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V. Committee Votes

  • All 14 topic areas within the recommendations were unanimously approved by the Committee.
  • All the indicators of each topic area were unanimously approved by the Committee. However, there was an amendment in the wording within the Healthy and Active Lifestyle indicator – the Committee recommended that a comment be included to reword the phrase to make it inspirational.
  • All three recommendations of the Subcommittee on Leading Health Indicators were unanimously approved by the Committee.

During the vote, the Committee discussed a proposed amendment in wording to an LHI objective (i.e., “improve food security” instead of “reduce food insecurity”). Dr. Kumanyika stated that food insecurity can be measured and that a change to “food security” would not accurately reflect current metrics. She asks the Committee to consider leaving the wording as is while noting to HHS that a positive statement could have been more effective. A Committee member disagreed, stating that empowering, affirmative language should be used when addressing health disparities. Dr. Manderscheid responded, saying that the Committee should use language appropriate to the actual measurement of the concept and that similar comments about wording could be made regarding other indicators. Dr. Kumanyika noted that the field has not yet evolved to having measures of satiety and that the concept of food security could convey more than intended. A Committee member agreed, saying that the Committee should use the term appropriate to the measure and that food security is not simply the inverse of food insecurity.

Dr. Manderscheid added that the proposed switch in wording brings up areas that cannot currently be measured and broadens the conceptual framework. Ms. Blakey noted that the Committee has tried to put forward an objective that is inspirational, but further conversation has clarified that the original wording should remain. She added that if the Committee later learns that the wording is inconsequential then they can give direction to HHS concerning a potential re-phrasing of the objective. A Committee member stated that the Committee can make a helpful suggestion to HHS and the appropriate agency can pursue the creation of metrics for food security. A Committee member confirmed that “reduce food insecurity” is currently being used in the Healthy People 2020 list of objectives and governs data collection. Dr. Manderscheid made a motion to keep the wording of the LHI indicator as it currently is but to make a recommendation to HHS to explore the concept of food security and come to a resolution in tandem with the Department of Agriculture.

VI. Next Steps

The Committee’s Final Report on the LHIs for Healthy People 2020 will be circulated to the Committee and then submitted to the Secretary. The Final Report will be considered as HHS finalizes the LHIs for Healthy People 2020.

This final meeting marks the retirement of the Secretary’s Advisory Committee. Ms. Blakey expressed her appreciation for the Committee’s tremendous effort in developing the LHI recommendations. She thanked the Committee for their invaluable work in advancing the development and implementation of Healthy People 2020 and praised them for their hard work in expanding the focus of Healthy People 2020 through drawing attention to the social determinants of health. She stated that the Committee has taken Healthy People into the Internet-age and initiated the use of social media tools. She informed the Committee that a farewell meeting will be organized with Dr. Howard Koh.

Dr. Kumanyika stated that she is so fortunate to have worked with ODPHP and NORC. She expressed her gratitude to RADM Penny Slade Sawyer and the Committee Chair, Dr. Fielding. Several Committee members expressed their gratitude for the opportunity to serve on the Committee. A Committee member noted the importance of the work around creating health equity and that this work must remain central to our focus, as health is a basic human right. Another member stated that the experience has inspired and reaffirmed a commitment for equity and justice. She reminded the Committee that they have made contributions on a national level but at the end of the day, public health is local and must be a daily commitment. Dr. Manderscheid added that ODPHP and Healthy People 2020 are well-positioned to move the health agenda of the US through shifting focus from disease to health, addressing problems at both national and local levels, and drawing attention to health equity. Dr. Kumanyika thanked the Committee for their participation and the meeting was adjourned.

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