[Federal Register Volume 62, Number 172 (Friday, September 5, 1997)]
[Notices]
[Pages 46975-46977]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-23567]


=======================================================================
-----------------------------------------------------------------------

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Office of the Secretary


Health Promotion and Disease Prevention Objectives for 2010

AGENCY: DHHS/OS/Office of Public Health and Science, Office of Disease 
Prevention and Health Promotion (ODPHP).

ACTION: Call for (1) comments on the proposed structure for Healthy 
People 2010 national health objectives for the year 2010 and (2) 
proposed objectives.

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

SUMMARY: The Department of Health and Human Services is soliciting 
comments on the proposed structure for Healthy People 2010, the third 
set of decade-long national health promotion and disease prevention 
objectives. The Department is also soliciting proposed objectives for 
2010. Guidance for comments is provided in the DHHS publication 
Developing Objectives for 2010. During the fall of 1997, individuals 
and organizations are encouraged to submit (1) comments on the proposed 
framework envisioned for 2010 (see Appendix to this Notice) and/or (2) 
objectives for 2010. In the fall of 1998, a draft document of Healthy 
People 2010 objectives will be made available for public review and 
comment.

DATES: The comment and submission period is September 15 through 
December 15, 1997.

ADDRESSES: By mail, comments postmarked no later than December 15 can 
be submitted to--Office of Disease Prevention and Health Promotion, 
Attention: Healthy People 2010 Objectives, Department of Health and 
Human Services, Room 738-G Hubert H. Humphrey Building, 200 
Independence Avenue, SW., Washington, DC. 20201. Comments sent by 
courier service will be accepted until 5 p.m. EST on December 15. 
Comments may also be submitted electronically through the Healthy 
People Home Page--http://web.health.gov/healthypeople.

FOR FURTHER INFORMATION CONTACT:
Office of Disease Prevention and Health Promotion, Room 738-G Hubert H. 
Humphrey Building, 200 Independence Avenue, SW., Washington, DC 20201, 
(202) 205-8583.

SUPPLEMENTARY INFORMATION:

Background

    In 1979, the Department of Health and Human Services began an 
initiative to use health promotion and disease prevention objectives to 
improve the health of people living in the United States. The first set 
of national health targets was published that year in Healthy People: 
The Surgeon General's Report on Health Promotion and Disease 
Prevention, which included five goals to be achieved by 1990 to reduce 
mortality among four different age groups and increase independence 
among older adults. The goals were supported by objectives that were 
released in 1980, also with 1990 targets.
    Healthy People 2000, the second and current national prevention 
initiative, reflects the progress and experience of ten years, as well 
as an expanded science base and surveillance system. With the 
collaboration of an extensive network of voluntary and professional 
organizations, businesses, and individuals, the framework of Healthy 
People 2000 was designed with three broad goals--increasing the span of 
healthy life, reducing health disparities, and achieving access to 
clinical preventive services. To help meet these goals, 319 objectives 
and 319 special population targets, organized into 22 priority areas, 
aim to achieve improvements in health status, risk reduction, and 
service delivery.

Structure of Healthy People 2010

    The healthy People 2010 process will build on Healthy People 2000. 
To ensure that the year 2010 goals and objectives address the needs of 
their many stakeholders, your input is requested. ODPHP is soliciting 
public assessment and comments on a preliminary framework (see Appendix 
to this Notice), which was developed with the assistance of focus 
groups composed of representatives from Healthy People 2000 Consortium 
member organizations. This draft framework includes a vision statement 
``Healthy People in Healthy Communities.'' Two overarching goals for 
the Nation are proposed: (1) Increase years of healthy life, and (2) 
eliminate health disparities. This first goal continues the year 2000 
goal with an emphasis on increasing quality life years, not just life 
expectancy. The second goal strengthens the Healthy People 2000 goal of 
reducing health disparities by calling for the elimination of those 
disparities. Four proposed enabling goals accompany the overarching 
ones. Their purpose is to provide strategies to achieve the overarching 
goals by: (Promoting healthy behaviors; (2) protecting health; (3) 
assuring access to quality health care; and (4) strengthening community 
prevention activities.
    The proposed focus areas are analogous to, and for the most part 
use the same names as, Healthy People 2000 priority areas. The term 
``focus area'' was chosen to avoid any implication of prioritization. 
New focus areas have been suggested in response to changes in health 
care and public health during the last 10 years and those anticipated 
over the next decade. These include mental and physical impairment and 
disability, and public health infrastructure. Since one of the 
overarching goals is to eliminate health disparities, specific special 
population focus areas--low income, race/ethnicity, gender, age, and 
people with disabilities--are under consideration to address this goal. 
In each of these focus areas, special population objectives would 
target the most significant

[[Page 46976]]

disparities in health status, health risk, and service delivery.
    Comments on the framework are invited to address (1) The proposed 
framework in its entirety; (2) the proposed vision statement; (3) the 
two proposed overarching goals; (4) the four proposed enabling goals; 
(5) the proposed focus areas; (6) the proposed arrangement of focus 
areas; or (7) entirely new proposals. For each heading addressed, the 
commenter should consider the appropriateness and usefulness of the 
proposed approach and/or offer alternative approaches. After the close 
of the comment period, the framework will be reconsidered and recast on 
the basis of comments received. A revised framework will be included in 
the draft 2010 document and a notice calling for public comment on the 
draft will be published in the Federal Register in the fall of 1998.

Objectives for Healthy People 2010

    Objectives for Healthy People 2010 can be updated or modified 
Healthy People 2000 objectives or entirely new ones submitted by 
commenters. The proposed approach for Healthy People 2010 calls for two 
broad types of objectives--measurable and developmental objectives. 
Recommendations for both types will be accepted during the comment 
period.
    Measurable objectives provide direction for action. They have 
baselines that use valid and reliable data derived from currently 
established, nationally recognized data systems. These baseline data 
provide the point from which a 2010 target can be set. Whenever 
possible, objectives should be measured with national systems that 
either build on, or are comparable with, state and local data systems. 
However, state data are not a prerequisite for developing an objective. 
Proxy data may be used when national data are not available or when 
regional data provide better measurability. When providing an idea for 
a measurable objective, please cite the data source. An example of a 
measurable objective is ``Reduce the infant mortality rate by (XX) 
percent to no more than (X) per 1,000 live births.'' The current 
Healthy People 2000 baseline is 10.1 per 1,000 live births in 1987, as 
recorded by National Vital Statistics System, the data source.
    Developmental objectives describe a desired outcome or achieved 
health status. However, current surveillance systems do not provide 
data on these objectives. The purposes of developmental objectives is 
to identify areas that are important and to stimulate the development 
of data systems to measure them. An example of a developmental 
objective is ``Increase to at least 90 percent the proportion of 
pregnant women and infants who receive risk-appropriate care.'' 
Baseline data to measure such an objective are not currently available.
    Proposals for 2010 objectives received by ODPHP will be assigned 
for consideration to lead agencies of DHHS, which will select proposed 
objectives for inclusion in the draft 2010 document. This draft will be 
available for public review and comment from October to December 1998. 
A listing of lead agencies is contained in the DHHS publication 
Developing Objectives for Healthy People 2010. This publication is for 
sale by the U.S. Government Printing Office, stock #017-001-00530-4; 
the price is $18, which includes shipping and handling. All orders must 
be prepaid. To order, call (202) 512-1800; FAX (202) 512-2250; or send 
orders to--Superintendent of Documents P0 Box 371954, Pittsburgh, PA 
15250-7954.
    Information about the Healthy People initiative as well as many 
publications relating to it are available electronically on the Healthy 
People Home Pages--http://odphp.osophs.dhhs.gov/pubs/hp2000 and <a href="http://
web.health.gov/healthy">http://
web.health.gov/healthy</a> people

    Dated: August 29, 1997.
John M. Eisenberg,
Acting Assistant Secretary for Health.

BILLING CODE 4160-17-M

[[Page 46977]]

[GRAPHIC] [TIFF OMITTED] TN05SE97.018



[FR Doc. 97-23567 Filed 9-4-97; 8:45 am]
BILLING CODE 4160-17-C