BY: JULIE TROCCHIO, M.S.
"Healthy People" is the federal government's blueprint for improving our nation's health through a set of science-based, 10-year objectives. For three decades, "Healthy People" has established goals for America's health and has monitored progress in order to encourage collaboration among sectors, guide individuals toward making informed health decisions and measure the impact of prevention activities.
The current version of this program, known as "Healthy People 2020," can offer useful resources for community benefit programs. Taking diabetes as an example, this article will show how to investigate the "Healthy People 2020" website (www.healthypeople.gov/2020/about/default.aspx) to find in-depth information that can be a valuable resource.
MISSION AND GOALS OF HEALTHY PEOPLE
As we enter the website, we discover the Healthy People 2020 mission and goals. The mission statement speaks to identifying nationwide health improvement priorities, increasing public understanding of the determinants of health and disease and providing measurable objectives and goals that apply at the national, state and local levels. It also strives to help multiple sectors take actions that reflect the best available evidence and knowledge.
Community benefit program goals are very consistent with these overarching goals of "Healthy People 2020":
- Attain high-quality, longer lives free of preventable disease, disability, injury and premature death
- Achieve health equity, eliminate disparities and improve the health of all groups
- Create social and physical environments that promote good health for all
- Promote quality of life, healthy development and healthy behaviors across all life stages
"Healthy People" has four foundational health measures to serve as indicators of progress towards achieving its goals. These are: general health status; health-related quality of life and well-being; determinants of health; and disparities. Each is a link to more information.
For example, clicking on "general health status" takes us to seven measures of a population's health status that are monitored by the federal government:
- Life expectancy (with international comparison)
- Healthy life expectancy
- Years of potential life lost (with international comparison)
- Physically and mentally unhealthy days
- Self-assessed health status
- Limitation of activity
- Chronic disease prevalence
LEARNING ABOUT DIABETES
To begin finding information on diabetes, we click "Chronic disease prevalence." Here we learn that chronic diseases are the nation's leading cause of death and disability and that in 2008, 107 million Americans — almost 1 out of every 2 adults age 18 or older — had at least one of these chronic illnesses: cardiovascular disease, arthritis, diabetes, asthma, cancer, chronic obstructive pulmonary disease (COPD).
Under a list of references at the bottom of the web page, the section for chronic disease prevalence offers a link to the Centers for Disease Control and Prevention's "Prevalence and Trends Data" page. Here are both national and state (when available) data on levels of adults who have ever been told they have diabetes. Data is presented both as prevalence (how many) and trends for each state, so you can see if the problem is worsening or improving.
Back on the "Healthy People" website, there are a series of tabs across the top of each page. Click "2020 Topics and Objectives" to find an index that includes diabetes. Here, we encounter three sections related to diabetes: Overview, Objectives, and Interventions and Resources.
The Overview section tells us that the national goal related to diabetes is to "reduce the disease and economic burden of diabetes mellitus (DM) and improve the quality of life for all persons who have, or are at risk for, DM." The website also presents basic information about diabetes. For example, we learn that the disease:
- Affects an estimated 23.6 million people in the United States
- Is the seventh leading cause of death
- Lowers life expectancy by up to 15 years
- Increases the risk of heart disease by 2 to 4 times
- Is the leading cause of kidney failure, lower limb amputations and adult-onset blindness
Other information includes the cost of diabetes ($174 billion in 2007); trends (increasing in U.S. and the world); frequent complications of diabetes (including chronic kidney disease, heart disease and stroke); and disparities (African-Americans, Hispanic/Latino Americans, American Indians are at particularly high risk).
We also learn that lifestyle change has been proven effective in preventing or delaying the onset of Type 2 diabetes in high-risk individuals. In fact, if we leave the diabetes Overview section and move to Objectives, we see that increasing prevention behaviors in persons at high risk for diabetes is one of 16 national diabetes objectives. These are divided into sub-objectives, namely increasing the proportion of (pre-diabetic) persons at high risk for diabetes who report that they are increasing their levels of physical activity; trying to lose weight; and reducing the amount of fat or calories in their diet.
IMPLICATIONS FOR COMMUNITY BENEFIT
Moving on to the Interventions and Resources section, we find evidence-based information and recommendations for diabetes in three categories: clinical recommendations, consumer information and community interventions.
Community interventions come from the CDC "Guide to Community Preventive Services" and include
- Individual behavior change programs
- Social support interventions
- Community-wide campaigns to increase exercise
- Case management and disease management for persons with diabetes
- Self-management education
- Environmental and policy approaches for increasing physical activity
- Worksite programs for preventing and controlling obesity
When we click to learn more about any of these interventions, we find a summary of the recommendations of the U.S. Task Force on Community Prevention Services and a review of studies that support the recommendations.
For example, to learn more about community-wide campaigns to increase physical activity, a click takes us to a task force page telling us these are interventions that involve many community sectors, include highly visible, broad-based and multicomponent strategies (such as social support, risk-factor screening and health education) and may also address other cardiovascular disease risk factors, particularly diet and smoking. We learn that the prevention task force "recommends community-wide campaigns on the basis of strong evidence of effectiveness in increasing physical activity and improving physical fitness among adults and children."
For more information, we can drill down even further to find two National Cancer Institute research-tested intervention programs for sedentary adults: "Wheeling Walks" and "Community Healthy Activities Model Program for Seniors" (CHAMPS).
WHAT WE HAVE LEARNED
In our review of the "Healthy People 2020" website, we have learned the what, where and why of this valuable federal public health resource. By focusing on chronic diseases, we learned about the prevalence and trends of chronic disease. Focusing further on diabetes, we found information on what it is and why it is a priority issue in our nation, states and for our communities.
Of particular importance to community benefit leaders, we learned that lifestyle change, including physical exercise, has been proven effective in preventing or delaying the onset of Type 2 diabetes in high-risk individuals. We found out that the U.S. Task Force on Community Prevention Services recommends community campaigns as a strategy to increase physical activity. We migrated to the CDC's "Guide to Preventive Community Services," where we found research-tested interventions that could be implemented by community benefit programs.
So, make a note for yourself under the heading "resources for community benefit programs." Set aside some time, and explore the riches within the "Healthy People 2020" website.
JULIE TROCCHIO, M.S., is CHA's senior director, community benefit and continuing care ministries, Washington, D.C. Write to her at [email protected].
Copyright © 2011 by the Catholic Health Association of the United States
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