The Committee briefly reviewed the draft outline for the report. Key
topics to be addressed included the value of prevention, health IT, and
preparedness in public health. The committee moved on to discuss and
finalize the preamble. Dr. Kumanyika indicated that the current draft
incorporates the concepts of leadership, vision, and the belief that
socioeconomic factors are critical determinants of health. It generally
consists of motivational language outlining the purpose of the Healthy
People 2020 objectives. Even though it says who the audiences are, it
doesn't really state who is writing the preamble. She asked whether this
document should be read as coming from the Secretary, or the Committee.
The document does not convey a sense of governmental responsibility, but
in some places seems to suggest that responsibility lies with citizens
themselves. She felt it was important that the preamble not be silent on
the issue of who is doing the talking.
Dr. Fielding expressed the view that this should be considered the
preamble to the Committee's September report to the Secretary. The tone
and language of the preamble would be directed toward the Secretary. NORC
staff clarified that the current draft was based on a document that had
been prepared in 2007 by a "Technical Expert Panel" that had convened to
make recommendations for the Healthy People 2020 framework. That version
had been intended to serve as a preamble to the Healthy People 2020
objectives themselves. After some discussion, the Committee felt that the
document should be modified and offered to the Secretary as a suggestion
for the HHS preamble. While the Committee is in an advisory role, they
felt it would be important for the Secretary's voice to be behind the
objectives. They agreed to modify the preamble draft as a suggested
approach for the Secretary to consider.
Dr. Fielding noted that Ron Manderscheid had asked for time on the agenda
to propose the addition of a new goal. Dr. Manderscheid asked the
committee to consider adding a goal on health information technology and
health communication. He summarized the work that he had done with some
representatives of the FIW who have been addressing these issues. They
defined a set of requirements having to do with what type of information
technology system population health should have, how it should be driven,
what role health communication should have, and how efforts should relate
to the Office of the National Coordinator for Health IT (ONC) strategic
plan. Dr. Manderscheid went on to say that Healthy People 2020 should
include a strong focus on health IT and health communication. He described
early planning to create a "Healthy People Community" that would include
the IT infrastructure for Healthy People 2020. He described these plans in
Dr. Fielding noted that Dr. Manderscheid's presentation was, in essence,
the outline for the health IT section in the final report. He asked
whether this would be a Committee product that would be endorsed by the
FIW. Dr. Manderscheid clarified that it would be both an Advisory
Committee and FIW product. He thought the two groups should carry the same
message as frequently as possible, although there are differences between
the groups. Dr. Fielding agreed that it makes sense to harmonize whenever
possible, although these are two different groups with different charges.
He asked Dr. Manderscheid to produce a draft of the document by August.
A Committee member pointed out that, historically, the goals have been
broad statements of what Healthy People 2020 will achieve and cautioned
against including processes and infrastructure issues. Another member
asked whether technology-based health literacy has been discussed. Dr.
Manderscheid indicated that health literacy will be part of the health IT
subgroup's efforts, and that this will be part of the recommendations that
will be made. Dr. Fielding suggested that health IT may be how to achieve
the goals, rather than a goal in itself. The issue of whether to consider
an additional goal about health IT was tabled until the next meeting.
VIII. Preparations for the September Meeting
The September meeting will involve reviewing an integrated draft of a
final report for Phase I of the Committee's activities, as well as an
initial foray into topics for Phase II of the group's work. Topics that
will be important to address include the organizational structure of the
Healthy People report or database. The Committee will also work with ODPHP
to clarify the charge for the second year of its work. NORC will
distribute a draft of the report in advance of the September meeting, and
Committee members should plan to comment on that fairly quickly. Dr.
Fielding said that the main task for the September meeting will be to get
final agreement on the Advisory Committee's Phase I report to the
With regard to logistics for the next meeting, Dr. Fielding said it
might be best to use WebEx as a vehicle for future meetings—even if they
are full day meetings on successive days. After some discussion, the group
agreed that the September meeting would consist of two WebEx meetings
lasting six hours each; members should block off time in the afternoons of
both days so that they can work on writing assignments.
IX. Summary and Closing Remarks
Dr. Fielding thanked the Committee members for their commitment to this
very important process, and expressed his hopes that their work would be
helpful to the HHS Secretary and to the FIW.