma Management Programs\               |
|                       | (e) Cancer Management Programs\               |
|                       | (f) Depression Management Programs\           |
|                       | (g) Hypertension Management Programs\         |
|                       | (h) Cardiovascular Management Programs\       |
|                       | (i) Obesity Management Programs               |
+-----------------------+-----------------------------------------------+
|                       | \[Component 2: Supportive Social and Physical |
|                       | Work Environment\]                            |
|                       |                                               |
|                       | -   Do you have a formal policy for tobacco   |
|                       |     that prohibits or severely restricts      |
|                       |     smoking at the worksite/on the job?       |
+-----------------------+-----------------------------------------------+
|                       | -   Do you have a formal policy for alcohol,  |
|                       |     specifically addressing employee use of   |
|                       |     alcohol at the worksite/on the job?       |
+-----------------------+-----------------------------------------------+
|                       | -   Do you have a formal policy for drugs,    |
|                       |     specifically addressing employee use of   |
|                       |     illegal drugs at the worksite/on the job? |
+-----------------------+-----------------------------------------------+
|                       | -   Do you have a formal policy for           |
|                       |     occupational (sic) protection,            |
|                       |     specifically requiring use of seat belts  |
|                       |     during business travel in an automobile?  |
+-----------------------+-----------------------------------------------+
|                       | -   Are financial incentives used to          |
|                       |     encourage program participation in health |
|                       |     promotion?How is your ([Insert Program    |
|                       |     Type]{.underline}) program funded? Is     |
|                       |     it\...                                    |
|                       |                                               |
|                       |     1\. Company paid\                         |
|                       |     2. Employee paid\                         |
|                       |     3. Shared cost                            |
|                       |                                               |
|                       |     PROGRAM TYPE:\                            |
|                       |     a. Health Screening\                      |
|                       |     b. Health Risk Assessment\                |
|                       |     c. Health Awareness Information\          |
|                       |     d. Lifestyle Behavior Change              |
|                       |                                               |
|                       | -   Does your worksite have an on-site        |
|                       |     exercise facility?                        |
+-----------------------+-----------------------------------------------+
|                       | \[Component 3: Integration of the Worksite    |
|                       | Program into the Organization's               |
|                       | Administrative Structure\]                    |
|                       |                                               |
|                       | -   Does your worksite have at least one      |
|                       |     part-time person responsible for Health   |
|                       |     Promotion or Worksite Wellness?           |
+-----------------------+-----------------------------------------------+
|                       | -   Is the improvement of the health status   |
|                       |     of employees a stated mission or goal for |
|                       |     your company?                             |
+-----------------------+-----------------------------------------------+
|                       | -   What are the barriers or challenges to    |
|                       |     your program's success?                   |
|                       |                                               |
|                       |     \(a\) Lack of access to data (medical,    |
|                       |     R~x~ claims, disability, HRA).\           |
|                       |     (b) Lack of integration with other        |
|                       |     programs/services.                        |
+-----------------------+-----------------------------------------------+
|                       | \[Component 4: Related Programs like          |
|                       | Employees Assistance Programs (EAP)\]         |
|                       |                                               |
|                       | -   Do you currently offer Nurse Advice Lines |
|                       |     either though the company, through one or |
|                       |     more employee health plan, or not at all? |
+-----------------------+-----------------------------------------------+
|                       | \[Component 5: Screening Programs\]           |
|                       |                                               |
|                       | -   During the last 12 months, did you offer  |
|                       |     ([Insert Program Type]{.underline}) to    |
|                       |     your employees at the worksite or through |
|                       |     one of your health plans?                 |
|                       |                                               |
|                       | -   \(a\) Screenings for high blood pressure\ |
|                       |     (b) Screenings for cholesterol level\     |
|                       |     (c) Screenings for any form of cancer\    |
|                       |     (d) Health Risk Assessment (HRA) -        |
|                       |     questionnaires about health habits        |
+-----------------------+-----------------------------------------------+
|                       | \[DENOMINATOR:\]                              |
|                       |                                               |
|                       | -   How many full-time employees are          |
|                       |     currently employed at this worksite?      |
|                       |     These are employees who are continuously  |
|                       |     employed by this particular worksite, not |
|                       |     the entire organization if it has more    |
|                       |     than one site?                            |
|                       |                                               |
|                       |     Number of full-time employees             |
|                       |     \_\_\_\_\_\_\_\_\_\_\                     |
|                       |     Number of part-time employees             |
|                       |     \_\_\_\_\_\_\_\_\_                        |
+-----------------------+-----------------------------------------------+
| **Expected            | Periodic.                                     |
| Periodicity**         |                                               |
+-----------------------+-----------------------------------------------+
| **Comments**          | A worksite is considered to have a            |
|                       | comprehensive health promotion program if it  |
|                       | contains all of the following elements:       |
+-----------------------+-----------------------------------------------+
|                       | \(1\) A positive response to any of the       |
|                       | programs/services listed in Component 1 in    |
|                       | the questions above; and                      |
+-----------------------+-----------------------------------------------+
|                       | \(2\) A positive response to any of the       |
|                       | policies listed in Component 2; and           |
+-----------------------+-----------------------------------------------+
|                       | \(3\) A positive response to either of the    |
|                       | first two questions (person responsible and   |
|                       | stated mission), or a lack of a positive      |
|                       | response to the third question                |
|                       | (barriers/challenges) listed in Component 3;  |
|                       | and                                           |
+-----------------------+-----------------------------------------------+
|                       | \(4\) A positive response to the Nurse Advice |
|                       | lines question in Component 4; and            |
+-----------------------+-----------------------------------------------+
|                       | \(5\) A positive response to any of the       |
|                       | screening programs listed in Component 5 in   |
|                       | the questions above.                          |
+-----------------------+-----------------------------------------------+
|                       | Both full- and part-time employees are        |
|                       | included for determining worksite size. The   |
|                       | sum of full- and part-time employees must be  |
|                       | greater than 49 employees.                    |
+-----------------------+-----------------------------------------------+
|                       | This objective is adapted from a measure in   |
|                       | Healthy People 2000 objective 8.6, which      |
|                       | tracked worksites with less than 50           |
|                       | employees, 50 or more employees, as well as   |
|                       | medium and large companies. It measured the   |
|                       | proportion that offered any health promotion  |
|                       | activity for their employees, preferably as   |
|                       | part of a comprehensive employee health       |
|                       | promotion program. This measure tracks the    |
|                       | proportion of worksites with less than 50, 50 |
|                       | to 99, 100-249, 250 to 749, and 750 or more   |
|                       | employees who offer a comprehensive (as       |
|                       | defined above) health promotion program to    |
|                       | both full- and part-time employees.           |
+-----------------------+-----------------------------------------------+
|                       | See Part C for a description of NWHPS and     |
|                       | Appendix A for focus area contact             |
|                       | information.                                  |
+-----------------------+-----------------------------------------------+

  ----------------------- -----------------------------------------------
  7-5c. Worksites with 50 
  to 99 employees.        

  **National Data         1999 National Worksite Health Promotion Survey
  Source**                (NWHPS), Association for Worksite Health
                          Promotion (AWHP).

  **State Data Source**   Not identified.

  **Healthy People 2000   Adapted from 8.6 (Educational and
  Objective**             Community-Based Programs).

  **Measure**             Percent.

  **Baseline**            33 (1999).

  **Numerator**           Number of worksites with 50 to 99 employees
                          that offer a comprehensive health promotion
                          program.

  **Denominator**         Number of worksites with 50 to 99 employees.

  **Questions Used To     See Questions Used To Obtain the National Data
  Obtain the National     provided with 7-5b.
  Data**                  

  **Expected              Periodic.
  Periodicity**           

  **Comments**            See Comments provided with 7-5b for more
                          information.

  7-5d. Worksites with    
  100 to 249 employees.   

  **National Data         1999 National Worksite Health Promotion Survey
  Source**                (NWHPS), Association for Worksite Health
                          Promotion (AWHP).

  **State Data Source**   Not identified.

  **Healthy People 2000   Adapted from 8.6 (Educational and
  Objective**             Community-Based Programs).

  **Measure**             Percent.

  **Baseline**            33 (1999).

  **Numerator**           Number of worksites with 100 to 249 employees
                          that offer a comprehensive health promotion
                          program.

  **Denominator**         Number of worksites with 100 to 249 employees.

  **Questions Used To     See Questions Used To Obtain the National Data
  Obtain the National     provided with 7-5b.
  Data**                  

  **Expected              Periodic.
  Periodicity**           

  **Comments**            See Comments provided with 7-5b for more
                          information.

  7-5e. Worksites with    
  250 to 749 employees.   

  **National Data         1999 National Worksite Health Promotion Survey
  Source**                (NWHPS), Association for Worksite Health
                          Promotion (AWHP).

  **State Data Source**   Not identified.

  **Healthy People 2000   Adapted from 8.6 (Educational and
  Objective**             Community-Based Programs).

  **Measure**             Percent.

  **Baseline**            38 (1999).

  **Numerator**           Number of worksites with 250 to 749 employees
                          that offer a comprehensive health promotion
                          program.

  **Denominator**         Number of worksites with 250 to 749 employees.

  **Questions Used To     See Questions Used To Obtain the National Data
  Obtain the National     provided with 7-5b.
  Data**                  

  **Expected              Periodic.
  Periodicity**           

  **Comments**            See Comments provided with 7-5b for more
                          information.
  ----------------------- -----------------------------------------------

+-----------------------+-----------------------------------------------+
| 7-5f. Worksites with  |                                               |
| 750 or more           |                                               |
| employees.            |                                               |
+-----------------------+-----------------------------------------------+
| **National Data       | 1999 National Worksite Health Promotion       |
| Source**              | Survey (NWHPS), Association for Worksite      |
|                       | Health Promotion (AWHP).                      |
+-----------------------+-----------------------------------------------+
| **State Data Source** | Not identified.                               |
+-----------------------+-----------------------------------------------+
| **Healthy People 2000 | Adapted from 8.6 (Educational and             |
| Objective**           | Community-Based Programs).                    |
+-----------------------+-----------------------------------------------+
| **Measure**           | Percent.                                      |
+-----------------------+-----------------------------------------------+
| **Baseline**          | 50 (1999).                                    |
+-----------------------+-----------------------------------------------+
| **Numerator**         | Number of worksites with 750 or more          |
|                       | employees that offer a comprehensive health   |
|                       | promotion program.                            |
+-----------------------+-----------------------------------------------+
| **Denominator**       | Number of worksites with 750 or more          |
|                       | employees.                                    |
+-----------------------+-----------------------------------------------+
| **Questions Used To   | See Questions Used To Obtain the National     |
| Obtain the National   | Data provided with 7-5b.                      |
| Data**                |                                               |
+-----------------------+-----------------------------------------------+
| **Expected            | Periodic.                                     |
| Periodicity**         |                                               |
+-----------------------+-----------------------------------------------+
| **Comments**          | See Comments provided with 7-5b for more      |
|                       | information.                                  |
+-----------------------+-----------------------------------------------+
| 7-6. Increase the     |                                               |
| proportion of         |                                               |
| employees who         |                                               |
| participate in        |                                               |
| employer-sponsored    |                                               |
| health promotion      |                                               |
| activities.           |                                               |
+-----------------------+-----------------------------------------------+
| **National Data       | National Health Interview Survey (NHIS), CDC, |
| Source**              | NCHS.                                         |
+-----------------------+-----------------------------------------------+
| **State Data Source** | Not identified.                               |
+-----------------------+-----------------------------------------------+
| **Healthy People 2000 | Adapted from 8.7 (Educational and             |
| Objective**           | Community-Based Programs).                    |
+-----------------------+-----------------------------------------------+
| **Measure**           | Percent.                                      |
+-----------------------+-----------------------------------------------+
| **Baseline**          | 61 (1994).                                    |
+-----------------------+-----------------------------------------------+
| **Numerator**         | Number of persons 18 years and older who      |
|                       | reported that they participated in either     |
|                       | quit smoking programs, screening tests, used  |
|                       | exercise facilities, or received educational  |
|                       | information sponsored by their employer.      |
+-----------------------+-----------------------------------------------+
| **Denominator**       | Number of persons aged 18 years and older.    |
+-----------------------+-----------------------------------------------+
| **Population          | U.S. civilian, noninstitutionalized           |
| Targeted**            | population.                                   |
+-----------------------+-----------------------------------------------+
| **Questions Used To   | From the 1994 National Health Interview       |
| Obtain the National   | Survey:                                       |
| Data**                |                                               |
+-----------------------+-----------------------------------------------+
|                       | \[NUMERATOR:\]                                |
|                       |                                               |
|                       | -   In the past year, have you participated   |
|                       |     in a quit smoking program made available  |
|                       |     by your employer?                         |
+-----------------------+-----------------------------------------------+

+-----------------------+-----------------------------------------------+
|                       | -   In the past year, which of these          |
|                       |     facilities did you use?                   |
|                       |                                               |
|                       |     \(a\) Gymnasium/Exercise room\            |
|                       |     (b) Weight lifting equipment\             |
|                       |     (c) Exercise equipment\                   |
|                       |     (d) Walking/jogging path\                 |
|                       |     (e) Parcourse/Fitness trail\              |
|                       |     (f) Bike path\                            |
|                       |     (g) Bike racks\                           |
|                       |     (h) Swimming pools\                       |
|                       |     (i) Showers\                              |
|                       |     (j) Lockers\                              |
|                       |     (k) Other - specify                       |
+-----------------------+-----------------------------------------------+
|                       | -   In the past year, which of these programs |
|                       |     did you participate in?                   |
|                       |                                               |
|                       |     \(a\) Walking group\                      |
|                       |     (b) Jogging/Running group\                |
|                       |     (c) Biking/Cycling group\                 |
|                       |     (d) Aerobic class\                        |
|                       |     (e) Swimming class\                       |
|                       |     (f) Non-aerobic exercise class\           |
|                       |     (g) Weight lifting class\                 |
|                       |     (h) Fully paid membership in              |
|                       |     health/fitness club\                      |
|                       |     (i) Partially paid membership in          |
|                       |     health/fitness club\                      |
|                       |     (j) Physical activity or exercise         |
|                       |     competition\                              |
|                       |     (k) Other - specify                       |
+-----------------------+-----------------------------------------------+
|                       | -   In the past year, did you receive a       |
|                       |     screening test at your workplace for --   |
|                       |                                               |
|                       |     1\) Blood pressure?\                      |
|                       |     2) Cholesterol?\                          |
|                       |     3) Cancer?                                |
+-----------------------+-----------------------------------------------+
|                       | -   In the past 12 months, which programs did |
|                       |     you participate in at your workplace?     |
|                       |                                               |
|                       |     \(a\) Weight control\                     |
|                       |     (b) Nutrition information\                |
|                       |     (c) Prenatal education\                   |
|                       |     (d) Stress reduction and management\      |
|                       |     (e) Alcohol and other drugs\              |
|                       |     (f) Sexually transmitted diseases         |
|                       |     (including HIV or AIDS)\                  |
|                       |     (g) Job hazards and injury prevention\    |
|                       |     (h) Back care and prevention of back      |
|                       |     injury\                                   |
|                       |     (i) Preventing off-the-job accidents\     |
|                       |     (j) Other - specify                       |
+-----------------------+-----------------------------------------------+
|                       | \[DENOMINATOR:\]                              |
|                       |                                               |
|                       | -   Were you employed at a job or business    |
|                       |     during the past two weeks?                |
+-----------------------+-----------------------------------------------+
|                       | -   Does your employer have 50 or more        |
|                       |     employees at the building or location     |
|                       |     where you work?                           |
+-----------------------+-----------------------------------------------+
| **Expected            | Periodic.                                     |
| Periodicity**         |                                               |
+-----------------------+-----------------------------------------------+
| **Comments**          | Persons are considered to have participated   |
|                       | in employer-sponsored health promotion        |
|                       | programs if they responded "yes" any of the   |
|                       | services or programs listed in the questions  |
|                       | above.                                        |
+-----------------------+-----------------------------------------------+
|                       | Persons are considered to be employed if they |
|                       | reported they were employed in the past 2     |
|                       | weeks at a job with 50 or more employees.     |
+-----------------------+-----------------------------------------------+
|                       | This objective is adapted from Healthy People |
|                       | 2000 objective 8.7, which tracked the         |
|                       | proportion of hourly workers who participated |
|                       | regularly in employer-sponsored quit smoking  |
|                       | programs, screening tests, who used exercise  |
|                       | facilities, or received educational           |
|                       | information. This measure tracks the          |
|                       | proportion of all employees, in all           |
|                       | occupations, who participated in              |
|                       | employer-sponsored quit smoking programs,     |
|                       | screening tests, who used exercise facilities |
|                       | and received educational information.         |
+-----------------------+-----------------------------------------------+
|                       | See Part C for a description of NHIS and      |
|                       | Appendix A for focus area contact             |
|                       | information.                                  |
+-----------------------+-----------------------------------------------+

### Health Care Setting

+-----------------------+-----------------------------------------------+
| 7-7. (Developmental)  |                                               |
| Increase the          |                                               |
| proportion of health  |                                               |
| care organizations    |                                               |
| that provide patient  |                                               |
| and family education. |                                               |
+-----------------------+-----------------------------------------------+
| **Comments**          | An operational definition could not be        |
|                       | specified at the time of publication.         |
+-----------------------+-----------------------------------------------+
|                       | A proposed data source is the Joint           |
|                       | Commission on Accreditation of Healthcare     |
|                       | Organizations (JCAHO).                        |
+-----------------------+-----------------------------------------------+
|                       | Health care organizations refer to            |
|                       | organizations that provide health care        |
|                       | services. The specific standards for the      |
|                       | education provided include:                   |
|                       |                                               |
|                       | > \(a\) Assessment considers cultural and     |
|                       | > language barriers and desire to learn\      |
|                       | > (b) Safe and effective use of medication\   |
|                       | > (c) Safe and effective use of medical       |
|                       | > equipment\                                  |
|                       | > (d) Potential drug-food interactions\       |
|                       | > (e) Rehabilitation techniques\              |
|                       | > (f) Access to additional resources in the   |
|                       | > community\                                  |
|                       | > (g) Further treatment\                      |
|                       | > (h) Discharge instructions\                 |
|                       | > (i) Educational resources                   |
+-----------------------+-----------------------------------------------+
|                       | Patient education is defined as a series of   |
|                       | structured or nonstructured experiences which |
|                       | are designed to assist patients to cope       |
|                       | voluntarily with the immediate crisis         |
|                       | response to their diagnosis, with long-term   |
|                       | adjustments, and with symptoms; gain needed   |
|                       | skills, knowledge, and attitudes to maintain  |
|                       | or regain health status.                      |
+-----------------------+-----------------------------------------------+
|                       | This objective is adapted from a measure in   |
|                       | Healthy People 2000 objective 8.12, which     |
|                       | tracked the proportion of hospitals, health   |
|                       | maintenance organizations, and large group    |
|                       | practices that provide patient education      |
|                       | programs, and the proportion of community     |
|                       | hospitals that offer community health         |
|                       | programs addressing the priority health needs |
|                       | of their communities. This measure will track |
|                       | the proportion of hospitals, health           |
|                       | maintenance organizations, and large group    |
|                       | practices that provide both patient and       |
|                       | family education programs.                    |
+-----------------------+-----------------------------------------------+
|                       | See Appendix A for focus area contact         |
|                       | information.                                  |
+-----------------------+-----------------------------------------------+

-   

7-8. (Developmental) Increase the proportion of patients who report that
they are satisfied with the patient education they receive from their
health care organization.

  ----------------------- -----------------------------------------------
  **Comments**            An operational definition could not be
                          specified at the time of publication.

                          A proposed data source is the Press Ganey.

                          Patient education is defined as a series of
                          structured or nonstructured experiences which
                          are designed to assist patients to cope
                          voluntarily with the immediate crisis response
                          to their diagnosis, with long-term adjustments,
                          and with symptoms; gain needed skills,
                          knowledge, and attitudes to maintain or regain
                          health status.

                          See Appendix A for focus area contact
                          information.
  ----------------------- -----------------------------------------------

+-----------------------+-----------------------------------------------+
| 7-9. (Developmental)  |                                               |
| Increase the          |                                               |
| proportion of         |                                               |
| hospitals and managed |                                               |
| care organizations    |                                               |
| that provide          |                                               |
| community disease     |                                               |
| prevention and health |                                               |
| promotion activities  |                                               |
| that address the      |                                               |
| priority health needs |                                               |
| identified by their   |                                               |
| community.            |                                               |
+-----------------------+-----------------------------------------------+
| **Comments**          | An operational definition could not be        |
|                       | specified at the time of publication.         |
+-----------------------+-----------------------------------------------+
|                       | A proposed data source is the American        |
|                       | Hospital Association Survey. This annual      |
|                       | survey does not include managed care          |
|                       | organizations (MCOs), which are systems that  |
|                       | integrate the financing and delivery of       |
|                       | health care services to covered individuals   |
|                       | by means of arrangements with selected        |
|                       | providers to furnish health care services to  |
|                       | members.                                      |
+-----------------------+-----------------------------------------------+
|                       | Proposed questions from the American Hospital |
|                       | Association Survey to be used to obtain the   |
|                       | data are:                                     |
|                       |                                               |
|                       | -   Does the hospital's mission statement     |
|                       |     include a focus on community benefit?     |
|                       |                                               |
|                       | -   Does the hospital have a long-term plan   |
|                       |     for improving the health of its           |
|                       |     community?                                |
|                       |                                               |
|                       | -   Does the hospital have resources for its  |
|                       |     community benefits activities?            |
|                       |                                               |
|                       | -   Does the hospital work with other local   |
|                       |     providers, public agencies or community   |
|                       |     representatives to conduct a health       |
|                       |     status assessment of the community?       |
+-----------------------+-----------------------------------------------+
|                       | -   Does the hospital work with other local   |
|                       |     providers, public agencies or community   |
|                       |     representatives to develop a written      |
|                       |     assessment of the appropriate capacity    |
|                       |     for health services in the community?     |
|                       |                                               |
|                       |     \[If yes:\]                               |
|                       |                                               |
|                       |     -   Has the hospital used the assessment  |
|                       |         to identify unmet health needs,       |
|                       |         excess capacity, or duplicative       |
|                       |         services in the community?            |
+-----------------------+-----------------------------------------------+
|                       | This objective is adapted from a measure in   |
|                       | Healthy People 2000 objective number 8.12,    |
|                       | which tracked the proportion of community     |
|                       | hospitals that offer community health         |
|                       | programs addressing the priority health needs |
|                       | of their communities. This measure will track |
|                       | the proportion of community hospitals, as     |
|                       | well as managed care organizations, that      |
|                       | provide community disease prevention and      |
|                       | health promotion activities that address the  |
|                       | priority health needs identified by their     |
|                       | communities.                                  |
+-----------------------+-----------------------------------------------+
|                       | Managed care includes health maintenance      |
|                       | organizations (HMOs), preferred provider      |
|                       | organizations (PPOs), and point-of-service    |
|                       | (POS) plans.                                  |
+-----------------------+-----------------------------------------------+
|                       | See Appendix A for focus area contact         |
|                       | information.                                  |
+-----------------------+-----------------------------------------------+

### Community Setting and Special Populations

  ----------------------- -----------------------------------------------
  7-10. (Developmental)   
  Increase the proportion 
  of Tribal and local     
  health service areas or 
  jurisdictions that have 
  established a community 
  health promotion        
  program that addresses  
  multiple Healthy People 
  2010 focus areas.       

  **Comments**            An operational definition could not be
                          specified at the time of publication.

                          A proposed data source is a survey to be
                          developed and administered by Association of
                          State and Territorial Directors of Health
                          Promotion and Public Health Education
                          (ASTDHPPHE).

                          The proposed measure is the proportion of local
                          health service areas or jurisdictions,
                          identified by ASTDHPPHE representatives in each
                          State, the District of Columbia, the
                          Territories (American Samoa, Guam, Puerto Rico,
                          and Virgin Islands), and Regional Indian Health
                          Service offices that have health promotion
                          initiatives existing in the identified local
                          health service areas or jurisdictions.

                          Local health service areas refers to local
                          health jurisdictions and local health serving
                          unit catchment areas.

                          Community health promotion initiative includes
                          all of the following:

                          \(1\) Community participation with
                          representatives from at least three of the
                          following community sectors: government,
                          education, business, faith organizations,
                          health care, media, voluntary agencies, and the
                          public;

                          \(2\) Community assessment, guided by a
                          community assessment and planning model (such
                          as APEX/PH; Healthy Cities, Healthy
                          Communities; PATCH; or other comprehensive
                          model), to determine community health problems,
                          resources, perceptions, and priorities for
                          action;

                          \(3\) Targeted and measurable objectives to
                          address at least one of the following: health
                          concerns, risk factors, public awareness,
                          services, and protection;

                          \(4\) Comprehensive multifaceted, culturally
                          relevant interventions that have multiple
                          targets for change (individuals, organizations,
                          and environments) and multiple approaches to
                          change, including education, community
                          organization, and regulatory and environmental
                          reforms; and

                          \(5\) Monitoring and evaluation processes to
                          determine whether the objectives are reached.

                          This objective was adapted from Healthy People
                          2000 objective 8.10, which tracked the
                          establishment of community health promotion
                          programs that separately or together address at
                          least 3 of the Healthy People 2000 priority
                          areas. This measure will track the proportion
                          of Tribal and local health service areas or
                          jurisdictions that have established a community
                          health promotion program that addresses
                          multiple Healthy People 2010 health focus
                          areas.

                          See Appendix A for focus area contact
                          information.
  ----------------------- -----------------------------------------------

7-11. Increase the proportion of local health departments that have
established culturally appropriate and linguistically competent
community health promotion and disease prevention programs.

  ----------------------- -----------------------------------------------
  7-11a. (Developmental)  
  Access to quality       
  health services.        

  **Comments**            An operational definition could not be
                          specified at the time of publication.

                          This measure is adapted from Healthy People
                          2000 objective 8.11, which tracked the
                          proportion of local health departments that
                          have established culturally and linguistically
                          appropriate community health promotion programs
                          for clinical preventive services for racial and
                          ethnic minority populations. This measure will
                          track the proportion of local health
                          departments that have culturally appropriate
                          and linguistically competent community health
                          promotion programs that address access to
                          quality health services racial and ethnic
                          minority populations.

                          Data from the 1996--97 National Profile of
                          Local Health Departments on clinical preventive
                          services are presented for illustrative
                          purposes for the access to quality health
                          services measure.

                          See Part C for a description of NPLHD and
                          Appendix A for focus area contact information.

  7-11b. (Developmental)  
  Arthritis,              
  osteoporosis, and       
  chronic back            
  conditions.             

  **Comments**            An operational definition could not be
                          specified at the time of publication.

                          This measure is adapted from Healthy People
                          2000 objective 8.11, which tracked the
                          proportion of local health departments that
                          have established culturally and linguistically
                          appropriate community health promotion programs
                          for diabetes and other chronic disabling
                          conditions, which included arthritis,
                          osteoporosis, and chronic back conditions as a
                          component, for racial and ethnic minority
                          populations.

                          This measure will only track the proportion of
                          local health departments that have culturally
                          appropriate and linguistically competent
                          community arthritis, osteoporosis, and chronic
                          back conditions programs for racial and ethnic
                          minority populations.

                          See Part C for a description of NPLHD and
                          Appendix A for focus area contact information.
  ----------------------- -----------------------------------------------

+-----------------------+-----------------------------------------------+
| 7-11c. Cancer.        |                                               |
+-----------------------+-----------------------------------------------+
| **National Data       | National Profile of Local Health Departments, |
| Source**              | NACCHO.                                       |
+-----------------------+-----------------------------------------------+
| **State Data Source** | National Profile of Local Health Departments, |
|                       | NACCHO.                                       |
+-----------------------+-----------------------------------------------+
| **Healthy People 2000 | 8.11 (Educational and Community-Based         |
| Objective**           | Programs).                                    |
+-----------------------+-----------------------------------------------+
| **Measure**           | Percent.                                      |
+-----------------------+-----------------------------------------------+
| **Baseline**          | 30 (1996--97).                                |
+-----------------------+-----------------------------------------------+
| **Numerator**         | Number of local health departments that       |
|                       | provided culturally and linguistically        |
|                       | appropriate cancer programs to their          |
|                       | jurisdiction in the past year.                |
+-----------------------+-----------------------------------------------+
| **Denominator**       | Number of local health departments with one   |
|                       | or more minority racial/ethnic population     |
|                       | groups comprising at least 10 percent of the  |
|                       | population.                                   |
+-----------------------+-----------------------------------------------+
| **Questions Used To   | From the 1996--97 National Profile of Local   |
| Obtain the National   | Health Departments:                           |
| Data**                |                                               |
|                       | \[NUMERATOR:\]                                |
|                       |                                               |
|                       | -   In the past year, which of the following  |
|                       |     programs and interventions were provided  |
|                       |     in your jurisdiction, either directly by  |
|                       |     your local health department or through a |
|                       |     contractual agreement with another        |
|                       |     organization?                             |
|                       |                                               |
|                       |     \[Programs:\]                             |
|                       |                                               |
|                       |     \(a\) Physical activities and fitness\    |
|                       |     (b) Nutrition\                            |
|                       |     (c) Tobacco\                              |
|                       |     (d) Alcohol and other drugs\              |
|                       |     (e) Family Planning\                      |
|                       |     (f) Mental health and mental disorders\   |
|                       |     (g) Violent and abusive behavior\         |
|                       |     (h) Educational and community-based       |
|                       |     programs\                                 |
|                       |     (i) Unintentional injuries\               |
|                       |     (j) Occupational safety and health\       |
|                       |     (k) Environment health\                   |
|                       |     (l) Food and drug safety\                 |
|                       |     (m) Oral health\                          |
|                       |     (n) Maternal and infant health\           |
|                       |     (o) Heart disease and stroke\             |
|                       |     (p) Cancer\                               |
|                       |     (q) Diabetes and chronic disabling        |
|                       |     conditions\                               |
|                       |     (r) HIV infections\                       |
|                       |     (s) Sexually transmitted diseases\        |
|                       |     (t) Immunization and infectious diseases\ |
|                       |     (u) Clinical preventive services\         |
|                       |     (v) Surveillance and data systems\        |
|                       |     (w) Other (specify)                       |
|                       |     \_\_\_\_\_\_\_\_\_\_\_\_                  |
+-----------------------+-----------------------------------------------+
|                       | \[Interventions:\]                            |
|                       |                                               |
|                       | Informational Materials                       |
|                       |                                               |
|                       | \(a\) Print\                                  |
|                       | (b) Audiovisual                               |
+-----------------------+-----------------------------------------------+
|                       | Public Service Announcement                   |
|                       |                                               |
|                       | \(a\) Radio\                                  |
|                       | (b) Television                                |
+-----------------------+-----------------------------------------------+
|                       | Internet\                                     |
|                       | Community Outreach                            |
+-----------------------+-----------------------------------------------+
|                       | On-site                                       |
|                       |                                               |
|                       | \(a\) Individual Instruction\                 |
|                       | (b) Group Instruction\                        |
|                       | Other (specify)                               |
|                       | \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_            |
+-----------------------+-----------------------------------------------+

+---+---------------------+---+---------------------------------------------+---+
|   |                     |   | -   [In the past year]{.underline}, which   |   |
|   |                     |   |     of the following programs and           |   |
|   |                     |   |     interventions listed above were adapted |   |
|   |                     |   |     and/or provided to meet the special     |   |
|   |                     |   |     language needs of any racial/minority   |   |
|   |                     |   |     group you serve, either directly by     |   |
|   |                     |   |     your local health department of through |   |
|   |                     |   |     a contractual agreement with another    |   |
|   |                     |   |     organization?                           |   |
+===+=====================+===+=============================================+===+
|   |                     |   | -   [In the past year]{.underline}, which   |   |
|   |                     |   |     of the following programs and           |   |
|   |                     |   |     interventions listed above were adapted |   |
|   |                     |   |     and/or provided to address the cultural |   |
|   |                     |   |     differences of any racial/minority      |   |
|   |                     |   |     population you serve, either directly   |   |
|   |                     |   |     by your local health department of      |   |
|   |                     |   |     through a contractual agreement with    |   |
|   |                     |   |     another organization?                   |   |
+---+---------------------+---+---------------------------------------------+---+
|   |                     |   | \[DENOMINATOR:\]                            |   |
|   |                     |   |                                             |   |
|   |                     |   | -   Please indicate the percentages of the  |   |
|   |                     |   |     [racial composition]{.underline} of     |   |
|   |                     |   |     your jurisdiction.                      |   |
|   |                     |   |                                             |   |
|   |                     |   |     \(a\) Asian or pacific Islander\        |   |
|   |                     |   |     (b) American Indian, Alaska native or   |   |
|   |                     |   |     Aleut\                                  |   |
|   |                     |   |     (c) Black\                              |   |
|   |                     |   |     (d) White\                              |   |
|   |                     |   |     (e) Other                               |   |
+---+---------------------+---+---------------------------------------------+---+
|   |                     |   | -   Please indicate the percentages of the  |   |
|   |                     |   |     [ethnic composition]{.underline} of     |   |
|   |                     |   |     your jurisdiction.                      |   |
|   |                     |   |                                             |   |
|   |                     |   |     \(a\) Hispanic origin\                  |   |
|   |                     |   |     (b) Not of Hispanic origin\             |   |
|   |                     |   |     (c) Unknown                             |   |
+---+---------------------+---+---------------------------------------------+---+
|   | **Expected          |   | Periodic.                                   |   |
|   | Periodicity**       |   |                                             |   |
+---+---------------------+---+---------------------------------------------+---+
|   | **Comments**        |   | A local health department is classified as  |   |
|   |                     |   | having a culturally appropriate and         |   |
|   |                     |   | linguistically competent community program  |   |
|   |                     |   | in the specific health area targeted by the |   |
|   |                     |   | objective if it indicated that in the past  |   |
|   |                     |   | year:                                       |   |
+---+---------------------+---+---------------------------------------------+---+
|   |                     |   | \(1\) it provided programs or interventions |   |
|   |                     |   | in the specific health area targeted by the |   |
|   |                     |   | objective (in the first question above);    |   |
+---+---------------------+---+---------------------------------------------+---+
|   |                     |   | \(2\) the programs were adapted and/or      |   |
|   |                     |   | provided to meet special language needs of  |   |
|   |                     |   | racial/ethnic minorities (in the second     |   |
|   |                     |   | question above); and,                       |   |
+---+---------------------+---+---------------------------------------------+---+
|   |                     |   | \(3\) the programs were adapted and/or      |   |
|   |                     |   | provided to address cultural differences of |   |
|   |                     |   | racial/ethnic minorities (in the third      |   |
|   |                     |   | question above).                            |   |
+---+---------------------+---+---------------------------------------------+---+
|   |                     |   | Local health departments eligible for       |   |
|   |                     |   | inclusion in this objective are those for   |   |
|   |                     |   | which either the American Indian/Alaska     |   |
|   |                     |   | Native, Asian/Pacific Islander,             |   |
|   |                     |   | black/African American, or Hispanic         |   |
|   |                     |   | populations comprise at least 10 percent of |   |
|   |                     |   | the total population in their jurisdiction. |   |
+---+---------------------+---+---------------------------------------------+---+
|   |                     |   | This objective currently is being tracked   |   |
|   |                     |   | in local health departments in which a      |   |
|   |                     |   | racial or ethnic group constitutes at least |   |
|   |                     |   | 10 percent of the population. In future     |   |
|   |                     |   | studies, by utilizing census data, local    |   |
|   |                     |   | health departments that serve communities   |   |
|   |                     |   | in which at least 3,000 people in the       |   |
|   |                     |   | county indicate that their primary language |   |
|   |                     |   | is other than English or a similar          |   |
|   |                     |   | population meets the concentration          |   |
|   |                     |   | standards of 1,000 in a single zip code or  |   |
|   |                     |   | 1,500 in two contiguous zip codes also      |   |
|   |                     |   | should be measured.                         |   |
+---+---------------------+---+---------------------------------------------+---+
|   |                     |   | Culturally appropriate refers to an         |   |
|   |                     |   | unbiased attitude and organizational policy |   |
|   |                     |   | that values cultural diversity in the       |   |
|   |                     |   | population served; reflects an              |   |
|   |                     |   | understanding of diverse attitudes,         |   |
|   |                     |   | beliefs, behaviors, practices, and          |   |
|   |                     |   | communication patterns that could be        |   |
|   |                     |   | attributed to race, ethnicity, religion,    |   |
|   |                     |   | socioeconomic status, historical and social |   |
|   |                     |   | context, physical or mental ability, age,   |   |
|   |                     |   | gender, sexual orientation, or generations  |   |
|   |                     |   | and acculturation status; an awareness that |   |
|   |                     |   | cultural differences may affect health and  |   |
|   |                     |   | the effectiveness of health care delivery;  |   |
|   |                     |   | and knowledge of disease prevalence in      |   |
|   |                     |   | specific cultural populations, whether      |   |
|   |                     |   | defined by race, ethnicity, socioeconomic   |   |
|   |                     |   | status, physical or mental ability, gender, |   |
|   |                     |   | sexual orientation, age, disability, or     |   |
|   |                     |   | habits.                                     |   |
+---+---------------------+---+---------------------------------------------+---+
|   |                     |   | Linguistically competent refers to skills   |   |
|   |                     |   | to communicate effectively in the native    |   |
|   |                     |   | language or dialect of the targeted         |   |
|   |                     |   | population, taking into account general     |   |
|   |                     |   | educational level, literacy, and language   |   |
|   |                     |   | preferences.                                |   |
+---+---------------------+---+---------------------------------------------+---+
|   |                     |   | In 1996--97, 151 local health departments   |   |
|   |                     |   | reported that a program or intervention in  |   |
|   |                     |   | the area of cancer was provided to its      |   |
|   |                     |   | jurisdiction.                               |   |
+---+---------------------+---+---------------------------------------------+---+
|   |                     |   | See Part C for a description of NPLHD and   |   |
|   |                     |   | Appendix A for focus area contact           |   |
|   |                     |   | information.                                |   |
+---+---------------------+---+---------------------------------------------+---+
| 7 |                     |   |                                             |   |
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+---+---------------------+---+---------------------------------------------+---+
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+---+---------------------+---+---------------------------------------------+---+
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|   |                     | a |                                             |   |
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|   |                     | H |                                             |   |
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|   |                     | 2 |                                             |   |
|   |                     | 0 |                                             |   |
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|   |                     | 8 |                                             |   |
|   |                     | . |                                             |   |
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|   |                     | 1 |                                             |   |
|   |                     | , |                                             |   |
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|   |                     | a |                                             |   |
|   |                     | l |                                             |   |
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|   |                     | d |                                             |   |
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|   |                     | n |                                             |   |
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|   |                     | s |                                             |   |
|   |                     | t |                                             |   |
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|   |                     | a |                                             |   |
|   |                     | t |                                             |   |
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|   |                     | v |                                             |   |
|   |                     | e |                                             |   |
|   |                     | e |                                             |   |
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|   |                     | t |                                             |   |
|   |                     | a |                                             |   |
|   |                     | b |                                             |   |
|   |                     | l |                                             |   |
|   |                     | i |                                             |   |
|   |                     | s |                                             |   |
|   |                     | h |                                             |   |
|   |                     | e |                                             |   |
|   |                     | d |                                             |   |
|   |                     | c |                                             |   |
|   |                     | u |                                             |   |
|   |                     | l |                                             |   |
|   |                     | t |                                             |   |
|   |                     | u |                                             |   |
|   |                     | r |                                             |   |
|   |                     | a |                                             |   |
|   |                     | l |                                             |   |
|   |                     | l |                                             |   |
|   |                     | y |                                             |   |
|   |                     | a |                                             |   |
|   |                     | n |                                             |   |
|   |                     | d |                                             |   |
|   |                     | l |                                             |   |
|   |                     | i |                                             |   |
|   |                     | n |                                             |   |
|   |                     | g |                                             |   |
|   |                     | u |                                             |   |
|   |                     | i |                                             |   |
|   |                     | s |                                             |   |
|   |                     | t |                                             |   |
|   |                     | i |                                             |   |
|   |                     | c |                                             |   |
|   |                     | a |                                             |   |
|   |                     | l |                                             |   |
|   |                     | l |                                             |   |
|   |                     | y |                                             |   |
|   |                     | a |                                             |   |
|   |                     | p |                                             |   |
|   |                     | p |                                             |   |
|   |                     | r |                                             |   |
|   |                     | o |                                             |   |
|   |                     | p |                                             |   |
|   |                     | r |                                             |   |
|   |                     | i |                                             |   |
|   |                     | a |                                             |   |
|   |                     | t |                                             |   |
|   |                     | e |                                             |   |
|   |                     | d |                                             |   |
|   |                     | i |                                             |   |
|   |                     | a |                                             |   |
|   |                     | b |                                             |   |
|   |                     | e |                                             |   |
|   |                     | t |                                             |   |
|   |                     | e |                                             |   |
|   |                     | s |                                             |   |
|   |                     | a |                                             |   |
|   |                     | n |                                             |   |
|   |                     | d |                                             |   |
|   |                     | o |                                             |   |
|   |                     | t |                                             |   |
|   |                     | h |                                             |   |
|   |                     | e |                                             |   |
|   |                     | r |                                             |   |
|   |                     | c |                                             |   |
|   |                     | h |                                             |   |
|   |                     | r |                                             |   |
|   |                     | o |                                             |   |
|   |                     | n |                                             |   |
|   |                     | i |                                             |   |
|   |                     | c |                                             |   |
|   |                     | d |                                             |   |
|   |                     | i |                                             |   |
|   |                     | s |                                             |   |
|   |                     | a |                                             |   |
|   |                     | b |                                             |   |
|   |                     | l |                                             |   |
|   |                     | i |                                             |   |
|   |                     | n |                                             |   |
|   |                     | g |                                             |   |
|   |                     | c |                                             |   |
|   |                     | o |                                             |   |
|   |                     | n |                                             |   |
|   |                     | d |                                             |   |
|   |                     | i |                                             |   |
|   |                     | t |                                             |   |
|   |                     | i |                                             |   |
|   |                     | o |                                             |   |
|   |                     | n |                                             |   |
|   |                     | s |                                             |   |
|   |                     | c |                                             |   |
|   |                     | o |                                             |   |
|   |                     | m |                                             |   |
|   |                     | m |                                             |   |
|   |                     | u |                                             |   |
|   |                     | n |                                             |   |
|   |                     | i |                                             |   |
|   |                     | t |                                             |   |
|   |                     | y |                                             |   |
|   |                     | h |                                             |   |
|   |                     | e |                                             |   |
|   |                     | a |                                             |   |
|   |                     | l |                                             |   |
|   |                     | t |                                             |   |
|   |                     | h |                                             |   |
|   |                     | p |                                             |   |
|   |                     | r |                                             |   |
|   |                     | o |                                             |   |
|   |                     | m |                                             |   |
|   |                     | o |                                             |   |
|   |                     | t |                                             |   |
|   |                     | i |                                             |   |
|   |                     | o |                                             |   |
|   |                     | n |                                             |   |
|   |                     | p |                                             |   |
|   |                     | r |                                             |   |
|   |                     | o |                                             |   |
|   |                     | g |                                             |   |
|   |                     | r |                                             |   |
|   |                     | a |                                             |   |
|   |                     | m |                                             |   |
|   |                     | s |                                             |   |
|   |                     | f |                                             |   |
|   |                     | o |                                             |   |
|   |                     | r |                                             |   |
|   |                     | r |                                             |   |
|   |                     | a |                                             |   |
|   |                     | c |                                             |   |
|   |                     | i |                                             |   |
|   |                     | a |                                             |   |
|   |                     | l |                                             |   |
|   |                     | a |                                             |   |
|   |                     | n |                                             |   |
|   |                     | d |                                             |   |
|   |                     | e |                                             |   |
|   |                     | t |                                             |   |
|   |                     | h |                                             |   |
|   |                     | n |                                             |   |
|   |                     | i |                                             |   |
|   |                     | c |                                             |   |
|   |                     | m |                                             |   |
|   |                     | i |                                             |   |
|   |                     | n |                                             |   |
|   |                     | o |                                             |   |
|   |                     | r |                                             |   |
|   |                     | i |                                             |   |
|   |                     | t |                                             |   |
|   |                     | y |                                             |   |
|   |                     | p |                                             |   |
|   |                     | o |                                             |   |
|   |                     | p |                                             |   |
|   |                     | u |                                             |   |
|   |                     | l |                                             |   |
|   |                     | a |                                             |   |
|   |                     | t |                                             |   |
|   |                     | i |                                             |   |
|   |                     | o |                                             |   |
|   |                     | n |                                             |   |
|   |                     | s |                                             |   |
|   |                     | . |                                             |   |
|   |                     | T |                                             |   |
|   |                     | h |                                             |   |
|   |                     | i |                                             |   |
|   |                     | s |                                             |   |
|   |                     | m |                                             |   |
|   |                     | e |                                             |   |
|   |                     | a |                                             |   |
|   |                     | s |                                             |   |
|   |                     | u |                                             |   |
|   |                     | r |                                             |   |
|   |                     | e |                                             |   |
|   |                     | i |                                             |   |
|   |                     | n |                                             |   |
|   |                     | c |                                             |   |
|   |                     | l |                                             |   |
|   |                     | u |                                             |   |
|   |                     | d |                                             |   |
|   |                     | e |                                             |   |
|   |                     | s |                                             |   |
|   |                     | o |                                             |   |
|   |                     | n |                                             |   |
|   |                     | l |                                             |   |
|   |                     | y |                                             |   |
|   |                     | t |                                             |   |
|   |                     | h |                                             |   |
|   |                     | e |                                             |   |
|   |                     | p |                                             |   |
|   |                     | r |                                             |   |
|   |                     | o |                                             |   |
|   |                     | p |                                             |   |
|   |                     | o |                                             |   |
|   |                     | r |                                             |   |
|   |                     | t |                                             |   |
|   |                     | i |                                             |   |
|   |                     | o |                                             |   |
|   |                     | n |                                             |   |
|   |                     | o |                                             |   |
|   |                     | f |                                             |   |
|   |                     | l |                                             |   |
|   |                     | o |                                             |   |
|   |                     | c |                                             |   |
|   |                     | a |                                             |   |
|   |                     | l |                                             |   |
|   |                     | h |                                             |   |
|   |                     | e |                                             |   |
|   |                     | a |                                             |   |
|   |                     | l |                                             |   |
|   |                     | t |                                             |   |
|   |                     | h |                                             |   |
|   |                     | d |                                             |   |
|   |                     | e |                                             |   |
|   |                     | p |                                             |   |
|   |                     | a |                                             |   |
|   |                     | r |                                             |   |
|   |                     | t |                                             |   |
|   |                     | m |                                             |   |
|   |                     | e |                                             |   |
|   |                     | n |                                             |   |
|   |                     | t |                                             |   |
|   |                     | s |                                             |   |
|   |                     | t |                                             |   |
|   |                     | h |                                             |   |
|   |                     | a |                                             |   |
|   |                     | t |                                             |   |
|   |                     | h |                                             |   |
|   |                     | a |                                             |   |
|   |                     | v |                                             |   |
|   |                     | e |                                             |   |
|   |                     | c |                                             |   |
|   |                     | u |                                             |   |
|   |                     | l |                                             |   |
|   |                     | t |                                             |   |
|   |                     | u |                                             |   |
|   |                     | r |                                             |   |
|   |                     | a |                                             |   |
|   |                     | l |                                             |   |
|   |                     | l |                                             |   |
|   |                     | y |                                             |   |
|   |                     | a |                                             |   |
|   |                     | p |                                             |   |
|   |                     | p |                                             |   |
|   |                     | r |                                             |   |
|   |                     | o |                                             |   |
|   |                     | p |                                             |   |
|   |                     | r |                                             |   |
|   |                     | i |                                             |   |
|   |                     | a |                                             |   |
|   |                     | t |                                             |   |
|   |                     | e |                                             |   |
|   |                     | a |                                             |   |
|   |                     | n |                                             |   |
|   |                     | d |                                             |   |
|   |                     | l |                                             |   |
|   |                     | i |                                             |   |
|   |                     | n |                                             |   |
|   |                     | g |                                             |   |
|   |                     | u |                                             |   |
|   |                     | i |                                             |   |
|   |                     | s |                                             |   |
|   |                     | t |                                             |   |
|   |                     | i |                                             |   |
|   |                     | c |                                             |   |
|   |                     | a |                                             |   |
|   |                     | l |                                             |   |
|   |                     | l |                                             |   |
|   |                     | y |                                             |   |
|   |                     | c |                                             |   |
|   |                     | o |                                             |   |
|   |                     | m |                                             |   |
|   |                     | p |                                             |   |
|   |                     | e |                                             |   |
|   |                     | t |                                             |   |
|   |                     | e |                                             |   |
|   |                     | n |                                             |   |
|   |                     | t |                                             |   |
|   |                     | c |                                             |   |
|   |                     | o |                                             |   |
|   |                     | m |                                             |   |
|   |                     | m |                                             |   |
|   |                     | u |                                             |   |
|   |                     | n |                                             |   |
|   |                     | i |                                             |   |
|   |                     | t |                                             |   |
|   |                     | y |                                             |   |
|   |                     | c |                                             |   |
|   |                     | h |                                             |   |
|   |                     | r |                                             |   |
|   |                     | o |                                             |   |
|   |                     | n |                                             |   |
|   |                     | i |                                             |   |
|   |                     | c |                                             |   |
|   |                     | k |                                             |   |
|   |                     | i |                                             |   |
|   |                     | d |                                             |   |
|   |                     | n |                                             |   |
|   |                     | e |                                             |   |
|   |                     | y |                                             |   |
|   |                     | d |                                             |   |
|   |                     | i |                                             |   |
|   |                     | s |                                             |   |
|   |                     | e |                                             |   |
|   |                     | a |                                             |   |
|   |                     | s |                                             |   |
|   |                     | e |                                             |   |
|   |                     | p |                                             |   |
|   |                     | r |                                             |   |
|   |                     | o |                                             |   |
|   |                     | g |                                             |   |
|   |                     | r |                                             |   |
|   |                     | a |                                             |   |
|   |                     | m |                                             |   |
|   |                     | s |                                             |   |
|   |                     | f |                                             |   |
|   |                     | o |                                             |   |
|   |                     | r |                                             |   |
|   |                     | r |                                             |   |
|   |                     | a |                                             |   |
|   |                     | c |                                             |   |
|   |                     | i |                                             |   |
|   |                     | a |                                             |   |
|   |                     | l |                                             |   |
|   |                     | a |                                             |   |
|   |                     | n |                                             |   |
|   |                     | d |                                             |   |
|   |                     | e |                                             |   |
|   |                     | t |                                             |   |
|   |                     | h |                                             |   |
|   |                     | n |                                             |   |
|   |                     | i |                                             |   |
|   |                     | c |                                             |   |
|   |                     | m |                                             |   |
|   |                     | i |                                             |   |
|   |                     | n |                                             |   |
|   |                     | o |                                             |   |
|   |                     | r |                                             |   |
|   |                     | i |                                             |   |
|   |                     | t |                                             |   |
|   |                     | y |                                             |   |
|   |                     | p |                                             |   |
|   |                     | o |                                             |   |
|   |                     | p |                                             |   |
|   |                     | u |                                             |   |
|   |                     | l |                                             |   |
|   |                     | a |                                             |   |
|   |                     | t |                                             |   |
|   |                     | i |                                             |   |
|   |                     | o |                                             |   |
|   |                     | n |                                             |   |
|   |                     | s |                                             |   |
|   |                     | . |                                             |   |
+---+---------------------+---+---------------------------------------------+---+
|   |                     | S |                                             |   |
|   |                     | e |                                             |   |
|   |                     | e |                                             |   |
|   |                     | P |                                             |   |
|   |                     | a |                                             |   |
|   |                     | r |                                             |   |
|   |                     | t |                                             |   |
|   |                     | C |                                             |   |
|   |                     | f |                                             |   |
|   |                     | o |                                             |   |
|   |                     | r |                                             |   |
|   |                     | a |                                             |   |
|   |                     | d |                                             |   |
|   |                     | e |                                             |   |
|   |                     | s |                                             |   |
|   |                     | c |                                             |   |
|   |                     | r |                                             |   |
|   |                     | i |                                             |   |
|   |                     | p |                                             |   |
|   |                     | t |                                             |   |
|   |                     | i |                                             |   |
|   |                     | o |                                             |   |
|   |                     | n |                                             |   |
|   |                     | o |                                             |   |
|   |                     | f |                                             |   |
|   |                     | N |                                             |   |
|   |                     | P |                                             |   |
|   |                     | L |                                             |   |
|   |                     | H |                                             |   |
|   |                     | D |                                             |   |
|   |                     | a |                                             |   |
|   |                     | n |                                             |   |
|   |                     | d |                                             |   |
|   |                     | A |                                             |   |
|   |                     | p |                                             |   |
|   |                     | p |                                             |   |
|   |                     | e |                                             |   |
|   |                     | n |                                             |   |
|   |                     | d |                                             |   |
|   |                     | i |                                             |   |
|   |                     | x |                                             |   |
|   |                     | A |                                             |   |
|   |                     | f |                                             |   |
|   |                     | o |                                             |   |
|   |                     | r |                                             |   |
|   |                     | f |                                             |   |
|   |                     | o |                                             |   |
|   |                     | c |                                             |   |
|   |                     | u |                                             |   |
|   |                     | s |                                             |   |
|   |                     | a |                                             |   |
|   |                     | r |                                             |   |
|   |                     | e |                                             |   |
|   |                     | a |                                             |   |
|   |                     | c |                                             |   |
|   |                     | o |                                             |   |
|   |                     | n |                                             |   |
|   |                     | t |                                             |   |
|   |                     | a |                                             |   |
|   |                     | c |                                             |   |
|   |                     | t |                                             |   |
|   |                     | i |                                             |   |
|   |                     | n |                                             |   |
|   |                     | f |                                             |   |
|   |                     | o |                                             |   |
|   |                     | r |                                             |   |
|   |                     | m |                                             |   |
|   |                     | a |                                             |   |
|   |                     | t |                                             |   |
|   |                     | i |                                             |   |
|   |                     | o |                                             |   |
|   |                     | n |                                             |   |
|   |                     | . |                                             |   |
+---+---------------------+---+---------------------------------------------+---+

  ----------------------- -----------------------------------------------
  7-11e. (Developmental)  
  Diabetes.               

  **Comments**            An operational definition could not be
                          specified at the time of publication.

                          This measure is adapted from Healthy People
                          2000 objective 8.11, which tracked the
                          proportion of local health departments that
                          have established culturally and linguistically
                          appropriate diabetes and other chronic
                          disabling conditions community health promotion
                          programs for racial and ethnic minority
                          populations.

                          This measure includes only the proportion of
                          local health departments that have culturally
                          appropriate and linguistically competent
                          community diabetes programs for racial and
                          ethnic minority populations.

                          See Part C for a description of NPLHD and
                          Appendix A for focus area contact information.
  ----------------------- -----------------------------------------------

  ----------------------- -----------------------------------------------
  7-11f. (Developmental)  
  Disability and          
  secondary conditions.   

  **Comments**            An operational definition could not be
                          specified at the time of publication.

                          This measure is adapted from Healthy People
                          2000 objective 8.11, which tracked the
                          proportion of local health departments that
                          have established culturally and linguistically
                          appropriate diabetes and other chronic
                          disabling conditions community health promotion
                          programs for racial and ethnic minority
                          populations. This measure includes only the
                          proportion of local health departments that
                          have culturally appropriate and linguistically
                          competent community disability and secondary
                          conditions programs for racial and ethnic
                          minority populations.

                          See Part C for a description of NPLHD and
                          Appendix A for focus area contact information.
  ----------------------- -----------------------------------------------

  ----------------------- -----------------------------------------------
  7-11g. Educational and  
  community-based         
  programs.               

  **National Data         National Profile of Local Health Departments,
  Source**                NACCHO.

  **State Data Source**   National Profile of Local Health Departments,
                          NACCHO.

  **Healthy People 2000   8.11 (Educational and Community-Based
  Objective**             Programs).

  **Measure**             Percent.

  **Baseline**            33 (1996--97).

  **Numerator**           Number of local health departments that
                          provided culturally and linguistically
                          appropriate education and community-based
                          programs to their jurisdiction in the past
                          year.

  **Denominator**         Number of local health departments with one or
                          more minority racial/ethnic population groups
                          comprising at least 10 percent of the
                          population.

  **Questions Used To     See Questions Used To Obtain the National Data
  Obtain the National     provided with 7-11c.
  Data**                  

  **Expected              Periodic.
  Periodicity**           

  **Comments**            See the definition of racial/ethnic
                          composition, culturally appropriate, and
                          linguistically competent provided with 7-11c
                          for more information.

                          In 1996--97, 127 local health departments
                          reported that a program or intervention in the
                          area of education and community-based programs
                          was provided to its jurisdiction.

                          See Part C for a description of NPLHD and
                          Appendix A for focus area contact information.
  ----------------------- -----------------------------------------------

  ----------------------- -----------------------------------------------
  7-11h. Environmental    
  health.                 

  **National Data         National Profile of Local Health Departments,
  Source**                NACCHO.

  **State Data Source**   National Profile of Local Health Departments,
                          NACCHO.

  **Healthy People 2000   8.11 (Educational and Community-Based
  Objective**             Programs).

  **Measure**             Percent.

  **Baseline**            22 (1996--97).

  **Numerator**           Number of local health departments that
                          provided culturally and linguistically
                          appropriate environmental health programs to
                          their jurisdiction in the past year.

  **Denominator**         Number of local health departments with one or
                          more minority racial/ethnic population groups
                          comprising at least 10 percent of the
                          population.

  **Questions Used To     See Questions Used To Obtain the National Data
  Obtain the National     provided with 7-11c.
  Data**                  

  **Expected              Periodic.
  Periodicity**           

  **Comments**            See the definition of racial/ethnic
                          composition, culturally appropriate, and
                          linguistically competent provided with 7-11c
                          for more information.

                          In 1996--97, 149 local health departments
                          reported that a program or intervention in the
                          area of environmental health was provided to
                          its jurisdiction.

                          See Part C for a description of NPLHD and
                          Appendix A for focus area contact information.

  7-11i. Family planning. 

  **National Data         National Profile of Local Health Departments,
  Source**                NACCHO.

  **State Data Source**   National Profile of Local Health Departments,
                          NACCHO.

  **Healthy People 2000   8.11 (Educational and Community-Based
  Objective**             Programs).

  **Measure**             Percent.

  **Baseline**            42 (1996--97).

  **Numerator**           Number of local health departments that
                          provided culturally and linguistically
                          appropriate family planning programs to their
                          jurisdiction in the past year.

  **Denominator**         Number of local health departments with one or
                          more minority racial/ethnic population groups
                          comprising at least 10 percent of the
                          population.

  **Questions Used To     See Questions Used To Obtain the National Data
  Obtain the National     provided with 7-11c.
  Data**                  

  **Expected              Periodic.
  Periodicity**           

  **Comments**            See the definition of racial/ethnic
                          composition, culturally appropriate, and
                          linguistically competent provided with 7-11c
                          for more information.

                          In 1996--97, 158 local health departments
                          reported that a program or intervention in the
                          area of family planning was provided to its
                          jurisdiction.

                          See Part C for a description of NPLHD and
                          Appendix A for focus area contact information.

  7-11j. (Developmental)  
  Food safety.            

  **Comments**            An operational definition could not be
                          specified at the time of publication.

                          This measure is adapted from Healthy People
                          2000 objective 8.11, which tracked the
                          proportion of local health departments that
                          have established culturally and linguistically
                          appropriate food and drug safety community
                          health promotion programs for racial and ethnic
                          minority populations. This measure includes
                          only the proportion of local health departments
                          that have culturally appropriate and
                          linguistically competent community food safety
                          programs for racial and ethnic minority
                          populations.

                          See Part C for a description of NPLHD and
                          Appendix A for focus area contact information.
  ----------------------- -----------------------------------------------

  ----------------------- -----------------------------------------------
  7-11k. (Developmental)  
  Medical product safety. 

  **Comments**            An operational definition could not be
                          specified at the time of publication.

                          This measure is adapted from Healthy People
                          2000 objective 8.11, which tracked the
                          proportion of local health departments that
                          have established culturally and linguistically
                          appropriate food and drug safety community
                          health promotion programs for racial and ethnic
                          minority populations.

                          This measure includes only the proportion of
                          local health departments that have culturally
                          appropriate and linguistically competent
                          community medical product safety programs for
                          racial and ethnic minority populations.

                          See Part C for a description of NPLHD and
                          Appendix A for focus area contact information.
  ----------------------- -----------------------------------------------

  ----------------------- -----------------------------------------------
  7-11l. (Developmental)  
  Health communication.   

  **Comments**            An operational definition could not be
                          specified at the time of publication.

                          This measure is adapted from Healthy People
                          2000 objective 8.11, which tracked the
                          proportion of local health departments that
                          have established culturally and linguistically
                          appropriate community health promotion programs
                          for racial and ethnic minority populations.
                          This measure will track the proportion of local
                          health departments that have culturally
                          appropriate and linguistically competent
                          community health communication programs for
                          racial and ethnic minority populations.

                          See Part C for a description of NPLHD and
                          Appendix A for focus area contact information.
  ----------------------- -----------------------------------------------

  ----------------------- -----------------------------------------------
  7-11m. Heart disease    
  and stroke.             

  **National Data         National Profile of Local Health Departments,
  Source**                NACCHO.

  **State Data Source**   National Profile of Local Health Departments,
                          NACCHO.

  **Healthy People 2000   8.11 (Educational and Community-Based
  Objective**             Programs).

  **Measure**             Percent.

  **Baseline**            28 (1996--97).

  **Numerator**           Number of local health departments that
                          provided culturally and linguistically
                          appropriate heart disease and stroke programs
                          to their jurisdiction in the past year.

  **Denominator**         Number of local health departments with one or
                          more minority racial/ethnic population groups
                          comprising at least 10 percent of the
                          population.

  **Questions Used To     See Questions Used To Obtain the National Data
  Obtain the National     provided with 7-11a.
  Data**                  

  **Expected              Periodic.
  Periodicity**           

  **Comments**            See the definition of racial/ethnic
                          composition, culturally appropriate, and
                          linguistically competent provided with 7-11c
                          for more information.

                          In 1996--97, 148 local health departments
                          reported that a program or intervention in the
                          area of heart disease and stroke was provided
                          to its jurisdiction.

                          See Part C for a description of NPLHD and
                          Appendix A for focus area contact information.
  ----------------------- -----------------------------------------------

  ----------------------- -----------------------------------------------
  7-11n. HIV.             

  **National Data         National Profile of Local Health Departments,
  Source**                NACCHO.

  **State Data Source**   National Profile of Local Health Departments,
                          NACCHO.

  **Healthy People 2000   8.11 (Educational and Community-Based
  Objective**             Programs).

  **Measure**             Percent.

  **Baseline**            45 (1996--97).

  **Numerator**           Number of local health departments that
                          provided culturally and linguistically
                          appropriate HIV programs to their jurisdiction
                          in the past year.

  **Denominator**         Number of local health departments with one or
                          more minority racial/ethnic population groups
                          comprising at least 10 percent of the
                          population.

  **Questions Used To     See Questions Used To Obtain the National Data
  Obtain the National     provided with 7-11c.
  Data**                  

  **Expected              Periodic.
  Periodicity**           

  **Comments**            See the definition of racial/ethnic
                          composition, culturally appropriate, and
                          linguistically competent provided with 7-11c
                          for more information.

                          In 1996--97, 170 local health departments
                          reported that a program or intervention in the
                          area of HIV was provided to its jurisdiction.

                          See Part C for a description of NPLHD and
                          Appendix A for focus area contact information.
  ----------------------- -----------------------------------------------

  ----------------------- -----------------------------------------------
  7-11o. Immunizations    
  and infectious          
  diseases.               

  **National Data         National Profile of Local Health Departments,
  Source**                NACCHO.

  **State Data Source**   National Profile of Local Health Departments,
                          NACCHO.

  **Healthy People 2000   8.11 (Educational and Community-Based
  Objective**             Programs).

  **Measure**             Percent.

  **Baseline**            48 (1996--97).

  **Numerator**           Number of local health departments with that
                          provided culturally and linguistically
                          appropriate immunizations and infectious
                          disease programs to their jurisdiction.

  **Denominator**         Number of local health departments with at
                          least 10 percent racial/ethnic population
                          groups in their jurisdiction that offered
                          immunizations and infectious disease programs.

  **Questions Used To     See Questions Used To Obtain the National Data
  Obtain the National     provided with 7-11c.
  Data**                  

  **Expected              Periodic.
  Periodicity**           

  **Comments**            See the definition of racial/ethnic
                          composition, culturally appropriate, and
                          linguistically competent provided with 7-11c
                          for more information.

                          In 1996--97, 183 local health departments
                          reported that a program or intervention in the
                          area of immunizations and infectious diseases
                          was provided to its jurisdiction.

                          See Part C for a description of NPLHD and
                          Appendix A for focus area contact information.
  ----------------------- -----------------------------------------------

  ----------------------- -----------------------------------------------
  7-11p. (Developmental)  
  Injury and violence     
  prevention.             

  **Comments**            An operational definition could not be
                          specified at the time of publication.

                          This measure is adapted from Healthy People
                          2000 objective 8.11, which tracked the
                          proportion of local health departments that
                          have established culturally and linguistically
                          appropriate violent and abusive behavior or
                          unintentional injury community health promotion
                          programs for racial and ethnic minority
                          populations. This measure includes only the
                          proportion of local health departments that
                          have culturally appropriate and linguistically
                          competent community injury and violence
                          prevention programs for racial and ethnic
                          minority populations.

                          See Part C for a description of NPLHD and
                          Appendix A for focus area contact information.
  ----------------------- -----------------------------------------------

  ----------------------- -----------------------------------------------
  7-11q. Maternal, infant 
  (and child) health.     

  **National Data         National Profile of Local Health Departments,
  Source**                NACCHO.

  **State Data Source**   National Profile of Local Health Departments,
                          NACCHO.

  **Healthy People 2000   Adapted from 8.11 (Educational and
  Objective**             Community-Based Programs).

  **Measure**             Percent.

  **Baseline**            47 (1996--97).

  **Numerator**           Number of local health departments that
                          provided culturally and linguistically
                          appropriate maternal, infant and child health
                          programs to their jurisdiction in the past
                          year.

  **Denominator**         Number of local health departments with one or
                          more minority racial/ethnic population groups
                          comprising at least 10 percent of the
                          population.

  **Questions Used To     See Questions Used To Obtain the National Data
  Obtain the National     provided with 7-11c.
  Data**                  

  **Expected              Periodic.
  Periodicity**           

  **Comments**            See the definition of racial/ethnic
                          composition, culturally appropriate, and
                          linguistically competent provided with 7-11c
                          for more information.

                          This measure is adapted from Healthy People
                          2000 objective 8.11, which tracked the
                          proportion of local health departments that
                          have established culturally and linguistically
                          appropriate maternal and infant health
                          community health promotion programs for racial
                          and ethnic minority populations. This measure
                          tracks the proportion of local health
                          departments that have culturally appropriate
                          and linguistically competent community
                          maternal, infant and child health programs for
                          racial and ethnic minority populations.

                          In 1996--97, 174 local health departments
                          reported that a program or intervention in the
                          area of maternal and infant health was provided
                          to its jurisdiction.

                          See Part C for a description of NPLHD and
                          Appendix A for focus area contact information.
  ----------------------- -----------------------------------------------

  ----------------------- -----------------------------------------------
  7-11r. Mental health    
  (and mental disorders). 

  **National Data         National Profile of Local Health Departments,
  Source**                NACCHO.

  **State Data Source**   National Profile of Local Health Departments,
                          NACCHO.

  **Healthy People 2000   8.11 (Educational and Community-Based
  Objective**             Programs).

  **Measure**             Percent.

  **Baseline**            18 (1996--97).

  **Numerator**           Number of local health departments that
                          provided culturally and linguistically
                          appropriate mental health and mental disorders
                          programs to their jurisdiction in the past
                          year.

  **Denominator**         Number of local health departments with one or
                          more minority racial/ethnic population groups
                          comprising at least 10 percent of the
                          population.

  **Questions Used To     See Questions Used To Obtain the National Data
  Obtain the National     provided with 7-11c.
  Data**                  

  **Expected              Periodic.
  Periodicity**           

  **Comments**            See the definition of racial/ethnic
                          composition, culturally appropriate, and
                          linguistically competent provided with 7-11c
                          for more information.

                          In 1996--97, 76 local health departments
                          reported that a program or intervention in the
                          area of mental health and mental disorders was
                          provided to its jurisdiction.

                          See Part C for a description of NPLHD and
                          Appendix A for focus area contact information.
  ----------------------- -----------------------------------------------

  ----------------------- -----------------------------------------------
  7-11s. Nutrition and    
  overweight.             

  **National Data         National Profile of Local Health Departments,
  Source**                NACCHO.

  **State Data Source**   National Profile of Local Health Departments,
                          NACCHO.

  **Healthy People 2000   Adapted from 8.11 (Educational and
  Objective**             Community-Based Programs).

  **Measure**             Percent.

  **Baseline**            44 (1996--97).

  **Numerator**           Number of local health departments that
                          provided culturally and linguistically
                          appropriate nutrition and overweight programs
                          to their jurisdiction in the past year.

  **Denominator**         Number of local health departments with one or
                          more minority racial/ethnic population groups
                          comprising at least 10 percent of the
                          population.

  **Questions Used To     See Questions Used To Obtain the National Data
  Obtain the National     provided with 7-11c.
  Data**                  

  **Expected              Periodic.
  Periodicity**           

  **Comments**            See the definition of racial/ethnic
                          composition, culturally appropriate, and
                          linguistically competent provided with 7-11c
                          for more information.

                          This measure is adapted from Healthy People
                          2000 objective 8.11, which tracked the
                          proportion of local health departments that
                          have established culturally and linguistically
                          appropriate community health promotion programs
                          for racial and ethnic minority populations.
                          This measure tracks the proportion of local
                          health departments that have culturally
                          appropriate and linguistically competent
                          nutrition and overweight programs for racial
                          and ethnic minority populations.

                          In 1996--97, 168 local health departments
                          reported that a program or intervention in the
                          area of nutrition and overweight was provided
                          to its jurisdiction.

                          See Part C for a description of NPLHD and
                          Appendix A for focus area contact information.
  ----------------------- -----------------------------------------------

  ----------------------- -----------------------------------------------
  7-11t. Occupational     
  safety and health.      

  **National Data         National Profile of Local Health Departments,
  Source**                NACCHO.

  **State Data Source**   National Profile of Local Health Departments,
                          NACCHO.

  **Healthy People 2000   8.11 (Educational and Community-Based
  Objective**             Programs).

  **Measure**             Percent.

  **Baseline**            13 (1996--97).

  **Numerator**           Number of local health departments that
                          provided culturally and linguistically
                          appropriate occupational safety and health
                          programs to their jurisdiction in the past
                          year.

  **Denominator**         Number of local health departments with one or
                          more minority racial/ethnic population groups
                          comprising at least 10 percent of the
                          population.

  **Questions Used To     See Questions Used To Obtain the National Data
  Obtain the National     provided with 7-11c.
  Data**                  

  **Expected              Periodic.
  Periodicity**           

  **Comments**            See the definition of racial/ethnic
                          composition, culturally appropriate, and
                          linguistically competent provided with 7-11c
                          for more information.

                          In 1996--97, 84 local health departments
                          reported that a program or intervention in the
                          area of occupational safety and health was
                          provided to its jurisdiction.

                          See Part C for a description of NPLHD and
                          Appendix A for focus area contact information.
  ----------------------- -----------------------------------------------

  ----------------------- -----------------------------------------------
  7-11u. Oral health.     

  **National Data         National Profile of Local Health Departments,
  Source**                NACCHO.

  **State Data Source**   National Profile of Local Health Departments,
                          NACCHO.

  **Healthy People 2000   8.11 (Educational and Community-Based
  Objective**             Programs).

  **Measure**             Percent.

  **Baseline**            25 (1996--97).

  **Numerator**           Number of local health departments that
                          provided culturally and linguistically
                          appropriate oral health programs to their
                          jurisdiction in the past year.

  **Denominator**         Number of local health departments with one or
                          more minority racial/ethnic population groups
                          comprising at least 10 percent of the
                          population.

  **Questions Used To     See Questions Used To Obtain the National Data
  Obtain the National     provided with 7-11c.
  Data**                  

  **Expected              Periodic.
  Periodicity**           

  **Comments**            See the definition of racial/ethnic
                          composition, culturally appropriate and
                          linguistically competent provided with 7-11c
                          for more information.

                          In 1996--97, 126 local health departments
                          reported that a program or intervention in the
                          area of oral health was provided to its
                          jurisdiction.

                          See Part C for a description of NPLHD and
                          Appendix A for focus area contact information.
  ----------------------- -----------------------------------------------

  ----------------------- -----------------------------------------------
  7-11v. Physical         
  activity and fitness.   

  **National Data         National Profile of Local Health Departments,
  Source**                NACCHO.

  **State Data Source**   National Profile of Local Health Departments,
                          NACCHO.

  **Healthy People 2000   8.11 (Educational and Community-Based
  Objective**             Programs).

  **Measure**             Percent.

  **Baseline**            21 (1996--97).

  **Numerator**           Number of local health departments that
                          provided culturally and linguistically
                          appropriate physical activity and fitness
                          programs to their jurisdiction in the past
                          year.

  **Denominator**         Number of local health departments with one or
                          more minority racial/ethnic population groups
                          comprising at least 10 percent of the
                          population.

  **Questions Used To     See Questions Used To Obtain the National Data
  Obtain the National     provided with 7-11c.
  Data**                  

  **Expected              Periodic.
  Periodicity**           

  **Comments**            See the definition of racial/ethnic
                          composition, culturally appropriate, and
                          linguistically competent provided with 7-11c
                          for more information.

                          In 1996--97, 111 local health departments
                          reported that a program or intervention in the
                          area of physical activity and fitness was
                          provided to its jurisdiction.

                          See Part C for a description of NPLHD and
                          Appendix A for focus area contact information.
  ----------------------- -----------------------------------------------

  ----------------------- -----------------------------------------------
  7-11w. (Developmental)  
  Public health           
  infrastructure.         

  **Comments**            An operational definition could not be
                          specified at the time of publication.

                          This measure is adapted from Healthy People
                          2000 objective 8.11, which tracked the
                          proportion of local health departments that
                          have established culturally and linguistically
                          appropriate data and surveillance community
                          health promotion programs for racial and ethnic
                          minority populations. This measure tracks the
                          proportion of local health departments that
                          have culturally appropriate and linguistically
                          competent public health infrastructure programs
                          for racial and ethnic minority populations.

                          See Part C for a description of NPLHD and
                          Appendix A for focus area contact information.

  7-11x. (Developmental)  
  Respiratory diseases.   

  **Comments**            An operational definition could not be
                          specified at the time of publication.

                          This measure is adapted from Healthy People
                          2000 objective 8.11, which tracked the
                          proportion of local health departments that
                          have established culturally and linguistically
                          appropriate community health promotion tobacco,
                          environmental health or diabetes and other
                          chronic disabling conditions programs, which
                          included respiratory diseases as a component,
                          for racial and ethnic minority populations.
                          This measure will only track the proportion of
                          local health departments that have culturally
                          appropriate and linguistically competent
                          community respiratory diseases programs for
                          racial and ethnic minority populations.

                          See Part C for a description of NPLHD and
                          Appendix A for focus area contact information.
  ----------------------- -----------------------------------------------

  ----------------------- -----------------------------------------------
  7-11y. Sexually         
  transmitted diseases.   

  **National Data         National Profile of Local Health Departments,
  Source**                NACCHO.

  **State Data Source**   National Profile of Local Health Departments,
                          NACCHO.

  **Healthy People 2000   8.11 (Educational and Community-Based
  Objective**             Programs).

  **Measure**             Percent.

  **Baseline**            41 (1996--97).

  **Numerator**           Number of local health departments that
                          provided culturally and linguistically
                          appropriate sexually transmitted diseases
                          programs to their jurisdiction in the past
                          year.

  **Denominator**         Number of local health departments with one or
                          more minority racial/ethnic population groups
                          comprising at least 10 percent of the
                          population.

  **Questions Used To     See Questions Used To Obtain the National Data
  Obtain the National     provided with 7-11c.
  Data**                  

  **Expected              Periodic.
  Periodicity**           

  **Comments**            See the definition of racial/ethnic
                          composition, culturally appropriate, and
                          linguistically competent provided with 7-11c
                          for more information.

                          In 1996--97, 172 local health departments
                          reported that a program or intervention in the
                          area of sexually transmitted diseases was
                          provided to its jurisdiction.

                          See Part C for a description of NPLHD and
                          Appendix A for focus area contact information.
  ----------------------- -----------------------------------------------

  ----------------------- -----------------------------------------------
  7-11z. Substance abuse  
  (alcohol and other      
  drugs).                 

  **National Data         National Profile of Local Health Departments,
  Source**                NACCHO.

  **State Data Source**   National Profile of Local Health Departments,
                          NACCHO.

  **Healthy People 2000   Adapted from 8.11 (Educational and
  Objective**             Community-Based Programs).

  **Measure**             Percent.

  **Baseline**            26 (1996--97).

  **Numerator**           Number of local health departments that
                          provided culturally and linguistically
                          appropriate substance abuse of alcohol and
                          other drugs programs to their jurisdiction in
                          the past year.

  **Denominator**         Number of local health departments with one or
                          more minority racial/ethnic population groups
                          comprising at least 10 percent of the
                          population.

  **Questions Used To     See Questions Used To Obtain the National Data
  Obtain the National     provided with 7-11c.
  Data**                  

  **Expected              Periodic.
  Periodicity**           

  **Comments**            See the definition of racial/ethnic
                          composition, culturally appropriate, and
                          linguistically competent provided with 7-11c
                          for more information.

                          This measure is adapted from Healthy People
                          2000 objective 8.11, which tracked the
                          proportion of local health departments that
                          have established culturally and linguistically
                          appropriate alcohol and other drug community
                          health promotion programs for racial and ethnic
                          minority populations. This measure tracks the
                          proportion of local health departments that
                          have culturally appropriate and linguistically
                          competent substance abuse of alcohol and other
                          drugs programs for racial and ethnic minority
                          populations.

                          In 1996--97, 172 local health departments
                          reported that a program or intervention in the
                          area of substance abuse of alcohol and other
                          drugs was provided to its jurisdiction.

                          See Part C for a description of NPLHD and
                          Appendix A for focus area contact information.
  ----------------------- -----------------------------------------------

  ----------------------- -----------------------------------------------
  7-11aa. Tobacco use.    

  **National Data         National Profile of Local Health Departments,
  Source**                NACCHO.

  **State Data Source**   National Profile of Local Health Departments,
                          NACCHO.

  **Healthy People 2000   8.11 (Educational and Community-Based
  Objective**             Programs).

  **Measure**             Percent.

  **Baseline**            24 (1996--97).

  **Numerator**           Number of local health departments that
                          provided culturally and linguistically
                          appropriate tobacco use programs to their
                          jurisdiction in the past year.

  **Denominator**         Number of local health departments with one or
                          more minority racial/ethnic population groups
                          comprising at least 10 percent of the
                          population.

  **Questions Used To     See Questions Used To Obtain the National Data
  Obtain the National     provided with 7-11c.
  Data**                  

  **Expected              Periodic.
  Periodicity**           

  **Comments**            See the definition of racial/ethnic
                          composition, culturally appropriate, and
                          linguistically competent provided with 7-11c
                          for more information.

                          In 1996--97, 161 local health departments
                          reported that a program or intervention in the
                          area of tobacco use was provided to its
                          jurisdiction.

                          See Part C for a description of NPLHD and
                          Appendix A for focus area contact information.
  ----------------------- -----------------------------------------------

  ----------------------- -----------------------------------------------
                          

  7-11bb. (Developmental) 
  Vision and hearing.     

  **Comments**            An operational definition could not be
                          specified at the time of publication.

                          This measure is adapted from Healthy People
                          2000 objective 8.11, which tracked the
                          proportion of local health departments that
                          have established culturally and linguistically
                          appropriate community health promotion programs
                          for diabetes and other chronic disabling
                          conditions, which included vision and hearing
                          as a component, for racial and ethnic minority
                          populations. This measure will only track the
                          proportion of local health departments that
                          have culturally appropriate and linguistically
                          competent vision and hearing programs for
                          racial and ethnic minority populations.

                          See Part C for a description of NPLHD and
                          Appendix A for focus area contact information.
  ----------------------- -----------------------------------------------

+-----------------------+-----------------------------------------------+
| 7-12. Increase the    |                                               |
| proportion of older   |                                               |
| adults who have       |                                               |
| participated during   |                                               |
| the preceding year in |                                               |
| at least one          |                                               |
| organized health      |                                               |
| promotion activity.   |                                               |
+-----------------------+-----------------------------------------------+
| **National Data       | National Health Interview Survey (NHIS), CDC, |
| Source**              | NCHS.                                         |
+-----------------------+-----------------------------------------------+
| **State Data Source** | Not identified.                               |
+-----------------------+-----------------------------------------------+
| **Healthy People 2000 | 8.8 (Educational and Community-Based          |
| Objective**           | Programs).                                    |
+-----------------------+-----------------------------------------------+
| **Measure**           | Percent (age adjusted---see Comments).        |
+-----------------------+-----------------------------------------------+
| **Baseline**          | 12 (1998).                                    |
+-----------------------+-----------------------------------------------+
| **Numerator**         | Number of older adults aged 65 years and      |
|                       | older who participated in an exercise         |
|                       | class/program or attended a                   |
|                       | class/presentation on health topics in the    |
|                       | past 12 months.                               |
+-----------------------+-----------------------------------------------+
| **Denominator**       | Number of older adults aged 65 years and      |
|                       | older.                                        |
+-----------------------+-----------------------------------------------+
| **Population          | U.S. civilian, noninstitutionalized           |
| Targeted**            | population.                                   |
+-----------------------+-----------------------------------------------+
| **Questions Used To   | From the 1998 National Health Interview       |
| Obtain the National   | Survey:                                       |
| Data**                |                                               |
+-----------------------+-----------------------------------------------+
|                       | -   In the past 12 months, have you taken a   |
|                       |     class or attended a presentation on       |
|                       |     health topics?                            |
+-----------------------+-----------------------------------------------+
|                       | -   In the past 12 months, did you            |
|                       |     participate in an exercise class or       |
|                       |     exercise program?                         |
+-----------------------+-----------------------------------------------+
| **Expected            | Periodic.                                     |
| Periodicity**         |                                               |
+-----------------------+-----------------------------------------------+
| **Comments**          | Adults 65 years and older are considered to   |
|                       | have participated in an organized health      |
|                       | promotion activity if they report that had    |
|                       | taken a class or attended a presentation on   |
|                       | health topics, or had participated in an      |
|                       | exercise class or program in the past year.   |
+-----------------------+-----------------------------------------------+
|                       | An program is any health class, presentation  |
|                       | on a health-related topic, exercise class, or |
|                       | exercise program.                             |
+-----------------------+-----------------------------------------------+
|                       | Data are age adjusted to the 2000 standard    |
|                       | population. Age-adjusted percentages are      |
|                       | weighted sums of age-specific percentages.    |
|                       | For discussion on age adjustment, see Part A, |
|                       | section 5.                                    |
+-----------------------+-----------------------------------------------+
|                       | See Part C for a description of NHIS and      |
|                       | Appendix A for focus area contact             |
|                       | information.                                  |
+-----------------------+-----------------------------------------------+

## Reference

1\. U.S. Department of Health and Human Services. *1992 National Survey
of Worksite Health Promotion Activities Summary Report.* Washington, DC:
U.S. Government Printing Office, 1993.