Q&A: APHA’s Georges Benjamin discusses Leading Health Indicators with HHS leader Howard Koh: Set of Healthy People 2020 objectives guiding health of nation ================================================================================================================================================================= * Natalie McGill *Healthy People 2020, a comprehensive federal roadmap of health benchmarks, puts Americans on a path to better health and wellness. The plan includes a set of 26 priority objectives known as the Leading Health Indicators. The U.S. Department of Health and Human Services began work in 2010 on the most recent set of Leading Health Indicators, which span 12 topic areas such as oral health, substance abuse and access to health services.* *Howard Koh, MD, MPH, assistant secretary for health at HHS, sat down with APHA Executive Director Georges Benjamin, MD, in March to talk about the Leading Health Indicators and how communities can use them to improve health.* ## Benjamin: The Leading Health Indicators are a part of Healthy People 2020. There are many people who don’t know what they are. Could you tell us a little bit about them? Koh: We’re very proud of Healthy People 2020, I’d like to say we need a 20/20 vision for a healthier future. We’ve had Healthy People for the last number of decades, putting out a vision for a healthier country and putting out goals and targets that are pretty comprehensive. Right now, Healthy People has some 42 topic areas and over 1,200 objectives, so it’s very, very comprehensive. And people wanted a more focused area of high priority topics that could really make a difference for the public’s health. Starting in 2010 we started putting out the Leading Health Indicators — these are high-priority areas. And if we act aggressively as a nation in those areas, we can really make a difference, so that’s what the Leading Health Indicators are all about. We’re very proud of how it’s motivated action all around the country. ## Benjamin: Trying to focus on just these 12 (topic areas) is important. Can you tell us a little bit more about them, specifically? I know that one, for example, is access to care. Koh: Access to health care is important in the era of health reform. We’re living history through the Affordable Care Act and we’re trying to enroll millions of previously uninsured people. We’re stressing clinical preventive services. Of course, we have some traditional areas like tobacco and obesity that we’ve been tracking for a long time. ![Figure1](http://www.thenationshealth.org/http://www.thenationshealth.org/content/nathealth/44/4/11/F1.medium.gif) [Figure1](http://www.thenationshealth.org/content/44/4/11/F1) Benjamin, left, discusses the Leading Health Indicators with Koh. A video of the interview is on The Nation’s Health website. And then a new theme for the Leading Health Indicators is the social determinants of health and that’s really the future of public health action. I‘d like to say that health is much more than what happens to you in a doctor’s office, it’s where people live, labor, learn, play and pray. If you want to keep people healthier, you need — in addition to good direct care — healthy homes, healthy workplaces, healthy schools, good recreational areas. So we need that broad health in all policies approach, and that’s what we’re trying to promote with the Leading Health Indicators as well. ## Benjamin: I remember when you came to APHA in 2011 and you released (the indicators) at our Annual Meeting. So let’s talk about some more examples of how one can use those Leading Health Indicators. Koh: What we’re very proud of is the indicators give these high-priority areas a special focus that can be used at a national level to look at the data and then to align efforts and drive action. But we’re also very proud that we can use it at the state level and most importantly at the local level. States like Wisconsin have set up healthiest people 2020 efforts. We’re very proud of that. And we have a new webinar series called “Who’s Leading the Leading Health Indicators?” where we try to feature community heroes, people who have embraced the Leading Health Indicators and really made Healthy People intervention come alive. So we’re very proud of that. ## Benjamin: Let’s talk about those webinars. Do they cost anything? Koh: Webinars are free. We have them on a regular basis. We have well over 1,000 people each month on those webinars and it really crosses throughout the country in terms of its broad appeal and interest. We try to go through each topic area at a time. We also have a monthly bulletin that reaches over 30,000 people a month, so in these ways we try to keep Healthy People alive and vibrant and really aligning the action from coast to coast. ## Benjamin: You can go to the HHS website, I assume, and find all this information? Koh: We’ve now moved very aggressively onto the Web. [HealthyPeople.gov](http://HealthyPeople.gov) is a very vibrant, interactive website. You can get data that’s relevant to your area of interest and oftentimes at the state level and local level as well. We have e-learning courses. We have summaries of effective evidence-based effective interventions on the community level that make social determinants approaches come alive. So this is a really vibrant tool, and one that really captures the whole public health community. ## Benjamin: Any final information to share about the indicators? Koh: We’re very proud that this is really a community-driven, a stakeholder-driven process. We at the federal level help coordinate this, and I really want to thank our leaders in the (HHS) Office of Disease Prevention and Health Promotion who have coordinated this for a long, long time. We also have a federal interagency work group that has worked long and hard on developing these objectives and tracking them. We’ve had an advisory committee weigh in, so we’ve had multiple experts forging these indicators and tracking progress. But we, again, view the action coming from the local level. So we have Leading Health Indicator and Healthy People coordinators at the local level. We often have them in the state health departments working with us. That’s important to me as a former state health official. We have this throughout society and coast-to-coast, federal, state and local levels and, most important of all, based in the community. *For more information about the Leading Health Indicators, visit [www.healthypeople.gov/2020/LHI](http://www.healthypeople.gov/2020/LHI).* *For the webinar series, visit [www.healthypeople.gov/2020/learn/webinarsArchive.aspx](http://www.healthypeople.gov/2020/learn/webinarsArchive.aspx). APHA is providing free continuing education credit for the webinars.* *Watch a video of Benjamin and Koh’s conversation on The Nation’s Health website [video page](http://thenationshealth.aphapublications.org/site/misc/videos.xhtml).* * Copyright The Nation’s Health, American Public Health Association