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NC
Health Objectives 2010 -
User's Guide
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| The Governor’s
Task Force for Healthy Carolinians (GTF/HC) appointed five committees
to develop the North Carolina 2010 Health Objectives: Maternal and
Young Child, Child and Adolescent, Adult, Older Adult, and Community
Health. Each committee met at least monthly between August 1999 and
May 2000. Each committee’s membership was made up of GTF/HC members,
local Healthy Carolinians Task Force members, as well as professionals
representing agencies, programs, and organizations that specifically
target the age group being studied. The GTF/HC charged each committee
to study the issues that challenge the health and well being of North
Carolinians. The committees were also charged to be inclusive and
to study other North Carolina statewide plans, programs, and initiatives
that are focused on the same issues. The GTF/HC asked for health objective
recommendations that would support the work of health professionals,
both public and private, across the state and bring about collaborative
efforts.
Each committee set its own agenda and
determined subject areas for study and discussion. For each subject
studied, experts were invited to present detailed information about
(1) the issues, problems, and determinants/risk factors, (2) data
that demonstrated the problems and identified the disparities, and
(3) solutions – resources that exist, resources and policies
that are needed. Based on the information presented, the committee
developed their recommendations for health objectives.
Governmental and other agency representatives,
university faculty and research centers staff, advocacy groups,
and healthcare practitioners provided much guidance in developing
the health objectives.
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Process for
Developing North Carolina’s 2010 Health Objectives
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The health objectives are grouped into 12 major
focus areas. For most of the focus areas, specific health or safety
issues are listed. For example: Chronic Disease is a major focus area.
The specific health issues listed within that focus area are: Arthritis
and Osteoporosis, Asthma, Cancer, Diabetes, Heart Disease and Stroke,
and Overweight and Obesity.
Where possible, the Governor’s Task
Force for Healthy Carolinians worked collaboratively to support
the existing work and objectives of many statewide initiatives.
Many of the Health Objectives and items listed in the Call for Action
section are extracted from various state-level plans, such as: 2000
Child Health Report, NC institute of Medicine Task Force on Dental
Care Access, North Carolina Cancer Control Plan, State Aging Services
Plan, and Plan to Prevent Heart Disease and Stroke.
Focus areas include:
- Recommended health objectives and 2010 targets,
- Discussion and description of the issue,
- Discussion of health disparities,
- Description of the determinants and risk factors,
- Data to support the health objectives (when possible broken
out by race/ethnicity, gender, age, income, or education level,
and geographic location), and
- Call to Action
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Criteria
for Developing the Objectives
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The Governor’s
Executive Order that established the Governor’s Task Force for
Healthy Carolinians spelled out six goals for developing North Carolinian’s
health objectives for the Year 2010.
"The Governor’s Task Force shall have
the responsibility of developing and delivering to the Governor
a list of health objectives for the Year 2010 for the citizens of
North Carolina designed to:
- Increase the span of healthy life of the citizens of North Carolina;
- Remove health disparities among the disadvantaged;
- Promote access to preventive health services;
- Protect the public’s health;
- Foster positive and supportive living and working conditions
in our communities; and
- Support individuals."
"These objectives must:
- Be measurable;
- Include measures to benefit our disadvantaged populations;
- Emphasize individual and community intervention;
- Emphasize the value of health promotion and disease prevention
to our society; and
- Be obtainable by the Year 2010."
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Definitions
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The following Definitions adapted from Healthy
People 2010, were used in developing the health objectives:
Health Disparities: Differences in health
status among distinct segments of the population including differences
that occur by gender, race or ethnicity, education or income, disability,
and geographic location.
Determinants of Health: The array of
critical influences that determine the health of individuals including
biology (individual’s genetic makeup that may suggest a risk
for disease), behaviors, social environment (interactions with family,
friends, coworkers, and others), physical environment, policies,
and access to health care.
Geographic Location: Where possible,
data were complied by two geographic categories. Each county has
two designations (1) either urban or rural, and (2) within a region
- Eastern North Carolina, Piedmont North Carolina, and Western North
Carolina.
An Urban/Rural classification has been defined.
Ten counties have been classified as Urban (Buncombe, Cumberland,
Davidson, Durham, Forsyth, Gaston, Guilford, Mecklenburg, Onslow,
and Wake) and the rest are Rural. This classification scheme is
from NC Public Health Accountability Regions.
The state demographer and the GIS lab at the
State Center for Health Statistics have produced a Geographic Regional
Classification scheme based on "physiographic" qualities.
Western Region: The counties west of (and including) Surry, Wilkes,
Caldwell, Burke, and Rutherford. Eastern Region: Everything east
of (and including) Northampton, Halifax, Nash, Johnston, Cumberland,
Hoke, Harnett, and Scotland. Piedmont Region: The counties in between
the Western Region and the Eastern Region.
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Piedmont |
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| Western |
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Eastern |
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Types
of Objectives
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There are two
types of objectives listed in this document – measurable and
developmental.
Measurable Objectives: Measurable
objectives have a baseline using valid and reliable data derived
from currently established data systems. These data provide the
point from which the 2010 target has been set. Where possible, objectives
are measured with data that can be found at the local level for
use by local public health departments, Healthy Carolinians Task
Forces, and other community groups, agencies, and organizations.
The data source is noted with the baseline data for the objective.
Ninety-one of the 110 objectives are measurable.
Developmental Objectives:
Developmental objectives are not measurable at this time because
there are no data on these subjects. However, because data are currently
being collected or analyzed and will be available in 2001, these
Developmental objectives have been included. There are 19 of these
objectives recommended in this report with Targets to be set in
2001.
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Data
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When possible, a standard data table is used to
display the current status of population groups. The standard data
table is adapted from Healthy People 2010. The data identify where
health disparities exist at the state level and will guide state level
policy makers and program managers. The data tables will also enable
communities and program managers to use the health objectives to provide
direction for action. Healthy Carolinians Task Forces, community programs,
and local agencies will examine their own data and compare their data
to the state data to determine appropriate action. (See Appendix D
for more information about data sources.)
The mortality data, unless otherwise stated,
are age-adjusted to the year 2000 U.S. standard population.
The data in this report are state level data.
Some of these data are available at the county level. Where possible,
the State Center for Health Statistics will help local groups with
county level data. For county-specific data, contact:
State Center for Health Statistics
Agency homepage: http://www.schs.state.nc.us./SCHS
Agency phone: (919) 733-4728
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Target Setting
Methods
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One
Target has been set for each objective for all population groups (unless
otherwise stated) to reach by the year 2010. This supports the overarching
goal of eliminating health disparities. The following target setting
methods have been used:
- For eliminating health disparities,
the Target Setting Method is "better than the best"
population group. This provides a challenge for all population
groups that are defined in the baseline data.
- For building collaboration and coordination
among existing programs, the Target Setting Method is "Guidance
or Recommendation" of Division or existing programs. (Consistent
with ____).
- For objectives for which it is unlikely
that equal health outcomes will be achieved for all populations
within 10 years, the Target Setting Method is to set levels that
represent improvement. (____ percent improvement).
- For those objectives where it is
possible, the Target Setting Method is "complete elimination"
or "total coverage." (Targets like 0 percent or 100
percent or all Counties).
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