HHS Strategic Goals and Objectives - FY 2001 . Goal 1 - Reduce the Major Threats to the Health and Productivity of All Americans

Research indicates that a significant percentage of premature mortality and morbidity in the United States can be prevented if individuals avoid certain high-risk behaviors (e.g., smoking), adopt healthy ones (e.g., exercise), and reduce exposure to major environmental risks to health (e.g., lead-based paint). The strategic objectives under this goal focus Department efforts on changing behaviors and reducing the risks that are associated with the leading causes of premature mortality and morbidity (e.g., heart disease and stroke) in the United States.

The importance of this goal is evident from the health and economic consequences of the behaviors that are addressed. For example,

• Smoking is estimated to be responsible for more than 400,000 deaths annually (one in every five deaths in the United States is smoking-related), and it is estimated that smoking increases the risk of contracting other diseases, including heart disease and emphysema and other respiratory diseases.

• Unintentional injuries (primarily from fires, falls, drowning, and poisonings) are the leading cause of death in the United States for people between the ages of 1 and 44.

• Violence in intimate relationships is estimated to result in financial losses to women victims of $150 million a year.

• Poor diet and low levels of physical activity are associated with 300,000 deaths each year, second only to tobacco.

• Alcohol abuse exacts a financial toll on the nation, costing over $166 billion annually, of which approximately $58 billion is attributed to underage drinking.

• Drug abuse, estimated to cost society over $100 billion per year, is linked to other public health problems, such as suicide, homicide, motor-vehicle injury, sexually transmitted diseases, and HIV infection.

• Unsafe sexual behavior is related to more than 12 million cases of sexually transmitted diseases, high teen pregnancy rates, and billions of dollars in preventable health care spending each year. While the actual death rates from HIV infection have declined, the number of new infections (estimated at 40,000 annually) and cost of treatment remain high.

• Finally, infectious disease (e.g., pneumonia and influenza) was the sixth leading cause of death in the United States in 1998.

• Objective 1.1 - Reduce Tobacco Use, Especially Among Youth

  • How We Will Accomplish Our Objective

    We will provide funding and technical support for education campaigns to deliver the anti-tobacco message. Our efforts will focus on:

    • leading a national campaign to educate Americans about the health effects of tobacco use.

    • incorporating tobacco education into Department programs and initiatives that target youth such as Project Youth Connect, Teen Parents, Girl Power!, and the Runaway and Homeless Youth program.

    • promoting the adoption of tobacco education programs by primary care health care professionals and incorporation of the programs into primary health care services.

    • distributing information to health care practitioners and the public on the consequences of tobacco use through the National Clearinghouse on Alcohol and Drug Information.

    • disseminating Public Health Service guidelines on smoking cessation to health care practitioners and brochures to consumers.

    We will fund state tobacco control programs in all states. These programs will:

    1.1 Implementation Strategies

    Education Campaigns Tobacco Prevention/Control Programs Enforcing Prohibitions on Sales to Minors Research

    • educate young people about the dangers of tobacco use and help them to refuse tobacco use.

    • promote cessation of tobacco use among youth and adults.

    • protect the public from secondhand smoke.

    • identify and eliminate disparities in tobacco use among population subgroups.

    • reduce the use of smokeless tobacco.

    We will provide assistance to state health departments, schools (in collaboration with the Department of Education), local governments, national anti-tobacco and other organizations to help develop tobacco prevention and control programs. This assistance effort will include a focus on working with states to implement the Synar Amendment.

    We will continue to support enforcement of state and local laws and regulations preventing the sale of tobacco to minors through data sharing and technical assistance.

    HHS Agencies contributing to this objective (1): ACF CDC FDA HRSA IHS NIH OS SAMHSA

    We will undertake research and demonstrations to:

    • better understand why people smoke (e.g., the genetic base, environmental interactions, and socioeconomic factors) as a precursor to developing better interventions to prevent or stop tobacco use.

    • monitor trends in tobacco use.

    • design new ways of preventing or stopping tobacco use and assess the effectiveness of interventions.

    • learn how to more effectively translate proven interventions into practice.

    (1) All agencies are listed in Appendix I.

• Objective 1.2 - Reduce the Incidence and Impact of Injuries and Violence in American Society

  • How We Will Accomplish Our Objective

    We will help develop and improve public and private injury and violence prevention programs. Elements of this strategy include:

    • providing information and technical assistance to hospitals and public health agencies on how to standardize and expand the collection of mortality, hospital, and emergency department data to improve surveillance and monitoring.

    • directing resources to help tribes develop risk identification and intervention programs.

    • directing resources to help states develop the basic capacity for state injury and poison prevention programs.

    • providing technical assistance to state and local health departments, state and agency networks on aging, and other organizations serving the elderly to help implement fall prevention programs.

    • providing financial and technical assistance to community injury and violence prevention programs, such as programs that focus on preventing suicide, youth/school violence and violence against women, fire safety, and bicycle safety.

    We will widely disseminate information on preventing injuries and violence. Particular areas of focus will be:

    1.2 Implementation Strategies

    Injury/Violence Prevention Programs Information Dissemination Promoting Safety Legislation Research

    • children: disseminating information from demonstration programs to safety organizations such as the National Bicycle Safety Network, local bicycle safety programs, and the National Fire Protection Association, on how to prevent childhood injuries.

    • the workplace: disseminating information to industry on ways to improve workplace safety.

    • the elderly: launching a nationwide campaign to educate older Americans about how to modify their home environment to avoid potentially harmful and debilitating falls.

    • youth: in collaboration with the Departments of Education and Justice, disseminating information on school and community youth violence prevention programs.

    • communities: in conjunction with the Departments of Education and Justice, providing communities with current information on the incidence of school, street, and gang violence, domestic violence, and substance abuse and violence.

    We will foster the development and improvement of state safety legislation by supplying current surveillance data that highlight safety issues; e.g., providing data from our Traumatic Brain Injury surveillance system to help states develop motorcycle helmet, safety belt, and snowmobile legislation.

    We will conduct research and demonstrations to:

    HHS Agencies contributing to this objective: AHRQ ACF AoA CDC HCFA HRSA IHS NIH OS SAMHSA

    • identify the causes and risk factors (e.g., alcohol consumption, workplace hazards, socioeconomic factors) for violence and injuries to help develop more effective prevention programs.

    • design better interventions for controlling aggressive behavior and violence in youth.

    • design better strategies for preventing injuries in the home, childcare environments, and the workplace.

    • understand the pathology and effective treatment of injuries to lessen their impact.

    • study the effectiveness of health care interventions for victims of domestic violence.

• Objective 1.3 - Improve the Diet and the Level of Physical Activity of Americans

  • How We Will Accomplish Our Objective

    We will carry out education campaigns to encourage the public to improve their diet and exercise habits. Our focus will be on:

    • conducting our Five-A-Day education program on the importance of eating vegetables and fruits.

    • implementing counseling programs on diet and physically active lifestyles in our primary care programs.

    • conducting a national campaign to inform women of childbearing age about the importance of consuming 400 micrograms of folic acid daily, in addition to an appropriate diet, to prevent some types of serious birth defects.

    • providing consumers with food content information (food labels) to help them make better diet choices.

    1.3 Implementation Strategies

    Education Campaigns Supporting Nutrition Programs Research

    We will provide financial support and technical assistance to help states develop programs promoting good nutrition and the reduction of excessive consumption of saturated fat and calories, physical inactivity, and obesity among youth.

    We will provide nutritious meals, nutrition education, and individual nutrition counseling for the elderly in congregate and home-delivered settings.

    HHS Agencies contributing to this objective: AoA CDC FDA HRSA IHS NIH OS

    We will conduct research to:

    • learn about and inform the public regarding the effects of diet and exercise on health.

    • develop better interventions for the prevention and treatment of obesity.

    • evaluate the effectiveness of education in changing diet and exercise behavior.

    • develop sound scientific data and expertise to support standards and guidance for evaluating the safety of dietary supplements (e.g., vitamins).

      

• Objective 1.4 - Reduce Alcohol Abuse and Prevent Underage Drinking

  • How We Will Accomplish Our Objective

    We will conduct education campaigns directed at high-risk groups to discourage underage drinking and alcohol abuse. These include Girl Power!, Teen Drinking Prevention Campaigns, and others.

    We will provide technical assistance to community programs to help develop effective prevention strategies, including public service advertisements and enforcement activities to prevent sales to minors.

    1.4 Implementation Strategies

    Education Campaigns Enforcing Prohibitions on Sales to Minors Alcohol Abuse Treatment Services Surveillance Research

    We will provide financial assistance for screening, residential, and outpatient treatment services.

    We will provide technical assistance and financial support to improve surveillance and data systems that provide information to public health officials on trends in alcohol abuse related to youth, domestic abuse, fetal alcohol syndrome, and chronic diseases.

    HHS Agencies contributing to this objective: CDC HRSA IHS NIH OS SAMHSA

    We will conduct research to:

    • understand the causes (e.g., genetic, biological, socioeconomic) of alcohol addiction as a precursor to the development of new prevention and treatment methods.

    • design more effective prevention and treatment methods and programs.

    • learn more about the health and social costs of underage drinking to guide public policy decisions.

• Objective 1.5 - Reduce the Abuse and Illicit Use of Drugs

  • How We Will Accomplish Our Objective

    We will provide science-based information on the effects of drug use and on effective prevention and treatment strategies to health professionals, states, communities, and the public.

    We will conduct anti-drug education campaigns targeted at high-risk groups and delivered through networks of community-based organizations and health care providers.

    We will help states and communities develop drug prevention and treatment services at the community level, including a targeted capacity expansion strategy to address treatment gaps in communities with serious, emerging drug problems. Other priorities include:

    1.5 Implementation Strategies

    Information Dissemination Education Campaigns Drug Prevention/Treatment Services Monitoring Trends Research

    • community drug abuse prevention programs, especially programs targeted at vulnerable populations.

    • community outpatient treatment, methadone programs, and residential treatment services for adolescents and other underserved populations.

    • prevention and treatment services to rural and urban Indian communities.

    • the Federal Drug-Free Workplace Program.

    We will monitor trends in drug use and provide that information to public health and other officials involved in prevention and treatment.

    HHS Agencies contributing to this objective: FDA HRSA IHS NIH OS SAMHSA

    We will conduct research to:

    • learn more about the causes of and risk factors for drug addiction (e.g., genetic, biological, and socioeconomic) and translate that knowledge into prevention and treatment methods.

    • design better prevention and treatment strategies and services (e.g., medication for treatment and behavioral modification strategies).

    • understand drug use patterns to adapt treatment to community needs.

• Objective 1.6 - Reduce Unsafe Sexual Behaviors

  • How We Will Accomplish Our Objective

    We will provide financial and technical assistance to a variety of community prevention services. Our priorities include:

    • comprehensive state programs for the prevention of sexually transmitted diseases (STDs).

    • state programs to provide abstinence education, including mentoring, counseling, and adult supervision to promote abstinence from sexual activity.

    • a variety of prevention and counseling services for high-risk populations served by Department programs such as federally funded health centers, American Indian and Alaska Native (AI/AN) clinics, and mental health and substance abuse providers.

    • programs in community organizations that provide HIV prevention services to high-risk individuals (e.g., community health centers that serve gay and lesbian populations).

    We will promote the application of privacy/confidentiality policies (through privacy regulations, conferences, posting information on health information surveillance boards, etc.) to encourage individuals to seek testing and counseling.

    We will provide technical assistance to help a variety of organizations increase their capacity to provide prevention services. Our efforts will focus on helping:

    1.6 Implementation Strategies

    STD Prevention Services Promoting Privacy/Confidentiality Developing Service Capacity Research

    • cities, states, territories, and selected countries build HIV/AIDS surveillance systems that are capable of tracking the course of HIV and AIDS, targeting prevention programs for population groups or geographic areas, and evaluating the effectiveness of prevention programs.

    • states develop curricula and train teachers who can provide youth with the information and skills to avoid HIV infection and reduce unsafe sexual behaviors (in coordination with the Department of Education).

    • community-based organizations, medical and public health professionals, HIV community planning groups, and other organizations train their staff in prevention strategies.

    HHS Agencies contributing to this objective: ACF CDC HRSA IHS NIH OS SAMHSA

    We will fund research to:

    • learn more about the spread of sexually transmitted diseases, including the high-risk behaviors associated with spread of the disease, to develop more effective prevention strategies.

    • evaluate new tools and techniques for preventing HIV transmission, including promising integration of biomedical and behavioral interventions.

• Objective 1.7 - Reduce the Incidence and Impact of Infectious Diseases

  • How We Will Accomplish Our Objective

    We will provide financial and technical assistance to state and local infectious disease control programs. Our priorities will be to:

    • develop and implement national data and information system standards for surveillance reporting of infectious diseases.

    • provide technical assistance to state and local health departments on how to collect and maintain epidemiological information that can rapidly detect, investigate, and monitor emerging pathogens, the diseases they cause, and the factors influencing their emergence.

    • provide funding and technical assistance to support screening and treatment for selected diseases at state and local health departments (e.g., sexually transmitted disease, tuberculosis, HIV/AIDS, Hepatitis C Virus, and emerging infections).

    • provide funding and technical assistance to state and local health departments and hospitals in the surveillance, prevention, and control of antimicrobial resistance.

    1.7 Implementation Strategies

    Infectious Disease Control Programs Syphilis Elimination Tuberculosis Reduction Increasing Vaccine Coverage Polio and Measles Eradication Research

    We will provide emergency epidemic assistance to domestic and international partners in cases of disease outbreaks that are major public health concerns.

    We will provide leadership for planning and implementing a comprehensive initiative for eliminating syphilis in the United States.

    We will provide leadership for planning and implementing a comprehensive initiative for reducing tuberculosis (TB). Our strategy includes:

    • carrying out a major clinical trial on TB prevention, in conjunction with the Veterans Administration.

    • training physicians and other health care providers in tuberculosis diagnosis and treatment.

    • implementing cooperative agreements with state and local health departments to maintain a TB prevention and control program in each state.

    • continuing collaboration with international partners to advance TB control activities relevant to the United States.

    We will implement a strategy to increase vaccine coverage in the United States. Key elements of the strategy will include:

    • funding and technical assistance to health departments, health care providers, and other community organizations to administer vaccines against infectious diseases.

    • outreach to and education of the public about the efficacy and safety of vaccines, especially through Department and other federal programs.

    We will provide technical assistance and support for HIV/AIDS prevention, care, treatment, and infrastructure development to country programs in Africa, Asia, and the Caribbean/Latin America region.

    We will maintain a program of technical assistance to other countries to support efforts to eradicate polio and control measles, to prevent the spread of those diseases to the United States.

    HHS Agencies contributing to this objective: ACF AoA CDC FDA HCFA HRSA IHS NIH OS SAMHSA

    We will fund research to:

    • develop new and improved diagnostic tests, drug therapies, vaccines and epidemiologic and laboratory methods for detecting, controlling, and preventing infectious diseases.

    • develop new monitoring tools needed to detect emerging infectious diseases.

    • study the relationship between drug abuse and the spread of infectious diseases to help develop more effective prevention strategies.

    • learn more about negative reactions to vaccines to improve vaccine safety and vaccination coverage levels.

• Objective 1.8 - Reduce the Impact of Environmental Factors on Human Health

  • How We Will Accomplish Our Objective

    We will help state and local health agencies develop and implement surveillance and prevention programs that reduce environmental threats. We will focus our efforts on reducing threats to children by helping state and local agencies:

    • develop and implement effective environmental interventions to prevent and reduce the onset, suffering, and disproportionate burden of illness related to asthma.

    1.8 Implementation Strategies

    Surveillance/Prevention Programs Education Research

    • identify children at risk for lead poisoning.

    We will support the national effort to reduce environmental threats to health by:

    • conducting research to better understand the relationship between exposure to toxic substances and human health, develop new and improved biomonitoring methods and prevention strategies, and identify the risk and protective factors for birth defects.

    • monitoring the exposure to toxic substances and identifying and reporting health threats.

    • educating health care providers about the consequences of exposure to toxic substances and the availability and value of using existing information systems to prevent and combat environmental health problems.

    HHS Agencies contributing to this objective:

    ATSDR
    CDC
    HCFA
    NIH
    OS