Workers using Healthy People goals to improve local health: Objectives guide work in communities
================================================================================================

* Kim Krisberg

Forty years since the U.S. Healthy People initiative first began, public health workers are still successfully using the decade-long objectives to drive health improvements on the ground.

“State, local and territorial health departments benefit tremendously from using Healthy People 2020 to drive action on national objectives that most directly affect the communities which they serve,” Carter Blakey, deputy director of the U.S. Office of Disease Prevention and Health Promotion, which oversees Healthy People, told *The Nation’s Health*.

Healthy People 2020 includes more than 1,200 objectives on a wide range of disease and health measures, which track high-priority determinants that shape health and quality of life. While Healthy People sets national goals, state and local health workers have long leveraged its data, tools and objectives to advance efforts at the community level, such as using it to track progress, rally cross-sector stakeholders, and learn about evidence-based health interventions.

In Texas, public health workers use Healthy People to help drive support for expanding HIV testing access, said Jenny McFarlane, HIV prevention manager at the Texas Department of State Health Services. The work began a few years after the Centers for Disease Control and Prevention recommended that HIV screening become a routine part of care. By 2008, however, McFarlane said it was clear that the 2006 recommendations “were not opening up doors to testing like we had hoped.” So she and colleagues in the agency’s HIV-STD Program decided to knock on the doors themselves.

They reached out to and partnered with a variety of health care settings — hospitals, emergency centers, community and correctional health centers — to help providers integrate routine HIV testing. For example, McFarlane and colleagues partnered with large hospitals in the Houston and Dallas areas to integrate HIV testing into emergency care — an especially important strategy for reachrt has shown it is possible for large health systems to successfully fold routine HIV testing into their everyday services.

“It’s definitely helped us engage with providers who are already familiar with (the initiative),” McFarlane said of Healthy People’s role in their HIV work. “It gives you a common language for talking with stakeholders in your community, whether that be a community member, a hospital administrator or a policymaker.”

![Figure1](http://www.thenationshealth.org/http://www.thenationshealth.org/content/nathealth/49/4/8.1/F1.medium.gif)

[Figure1](http://www.thenationshealth.org/content/49/4/8.1/F1)

Healthy People 2020 has inspired public health programs across the nation, including strategies to deter tobacco use.

Photo by Tom Foldes, courtesy iStockphoto

To the north in Minnesota, successful efforts to reduce tobacco use were featured in a recent ODPHP webcast on achieving Healthy People 2020 indicators on tobacco. Laura Oliven, MPP, Tobacco Control Program manager at the Minnesota Department of Health, said a concerted focus on policy, systems and environmental change has been central in driving tobacco use to new lows.

Over the decades, and in conjunction with multiple partners, the Minnesota health department has helped advance a variety of effective tobacco control strategies, from higher taxes to stronger indoor air laws, ultimately driving the state’s tobacco use rate to the lowest numbers on record.

Now, Oliven told *The Nation’s Health*, health workers are turning their attention to advanced control strategies, such as raising the tobacco purchasing age to 21 and expanding indoor air policies to include e-cigarettes, which she said threaten to disrupt a 17-year downward trend in youth tobacco use.

Oliven noted that Healthy People not only helps set common goals for tobacco prevention, but also serves as a reminder that tobacco use remains a leading cause of preventable death.

“It gives us a numeric goal that we can all work together toward,” she said of Healthy People. “I think it’s a really valuable framework and umbrella structure for public health.”

Both the Texas and Minnesota experiences are among the many highlighted in Healthy People’s online bank of local health improvement stories — for more, visit [bit.ly/healthypeoplestories](http://bit.ly/bit.ly/healthypeoplestories).

For more on Healthy People 2020 and the upcoming Healthy People 2030, visit [www.healthypeople.gov](http://www.healthypeople.gov).

*   Copyright The Nation’s Health, American Public Health Association