Causes Of Death to Leading Health Indicators Essay

The SLP assignment for this course will entail becoming familiar with Healthy People initiative. To the end, you will be asked to view a series of videos presenting the key components of Healthy People 2020, illustrating how these are being implemented, noting data sources available to monitor progress toward achievement of Healthy People goals objectives, and recommending strategies for incorporating Healthy People into the work we do as health educators.Causes Of Death to Leading Health Indicators Essay

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View the second of these videos. After watching the video, address the following questions:

What are the “interagency workgroups” to which the speaker refers, and what is their role?
Where can one go to find a complete overview of each Healthy People 2020 objective?
What type on information on leading health indicators is provided by the National Center for Health Statistics?
How is progress toward Healthy People 2020 targets measured?
SLP Assignment Expectations
Length: 2–3 pages.

Assessment and Grading: Your paper will be assessed based on the performance assessment rubric. You can view it under Assessments at the top of the page. Review it before you begin working on the assignment. Your work should also follow these Assignment Expectations.Causes Of Death to Leading Health Indicators Essay

Leading Health Indicators

Healthy People 2020 provides a comprehensive set of 10-year, national goals and objectives for improving the health of all Americans. Healthy People 2020 contains 42 topic areas with more than 1,200 objectives. A smaller set of Healthy People 2020 objectives, called Leading Health Indicators (LHIs), have been selected to communicate high-priority health issues and actions that can be taken to address them.

Great strides have been made during the past decade: life expectancy at birth increased; rates of death from coronary heart disease and stroke decreased. Nonetheless, public health challenges remain, and significant health disparities persist.

Track Progress Toward LHIs!

Check out our interactive infographic to see the Nation’s progress toward each Leading Health Indicator.

The Healthy People 2020 LHIs place renewed emphasis on overcoming these challenges as we track progress over the course of the decade. The indicators will be used to assess the health of the Nation, facilitate collaboration across sectors, and motivate action at the national, state, and community levels to improve the health of the U.S. population.Causes Of Death to Leading Health Indicators Essay

1. The Health Benefits of Education
Income and Resources
“Being educated now means getting better employment, teaching our kids to be successful and just making a difference in, just in everyday life.” —Brenda
Better jobs: In today’s knowledge economy, an applicant with more education is more likely to be employed and land a job that provides health-promoting benefits such as health insurance, paid leave, and retirement.5 Conversely, people with less education are more likely to work in high-risk occupations with few benefits.

Higher earnings: Income has a major effect on health and workers with more education tend to earn more money.2 In 2012, the median wage for college graduates was more than twice that of high school dropouts and more than one and a half times higher than that of high school graduates.6 Read More +/-

“Definitely having a good education and a good paying job can relieve a lot of mental stress.”Causes Of Death to Leading Health Indicators Essay
—Chimere
Resources for good health: Families with higher incomes can more easily purchase healthy foods, have time to exercise regularly, and pay for health services and transportation. Conversely, the job insecurity, low wages, and lack of assets associated with less education can make individuals and families more vulnerable during hard times—which can lead to poor nutrition, unstable housing, and unmet medical needs. Read More +/-

Figure 1Figure 2FIgure 4
Figure 1
Social and Psychological Benefits
“So through school, we learn how to socially engage with other classmates. We learn how to engage with our teachers. How we speak to others and how we allow that to grow as we get older allows us to learn how to ask those questions when we’re working within the healthcare system, when we’re working with our doctor to understand what is going on with us.”
—Chanel
Reduced stress: People with more education—and thus higher incomes—are often spared the health-harming stresses that accompany prolonged social and economic hardship. Those with less education often have fewer resources (e.g., social support, sense of control over life, and high self-esteem) to buffer the effects of stress. Causes Of Death to Leading Health Indicators Essay

Social and psychological skills: Education in school and other learning opportunities outside the classroom build skills and foster traits that are important throughout life and may be important to health, such as conscientiousness, perseverance, a sense of personal control, flexibility, the capacity for negotiation, and the ability to form relationships and establish social networks. These skills can help with a variety of life’s challenges—from work to family life—and with managing one’s health and navigating the health care system. Read More +/-

Social networks: Educated adults tend to have larger social networks—and these connections bring access to financial, psychological, and emotional resources that may help reduce hardship and stress and improve health. Read More +/-

“Being able to advocate and ask for what you want, helps to facilitate a healthier lifestyle. … If it’s needing your community to have green spaces, have a park, a playground, have better trails within the community, advocating for that will help.”
—Chanel
Health Behaviors
Knowledge and skills: In addition to being prepared for better jobs, people with more education are more likely to learn about healthy behaviors. Educated patients may be more able to understand their health needs, follow instructions, advocate for themselves and their families, and communicate effectively with health providers.Causes Of Death to Leading Health Indicators Essay

Healthier Neighborhoods
“Poor neighborhoods oftentimes lead to poor schools. Poor schools lead to poor education. Poor education oftentimes leads to poor work. Poor work puts you right back into the poor neighborhood. It’s a vicious cycle that happens in communities, especially inner cities.” —Albert
Lower income and fewer resources mean that people with less education are more likely to live in low-income neighborhoods that lack the resources for good health. These neighborhoods are often economically marginalized and segregated and have more risk factors for poor health such as:

Less access to supermarkets or other sources of healthy food and an oversupply of fast food restaurants and outlets that promote unhealthy foods.25
Read More +/-

“If the best thing that you see in the neighborhood is a drug dealer, then that becomes your goal. If the best thing you see in your neighborhood is working a 9 to 5, then that becomes your goal. But if you see the doctors and the lawyers, if you see the teachers and the professors, then that becomes your goal.” —Marco“It’s a lot of things going on [in this community], a lot of challenges. It’s just hard sometimes to try and get people to come together, as one, just so we can solve the problem.” —Toni
Less green space, such as sidewalks and parks to encourage outdoor physical activity and walking or cycling to work or school.
Rural and low-income areas, which are more populated by people with less education, often suffer from shortages of primary care physicians and other health care providers and facilities.
Higher crime rates, exposing residents to greater risk of trauma and deaths from violence and the stress of living in unsafe neighborhoods. People with less education, particularly males, are more likely to be incarcerated, which carries its own public health risks.Causes Of Death to Leading Health Indicators Essay
Fewer high-quality schools, often because public schools are poorly resourced by low property taxes. Low-resourced schools have greater difficulty offering attractive teacher salaries or properly maintaining buildings and supplies.
Fewer jobs, which can exacerbate the economic hardship and poor health that is common for people with less education.
Higher levels of toxins, such as air and water pollution, hazardous waste, pesticides, andindustrial chemicals.27
Less effective political influence to advocate for community needs, resulting in a persistent cycle of disadvantage.
2. Poor Health That Affects Education (Reverse Causality)
“Things that happen in the home can definitely affect a child being able to even concentrate in the classroom. … If you’re hungry, you can’t learn with your belly growling. … If you’re worried about your mom being safe while you’re at school, you’re not going to be able to pay attention.” —Chimere
The relationship between education and health is never a simple one. Poor health not only results from lower educational attainment, it can also cause educational setbacks and interfere with schooling.

For example, children with asthma and other chronic illnesses may experience recurrent absences and difficulty concentrating in class.28 Disabilities can also affect school performance due to difficulties with vision, hearing, attention, behavior, absenteeism, or cognitive skills. Read More +/-

3. Conditions Throughout the Life Course—Beginning in Early Childhood—That Affect Both Health and Education
A third way that education can be linked to health is by exposure to conditions, beginning in early childhood, which can affect both education and health. Throughout life, conditions at home, socioeconomic status, and other contextual factors can create stress, cause illness, and deprive individuals and families of resources for success in school, the workplace, and healthy living. Causes Of Death to Leading Health Indicators Essay

What about social policy?
Social policy—decisions about jobs, the economy, education reform, etc.—is an important driver of educational outcomes AND affects all of the factors described in this brief. For example, underperforming schools and discrimination affect not only educational outcomes but also economic success, the social environment, personal behaviors, and access to quality health care. Social policy affects the education system itself but, in addition, individuals with low educational attainment and fewer resources are more vulnerable to social policy decisions that affect access to health care, eligibility for aid, and support services.

A growing body of research suggests that chronic exposure of infants and toddlers to stressors—what experts call “adverse childhood experiences”—can affect brain development and disturb the child’s endocrine and immune systems, causing biological changes that increase the risk of heart disease and other conditions later in life (see Graphic 1). For example:

“The connection that I will say between education and health would be a healthy mind produces a healthy person. A motivated mind produces a motivated person. A curious mind produces a curious person. When you have those things it drives you to want to know more, to want to have more, to want to inquire more. And when you want more, you will get more. You know where the mind goes the person follows… and that includes health.” —Marco
The adverse effects of stress on the developing brain and on behavior can affect performance in school and explain setbacks in education. Thus, the correlation between lower educational attainment and illness that is later observed among adults may have as much to do with the seeds of illnessand disability that are planted before children ever reach school age as witheducation itself.
Children exposed to stress may also be drawn to unhealthy behaviors—such as smoking or unhealthy eating—during adolescence, the age when adult habits are often first established.

The Assistant Secretary for Health has charged this National
Academies of Sciences, Engineering, and Medicine committee with
assisting
in the development of Leading Health Indicators (LHIs) for Healthy
People 2030. The committee will develop (1) recommendations regarding
the criteria for selecting LHIs and (2) a slate of LHIs that will serve as options for the Healthy People Federal Interagency Workgroup to consider
as they develop the final criteria and set of LHIs for Healthy People 2030.
The committee may identify gaps and may recommend new objectives
for LHI consideration that meet the core objective criteria.
This brief report responds to the first part of the task. The committee
reviewed past and current Healthy People materials, both those developed
by the Department of Health and Human Services (HHS) and the current
Secretary’s Advisory Committee on National Health Promotion and Disease Prevention Objectives for 2030 (SAC), and prior National Academies
reports. The committee’s information-gathering activities included three
open meetings: two were online and consisted of presentations from
HHS and the leadership of the SAC and its relevant subcommittees, and
one meeting took place at the Keck Center of the National Academies in
Washington, DC.Causes Of Death to Leading Health Indicators Essay
In this report, the committee makes four findings and two recommendations based on its review of relevant materials and information.
1

2 CRITERIA FOR SELECTING THE LHIs
Finding 1: The committee finds that the Healthy People 2030 draft
objectives document is missing some key topics necessary to fully
reflect the intent of the Healthy People 2030 Framework’s vision, mission, foundational principles, and overarching goals.1
Finding 2: The committee finds that the draft objectives do not offer
an appropriately balanced and comprehensive range from which to
derive Leading Health Indicators that also reflect the intent of the
Healthy People 2030 Framework’s vision, mission, foundational principles, and overarching goals.
Finding 3: The committee finds that the Healthy People 2030 draft
objectives document includes too few objectives that allow for making
important comparisons to other countries, including to peer nations
in the Organisation for Economic Co-operation and Development.
Finding 4: The committee finds that if the existing criteria for Leading Health Indicator (LHI) selection were applied to the existing
Healthy People 2030 draft objectives, the resulting LHI set would not
be aligned with the Healthy People 2030 Framework—it would not tell
a coherent story about the nation’s (or communities’) health, wellbeing, and the state of health equity.
Recommendation 1: The committee recommends that the Department of Health and Human Services and the Federal Interagency
Workgroup add to the Healthy People 2030 objectives topics or
implement a structural reorganization (with additional topics) that
will yield more core objectives that reflect the Healthy People 2030
Framework and could lead to better Leading Health Indicators.
Cross-cutting topics (i.e., topics that refer to or link with multiple
health states, life stages, systems, and all dimensions of health)
should include health equity; the social, physical, and economic
determinants of health; shared responsibility and multiple sectors;
and all levels of government.
Recommendation 2: The committee recommends a three-phase process should be used for Leading Health Indicator (LHI) selection
from the Healthy People 2030 objectives. A new phase would precede the existing two, and it would apply the Healthy People 2030
1 Refers to the topic categories under which lists of objectives are nested beginning with
Adolescent Health and concluding with Vision.

SUMMARY 3
Framework (especially the vision, mission, foundational principles,
and overarching goals) in consideration of additional objectives
and in selecting LHIs.Causes Of Death to Leading Health Indicators Essay

  NOW

1

Introduction

At the request of the Department of Health and Human Services’
(HHS’s) Office of the Assistant Secretary for Health, the National
Academies of Sciences, Engineering, and Medicine appointed a committee of experts to assist HHS with one component of the Healthy People
initiative. Healthy People is a decadal HHS effort launched in 1979 to
“develop a framework for improving the health of all people in the United
States” and offer “a strategic agenda to align health promotion and disease prevention activities in communities around the country” (Azar,
2018). The National Academies committee was given the following Statement of Task:
The Department of Health and Human Services, Office of the Assistant
Secretary for Health, requests that the National Academies of Sciences,
Engineering, and Medicine convene an ad hoc committee to assist in the
development of Leading Health Indicato

At the request of the Department of Health and Human Services’
(HHS’s) Office of the Assistant Secretary for Health, the National
Academies of Sciences, Engineering, and Medicine appointed a committee of experts to assist HHS with one component of the Healthy People
initiative. Healthy People is a decadal HHS effort launched in 1979 to
“develop a framework for improving the health of all people in the United
States” and offer “a strategic agenda to align health promotion and disease prevention activities in communities around the country” (Azar,
2018). The National Academies committee was given the following Statement of Task:
The Department of Health and Human Services, Office of the Assistant
Secretary for Health, requests that the National Academies of Sciences,
Engineering, and Medicine convene an ad hoc committee to assist in the
development of Leading Health Indicators (LHIs) for Healthy People 2030.
The committee will develop (1) recommendations regarding the criteria
for selecting LHIs and (2) a slate of LHIs that will serve as options for
the Healthy People Federal Interagency Workgroup to consider as they
develop the final criteria and set of LHIs for Healthy People 2030. The
committee may identify gaps and may recommend new objectives for
LHI consideration that meet the core objective criteria.
This brief report represents the National Academies committee (or
“the committee”) response to the first portion of the charge, providing a
review of the criteria for selecting LHIs along with—in response to the
5

6 CRITERIA FOR SELECTING THE LHIs
last sentence of the charge—comments about the Healthy People 2030 objectives (HP2030 objectives), currently in draft form. This report lays the
groundwork for the second report, which will provide additional comments about the HP2030 objectives from which LHIs are to be selected,
and will recommend a slate of LHIs.
At the time the National Academies committee began its work in late
2018, the Secretary’s Advisory Committee on National Health Promotion
and Disease Prevention Objectives for 2030 (SAC) had met 12 times and
had developed the framework for Healthy People 2030 (HP2030 Framework) incorporating a round of public comments. The SAC has prepared
seven reports, on topics including the criteria for selecting the HP2030
objectives and the criteria for selecting the LHIs, and the SAC also worked
with outside experts to prepare a series of briefs intended to “clarify,
discuss, and offer insights” about the HP2030 Framework (see Box 1-1
for the Framework) (SAC, 2019a). By late 2018, the Federal Interagency
Workgroup (FIW), which includes HHS agencies and representatives of
other federal departments, had also met to generate the HP2030 objectives, which were expected to be aligned with the HP2030 Framework.
The draft objectives were released for public comment between December
2018 and January 2019.Causes Of Death to Leading Health Indicators Essay
Because the HP2030 objectives will not be finalized and released until
2020, the National Academies committee was asked to first comment on
the draft LHI criteria and then, in preparation for its second report proposing a set of LHIs to inform the work of the FIW, review the objectives
and identify relevant gaps in the core objectives in accordance with the
core objective criteria. Figure 1-1 describes the main inputs and timeline
for the LHIs for Healthy People 2030.
BOX 1-1

Healthy People 2030 Framework:

Vision, Mission, Principles, Goalsa

(developed by the Secretary’s Advisory Committee)
Vision: A society in which all people can achieve their full potential for health and
well-being across the life span.
Mission: To promote, strengthen, and evaluate the nation’s efforts to improve the
health and well-being of all people. Causes Of Death to Leading Health Indicators Essay
INTRODUCTION 7
BOX 1-1 Continued
Foundational principles: Foundational principles explain the thinking that guides
decisions about Healthy People 2030. The health and well-being of all people
and communities are essential to a thriving, equitable society. Promoting health
and well-being and preventing disease are linked efforts that encompass physical, mental, and social health dimensions. Investing to achieve the full potential
for health and well-being for all provides valuable benefits to society. Achieving
health and well-being requires eliminating health disparities, achieving health
equity, and attaining health literacy. Healthy physical, social, and economic environments strengthen the potential to achieve health and well-being. Promoting
and achieving the nation’s health and well-being is a shared responsibility that is
distributed across the national, state, tribal, and community levels, including the
public, private, and not-for-profit sectors. Working to attain the full potential for
health and well-being of the population is a component of decision making and
policy formulation across all sectors.
Overarching goals: Attain healthy, thriving lives and well-being, free of preventable disease, disability, injury, and premature death. Eliminate health disparities,
achieve health equity, and attain health literacy to improve the health and wellbeing of all. Create social, physical, and economic environments that promote
attaining full potential for health and well-being for all. Promote healthy development, healthy behaviors, and well-being across all life stages. Engage leadership,
key constituents, and the public across multiple sectors to take action and design
policies that improve the health and well-being of all.
Plan of action: Set national goals and measurable objectives to guide evidencebased policies, programs, and other actions to improve health and well-being.
Provide data that are accurate, timely, accessible, and can drive targeted actions
to address regions and populations with poor health or at high risk for poor health
in the future. Foster improvement through public and private efforts to improve
health and well-being for people of all ages and the communities in which they
live. Provide tools for the public, programs, policy makers, and others to evaluate progress toward improving health and well-being. Share and support the
implementation of evidence-based programs and policies that are replicable,
scalable, and sustainable. Report biennially on progress throughout the decade
from 2020 to 2030. Stimulate research and innovation toward meeting Healthy
People 2030 goals and highlight critical research, data, and evaluation needs.
Facilitate development and availability of affordable means of health promotion,
disease prevention, and treatment.
NOTE: The Healthy People Framework includes a preamble that summarizes the background, history, and contributions of the Healthy People initiative. a See https://www.healthypeople.gov/2020/About-Healthy-People/Development-HealthyPeople-2030/Framework (accessed July 9, 2019).
SOURCE: HHS, 2019a.

8 CRITERIA FOR SELECTING THE LHIs
FIGURE 1-1 Main inputs into and timeline for the selection of Leading Health
Indicators by the Department of Health and Human Services and the Federal
Interagency Workgroup.
NOTE: HHS = Department of Health and Human Services; HP2030 = Healthy
People 2030; LHI = Leading Health Indicator.
REFLECTIONS ON THE HP2030 FRAMEWORK
The SAC’s Recommendations for the Healthy People 2030 Leading Health
Indicators (2018a) described the HP2030 Framework as “a foundation for
the criteria for selecting LHIs for the Healthy People 2030 initiative.” In the
same report, the SAC stated that it was proposing “criteria for selecting
Healthy People 2030 LHIs that are informed by the Healthy People 2030
Framework,Causes Of Death to Leading Health Indicators Essay
1 including the vision, mission, foundational principles, overarching goals, and plan of action.”
The National Academies committee recognizes that the HP2030
Framework has built considerably on the foundation of previous Healthy
People efforts by broadening the conceptual framing of the initiative
to strengthen the emphasis on health equity; expand the consideration
of the social, environmental, and economic determinants of health; and
add the useful and multidimensional notion of well-being. This evolution of the HP2030 Framework is consistent with recent advances in the
understanding of those factors that lead to better health and well-being,
and the set of issue briefs released by the SAC provides context and the
evidence base for the main elements of the Framework (SAC, 2019a).
Below, the National Academies committee further discusses the relevance
of the major elements of the HP2030 Framework to the HP2030 objectives
and LHIs:
• The health equity focus of the Framework underscores the importance of disaggregating information, when feasible, about
the LHIs by race, ethnicity, rurality, and other characteristics.
1 Underline added for emphasis.

INTRODUCTION 9
However, this is not enough. Measures of health equity are also
needed. In defining health equity as “the principle underlying a
commitment to reduce—and, ultimately, eliminate—disparities
in health and in its determinants, including social determinants,”
Braveman (2014) referred to Healthy People 2020 as the first time
that a federal government entity defined health disparity with
specificity. Healthy People 2020 described disparities as “linked
with economic, social, or environmental disadvantage” or with
other “characteristics historically linked to discrimination or
exclusion” (SAC, 2010). Braveman added to the definition that
“pursuing health equity means striving for the highest possible
standard of health for all people and giving special attention to
the needs of those at greatest risk of poor health, based on social
conditions” (Braveman, 2014).Causes Of Death to Leading Health Indicators Essay
• The determinants of health focus calls for both acknowledging
the evidence showing those factors account for the largest effect
on health outcomes, and highlighting the value of a cross-sector
and all-levels-of-government approach to health promotion.
• The well-being focus is consonant with the longstanding World
Health Organization definition of health and its physical, mental,
and social dimensions (WHO, 2014), and it offers a further link for
engaging the attention of sectors that make important contributions to population well-being, for exploring the metrics available
from those other sectors, and for comparing against what other
countries measure. A key aspect of this focus is that health is not
simply the absence of disease or injury; it is also related to being
well in social and emotional terms. Causes Of Death to Leading Health Indicators Essay

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