Question

When reviewing the goals of Healthy People 2020 (HP2020) on its website, it becomes apparent there are implications of the use of epidemiological data when designing policies and measuring success in achieving public health goals. Evaluate the following overarching HP2020 goals:

• 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.

Discuss how epidemiological practices and methods have been used to explore and advance the progress toward achieving these goals. Justify your response with appropriate language from the HP2020 website. Use the keyword HP2020 to search the HP2020 website.

• Discussed how epidemiologic practices and methods have been used to explore and advance the progress toward achieving overarching HP2020 goals.
• Justified answers with appropriate research and reasoning by using examples and references

Answer 1

THE VISION, MISSION, AND GOALS OF HEALTHY PEOPLE 2020

Vision—A society in which all people live long, healthy lives.

Mission—Healthy People 2020 strives to:

Identify nationwide health improvement priorities;

Increase public awareness and understanding of the determinants of health, disease, and disability and the opportunities for progress;

Provide measurable objectives and goals that are applicable at the national, state, and local levels;

Engage multiple sectors to take actions to strengthen policies and improve practices that are driven by the best available evidence and knowledge; and

Identify critical research, evaluation, and data collection needs. Overarching Goals

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.

What Is Healthy People.

Provides science-based, 10-year national objectives for improving the health of the Nation

A national agenda that communicates a vision for improving health and achieving health equity Identifies measurable objectives with targets to be achieved by the year 2020

Requires tracking of data-driven outcomes to monitor progress and to motivate, guide, and focus action

People Use Healthy People

Data tool for measuring program performance

Framework for program planning and development

Goal setting and agenda building

Teaching public health courses Benchmarks to compare State and local data

Way to develop nontraditional partnerships

HEALTHY PEOPLE 2020 OBJECTIVES FOR ORAL HEALTH

Seventeen of the Healthy People 2020 objectives relate directly to oral health and a number of others reflect the connection between oral disease and other chronic illnesses such as diabetes and cancer. Centers for Disease Control and Prevention (CDC), National Institute of Dental and Craniofacial Research (NIDCR), Indian Health Service (IHS), and the Health Resources and Services Administration (HRSA) are the leads for tracking the progress of these objectives.

The overall goal of the Healthy People 2020 oral health objectives is to prevent and control oral and craniofacial diseases, conditions, and injuries and improve access to related services. Like general health, oral health status in the United States tends to vary based on social and economic conditions

The Importance of an Ecological and Determinants Approach to Health Promotion and Disease Prevention

Health and health behaviors are determined by influences at multiple levels, including personal

organizational/institutional, environmental and policy levels. Because significant and dynamic inter-relationships exist among these different levels of health determinants, interventions are most likely to, be effective when they address determinants at all levels. Historically, many health fields have focused on individual-level health determinants and interventions

The Role of Health Information Technology and Health Communication

Health information technology (IT) and health communication will be encouraged and supported

as being an integral part of the implementation and success of Healthy People 2020. Efforts will

include building, and integrating where feasible, the public health IT infrastructure in

conjunction with the Nationwide Health Information Network.

Addressing “All Hazards” Preparedness as a Public Health Issue

the devastating effects of natural disasters such as hurricanes Katrina

and Ike, and concerns about an influenza pandemic have added urgency to the importance of

preparedness as a public health issue. Being prepared for any emergency must be a high priority

for public health in the coming decade, and Healthy People 2020 will highlight this issue.

Because preparedness for all emergencies involves common elements, an “all hazards” approach

is necessary.

WHY ACCESS TO HEALTH SERVICES IS IMPORTANT

Access to health services means "the timely use of personal health services to achieve the best health outcomes."1 It requires 3 distinct steps:

Gaining entry into the health care system (usually through insurance coverage)

Accessing a location where needed health care services are provided (geographic availability)

Finding a health care provider whom the patient trusts and can communicate with (personal relationship)2

Access to health care impacts one's overall physical, social, and mental health status and quality of life.

Barriers to health services include:

High cost of care

Inadequate or no insurance coverage

Lack of availability of services

Lack of culturally competent care

These barriers to accessing health services lead to:

Unmet health needs

Delays in receiving appropriate care

Inability to get preventive services

Financial burdens

Preventable hospitalizations

Access to care often varies based on race, ethnicity, socioeconomic status, age, sex, disability status, sexual orientation, gender identity, and residential location

Understanding Access to Health Services

The Access to Health Services topic area encompasses 3 components: coverage, services, and timeliness.

Coverage

Health insurance coverage helps patients gain entry into the health care system. Lack of adequate coverage makes it difficult for people to get the health care they need and, when they do get care, burdens them with large medical bills. Uninsured people are:

More likely to have poor health status

Less likely to receive medical care

More likely to be diagnosed later

More likely to die prematurely

Services

Improving access to health care services depends in part on ensuring that people have a usual and ongoing source of care (that is, a provider or facility where one regularly receives care). People with a usual source of care have better health outcomes, fewer disparities, and lower costs

Greater patient trust in the provider

Better patient-provider communication

Increased likelihood that patients will receive appropriate care12,13

Lower mortality from all causes

Timeliness

Timeliness is the health care system's ability to provide health care quickly after a need is recognized. Measures of timeliness include:

Availability of appointments and care for illness or injury when it is needed

Time spent waiting in doctors' offices and emergency departments (EDs)

Increased emotional distress

Increased complications

Higher treatment costs

Increased hospitalizations

EMERGING ISSUES IN ACCESS TO HEALTH SERVICES

Increasing and measuring insurance coverage and access to the entire care continuum (from clinical preventive services to oral health care to long-term and palliative care)

Addressing disparities that affect access to health care (e.g., race, ethnicity, socioeconomic status, age, sex, disability status, sexual orientation, gender identity, and residential location)

Assessing the capacity of the health care system to provide services for newly insured individuals

Determining changes in health care workforce needs as new models for the delivery of primary care become more prevalent, such as the patient-centered medical home and team-based care

Monitoring the increasing use of telehealth as an emerging method of delivering health care