HP2020objectives

Healthy People 2020 Objective Topic Areas and Page Numbers

Access to Health Services…2 Heart Disease and Stroke…150

Adolescent Health…8 HIV…160

Arthritis, Osteoporosis, and Chronic Back Immunization and Infectious Diseases…166
Conditions…15
Injury and Violence Prevention…185
Blood Disorders and Blood Safety…21
Lesbian, Gay, Bisexual, and Transgender
Cancer…27 Health *

Chronic Kidney Disease…35 Maternal, Infant, and Child Health…202

Dementias, including Alzheimer’s Medical Product Safety…221
Disease…43
Mental Health and Mental Disorders…225
Diabetes…45
Nutrition and Weight Status…230
Disability and Health…51
Occupational Safety and Health…242
Early and Middle Childhood…59
Older Adults…247
Educational and Community-Based
Programs…64 Oral Health…253

Environmental Health…87 Physical Activity…263

Family Planning…106 Preparedness…273

Food Safety…118 Public Health Infrastructure…276

Genomics…125 Respiratory Diseases…286

Global Health…127 Sexually Transmitted Diseases…294

Health Communication and Health Sleep Health…300
Information Technology…130
Social Determinants of Health *
Healthcare-Associated Infections…136
Substance Abuse…302
Health-Related Quality of Life and Well-
Being * Tobacco Use…315

Hearing and Other Sensory or Vision…331
Communication Disorders…138

* Objectives for these topic areas are under development.
1

Healthy People 2020 Summary of Objectives

Access to Health Services
Number Objective Short Title
AHS–1 Persons with health insurance

AHS–2 Health insurance coverage for clinical preventive services

AHS–3 Persons with usual primary care provider

AHS–4 Practicing primary care providers

AHS–5 Source of ongoing care

AHS–6 Inability to obtain or delay in obtaining necessary medical care, dental care or
prescription medicines

AHS–7 Receipt of evidence-based clinical preventive services

AHS–8 Rapid prehospital emergency care

AHS–9 Wait time at emergency departments

AHS-1
2

Topic Area: Access to Health Services
AHS-1: Increase the proportion of persons with health insurance.

AHS-1.1 Medical insurance.

Target: 100 percent.

Baseline: 83.2 percent of persons had medical insurance in 2008.

Target setting method: Total coverage.

Data source: National Health Interview Survey (NHIS), CDC, NCHS.

AHS-1.2 (Developmental) Dental insurance.

Potential data source: National Health Interview Survey (NHIS), CDC, NCHS.

AHS-1.3 (Developmental) Prescription drug insurance.


AHS-2: (Developmental) Increase the proportion of insured persons with coverage for clinical
preventive services.

Potential data sources: Children’s Health Insurance Program (CHIP), CMS; AGing Integrated
Database (AGID), AoA; CMS claims data and Medicare Current Beneficiary Survey (MCBS),
CMS.

AHS-3: Increase the proportion of people with a usual primary care provider.

Target: 83.9 percent.

Baseline: 76.3 percent of persons had a usual primary care provider in 2007.

Target setting method: 10 percent improvement.

Data source: Medical Expenditure Panel Survey (MEPS), AHRQ.

AHS-4: (Developmental) Increase the number of practicing primary care providers.

AHS-4.1 (Developmental) Medical doctor.

Potential data source: American Medical Association (AMA) Masterfile, AMA.

AHS-4.2 (Developmental) Doctor of osteopathy.

Potential data source: American Osteopathic Association (AOA) Masterfile, AOA.

AHS-2
3

AHS-4.3 (Developmental) Physician assistant.

Potential data source: American Academy of Physician Assistants (AAPA) Census, AAPA.

AHS-4.4 (Developmental) Nurse practitioner.

Potential data source: National Provider Identifier (NPI) Registry, CMS.

AHS-5: Increase the proportion of persons who have a specific source of ongoing care.

AHS-5.1 All ages.


Baseline: 86.4 percent of persons of all ages had a specific source of ongoing care in 2008.



AHS-5.2 Children and youth aged 17 years and under.


Baseline: 94.3 percent of children and youth aged 17 years and under had a specific source of
ongoing care in 2008.

Target setting method: 6.0 percent improvement.


AHS-5.3 Adults aged 18 to 64 years.


Baseline: 81.3 percent of persons aged 18 to 64 years had a specific source of ongoing care in
2008.



AHS-5.4 Adults aged 65 years and older.


Baseline: 96.3 percent of persons aged 65 years and older had a specific source of ongoing
care in 2008.


AHS-3
4

Data source: National Health Interview Survey (NHIS), CDC.

AHS-6: Reduce the proportion of individuals who are unable to obtain or delay in obtaining
necessary medical care, dental care, or prescription medicines.

AHS-6.1 Individuals: medical care, dental care, or prescription medicines.


Baseline: 10.0 percent of all persons were unable to obtain or delayed in obtaining necessary
medical care, dental care, or prescription medicines in 2007.



AHS-6.2 Individuals: medical care.


medical care in 2007.



AHS-6.3 Individuals: dental care.


dental care in 2007.



AHS-6.4 Individuals: prescription medicines.


prescription medicines in 2007.



AHS-4
5

AHS-7: (Developmental) Increase the proportion of persons who receive appropriate evidence-
based clinical preventive services.

Potential data source: Medical Expenditure Panel Survey (MEPS), AHRQ.

AHS-8: (Developmental) Increase the proportion of persons who have access to rapidly
responding prehospital emergency medical services.

AHS-8.1 Population covered by basic life support.

Potential data source: National EMS Information System (NEMSIS).

AHS- 8.2 Population covered by advanced life support.

Potential data source: National EMS Information System (NEMSIS).

AHS-9: (Developmental) Reduce the proportion of hospital emergency department visits in
which the wait time to see an emergency department clinician exceeds the recommended
timeframe.

AHS-9.1 (Developmental) All Visits.

Potential data source: National Hospital Ambulatory Medical Care Survey (NHAMCS), CDC,
NCHS.

AHS-9. 2 (Developmental) Level 1: Immediate.

NCHS.

AHS-9. 3 (Developmental) Level 2: Emergent.

NCHS.

AHS-9. 4 (Developmental) Level 3: Urgent.

NCHS.

AHS-9. 5 (Developmental) Level 4: Semiurgent.

NCHS.

AHS-5
6

AHS-9. 6 (Developmental) Level 5: Nonurgent.

NCHS.

AHS-6
7


Adolescent Health

AH–1 Adolescent wellness checkup

AH–2 Afterschool activities

AH–3 Adolescent-adult connection

AH–4 Transition to self-sufficiency from foster care

AH–5 Educational achievement

AH–6 School breakfast program

AH–7 Illegal drugs on school property

AH–8 Student safety at school as perceived by parents

AH–9 Student harassment related to sexual orientation and gender identity

AH–10 Serious violent incidents in public schools

AH–11 Youth perpetration of, and victimization by, crimes

AH–1
8

Topic Area: Adolescent Health
AH–1 Increase the proportion of adolescents who have had a wellness checkup in the past 12
months.


Baseline: 68.7 percent of adolescents aged 10 to 17 years had a wellness checkup in the past
12 months, as reported in 2008.



AH–2: Increase the proportion of adolescents who participate in extracurricular and out-of-
school activities.


Baseline: 82.5 percent of adolescents aged 12 to 17 years participated in extracurricular and/or
out-of-school activities in the past 12 months, as reported in 2007.


Data source: National Survey of Children’s Health (NSCH), HRSA, MCHB; CDC, NCHS.

AH–3: Increase the proportion of adolescents who are connected to a parent or other positive
adult caregiver.

AH–3.1 Increase the proportion of adolescents who have an adult in their lives with whom
they can talk about serious problems.


Baseline: 75.7 percent of adolescents aged 12 to 17 years had an adult in their lives with whom
they could talk about serious problems, as reported in 2008.


Data source: National Survey on Drug Use and Health (NSDUH), SAMHSA.

AH–3.2 Increase the proportion of parents who attend events and activities in which their
adolescents participate.


Baseline: 82.1 percent of parents of adolescents aged 12 to 17 years who participated in
extracurricular or out-of-school activities during the past 12 months usually or always attended
events and activities in which their adolescents participated, as reported in 2007.

AH–2
9



AH–4: (Developmental) Increase the proportion of adolescents and young adults who transition
to self-sufficiency from foster care.

Potential data source: National Youth in Transition Database (NYTD), ACF, ACYF.

AH–5: Increase educational achievement of adolescents and young adults.

AH–5.1 Increase the proportion of students who graduate with a regular diploma 4 years
after starting 9th grade.


Baseline: 74.9 percent of students attending public schools graduated with a regular diploma in
2007-08, 4 years after starting 9th grade.


Data source: Common Core of Data (CCD), State Nonfiscal Survey of Public
Elementary/Secondary Education, ED, IES, NCES.

AH–5.2 Increase the proportion of students who are served under the Individuals with
Disabilities Education Act who graduate high school with a diploma.


Baseline: 59.3 percent of students aged 14 to 21 years served under the Individuals with
Disabilities Education Act who exited high school in 2007–08 graduated with a diploma.


Data source: Individuals with Disabilities Education Act, ED, OSEP, DANS.

AH–5.3 Increase the proportion of students whose reading skills are at or above the
proficient achievement level for their grade.

AH–5.3.1 Fourth (4th) grade.


Baseline: 33.0 percent of 4th grade students, including those who attended public and private
schools, had reading skills at or above the proficient achievement level for their grade in 2009.


Data source: National Assessment of Educational Progress, ED, IES, NCES.

AH–3
10

AH–5.3.2 Eighth (8th) grade.





AH–5.3.3 Twelfth (12th) grade.





AH–5.4 Increase the proportion of students whose mathematics skills are at or above the
proficient achievement level for their grade.

AH–5.4.1 Fourth (4th) grade.


schools, had mathematics skills that were at or above the proficient achievement level for their
grade in 2009.



AH–5.4.2 Eighth (8th) grade.


grade in 2009.



AH–5.4.3 Twelfth (12th)grade.


AH–4
11

grade in 2005.



AH–5.5 Increase the proportion of adolescents who consider their school work to be
meaningful and important.


Baseline: 26.6 percent of adolescents aged 12 to 17 years always considered their school work
to be meaningful and important, as reported in 2008.



AH–5.6 Decrease school absenteeism among adolescents due to illness or injury.


Baseline: 14.6 percent of adolescents aged 12 to 17 years missed 11 or more whole school
days due to illness or injury in the previous 12 months, as reported in 2008.



AH–6: Increase the proportion of schools with a school breakfast program.


Baseline: 68.6 percent of schools overall, including public and private elementary, middle and
high schools, had a school breakfast program in 2006.


Data source: School Health Policies and Programs Study (SHPPS), CDC, NCCDPHP.

AH–7: Reduce the proportion of adolescents who have been offered, sold, or given an illegal
drug on school property.


Baseline: 22.7 percent of students in grades 9–12 were offered, sold, or given an illegal drug on
school property during the past 12 months, as reported in 2009.

AH–5
12


Data source: Youth Risk Behavior Surveillance System (YRBSS), CDC, NCCDPHP.

AH–8: Increase the proportion of adolescents whose parents consider them to be safe at
school.


Baseline: 86.4 percent of parents of adolescents aged 12 to 17 years reported that they felt their
child was usually or always safe at school, as reported in 2007.



AH–9: (Developmental) Increase the proportion of middle and high schools that prohibit
harassment based on a student’s sexual orientation or gender identity.

Potential data source: School Health Profiles Study (SHPS), CDC, NCCDPHP.

AH–10: Decrease the proportion of public schools with a serious violent incident.


Baseline: 17.2 percent of public schools overall, including primary, middle and high schools,
reported a serious violent incident in 2007–08.


Data source: School Survey on Crime and Safety (SSOCS), ED, IES, NCES.

AH–11: Reduce adolescent and young adult perpetration of, as well as victimization by, crimes.

AH–11.1 Decrease the rate of minor and young adult perpetration of violent crimes.

Target: 399.6 arrests per 100,000 population aged 10 to 24 years.

Baseline: 444.0 per 100,000 adolescents and young adults aged 10 to 24 years were arrested
in 2008 for perpetration of crimes included in the Violent Crime Index.


Data source: Violent Crime Index, Uniform Crime Reporting Program, DOJ, FBI, CJIS.

AH–11.2 Decrease the rate of minor and young adult perpetration of serious property
crimes.

Target: 1,374.0 arrests per 100,000 population aged 10 to 24 years.

AH–6
13

Baseline: 1,526.7 per 100,000 adolescents and young adults aged 10 to 24 years were arrested
in 2008 for perpetration of crimes included in the Property Crime Index.


Data source: Property Crime Index, Uniform Crime Reporting Program, DOJ, FBI, CJIS.

AH–11.3 (Developmental) Decrease the percentage of counties and cities reporting youth
gang activity.

Potential data source: National Youth Gang Survey, DOJ, OJP, OJJDP.

AH–11.4 (Developmental) Reduce the rate of adolescent and young adult victimization from
crimes of violence.

Potential data source: Criminal Victimization in the United States, DOJ, OJP, BJS.

AH–7
14


Arthritis, Osteoporosis, and Chronic Back Conditions

Arthritis

AOCBC–1 Joint pain

AOCBC–2 Activity limitation

AOCBC–3 Joint-related activities

AOCBC–4 Personal care limitations

AOCBC–5 Serious psychological distress

AOCBC–6 Employment

AOCBC–7 Receipt of health care provider counseling

AOCBC–8 Arthritis education

AOCBC–9 Seeing health care provider

Osteoporosis

AOCBC–10 Osteoporosis

AOCBC–11 Hip fractures

Chronic Back Conditions

AOCBC–12 Activity limitation due to chronic back conditions

AOCBC–1
15

Topic Area: Arthritis, Osteoporosis, and Chronic Back Conditions
Arthritis

AOCBC–1: Reduce the mean level of joint pain among adults with doctor-diagnosed arthritis.

Target: 5.0 mean pain level.

Baseline: 5.6 was the mean level of joint pain on a visual analog scale of 0 (no pain) to 10 (pain
as bad as it can be) among adults aged 18 years and older with doctor-diagnosed arthritis in
2006 (age adjusted to the year 2000 standard population).


Data source: National Health Interview Survey, CDC, NCHS.

AOCBC–2: Reduce the proportion of adults with doctor-diagnosed arthritis who experience a
limitation in activity due to arthritis or joint symptoms.


Baseline: 39.4 percent of adults aged 18 years and older with doctor-diagnosed arthritis
experienced a limitation in activity due to arthritis or joint symptoms in 2008 (age adjusted to the
year 2000 standard population).



AOCBC–3: Reduce the proportion of adults with doctor-diagnosed arthritis who find it “very
difficult” to perform specific joint-related activities.

AOCBC–3.1 Walk a quarter of a mile—about 3 city blocks.


Baseline: 15.2 percent of adults aged 18 years and older with doctor-diagnosed arthritis found it
“very difficult” to walk a quarter of a mile in 2008 (age adjusted to the year 2000 standard
population).



AOCBC–3.2 Walk up 10 steps without resting.


AOCBC–2
16

“very difficult” to walk up 10 steps without resting in 2008 (age adjusted to the year 2000
standard population).



AOCBC–3.3 Stoop, bend, or kneel.


“very difficult” to stoop, bend, or kneel in 2008 (age adjusted to the year 2000 standard
population).



AOCBC–3.4 Use fingers to grasp or handle small objects.


“very difficult” to use fingers to grasp or handle small objects in 2008 (age adjusted to the year
2000 standard population).



AOCBC–4: Reduce the proportion of adults with doctor-diagnosed arthritis who have difficulty in
performing two or more personal care activities, thereby preserving independence.


Baseline: 2.7 percent of adults aged 18 years and older with doctor-diagnosed arthritis had
difficulty in performing two or more personal care activities in 2008 (age adjusted to the year



AOCBC–5: Reduce the proportion of adults with doctor-diagnosed arthritis who report serious
psychological distress.


AOCBC–3
17

Baseline: 7.3 percent of adults aged 18 years and older with doctor-diagnosed arthritis reported
serious psychological distress in 2008 (age adjusted to the year 2000 standard population).



AOCBC–6: Reduce the impact of doctor-diagnosed arthritis on employment in the working-aged
population.

AOCBC–6.1 Reduction in the unemployment rate among adults with doctor-diagnosed
arthritis.


Baseline: 35.0 percent of adults aged 18 to 64 years with doctor-diagnosed arthritis were
unemployed in the past week in 2008 (age adjusted to the year 2000 standard population).



AOCBC–6.2 Reduction in the proportion of adults with doctor-diagnosed arthritis who are
limited in their ability to work for pay due to arthritis.


Baseline: 33.1 percent of adults aged 18 to 64 years with doctor-diagnosed arthritis were limited
in their ability to work for pay due to arthritis in 2006 (age adjusted to the year 2000 standard
population).



AOCBC–7: Increase the proportion of adults with doctor-diagnosed arthritis who receive health
care provider counseling.

AOCBC–7.1 For weight reduction among overweight and obese persons.


Baseline: 41.2 percent of overweight and obese adults aged 18 years and older with doctor-
diagnosed arthritis received health care provider counseling for weight reduction in 2006 (age
adjusted to the year 2000 standard population).


Data Source: National Health Interview Survey, CDC, NCHS.

AOCBC–4
18

AOCBC–7.2 For physical activity or exercise.


Baseline: 52.2 percent of adults aged 18 years and older with doctor-diagnosed arthritis
received health care provider counseling for physical activity or exercise in 2006 (age adjusted
to the year 2000 standard population).



AOCBC–8: Increase the proportion of adults with doctor-diagnosed arthritis who have had
effective, evidence-based arthritis education as an integral part of the management of their
condition.


Baseline: 10.6 percent of adults aged 18 years and older with doctor-diagnosed arthritis had
effective, evidence-based arthritis education as an integral part of the management of their
condition in 2006 (age adjusted to the year 2000 standard population).



AOCBC–9: Increase the proportion of adults with chronic joint symptoms who have seen a
health care provider for their symptoms.


Baseline: 72.0 percent of adults aged 18 years and older with chronic joint symptoms saw a
health care provider for their symptoms in 2008 (age adjusted to the year 2000 standard
population).



Osteoporosis

AOCBC–10: Reduce the proportion of adults with osteoporosis.


Baseline: 5.9 percent of adults aged 50 years and older had osteoporosis in 2005–08 (age


Data source: National Health and Nutrition Examination Survey, CDC, NCHS.

AOCBC–5
19

AOCBC–11: Reduce hip fractures among older adults.

AOCBC–11.1 Females aged 65 years and older.

Target: 741.2 hospitalizations per 100,000 population.

Baseline: 823.5 hospitalizations for hip fractures per 100,000 females aged 65 years and older
(age adjusted to the year 2000 standard population) occurred in 2007.


Data source: National Hospital Discharge Survey, CDC, NCHS.

AOCBC–11.2 Males aged 65 years and older.


Baseline: 464.9 hospitalizations for hip fractures per 100,000 males aged 65 years and older
(age adjusted to the year 2000 standard population) occurred in 2007.


Data source: National Hospital Discharge Survey, CDC, NCHS.

Chronic Back Conditions

AOCBC–12: Reduce activity limitation due to chronic back conditions.

Target: 27.6 adults per 1,000 population.

Baseline: 30.7 adults per 1,000 population aged 18 years and older experienced activity
limitation due to chronic back conditions in 2008 (age adjusted to the year 2000 standard
population).


Data Source: National Health Interview Survey, CDC, NCHS.

AOCBC–6
20


Blood Disorders and Blood Safety

Hemoglobinapthies

BDBS–1 Vaccinations of persons with hemoglobinopathies

BDBS–2 Patient and family referral for hemoglobinopathies

BDBS–3 Hemoglobinopathies care in a medical home

BDBS–4 Screening for complications of hemoglobinopathies

BDBS–5 Disease-modifying therapies for hemoglobinopathies

BDBS–6 Penicillin prophylaxis for sickle cell disease

BDBS–7 Hospitalizations for sickle cell disease

BDBS–8 High school completion among persons with hemoglobinopathies

BDBS–9 Community-based organizations campaigns for hemoglobinopathies

BDBS–10 Awareness of hemoglobinopathy carrier status

Bleeding and Clotting

BDBS-11 Vaccinations of persons with bleeding disorders

BDBS–12 Venous thromboembolism

BDBS–13 Venous thromboembolism during hospitalization

BDBS–14 Provider referrals for inherited bleeding disorders in women

BDBS–15 Diagnosis of von Willebrand Disease (vWD) in women

BDBS–16 Reduced joint mobility among persons with hemophilia

Blood Safety

BDBS–17 Blood donations

BDBS–18 Adverse events related to blood and blood products

BDBS-19 Blood product shortage

BDBS–1
21

Topic Area: Blood Disorders and Blood Safety

Hemoglobinapthies

BDBS–1: (Developmental) Increase the proportion of persons with hemoglobinopathies
who receive recommended vaccinations.

Potential data source: Registries and Surveillance in Hemoglobinopathies (RuSH), NIH
and CDC.

BDBS–2: (Developmental) Increase the proportion of persons with a diagnosis of
hemoglobinopathies and their families who are referred for evaluation and treatment.

and CDC.

who receive care in a patient/family-centered medical home.

and CDC.

hemoglobinopathies who receive early and continuous screening for complications.

and CDC.

who receive disease-modifying therapies.

and CDC.

BDBS–6: (Developmental) Increase the proportion of children with sickle cell disease
who receive penicillin prophylaxis from 4 months to 5 years of age.

and CDC.

BDBS–2
22

BDBS–7: (Developmental) Reduce hospitalizations due to preventable complications of
sickle cell disease among children aged 9 years and under.

Potential data sources: Sickle Cell Disease Treatment Demonstration Program
(SCDTDP), HRSA; Registries and Surveillance in Hemoglobinopathies (RuSH), NIH
and CDC.

hemoglobinopathies who complete high school education or a General Education or
Equivalency Diploma (GED) by 25 years of age.

and CDC.

BDBS–9: (Developmental) Increase the proportion of community-based organizations
(CBOs) that provide outreach and awareness campaigns for hemoglobinopathies.

and CDC.

BDBS–10: (Developmental) Increase the proportion of hemoglobinopathy carriers who
know their own carrier status.

and CDC.

Bleeding and Clotting

BDBS–11: (Developmental) Increase the proportion of persons with bleeding disorders
who receive recommended vaccinations.

Potential data source: Universal Data Collection Project (UDC), CDC.

BDBS–12 Reduce the number of persons who develop venous thromboembolism
(VTE).

Target: 48.9 per 10,000 population.

Baseline: 54.3 per 10,000 population aged 18 years and older developed venous
thromboembolism (VTE) in 2007 (age adjusted to the year 2000 standard population).


Data sources: National Ambulatory Medical Care Survey (NAMCS), CDC, NCHS;
National Hospital Ambulatory Medical Care Survey (NHAMCS), CDC, NCHS.

BDBS–3
23

BDBS–13: (Developmental) Reduce the number of adults who develop venous
thromboembolism (VTE) during hospitalization.

BDBS–13.1 (Developmental) VTE among adult medical inpatients.

Potential data source: National Hospital Discharge Survey (NHDS), CDC, NCHS.

BDBS–13.2 (Developmental) VTE among adult surgical patients.

Potential data sources: National Hospital Discharge Survey (NHDS), CDC, NCHS; Joint
Commission on Accreditation of Health Care Organizations (JCAHO) survey.

BDBS–14: (Developmental) Increase the proportion of providers who refer women with
symptoms suggestive of inherited bleeding disorders for diagnosis and treatment.

Potential data source: American College of Obstetricians and Gynecologists (ACOG)
Survey.

BDBS–15: Increase the proportion of women with von Willebrand disease (vWD) who
are timely and accurately diagnosed.


Baseline: 28.4 percent of females with von Willebrand disease (vWD) were timely and
accurately diagnosed in 2008.


Data source: Universal Data Collection Project (UDC), CDC.

BDBS–16: Reduce the proportion of persons with hemophilia who develop reduced
joint mobility due to bleeding into joints.


Baseline: 82.9 percent of persons with hemophilia developed reduced joint mobility due
to bleeding into joints in 2008.


Data source: Universal Data Collection Project (UDC), CDC.

BDBS–4
24

Blood Safety

BDBS–17: Increase the proportion of persons who donate blood.


Baseline: 6.1 percent of the population aged 18 years and older reported donating blood
within the past year in 2008 (age adjusted to the year 2000 standard population).



BDBS–18: (Developmental) Reduce the proportion of persons who develop adverse
events resulting from the use of blood and blood products.

BDBS–18.1 Due to transfusion-related acute lung injury (TRALI).

Potential data sources: National Healthcare Safety Network (NHSN) Hemovigilance
Module, CDC; National Blood Collection and Utilization Survey (NBCUS), HHS.

BDBS–18.2 Due to blood incompatibility.


BDBS–18.3 Due to transfusion-transmitted infections.


BDBS–18.4 Due to alloimmunization among persons with hemoglobinopathies.

Module, CDC; Registries and Surveillance in Hemoglobinopathies (RuSH), NIH and
CDC

BDBS–19: (Developmental) Reduce the proportion of persons who did not receive a
transfusion due to a blood product shortage.

BDBS–19.1 Persons who did not receive red blood cells.

Potential data sources: National Blood Collection and Utilization Survey (NBCUS), HHS

BDBS–5
25

BDBS–19.2 Persons who did not receive platelets.


BDBS–19.3 Persons who did not receive plasma derivatives.


BDBS–6
26


Cancer

C–1 Overall cancer deaths

C–2 Lung cancer deaths

C–3 Female breast cancer deaths

C–4 Uterine cervix cancer deaths

C–5 Colorectal cancer deaths

C–6 Oropharyngeal cancer deaths

C–7 Prostate cancer deaths

C–8 Melanoma deaths

C–9 Invasive colorectal cancer

C–10 Invasive uterine cervical cancer

C–11 Late-stage female breast cancer

C–12 Statewide cancer registries

C–13 Cancer survival

C–14 Mental and physical health-related quality of life of cancer survivors

C–15 Cervical cancer screening

C–16 Colorectal cancer screening

C–17 Breast cancer screening

C–18 Receipt of counseling about cancer screening

C–19 Prostate-specific antigen (PSA) test

C–20 Ultraviolet irradiation exposure

C–1
27

Topic Area: Cancer
C–1: Reduce the overall cancer death rate.

Target: 160.6 deaths per 100,000 population.

Baseline: 178.4 cancer deaths per 100,000 population occurred in 2007 (age adjusted to the


Data source: National Vital Statistics System (NVSS), CDC, NCHS.

C–2: Reduce the lung cancer death rate.


Baseline: 50.6 lung cancer deaths per 100,000 population occurred in 2007 (age adjusted to the



C–3: Reduce the female breast cancer death rate.

Target: 20.6 deaths per 100,000 females.

Baseline: 22.9 female breast cancer deaths per 100,000 females occurred in 2007 (age



C–4: Reduce the death rate from cancer of the uterine cervix.

Target: 2.2 deaths per 100,000 females.

Baseline: 2.4 uterine cervix cancer deaths per 100,000 females occurred in 2007 (age adjusted



C–5: Reduce the colorectal cancer death rate.


C–2
28

Baseline: 17.0 colorectal cancer deaths per 100,000 population occurred in 2007 (age adjusted

Target setting method: Modeling/projection.


C–6: Reduce the oropharyngeal cancer death rate.


Baseline: 2.5 oropharyngeal cancer deaths per 100,000 population occurred in 2007 (age



C–7: Reduce the prostate cancer death rate.

Target: 21.2 deaths per 100,000 males.

Baseline: 23.5 prostate cancer deaths per 100,000 males occurred in 2007 (age adjusted to the



C–8: Reduce the melanoma cancer death rate.


Baseline: 2.7 melanoma cancer deaths per 100,000 population occurred in 2007 (age adjusted



C–9: Reduce invasive colorectal cancer.

Target: 38.6 new cases per 100,000 population.

Baseline: 45.4 new cases of invasive colorectal cancer per 100,000 population were reported in


C–3
29

Data sources: National Program of Cancer Registries (NPCR), CDC; Surveillance,
Epidemiology and End Results (SEER) Program, NIH, NCI.

C–10: Reduce invasive uterine cervical cancer.

Target: 7.1 new cases per 100,000 females.

Baseline: 7.9 new cases of invasive uterine cancer per 100,000 females were reported in 2007
(age adjusted to the year 2000 standard population).



C–11: Reduce late-stage female breast cancer.

Target: 41.0 new cases per 100,000 females.

Baseline: 43.2 new cases of late-stage breast cancer per 100,000 females were reported in



C–12: Increase the number of central, population-based registries from the 50 States and the
District of Columbia that capture case information on at least 95 percent of the expected number
of reportable cancers.

Target: 51 (50 States and the District of Columbia).

Baseline: 42 States had central, population-based registries that captured case information on
at least 95 percent of the expected number of reportable cancers in 2006.



C–13: Increase the proportion of cancer survivors who are living 5 years or longer after
diagnosis.


Baseline: 66.2 percent of persons with cancer were living 5 years or longer after diagnosis in
2007.


C–4
30

Data source: Surveillance Epidemiology and End Results (SEER) Program, NIH, NCI.

C–14: (Developmental) Increase the mental and physical health-related quality of life of cancer
survivors.


C–15: Increase the proportion of women who receive a cervical cancer screening based on the
most recent guidelines.


Baseline: 84.5 percent of women aged 21 to 65 years received a cervical cancer screening
based on the most recent guidelines in 2008 (age adjusted to the year 2000 standard
population).


Data Source: National Health Interview Survey (NHIS), CDC, NCHS.

C–16: Increase the proportion of adults who receive a colorectal cancer screening based on the


Baseline: 54.2 percent of adults aged 50 to 75 years received a colorectal cancer screening
population).



C–17: Increase the proportion of women who receive a breast cancer screening based on the


Baseline: 73.7 percent of females aged 50 to 74 years received a breast cancer screening
population).



C–5
31

C–18: Increase the proportion of adults who were counseled about cancer screening consistent
with current guidelines.

C–18.1 Increase the proportion of women who were counseled by their providers about
mammograms.


Baseline: 69.8 percent of women aged 50 to 74 years were counseled by their providers about
mammograms in 2008 (age adjusted to the year 2000 standard population).



C–18.2 Increase the proportion of women who were counseled by their providers about Pap
tests.


Baseline: 59.8 percent of women aged 21 to 65 years were counseled by their providers about
Pap tests in 2008 (age adjusted to the year 2000 standard population).



C–18.3 (Developmental) Increase the proportion of adults who were counseled by their
providers about colorectal cancer screening.

Potential data source: National Health Interview Survey (NHIS), NCHS, CDC.

C–19: (Developmental) Increase the proportion of men who have discussed with their health
care provider whether or not to have a prostate-specific antigen (PSA) test to screen for
prostate cancer.


C–20: Increase the proportion of persons who participate in behaviors that reduce their
exposure to harmful ultraviolet (UV) irradiation and avoid sunburn.

C–20.1 (Developmental) Reduce the proportion of adolescents in grades 9 through 12 who
report sunburn.

Potential data source: Youth Risk Behavior Surveillance Survey (YRBSS), CDC.

C–6
32

C–20.2 (Developmental) Reduce the proportion of adults aged 18 years and older who
report sunburn.

Potential data source: National Health Interview Survey (NHIS), NCHS, CDC.

C–20.3 Reduce the proportion of adolescents in grades 9 through 12 who report using
artificial sources of ultraviolet light for tanning.


Baseline: 15.6 percent of adolescents in grades 9 through 12 reported using artificial sources of
ultraviolet light for tanning in 2009.


Data source: Youth Risk Behavior Surveillance Survey (YRBSS), CDC.

C–20.4 Reduce the proportion of adults aged 18 and older who report using artificial
sources of ultraviolet light for tanning.


Baseline: 15.2 percent of adults aged 18 and older reported using artificial sources of ultraviolet
light for tanning in 2008 (age adjusted to the year 2000 standard population).


Data source: National Health Interview Survey (NHIS), NCHS, CDC.

C–20.5 Increase the proportion of adolescents in grades 9 through 12 who follow protective
measures that may reduce the risk of skin cancer.


Baseline: 9.3 percent of adolescents in grades 9 through 12 followed protective measures that
may reduce the risk of skin cancer in 2009.


Data source: Youth Risk Behavior Surveillance Survey (YRBSS), CDC.

C–20.6 Increase the proportion of adults aged 18 years and older who follow protective
measures that may reduce the risk of skin cancer.


Baseline: 72.8 percent of adults aged 18 years and older followed protective measures that may
reduce the risk of skin cancer in 2008 (age adjusted to the year 2000 standard population).


C–7
33


C–8
34


Chronic Kidney Disease

CKD–1 Chronic kidney disease

CKD–2 Chronic kidney disease with knowledge of impaired renal function

CKD–3 Renal evaluation after acute kidney injury

CKD–4 Medical evaluation of persons with diabetes and chronic kidney disease

CKD–5 Medical treatment of persons with diabetes and chronic kidney disease

CKD–6 Cardiovascular care in persons with chronic kidney disease

CKD–7 Chronic kidney disease deaths

CKD–8 End-stage renal disease

CKD–9 End-stage kidney failure in diabetics

CKD–10 Pre-ESRD care from a nephrologist

CKD–11 Vascular access for hemodialysis

CKD–12 Waitlisting and/or transplantation

CKD–13 Kidney transplantation within 3 years of terminal kidney failure

CKD–14 End-stage renal disease deaths

CKD–1
35

Topic Area: Chronic Kidney Disease
CKD–1: Reduce the proportion of the U.S. population with chronic kidney disease.


Baseline: 15.1 percent of the U.S. population had chronic kidney disease in 1999–2004.


Data source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.

CKD–2: Increase the proportion of persons with chronic kidney disease (CKD) who know they
have impaired renal function.


Baseline: 7.3 percent of persons with CKD knew they had impaired renal function in 1999–2004.

Target setting method: 4 percentage points.


CKD–3: Increase the proportion of hospital patients who incurred acute kidney injury who have
follow-up renal evaluation in 6 months post discharge.


Baseline: 11.3 percent of hospital patients who incurred acute kidney injury had a follow-up
renal evaluation in 6 months post discharge in 2007.


Data source: U.S. Renal Data System, NIH, NIDDK.

CKD–4: Increase the proportion of persons with diabetes and chronic kidney disease who
receive recommended medical evaluation.

CKD–4.1 Increase the proportion of persons with chronic kidney disease who receive
medical evaluation with serum creatinine, lipids, and microalbuminuria.


Baseline: 25.8 percent of persons with chronic kidney disease received medical evaluation with
serum creatinine, lipids, and microalbuminuria in 2007.



CKD–2
36

CKD–4.2 Increase the proportion of persons with type 1 or type 2 diabetes and chronic
kidney disease who receive medical evaluation with serum creatinine, microalbuminuria,
HbA1c, lipids, and eye examinations.


Baseline: 23.1 percent of persons with type 1 or type 2 diabetes and chronic kidney disease
received medical evaluation with serum creatinine, microalbuminuria, HbA1c, lipids, and eye
examinations in 2007.



CKD–5: Increase the proportion of persons with diabetes and chronic kidney disease who
receive recommended medical treatment with angiotensin-converting enzyme (ACE) inhibitors
or angiotensin II receptor blockers (ARBS).


Baseline: 54.6 percent of persons with diabetes and chronic kidney disease received
recommended medical treatment with angiotensin-converting enzyme (ACE) inhibitors or
angiotensin II receptor blockers (ARBS) in 2007.



CKD–6: Improve cardiovascular care in persons with chronic kidney disease.

CKD–6.1 Reduce the proportion of persons with chronic kidney disease who have elevated
blood pressure.


Baseline: 74.1 percent of persons with chronic kidney disease had elevated blood pressure in
1999–2004.



CKD–6.2 Reduce the proportion of persons with chronic kidney disease who have elevated
lipid levels.


Baseline: 29.6 percent of persons with chronic kidney disease had elevated lipid levels in
1999–2004.


CKD–3
37


CKD–7: Reduce the death rate among persons with chronic kidney disease.

Target: Not applicable.

Baseline: 2.5 deaths per 100 person years occurred among persons with chronic kidney
disease in 1988–2006.

Target setting method: This measure is being tracked for informational purposes. If warranted, a
target will be set during the decade.

Data source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS;
National Death Index, CDC, NCHS.

CKD–8: Reduce the rate of new cases of end-stage renal disease (ESRD).

Target: 318.5 new cases per million population.

Baseline: 353.8 new cases of end-stage renal disease per million population were reported in
2007.



CKD–9: Reduce kidney failure due to diabetes.

CKD–9.1 Reduce kidney failure due to diabetes.

Target: 139.2 per million population.

Baseline: 154.7 per million population reported kidney failure due to diabetes in 2007.



CKD–9.2 Reduce kidney failure due to diabetes among persons with diabetes.

Target: 2,374.1 per million population.

Baseline: 2,637.9 persons with diabetes per million population reported kidney failure due to
diabetes in 2007.



CKD–4
38

CKD–10: Increase the proportion of chronic kidney disease patients receiving care from a
nephrologist at least 12 months before the start of renal replacement therapy.


Baseline: 27.1 percent of chronic kidney disease patients received care from a nephrologist at
least 12 months before the start of renal replacement therapy in 2007.



CKD–11: Improve vascular access for hemodialysis patients.

CKD–11.1 Increase the proportion of adult hemodialysis patients who use arteriovenous
fistulas as the primary mode of vascular access.


Baseline: 46.0 percent of adult hemodialysis patients used arteriovenous fistulas as the primary
mode of vascular access in 2006.


Data sources: U.S. Renal Data System, NIH, NIDDK; and Clinical Performance Measures
(CPM) Project, CMS.

CKD–11.2 Decrease the proportion of adult hemodialysis patients who use catheters as the
only mode of vascular access.


Baseline: 29.0 percent of adult hemodialysis patients used catheters as the only mode of
vascular access in 2006.


Data sources: U.S. Renal Data System, NIH, NIDDK; and Clinical Performance Measures
(CPM) Project, CMS.

CKD–11.3 Increase the proportion of adult hemodialysis patients who use arteriovenous
fistulas or have a maturing fistula as the primary mode of vascular access at the start of
renal replacement therapy.


Baseline: 31.3 percent adult hemodialysis patients used arteriovenous fistulas or had a maturing
fistula as the primary mode of vascular access at the start of renal replacement therapy in 2007.


CKD–5
39

Data sources: U.S. Renal Data System, NIH, NIDDK.

CKD–12: Increase the proportion of dialysis patients wait-listed and/or receiving a deceased
donor kidney transplant within 1 year of end-stage renal disease (ESRD) start (among patients
under 70 years of age).

Target: 18.8 percent of dialysis patients.

Baseline: 17.1 percent of dialysis patients under 70 years of age were wait-listed and/or
received a deceased donor kidney transplant within 1 year of ESRD start in 2006.



CKD–13: Increase the proportion of patients with treated chronic kidney failure who receive a
transplant.

CKD–13.1 Increase the proportion of patients receiving a kidney transplant within 3 years of
end-stage renal disease (ESRD).


Baseline: 17.9 percent of patients under 70 years of age who received a kidney transplant within
3 years of ESRD in 2004.



CKD–13.2 Increase the proportion of patients who receive a preemptive transplant at the
start of ESRD.


Baseline: 3.4 percent of patients under 70 years of age who received a preemptive transplant at
the start of ESRD in 2007.



CKD–14: Reduce deaths in persons with end-stage renal disease (ESRD).

CKD–14.1 Reduce the total death rate for persons on dialysis.

Target: 190.8 deaths per 1,000 patient years.

CKD–6
40

Baseline: 212.0 deaths of persons on dialysis per 1,000 patient years occurred in 2007.



CKD–14.2 Reduce the death rate in dialysis patients within the first 3 months of initiation of
renal replacement therapy.

Target: 319.9 deaths per 1,000 patient years at risk.

Baseline: 355.5 deaths of dialysis patients per 1,000 patient years at risk within the first
3 months of initiation of therapy occurred in 2007.



CKD–14.3 Reduce the cardiovascular death rate for persons on dialysis.


Baseline: 90.3 deaths from cardiovascular disease among persons on dialysis per 1,000 patient
years at risk occurred in 2007.


Data source: U.S. Renal Data System NIH, NIDDK.

CKD–14-4 Reduce the total death rate for persons with a functioning kidney transplant.


Baseline: 32.6 deaths among persons with a functioning transplant per 1,000 patient years at
risk occurred in 2007.



CKD–14.5 Reduce the cardiovascular death rate for persons with a functioning kidney
transplant.

Target: 4.5 cardiovascular deaths per 1,000 patient years at risk.

Baseline: 6.5 cardiovascular deaths among persons with a functioning transplant per 1,000
patient years at risk occurred in 2007.

Target setting method: 2 percentage point improvement.

CKD–7
41


CKD–8
42


Dementias, including Alzheimer’s Disease

DIA–1 Diagnosis awareness

DIA–2 Preventable hospitalizations

DIA–1
43

Topic Area: Dementias, Including Alzheimer’s Disease
DIA–1: (Developmental) Increase the proportion of persons with diagnosed Alzheimer’s disease
and other dementias, or their caregiver, who are aware of the diagnosis.

Potential data sources: Medicare Current Beneficiary Survey (MCBS) and Medicare Part B
claims.

DIA–2: (Developmental) Reduce the proportion of preventable hospitalizations in persons with
diagnosed Alzheimer’s disease and other dementias.

Potential data sources: Medicare Current Beneficiary Survey (MCBS) and Medicare Part A and
Part B claims.

DIA–2
44


Diabetes

D–1 New cases of diabetes

D–2 Diabetes-related deaths

D–3 Diabetes deaths

D–4 Lower extremity amputations

D–5 Glycemic control

D–6 Lipid control

D–7 Blood pressure control

D–8 Annual dental examinations

D–9 Annual foot examinations

D–10 Annual dilated eye examinations

D–11 Glycosylated hemoglobin measurement

D–12 Annual urinary microalbumin measurement

D–13 Self-blood glucose-monitoring

D–14 Diabetes education

D–15 Diagnosed diabetes

D–16 Prevention behaviors among persons with pre-diabetes

D–1
45

Topic Area: Diabetes
D–1: Reduce the annual number of new cases of diagnosed diabetes in the population.

Target: 7.2 new cases per 1,000 population aged 18 to 84 years.

Baseline: 8.0 new cases of diabetes per 1,000 population aged 18 to 84 years occurred in the
past 12 months, as reported in 2006–08 (age adjusted to the year 2000 standard population).



D–2: (Developmental) Reduce the death rate among the population with diabetes.

D–2.1 Reduce the rate of all-cause mortality among the population with diabetes.

Potential data sources: National Health Interview Survey (NHIS), CDC, NCHS; National Death
Index.

D–2.2 Reduce the rate of cardiovascular disease deaths in persons with diagnosed
diabetes.

Potential data sources: National Health Interview Survey (NHIS), CDC, NCHS; National Death
Index.

D–3: Reduce the diabetes death rate.


Baseline: 73.1 deaths per 100,000 population were related to diabetes in 2007 (age adjusted to
the year 2000 standard population).



D–4: Reduce the rate of lower extremity amputations in persons with diagnosed diabetes.


Baseline: 3.5 lower extremity amputations per 1,000 population with diagnosed diabetes
occurred in 2005–07 (age adjusted to the year 2000 standard population).


Data sources: National Hospital Discharge Survey (NHDS), CDC, NCHS; National Health
Interview Survey (NHIS), CDC, NCHS.

D–2
46

D–5: Improve glycemic control among the population with diagnosed diabetes.

D–5.1 Reduce the proportion of the diabetic population with an A1c value greater than
9 percent.


Baseline: 16.2 percent of adults aged 18 years and older with diagnosed diabetes had an A1c
value greater than 9 percent in 2005–08 (age adjusted to the year 2000 standard population).



D–5.2 Increase the proportion of the diabetic population with an A1c value less than 7
percent.


Baseline: 53.5 percent of adults aged 18 years and older with diagnosed diabetes had an A1c
value less than 7 percent in 2005–08 (age adjusted to the year 2000 standard population).



D–6: (Developmental) Improve lipid control among persons with diagnosed diabetes.

Potential data source: National Health and Nutrition Examination Survey (NHANES), CDC,
NCHS.

D–7: Increase the proportion of the population with diagnosed diabetes whose blood pressure is
under control.


Baseline: 51.8 percent of adults aged 18 years and older with diagnosed diabetes had their
blood pressure under control in 2005–08 (age adjusted to the year 2000 standard population).



D–8: Increase the proportion of persons with diagnosed diabetes who have at least an annual
dental examination.


D–3
47

Baseline: 55.6 percent of the population aged 2 years and older with diagnosed diabetes had
been to the dentist in the past year, as reported in 2008 (age adjusted to the year 2000 standard
population).



D–9: Increase the proportion of adults with diabetes who have at least an annual foot
examination.


Baseline: 68.0 percent of adults aged 18 years and older with diagnosed diabetes had at least
one foot examination by a health professional in the past 12 months, as reported in 2008 (age


Data source: Behavioral Risk Factor Surveillance System (BRFSS), CDC, NCCDPHP.

D–10: Increase the proportion of adults with diabetes who have an annual dilated eye
examination.


Baseline: 53.4 percent of adults aged 18 years and older with diagnosed diabetes had dilated
eye examination in the past year, as reported in 2008 (age adjusted to the year 2000 standard
population).



D–11: Increase the proportion of adults with diabetes who have a glycosylated hemoglobin
measurement at least twice a year.


Baseline: 64.6 percent of adults aged 18 years and older with diagnosed diabetes had a
glycosylated hemoglobin measurement at least twice in the past 12 months, as reported in 2008


Data source: Behavioral Risk Factor Surveillance System, CDC, NCCDPHP.

D–4
48

D–12: Increase the proportion of persons with diagnosed diabetes who obtain an annual urinary
microalbumin measurement.


Baseline: 33.6 percent of Medicare beneficiaries with diabetes obtained an annual urinary
microalbumin measurement in 2007.



D–13: Increase the proportion of adults with diabetes who perform self-blood glucose-
monitoring at least once daily.


Baseline: 64.0 percent of adults aged 18 years and older with diagnosed diabetes performed
self-blood glucose-monitoring at least once daily in 2008 (age adjusted to the year 2000



D–14: Increase the proportion of persons with diagnosed diabetes who receive formal diabetes
education.


Baseline: 56.8 percent of adults aged 18 years and older with diagnosed diabetes reported they
ever received formal diabetes education in 2008 (age adjusted to the year 2000 standard
population).



D–15 Increase the proportion of persons with diabetes whose condition has been diagnosed.


Baseline: 72.8 percent of adults aged 20 years and older with diabetes had been diagnosed, as
reported in 2005–08 (age adjusted to the year 2000 standard population).



D–5
49

D–16: Increase prevention behaviors in persons at high risk for diabetes with pre-diabetes.

D–16.1 Increase the proportion of persons at high risk for diabetes with pre-diabetes who
report increasing their levels of physical activity.


Baseline: 44.6 percent of adults aged 18 years and older who were at high risk for diabetes with
pre-diabetes reported increasing their levels of physical activity in 2005–08 (age adjusted to the



report trying to lose weight.


pre-diabetes reported controlling or trying to lose weight in 2005–08 (age adjusted to the year



report reducing the amount of fat or calories in their diet.


pre-diabetes reported reducing the amount of fat or calories in their diet in 2005–08 (age



D–6
50


Disability and Health

Systems and Policies

DH–1 Identification of “people with disabilities” in data systems

DH–2 Surveillance and health promotion programs

DH–3 Graduate-level courses in disability and health

Barriers to Health Care

DH–4 Barriers to primary care

DH–5 Transition planning

DH–6 Medical care for epilepsy and uncontrolled seizures

DH–7 Use of inappropriate medications

Environment

DH–8 Barriers to health and wellness programs

DH–9 Barriers to participation

DH–10 Barriers to obtaining assistive devices, service animals and technology

DH–11 Visitable features

DH–12 Congregate care

Activities and Participation

DH–13 Participation in social, spiritual, recreational, community, and civic activities

DH–14 Inclusion of children and youth with disabilities in regular education programs

DH–15 Unemployment

DH–16 Employment

DH–17 Social and emotional support

DH–18 Serious psychological distress

DH–19 Nonfatal unintentional injuries requiring medical care

DH–1
51

DH–20 Early intervention services.

DH–2
52

Topic Area: Disability and Health
Systems and Policies

DH–1: Include in the core of Healthy People 2020 population data systems a standardized set
of questions that identify “people with disabilities.”

Target: 4 data systems.

Baseline: 2 of 26 Healthy People 2020 data systems contained a standardized set of questions
that identify “people with disabilities” in 2010.


Data source: Periodic Assessment of Healthy People Population Data Systems, CDC.

DH–2: Increase the number of Tribes, States, and the District of Columbia that have public
health surveillance and health promotion programs for people with disabilities and caregivers.

States and District of Columbia

DH–2.1 Increase the number of State and the District of Columbia health departments that
have at least one health promotion program aimed at improving the health and well-being of
people with disabilities.

Target: 18 States and the District of Columbia.

Baseline: 16 of the States and the District of Columbia had health promotion programs for
people with disabilities in 2010.


Data source: Periodic Assessment of State Health Promotion Programs, CDC, NCBDDD.

conduct health surveillance for caregivers of people with disabilities.


Baseline: 2 States and the District of Columbia conducted health surveillance for caregivers of
people with disabilities in 2010.

Target setting method: Retention of HP2010 target.


DH–3
53

have at least one health promotion program aimed at improving the health and well-being of
caregivers of people with disabilities.


Baseline: 0 States and the District of Columbia had health promotion programs for caregivers in
2010.

Target setting method: Consistency with other programs.

Data source: Periodic Assessment of State Health Promotion Programs, CDC, NCBDDD.

Tribes

DH–2.4 (Developmental) Increase the number of Tribes that conduct health surveillance for
people with disabilities.

Potential data sources: Tribal, State, and District of Columbia reports; CDC, Disability and
Health Branch.

DH–2.5 (Developmental) Increase the number of Tribes that have at least one health
promotion program aimed at improving the health and well-being of people with disabilities.

Health Branch.

DH–2.6 (Developmental) Increase the number of Tribes that conduct health surveillance of
caregivers of people with disabilities.

Health Branch.

DH–2.7 (Developmental) Increase the number of Tribes that have at least one health
promotion program aimed at improving the health and well-being of caregivers of people
with disabilities.

Health Branch.

DH–3: (Developmental) Increase the proportion of U.S. master of public health (M.P.H.)
programs that offer graduate-level courses in disability and health.

Potential data source: Periodic Assessment of Schools of Public Health Courses, CDC,
NCBDDD.

DH–4
54

Barriers to Health Care

DH–4: (Developmental) Reduce the proportion of people with disabilities who report delays in
receiving primary and periodic preventive care due to specific barriers.


DH–5: Increase the proportion of youth with special health care needs whose health care
provider has discussed transition planning from pediatric to adult health care.


Baseline: 41.2 percent of youth with special health care needs had health care providers who
discussed transition planning from pediatric to adult health care in 2005–06.


Data source: National Survey of Children with Special Health Care Needs (NS-CSHN), HRSA,
Data Resource Center for Children and Adolescent Health.

DH–6: (Developmental) Increase the proportion of people with epilepsy and uncontrolled
seizures who receive appropriate medical care.


DH–7: (Developmental) Reduce the proportion of older adults with disabilities who use
inappropriate medications.

Potential data source: Medical Expenditure Panel Survey (MEPS), AHRQ, Center for Financing,
Access, and Cost Trends (CFACT).

Environment

DH–8: (Developmental) Reduce the proportion of people with disabilities who report physical or
program barriers to local health and wellness programs.

Potential data source: National Health Interview Survey (NHIS) Supplement, CDC, NCHS.

DH–9: (Developmental) Reduce the proportion of people with disabilities who encounter barriers
to participating in home, school, work, or community activities.

Potential data source: National Health Interview Survey (NHIS) Supplement, CDC, NCHS.

DH–5
55

DH–10: (Developmental) Reduce the proportion of people with disabilities who report barriers to
obtaining the assistive devices, service animals, technology services, and accessible
technologies that they need.

Potential data source: National Health Interview Survey Supplement, CDC, NCHS.

DH–11: Increase the proportion of newly constructed and retrofitted U.S. homes and residential
buildings that have visitable features.


Baseline: 42.1 percent of newly constructed and retrofitted U.S. homes and residential buildings
had visitable features in 2007.


Data sources: American Housing Survey (AHS), DHUD, Office of Policy Development and
Research (PD&R) and the U.S. Bureau of the Census.

DH–12: Reduce the number of people with disabilities living in congregate care residences.

DH–12.1 Reduce the number of adults with disabilities (aged 22 years and older) living in
congregate care residences that serve 16 or more persons.

Target: 31,604 adults.

Baseline: 57,462 adults (aged 22 years and older) with disabilities lived in congregate care
residences that served 16 or more persons in 2008.


Data source: Survey of State Developmental Disabilities Directors, University of Minnesota.

DH–12.2 Reduce the number of children and youth with disabilities (aged 21 years and
under) living in congregate care facilities.

Target: 26,001 children and youth with disabilities.

Baseline: 28,890 children and youth (aged 21 years and under) with disabilities lived in
congregate care facilities in 2009.


Data source: Survey of State Developmental Disabilities Directors, University of Minnesota.

DH–6
56

Activities and Participation

DH–13: (Developmental) Increase the proportion of people with disabilities who participate in
social, spiritual, recreational, community, and civic activities to the degree that they wish.

Potential data source: National Health Interview Survey Supplement, CDC, NCHS.

DH–14: Increase the proportion of children and youth with disabilities who spend at least 80
percent of their time in regular education programs.


Baseline: 56.8 percent of children and youth with disabilities spent at least 80 percent of their
time in regular education classrooms in 2007–08.


Data source: Individuals with Disabilities Education Act (IDEA) database, DoED, Office of
Special Education.

DH–15: Reduce unemployment among people with disabilities.


Baseline: 14.5 percent of people with disabilities were unemployed in 2009.


Data source: Current Population Survey (CPS), DOL, BLS.

DH–16: Increase employment among people with disabilities.


Baseline: 19.2 percent of people with disabilities were employed in 2009.


Data source: Current Population Survey (CPS), DOL, BLS.

DH–17: Increase the proportion of adults with disabilities who report sufficient social and
emotional support.


Baseline: 69.5 percent of adults with disabilities reported sufficient social and emotional support
in 2008.


DH–7
57

Data source: Behavioral Risk Factor Surveillance system (BRFSS), CDC, NCCDPHP.

DH-18: (Developmental) Reduce the proportion of people with disabilities who report serious
psychological distress.


DH–19: (Developmental) Reduce the proportion of people with disabilities who experience
nonfatal unintentional injuries that require medical care.


DH–20: Increase the proportion of children with disabilities, birth through age 2 years, who
receive early intervention services in home or community-based settings.

Target: 95 percent.

Baseline: 91 percent of children with disabilities, birth through age 2 years, received early
intervention services in home or community-based settings in 2007.


Data source: Individuals with Disabilities Education Act (IDEA) database, Office of Special
Education Programs, DoED,.

DH–8
58


Early and Middle Childhood

EMC–1 Healthy development for school readiness

EMC–2 Positive parenting

EMC–3 Quality of sleep in children

EMC–4 School health education

EMC–1
59

Topic Area: Early and Middle Childhood
EMC–1: (Developmental) Increase the proportion of children who are ready for school in all five
domains of healthy development: physical development, social-emotional development,
approaches to learning, language, and cognitive development.

Potential data sources: National Survey of Children’s Health (NSCH), HRSA, MCHS; CDC,
NCHS; National Household Education Surveys (NHES), ED.

EMC–2: Increase the proportion of parents who use positive parenting and communicate with
their doctors or other health care professionals about positive parenting.

EMC–2.1 (Developmental) Increase the proportion of parents who report a close
relationship with their child.

Potential data source: National Survey of Children’s Health (NSCH)/National Survey of Adoptive
Parents (NSAP), HRSA, MCHB; CDC, NCHS.

EMC–2.2 Increase the proportion of parents who use positive communication with their
child.


Baseline: 69.8 percent of parents of children aged 6 to 17 years reported that their child can
share ideas or talk about things that matter “very well” in 2007.



EMC–2.3 Increase the proportion of parents who read to their young child.


Baseline: 47.8 percent of parents of children aged 0 to 5 years reported that someone in their
family read to the child every day in the past week in 2007.



EMC–2.4 Increase the proportion of parents who receive information from their doctors or
other health care professionals when they have a concern about their children’s learning,
development, or behavior.


EMC–2
60

Baseline: 48.0 percent of parents of children aged 0 to 5 years who visited or used a health
service in the past 12 months reported that their child’s doctor asked about their concerns about
their child’s learning, development, or behavior in 2007.



EMC–2.5 (Developmental) Increase the proportion of parents with children under the age of
3 years whose doctors or other health care professionals talk with them about positive
parenting practices.

Potential data source: National Survey of Early Childhood Health (NSECH), HRSA, MCHB;
CDC, NCHS.

EMC–3: (Developmental) Decrease the proportion of children who have poor quality of sleep.

Potential data source: National Survey of Children’s Health (NSCH), HRSA, MCHB; CDC,
NCHS.

EMC–4: Increase the proportion of elementary, middle, and senior high schools that require
school health education.

EMC–4.1 Increase the proportion of schools that require newly hired staff who teach
required health education to have undergraduate or graduate training in health education.

EMC–4.1.1 Elementary schools.


Baseline: 35.2 percent of elementary schools, including public and private schools, required
newly hired staff who taught required health education to have undergraduate or graduate
training in health education in 2006.


Data source: School Health Policies and Programs Study (SHPPS), CDC, NCCDPHP

EMC–4.1.2 Middle schools.


Baseline: 56.9 percent of middle schools, including public and private schools, required newly
hired staff who taught required health education to have undergraduate or graduate training in
health education in 2006.



EMC–4.1.3 High schools.

EMC–3
61


Baseline: 76.8 percent of high schools, including public and private schools, required newly
hired staff who taught required health education to have undergraduate or graduate training in
health education in 2006.



EMC–4.2 Increase the proportion of schools that require newly hired staff who teach
required health instruction to be certified, licensed, or endorsed by the State in health
education.



newly hired staff who taught required health instruction to be certified, licensed, or endorsed by
the State in health education in 2006.





Baseline: 50.7 percent of middle schools, including public and private schools, required newly
hired staff who taught required health instruction to be certified, licensed, or endorsed by the
State in health education in 2006.





Baseline: 72.8 percent of high schools, including public and private schools, required newly
hired staff who taught required health instruction to be certified, licensed, or endorsed by the
State in health education in 2006.



EMC–4
62

EMC–4.3 Increase the proportion of schools that require cumulative instruction in health
education that meet the US National Health Education Standards for elementary, middle,
and senior high schools.



cumulative instruction in health education that met the US National Health Education Standards
in 2006.





Baseline: 10.3 percent of middle schools, including public and private schools, required
cumulative instruction in health education that met the US National Health Education Standards
in 2006.





Baseline: 6.5 percent of high schools, including public and private schools, required cumulative
instruction in health education that met the US National Health Education Standards in 2006.



EMC–4.4 Increase the proportion of required health education classes or courses with a
teacher who has had professional development related to teaching personal and social skills
for behavior change within the past 2 years.


Baseline: 52.5 percent of required health education classes or courses were taught by a teacher
who has had professional development related to teaching personal and social skills for
behavior change within the past 2 years in 2006.



EMC–5
63


Educational and Community-Based Programs
ECBP–1 Preschool health education

ECBP–2 School health education

ECBP–3 School health education standards

ECBP–4 School health education on personal growth and wellness

ECBP–5 School nurse-to-student ratio

ECBP–6 High school completion activities

ECBP–7 Health-risk behavior information in higher education

ECBP–8 Worksite health promotion programs

ECBP–9 Participation in employer-sponsored health promotion

ECBP–10 Community-based primary prevention services

ECBP–11 Culturally appropriate community health programs

ECBP–12 Clinical prevention and population health training - M.D.-granting medical schools

ECBP–13 Clinical prevention and population health training - D.O.-granting medical schools

ECBP–14 Clinical prevention and population health training - undergraduate nursing

ECBP–15 Clinical prevention and population health training - nurse practitioner

ECBP–16 Clinical prevention and population health training - physician assistant

ECBP‐1

64

Topic Area: Educational and Community-Based Programs

ECBP–1: (Developmental) Increase the proportion of preschool Early Head Start and Head
Start programs that provide health education to prevent health problems in the following areas:
unintentional injury; violence; tobacco use and addiction; alcohol and drug use, unhealthy
dietary patterns; and inadequate physical activity, dental health, and safety.

ECBP–1.1 All priority areas.

Potential data sources: National Head Start Program Survey; National Household Education
Surveys Program (NHES); National Survey of Children’s Health.

ECBP–1.2 Unintentional injury.


ECBP–1.3 Violence.


ECBP–1.4 Tobacco use and addiction.


ECBP–1.5 Alcohol and other drug use.


ECBP–1.6 Unhealthy dietary patterns.


ECBP–1.7 Inadequate physical activity.


ECBP–1.8 Dental and oral health.

ECBP‐2

65


ECBP–1.9 Safety.

Potential data source: National Head Start Program Survey; National Household Education

ECBP–2: Increase the proportion of elementary, middle, and senior high schools that provide
comprehensive school health education to prevent health problems in the following areas:
unintentional injury; violence; suicide; tobacco use and addiction; alcohol or other drug use;
unintended pregnancy, HIV/AIDS, and STD infection; unhealthy dietary patterns; and
inadequate physical activity.

ECBP–2.1 All priority areas.


Baseline: In 2006, 25.6 percent of elementary, middle, and senior high schools provided
comprehensive school health education to prevent health problems in all priority areas.





comprehensive school health education to prevent unintentional injury.





comprehensive school health education to prevent violence.



ECBP–2.4 Suicide.

ECBP‐3

66


comprehensive school health education to prevent suicide.





comprehensive school health education to prevent tobacco use and addiction.





comprehensive school health education to prevent alcohol and other drug use.



ECBP–2.7 Unintended pregnancy, HIV/AIDS, and STD infection.


comprehensive school health education to prevent unintended pregnancy, HIV/AIDS and STD
infection.





comprehensive school health education to prevent unhealthy dietary patterns.

ECBP‐4

67





comprehensive school health education to prevent inadequate physical activity.



ECBP–3: Increase the proportion of elementary, middle, and senior high schools that have
health education goals or objectives that address the knowledge and skills articulated in the
National Health Education Standards (high school, middle, elementary).

ECBP–3.1 Comprehending concepts related to health promotion and disease prevention
(knowledge).


Baseline: In 2006, 97.2 percent of elementary, middle, and senior high schools had health
education goals or objectives that addressed the comprehension of concepts related to health
promotion and disease prevention (knowledge) articulated in the National Health Education
Standards (high school, middle, and elementary).



ECBP–3.2 Accessing valid information and health promoting products and services (skills).


education goals or objectives that addressed accessing valid information and health promoting
products and services (skills) articulated in the National Health Education Standards (high
school, middle, and elementary).



ECBP–3.3 Advocating for personal, family, and community health (skills).


ECBP‐5

68

education goals or objectives that addressed advocating for personal, family, and community
health (skills) articulated in the National Health Education Standards (high school, middle, and
elementary).



ECBP–3.4 Analyzing the influence of culture, media, technology, and other factors on health
(skills).


education goals or objectives that addressed analyzing the influence of culture, media,
technology, and other factors on health (skills) articulated in the National Health Education
Standards (high school, middle, and elementary).



ECBP–3.5 Practicing health-enhancing behaviors and reducing health risks (skills).

Short title: Practicing healthy behaviors.


education goals or objectives that addressed practicing health-enhancing behaviors and
reducing health risks (skills) articulated in the National Health Education Standards (high school,
middle, and elementary).



ECBP–3.6 Using goal-setting and decision-making skills to enhance health (skills).

Short title: Goal-setting to enhance health.


education goals or objectives that addressed using goal-setting and decision-making skills to
enhance health (skills) articulated in the National Health Education Standards (high school,

ECBP‐6

69


ECBP–3.7 Using interpersonal communication skills to enhance health (skills).


education goals or objectives that addressed using interpersonal communication skills to
enhance health (skills) articulated in the National Health Education Standards (high school,



ECBP–4: Increase the proportion of elementary, middle, and senior high schools that provide
school health education to promote personal health and wellness in the following areas: hand
washing or hand hygiene; oral health; growth and development; sun safety and skin cancer
prevention; benefits of rest and sleep; ways to prevent vision and hearing loss; and the
importance of health screenings and checkups.

ECBP–4.1 Hand washing or hand hygiene.


Baseline: In 2006, 83.4 percent of elementary, middle, and senior high schools provided school
health education in hand washing or hand hygiene to promote personal health and wellness.



ECBP–4.2 Dental and oral health.


health education in dental and oral health.



ECBP–4.3 Growth and development.


health education in growth and development to promote personal health and wellness.

ECBP‐7

70



ECBP–4.4 Sun safety or skin cancer prevention.


health education in sun safety or skin cancer prevention to promote personal health and
wellness.



ECBP–4.5 Benefits of rest and sleep.


health education on the benefits of rest and sleep to promote personal health and wellness.



ECBP–4.6 Ways to prevent vision and hearing loss.


health education on ways to prevent vision and hearing loss to promote personal health and
wellness.



ECBP–4.7 Importance of health screenings and checkups.


health education on the importance of health screenings and checkups to promote personal
health and wellness.


ECBP‐8

71

ECBP-5: Increase the proportion of the Nation’s elementary, middle, and senior high schools
that have a full-time registered school nurse-to-student ratio of at least 1:750.

ECBP–5.1 All elementary, middle, and senior high schools.


Baseline: In 2006, 40.6 percent of all elementary, middle, and senior high school had a nurse-
to-student ratio of at least 1:750.



ECBP–5.2 Senior high schools.


Baseline: In 2006, 33.5 percent of all senior high school had a nurse-to-student ratio of at least
1:750.



ECBP–5.3 Middle schools.


Baseline: In 2006, 43.9 percent of all middle schools had a nurse-to-student ratio of at least
1:750.



ECBP–5.4 Elementary schools.


Baseline: In 2006, 41.4 percent of all elementary schools had a nurse-to-student ratio of at least
1:750.



ECBP–6: Increase the proportion of the population that completes high school education.

ECBP‐9

72

Baseline: In 2007, 89.0 percent of persons aged 18 to 24 years old had completed high school.


Data source: Current Population Survey, U.S. Department of Commerce, Bureau of the Census.

ECBP-7: Increase the proportion of college and university students who receive information
from their institution on each of the priority health risk behavior areas (all priority areas;
unintentional injury; violence; suicide; tobacco use and addiction; alcohol and other drug use;
unintended pregnancy, HIV/AIDS, and STD infection; unhealthy dietary patterns; and
inadequate physical activity).

ECBP– 7.1 (Developmental) All priority areas.

Potential data source: National College Health Assessment, American College Health
Association.



Baseline: In 2009, 27.3 percent of college and university students received health-risk behavior
information on unintentional injury from their institution.


Data source: National College Health Assessment, American College Health Association.



information on violence from their institution.



ECBP–7.4 Suicide.


information on suicide from their institution.



ECBP‐10

73



information on tobacco use and addiction from their institution.





information on alcohol and other drug use from their institution.



ECBP–7.7 Unintended pregnancy.


information on unintended pregnancy from their institution.



ECBP–7.8 HIV, AIDS and STD infection.


information on HIV/AIDS and STD infection from their institution.





information on unhealthy dietary patterns from their institution.
ECBP‐11

74





information on inadequate physical activity from their institution.



ECBP–8: (Developmental) Increase the proportion of worksites that offer an employee health
promotion program to their employees.

ECBP–8.1 Worksites with fewer than 50 employees.

Potential data source: National Survey of Employer-Sponsored Health Plans.

ECBP–8.2 Worksites with 50 or more employees.


ECBP–8.3 Worksites with 50 to 99 employees.






ECBP–8.6 Worksites with 750 or more employees.


ECBP‐12

75

ECBP–9: (Developmental) Increase the proportion of employees who participate in employer-
sponsored health promotion activities.


ECBP–10: Increase the number of community-based organizations (including local health
departments, tribal health services, nongovernmental organizations, and State agencies)
providing population-based primary prevention services in the following areas:

ECBP–10.1 Injury.


Baseline: In 2008, 76.6 percent of community-based organizations (including local health
provided population-based primary injury prevention services.


Data source: National Profile of Local Health Departments, National Association of County and
City Health Officials (NACCHO).



provided population-based primary violence prevention services.



ECBP–10.3 Mental illness.


provided population-based primary prevention services in mental illness.



ECBP–10.4 Tobacco use.

ECBP‐13

76


provided population-based primary prevention services in tobacco use.



ECBP–10.5 Substance abuse.


provided population-based primary prevention services in substance abuse.



ECBP–10.6 Unintended pregnancy.


provided population-based primary prevention services in unintended pregnancy.



ECBP–10.7 Chronic disease programs.


provided population-based primary prevention services in chronic disease programs.


ECBP‐14

77

ECBP–10.8 Nutrition.


provided population-based primary prevention services in nutrition.



ECBP–10.9 Physical activity.


provided population-based primary prevention services in physical activity.



ECBP–11: (Developmental) Increase the proportion of local health departments that have
established culturally appropriate and linguistically competent community health promotion and
disease prevention programs.

Potential data source: Culturally and Linguistically Appropriate Services in Health Care (CLAS)
standards, Office of Minority Health; Guidance and Standards on Language Access Services,
Office of the Inspector General.

Gaps in numbering will be corrected before publication.

ECBP–12: Increase the inclusion of core clinical prevention and population health content in
M.D.-granting medical schools.

ECBP–12.1 Counseling for health promotion and disease prevention.


Baseline: In 2008, 95.2 percent of M.D.-granting medical schools provided content in counseling
for health promotion and disease prevention in required courses.


ECBP‐15

78

Data source: Liaison Committee on Medical Education (LCME) Annual Medical School
Questionnaire, Association of American Medical Colleges (AAMC).

ECBP–12.2 Cultural diversity.


Baseline: In 2008, 99.2 percent of M.D.-granting medical schools provided content in cultural
diversity in required courses.



ECBP–12.3 Evaluation of health sciences literature.


Baseline: In 2008, 93.7 percent of M.D.-granting medical schools provided content in evaluation
of health sciences literature in required courses.



ECBP–12.4 Environmental health.


Baseline: In 2008, 85.7 percent of M.D.-granting medical schools provided content in
environmental health in required courses.



ECBP–12.5 Public health systems.


Baseline: In 2008, 78.6 percent of M.D.-granting medical schools provided content in public
health systems in required courses.


ECBP‐16

79


ECBP–12.6 Global health.


Baseline: In 2008, 77.8 percent M.D.-granting medical schools provided content in global health
in required courses.



D.O.-granting medical schools.


Target: Tracking method only.

Baseline: In 2009, 100 percent of D.O.-granting medical schools provided content in counseling
for health promotion and disease prevention in required courses or clerkships.


Data source: Annual Report on Osteopathic Medical Education, American Association of
Colleges of Osteopathic Medicine (AACOM).


Target: Tracking method only.

Baseline: In 2009, 100 percent of D.O.-granting medical schools provided content in cultural
diversity in required courses or clerkships.





ECBP‐17

80

Baseline: In 2009, 92.9 percent of D.O.-granting medical schools provided content in evaluation
of health sciences literature in required courses or clerkships.





Baseline: In 2009, 64.3 percent of D.O.-granting medical schools provided content in
environmental health in required courses or clerkships.





Baseline: In 2009, 82.1 percent of D.O.-granting medical schools provided content in public
health systems in required courses or clerkships.





Baseline: In 2009, 46.4 percent of D.O.-granting medical schools provided content in global
health in required courses or clerkships.



undergraduate nursing.


ECBP‐18

81


Baseline: 99 percent of undergraduate nursing schools included content on counseling
for health promotion and disease prevention in required courses in 2009.


Data source: Women’s Health in the Baccalaureate Nursing School Curriculum Survey,
American Association of Colleges of Nursing (AACN).



Baseline: 98 percent of undergraduate nursing schools included content on cultural
diversity in required courses in 2009.





Baseline: 97 percent of undergraduate nursing schools included content on evaluation
of health sciences literature in required courses in 2009.





Baseline: 94 percent of undergraduate nursing schools included content on
environmental health in required courses in 2009.





ECBP‐19

82

Baseline: 97 percent of undergraduate nursing schools included content on public
health systems in required courses in 2009.





Baseline: 93 percent of undergraduate nursing schools included content on global
health in required courses in 2009.



nurse practitioner training.



Baseline: In 2008, 95.8 percent of nurse practitioner schools included content on counseling for
health promotion and disease prevention in required courses.


Data source: Collaborative Curriculum Survey, AACN and National Organization of Nurse
Practitioner Faculties (NONPF).



Baseline: In 2008, 96.6 percent of nurse practitioner schools included content on cultural
diversity in required courses.




ECBP‐20

83


Baseline: In 2008, 98.1 percent of nurse practitioner schools included content on evaluation of
health sciences literature in required courses.





Baseline: In 2008, 74.3 percent of nurse practitioner schools included content on environmental
health in required courses.





Baseline: In 2008, 81.5 percent of nurse practitioner schools included content on public health
systems in required courses.





Baseline: In 2008, 72.5 percent of nurse practitioner schools included content on global health



physician assistant training.

ECBP‐21

84



Baseline: In 2010, 97 percent of physician assistant schools provided content on counseling for
health promotion and disease prevention in required courses.


Data source: Curriculum Survey, Physician Assistant Education Association (PAEA).



Baseline: In 2010, 99 percent of physician assistant schools provided content cultural diversity





Baseline: In 2010, 99.0 percent of physician assistant schools provided content on evaluation of
health sciences literature in required courses.





Baseline: In 2010, 53 percent of physician assistant schools provided content on environmental
health in required courses.





Baseline: In 2010, 89 percent of physician assistant schools provided content on public health
systems in required courses.
ECBP‐22

85





Baseline: In 2010, 49 percent of physician assistant schools provided content on global health in
required courses.



ECBP‐23

86


Environmental Health

Outdoor Air Quality

EH–1 Air Quality Index (AQI) exceeding 100

EH–2 Alternative modes of transportation

EH–3 Airborne toxins

Water Quality

EH–4 Safe drinking water

EH–5 Waterborne disease outbreaks

EH–6 Per capita domestic water withdrawals

EH-7 Beach closings

Toxics and Waste

EH–8 Blood lead levels in children

EH–9 Risks posed by hazardous sites

EH–10 Pesticide exposures resulting in visits to health care facility

EH–11 Toxic pollutants

EH–12 Recycling of municipal waste

Healthy Homes and Healthy Communities

EH–13 Indoor allergen levels

EH–14 Radon mitigation systems in homes

EH–15 Radon-reducing new home construction

EH–16 School policies to promote healthy and safe environment

EH–17 Home test for lead-based paint

EH–18 Homes with lead-based paint

EH–19 Housing units with physical problems

EH-1
87

Infrastructure and Surveillance

EH–20 Exposure to environmental chemicals

EH–21 Information systems used for environmental health

EH–22 Monitoring diseases caused by exposure to environmental hazards

EH–23 Schools located near highways

Global Environmental Health

EH–24 Global burden of disease

EH-2
88

Topic Area: Environmental Health

OUTDOOR AIR QUALITY

EH-1: Reduce the number of days the Air Quality Index (AQI) exceeds 100.

Target: 10 days.

Baseline: 11 days exceeded 100 on the Air Quality Index (AQI) in 2008.


Data source: Air Quality System (formerly the Aerometric Information Retrieval System), EPA.

EH-2: Increase use of alternative modes of transportation for work.

EH-2.1 Trips made by bicycling.


Baseline: 0.5 percent of trips were made to work via bicycle in 2008.


Data source: American Community Survey (ACS), U.S. Bureau of the Census.

EH-2.2 Trips made by walking.


Baseline: 2.8 percent of trips were made to work via walking in 2008.



EH-2.3 Trips made by mass transit.


Baseline: 5.0 percent of trips were made to work via mass transit in 2008.



EH-2.4 Persons who telecommute.


EH-3
89

Baseline: 4.1 percent of employees teleworked in 2008.



EH-3: Reduce air toxic emissions to decrease the risk of adverse health effects caused by
airborne toxics.

EH-3.1 Mobile sources.

Target: 1.0 million tons (2015 modeled data to be reported in 2020).

Baseline: 1.8 million tons of mobile sources of air toxic emissions were reported in 2005.


Data source: National Emissions Inventory(NEI), U.S. Environmental Protection Agency (EPA),
Office of Air and Radiation (OAR), Office of Air Quality Planning and Standards (OAQPS).

EH-3.2 Area sources.

Target: 1.7 million tons (2015 modeled data to be reported in 2020).

Baseline: 1.3 million tons of area sources of air toxic emissions were reported in 2005.


Data source: National Emissions Inventory (NEI), U.S. Environmental Protection Agency (EPA),

EH-3.3 Major sources.

Target: 0.7 million tons.

Baseline: 0.8 million tons of major sources of air toxic emissions were reported in 2005.


Data source: National Emissions Inventory (NEI), U.S. Environmental Protection Agency (EPA),

WATER QUALITY

EH-4: Increase the proportion of persons served by community water systems who receive a
supply of drinking water that meets the regulations of the Safe Drinking Water Act.

Target: 91 percent.

EH-4
90

Baseline: 89 percent of persons served by community water systems received a supply of
drinking water that meets the regulations of the Safe Drinking Water Act in 2005.

Target setting method: Consistency with national programs/regulations/policies/laws.

Data sources: Potable Water Surveillance System (PWSS), Safe Drinking Water Information
System (SDWIS), EPA, OW, OGWDW.

EH-5: Reduce waterborne disease outbreaks arising from water intended for drinking among
persons served by community water systems.

Target: 2 outbreaks.

Baseline: 7 outbreaks per year developed from water intended for drinking among persons
served by community water systems in 1999-2008.


Data sources: Morbidity and Mortality Weekly Report (MMWR), CDC, NCID, and State health
departments.

EH-6: Reduce per capita domestic water withdrawals with respect to use and conservation.

Target: 89.1 gallons per capita.

Baseline: 99 gallons of public-supplied domestic water per capita were withdrawn per capita in
2005.


Data source: “Estimated Use of Water in the United States,” U.S. Department of the Interior
(DOI), U.S. Geological Survey (USGS). State publications prepared as part of the USGS
National Water-Use Information Program as referenced at http://water.usgs.gov/watuse.

EH-7: Increase the proportion of days that beaches are open and safe for swimming.

Target: 96 percent.

Baseline: 95 percent of beach days were open and safe for swimming during the 2007
swimming season.


Data source: BEACH Program, EPA, Office of Water.

EH-5
91

TOXICS AND WASTE

EH-8: Reduce blood lead levels in children.

EH-8.1 Eliminate elevated blood lead levels in children.

Target: Not applicable

Baseline: 0.9 percent of children had elevated blood lead levels in 2005-08.


EH-8.2 Reduce the mean blood lead levels in children.

Target: 1.4 µg/dL average blood lead level in children aged 1 to 5 years.

Baseline: Children aged 1 to 5 years had an average blood lead level of 1.5 µg/dL in
2005-08.



EH-9: Minimize the risks to human health and the environment posed by hazardous sites.

Target: 1,151 sites.

Baseline: 1,279 hazardous sites presented risks to human health and the environment in 2010.


Data source: Comprehensive Environmental Response and Cleanup Liability Information
System (CERCLIS), EPA, OSWER, OSRTI.

EH-10: Reduce pesticide exposures that result in visits to a health care facility.

Target: 10,377 pesticide exposures.

Baseline: 15,965 pesticide exposures resulted in visits to a health care facility in 2008.


Data source: National Poison Data System, American Association of Poison Control Centers.

EH-11: Reduce the amount of toxic pollutants released into the environment.

Target: 3.5 billion pounds.

Baseline: 3.9 billion pounds of toxic pollutants were released in to the environment in 2008.

EH-6
92


Data source: U.S. National Toxics Release Inventory (TRI), EPA.

EH-12: Increase recycling of municipal solid waste.


Baseline: 33.2 percent of municipal solid waste was recycled in 2008.


Data source: Characterization of Municipal Solid Waste, EPA, OSW.

HEALTHY HOMES AND HEALTHY COMMUNITIES

EH-13: Reduce indoor allergen levels.

EH-13.1 Reduce indoor allergen levels: cockroach.

Target: 0.46 units of cockroach allergen/gram of settled dust.

Baseline: 0.51 units of cockroach allergen/gram of settled dust were reported in 2006.


Data source: American Healthy Homes Survey (AHHS), HUD.

EH-13.2 Reduce indoor allergen levels: mouse.

Target: 0.14 micrograms of mouse allergen/ gram of settled dust.

Baseline: 0.16 micrograms of mouse allergen/ gram of settled dust were reported in 2006.


Data source: American Healthy Homes Survey (AHHS), HUD.

EH-14: Increase the percentage of homes with an operating radon mitigation system for
persons living in homes at risk for radon exposure.

Target: 30 percent (3.1 million of 9.2 million homes) of homes with radon levels at or above
4 Pico curies per liter of air (pCi/L).

Baseline: 10.2 percent (788,000 of 7.7 million homes) of homes with radon levels of 4 pCi/L or
more prior to mitigation had installed a radon mitigation system in 2007.


EH-7
93

Data source: Annual Report to EPA by Radon Vent Fan Manufacturers, EPA, Indoor
Environments Division.

EH-15: Increase the percentage of new single family homes (SFH) constructed with radon-
reducing features, especially in high-radon-potential areas.

Target: 100 percent of homes in high-radon-potential areas built to include radon-reducing
features.

Baseline: 28.6 percent (62,900) of SFH homes built (220,000) in high-radon-potential areas
included radon-reducing features in 2007.

Target setting method: Consistency with national programs/ regulations/policies/laws.

Data source: Builder Practices Report: Radon-Resistant Construction Practices in New U.S.
Homes 2008, Annual Builder and Consumer Practices Surveys, National Association of Home
Builders Research Center, Inc. as reported to EPA, Indoor Environments Division.

EH-16: Increase the proportion of the Nation’s elementary, middle, and high schools that have
official school policies and engage in practices that promote a healthy and safe physical school
environment:

EH-16.1 Have an indoor air quality management program.


Baseline: 51.4 percent of the Nation’s elementary, middle, and high schools had an indoor air
quality management program, as reported in 2006.


Data Source: School Health Policies and Programs Study (SHPPS), CDC.

EH-16.2 Have a plan for how to address mold problems.


Baseline: 67.0 percent of the Nation’s elementary, middle, and high schools had a plan for how
to address mold problems in 2006.


Data source: School Health Policies and Programs Study (SHPPS), CDC.

EH-16.3 Have a plan for how to use, label, store, and dispose of hazardous materials.


Baseline: 85.9 percent of the Nation’s elementary, middle, and high schools had a plan for how
to use, label, store, and dispose of hazardous materials in 2006.

EH-8
94



EH-16.4 Reduce exposure to pesticides by using spot treatments and baiting rather than
widespread application of pesticide.


Baseline: 57.9 percent of the Nation’s elementary, middle, and high schools used spot
treatments and baiting rather than widespread application of pesticide in 2006.



EH-16.5 Reduce exposure to pesticides by marking areas to be treated with pesticides.


Baseline: 56.2 percent of the Nation’s elementary, middle, and high schools marked areas to be
treated by pesticides in 2006.



EH-16.6 Reduce exposure to pesticides by informing students and staff prior to application
of the pesticide.


Baseline: 65.4 percent of the Nation’s elementary, middle, and high schools informed students
and staff prior to application of pesticide in 2006.



EH-16.7 Inspect drinking water outlets for lead.


Baseline: 55.7 percent of the Nation’s elementary, middle, and high schools inspected drinking
water outlets for lead in 2006.



EH-9
95

EH-16.8 Among schools with community water systems, inspect drinking water outlets for
bacteria.


Baseline: 58.8 percent of the Nation’s elementary, middle, and high schools with community
water systems inspected drinking water outlets for bacteria in 2006.



EH-16.9 Among schools with community water systems, inspect drinking water outlets for
coliforms.


Baseline: 55.2 percent of the Nation’s elementary, middle, and high schools with community
water systems inspected drinking water outlets for coliforms in 2006.



EH-17: (Developmental) Increase the proportion of persons living in pre-1978 housing that has
been tested for the presence of lead-based paint or related hazards.

EH-17.1 Increase the proportion of pre-1978 housing that has been tested for the presence
of lead-based paint.

Potential data source: National Health Interview Survey (NHIS), CDC.

EH17.2 Increase the proportion of pre-1978 housing that has been tested for the presence
of paint-lead hazards


of lead in dust.


of lead in soil.

Potential data source: National Health Interview Survey, CDC, NCHS.

EH-10
96

EH-18: Reduce the number of U.S. homes that are found to have lead-based paint or related
hazards.

EH-18.1 Reduce the number of U.S. homes that are found to have lead-based paint.

Target: 3.7 million fewer homes with lead-based paint.

Baseline: 37 million homes were found to have lead-based paint in 2005-06.


Data source: American Healthy Homes Survey (AHHS), U.S. Department of Housing and Urban
Development (HUD), Office of Healthy Homes and Lead Hazard Control.

EH-18.2 Reduce the number of U.S. homes that have paint-lead hazards.

Target: 1.5 million fewer homes with paint-lead hazards.

Baseline: 15.3 million homes had paint-lead hazards in 2005-06.



EH-18.3 Reduce the number of U.S. homes that have dust-lead hazards.

Target: 1.4 million fewer homes with dust-lead hazards.

Baseline: 13.7 million homes had dust-lead hazards in 2005-06.



EH-18.4 Reduce the number of U.S. homes that have soil-lead hazards.

Target: 380,000 fewer homes with soil-lead hazards.

Baseline: 3.8 million homes had soil-lead hazards in 2005-06.



EH-11
97

EH-19: Reduce the proportion of occupied housing units that have moderate or severe physical
problems.


Baseline: 5.2 percent of housing units had moderate or severe physical problems in 2007.


Data source: American Housing Survey, U.S. Department of Commerce, Bureau of the Census.

INFRASTRUCTURE AND SURVEILLANCE
EH-20: Reduce exposure to selected environmental chemicals in the population, as measured
by blood and urine concentrations of the substances or their metabolites.

Metals

EH-20.1 Arsenic.

Target: 35.28 µg/g of creatinine.

Baseline: 50.4 µg/g of creatinine: Concentration level of urinary total arsenic (creatinine
corrected) at which 95 percent of the population aged 6 years and older is below the measured
level in 2003-04.


Data sources: National Report on Human Exposure to Environmental Chemicals, CDC, NCEH;
National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.

EH-20.2 Cadmium.

Target: 1.12 µg/L.

Baseline: 1.60 µg/L: Concentration level of cadmium in blood samples at which 95 percent of
the population aged 1 year and older is below the measured level in 2003-04.



EH-20.3 Lead.

Target: 2.94 µg/dL.

Baseline: 4.20 µg/dL: Concentration level of lead in blood samples at which 95 percent of the
population aged 1 year and older is below the measured level in 2003-04.


EH-12
98


EH-20.4 Mercury, children aged 1 to 5 years.

Target: 1.26 µg/L.

Baseline: 1.80 µg/L: Concentration level of mercury in blood samples at which 95 percent of
children aged 1 to 5 years is below the measured level in 2003-04.



EH-20.5 Mercury, females aged 16 to 49 years.

Target: 3.22 µg/L.

Baseline: 4.60 µg/L: Concentration level of mercury in blood samples at which 95 percent of
females aged 16 to 49 years is below the measured level in 2001-02.



Organochlorine pesticides

EH-20.6 Chlordane (Oxychlordane).

Target: 26.39 ng/g of lipid.

Baseline: 37.7 ng/g of lipid: Concentration level of oxychlordane (lipid adjusted) in serum
samples at which 95 percent of the population aged 12 years and older is below the measured
level in 2003-04.



EH-20.7 DDT (DDE).

Target: 1302 ng/g of lipid.

Baseline: 1860 ng/g of lipid: Concentration level of DDE (lipid adjusted) in serum samples at
which 95 percent of the population aged 12 years or more is below the measured level in
2003-04.

EH-13
99


EH-20.8 beta-hexachlorocyclohexane or beta-HCH.


Baseline: 56.5 ng/g of lipid: Concentration level of beta-Hexachlorocyclohexane (lipid adjusted)
in serum samples at which 95 percent of the population aged 12 years or more is below the
measured level in 2003-04.

Target setting method: Retention of Healthy People 2010 target.


Non-persistent insecticides

EH-20.9 Paranitrophenol (methyl parathion and parathions).


Baseline: 2.89 µg/of creatinine: Concentration level of para-Nitrophenol (creatinine corrected) in
urine samples at which 95 percent of the population aged 6 years or more is below the



EH-20.10 3,4,6-trichloro-2-pyridinol (chlorpyrifos).


Baseline: 9.22 µg/g of creatinine: Concentration level of 3,5,6-trichloro-2-pyridinol in urine
samples at which 95 percent of the population aged 6 years or more is below the measured
level in 2001-02.



EH-20.11 3-phenoxybenzoic acid.


EH-14
100

Baseline: 3.10 µg/g of creatinine: Concentration level of 3-Phenoxybenzoic acid (creatinine
corrected) in urine samples at which 95 percent of the population aged 6 years or more is below
the measured level in 2001-02.



Persistent industrial chemicals: Polychlorinated biphenyls (PCBs)

EH-20.12 PCB 153, representative of nondioxin-like PCBs.


Baseline: 97.1 ng/g of lipid: Concentration level of 2,2',4,4',5,5'-Hexachlorobiphenyl (PCB 153)
(lipid adjusted) in serum samples at which 95 percent of the population aged 12 years or more
is below the measured level in 2003-04.



EH-20.13 PCB 126, representative of dioxin-like PCBs.

Target: 48.09 pg/g of lipid.

Baseline: 68.7 pg/g of lipid: Concentration level of 3,3',4,4',5-Pentachlorobiphenyl (PCB 126)
(lipid adjusted) in serum samples at which 95 percent of the population aged 12 years or more



Persistent industrial chemicals: Dioxins

EH-20.14 1,2,3,6,7,8-hexachlorodibenzo-p-dioxin, representative of the dioxin class.

Target: 47.95 pg/g of lipid.

Baseline: 68.5 pg/g of lipid: Concentration level of 1,2,3,6,7,8-Hexachlorodibenzo-p-dioxin
(HxCDD) (lipid adjusted) in serum samples at which 95 percent of the population aged 12 years
or more is below the measured level in 2003-04.



EH-15
101

Potential endocrine disruptors

EH-20.15 Bisphenol A.


Baseline: 11.2 µg/g of creatinine: Concentration level of Bisphenol A (2,2-bis[4-Hydroxyphenyl]
propane) (creatinine corrected) in urine samples at which 95 percent of the population aged 6
years and older is below the measured level in 2003-04.



EH-20.16 Perchlorate.


Baseline: 12.0 µg/g of creatinine: Concentration level of perchlorate (creatinine corrected) in
urine samples at which 95 percent of the population aged 6 years and older is below the



EH-20.17 Mono-n-butyl phthalate.


Baseline: 91.6 µg/g of creatinine: Concentration level of Mono-n-butyl phthalate (MnBP)
(creatinine corrected) in urine samples at which 95 percent of the population aged 6 years and
older is below the measured level in 2003-04.



Flame retardants: polybrominated diphenyl ethers (BDEs)

EH-20.18 BDE 47, (2,2',4,4'-tetrabromodiphenyl ether).


Baseline: 163 ng/g of lipid: Concentration level of 2,2',4,4'-Tetrabromodiphenyl ether (BDE 47)
(lipid adjusted) in serum samples at which 95 percent of the population aged 12 years and older

EH-16
102



EH-21: Improve quality, utility, awareness, and use of existing information systems for
environmental health.


Baseline: 16 States used an integrated information system to monitor environmental health in
2006.


Data source: National Environmental Public Health Tracking Network (EPHT), CDC, NCEH.

EH-22: Increase the number of States, Territories, Tribes, and the District of Columbia that
monitor diseases or conditions that can be caused by exposure to environmental hazards.

EH-22.1 Lead poisoning.

Target: 56 States, Territories, and the District of Columbia.

Baseline: 29 States and District of Columbia monitored lead poisoning in 2009.


Data source: Council of State and Territorial Epidemiologists (CSTE) State Reportable
Conditions Data Inventory.

EH-22.2 Pesticide poisoning.


Baseline: 28 States monitored pesticide poisoning in 2009.



EH-22.3 Mercury poisoning.


Baseline: 24 States monitored mercury poisoning in 2009.


EH-17
103


EH-22.4 Arsenic poisoning.


Baseline: 22 States monitored arsenic poisoning in 2009.



EH-22.5 Cadmium poisoning.


Baseline: 21 States monitored cadmium poisoning in 2009.



EH-22.6 Acute chemical poisoning.


Baseline: 17 States monitored acute chemical poisoning in 2009.



EH-22.7 Carbon monoxide poisoning.


Baseline: 20 States monitored carbon monoxide poisoning in 2009.



EH-18
104

EH-23: Reduce the number of new schools sited within 500 feet of an interstate or Federal or
State highway.

Target: 18.9 percent or less of schools located within 500 feet.

Baseline: 18.9 percent of schools were located within 500 feet of an interstate or Federal or
State highway in 2005-06.


Data source: GRASP/ATSDR geocoded data from Homeland Security Information Program.

GLOBAL ENVIRONMENTAL HEALTH
EH-24: Reduce the global burden of disease due to poor water quality, sanitation, and
insufficient hygiene.

Target: 2.0 million deaths.

Baseline: 2.2 million deaths were caused by poor water quality, sanitation, and insufficient
hygiene in 2004.


Data source: Global Burden of Disease Project, World Health Organization (WHO).

EH-19
105


Family Planning

FP–1 Intended pregnancy

FP–2 Contraceptive failure

FP–3 Emergency contraception available at family planning clinics

FP–4 Health insurance coverage for contraceptive supplies and services

FP–5 Birth spacing

FP–6 Contraceptive use at most recent sexual intercourse

FP–7 Receipt of reproductive health services

FP–8 Adolescent pregnancy

FP–9 Abstinence ages 17 and under

FP–10 Use of condoms for pregnancy prevention and protection against disease

FP–11 Dual method use for pregnancy and disease prevention

FP–12 Adolescent Reproductive health education

FP–13 Parent-adolescent communication about reproductive health topics

FP–14 Medicaid eligibility for pregnancy-related care

FP–15 Receipt of publicly supported contraceptive services and supplies

FP–1
106

Topic Area: Family Planning
FP–1: Increase the proportion of pregnancies that are intended.

Target: 56 percent.

Baseline: As reported in 2002, 51 percent of all pregnancies were intended.


Data sources: National Survey of Family Growth (NSFG), CDC, NCHS; National Vital Statistics
System (NVSS), CDC, NCHS; Abortion Provider Survey, Guttmacher Institute; Abortion
Surveillance Data, CDC, NCCDPHP.

FP–2: Reduce the proportion of females experiencing pregnancy despite use of a reversible
contraceptive method.


Baseline: As reported in 2002, 12.4 percent of females experienced pregnancy despite use of a
reversible contraceptive method.

Target setting method: 20 percent improvement based on trend analysis.

Data sources: National Survey of Family Growth (NSFG), CDC, NCHS; Abortion Provider
Survey, Guttmacher Institute.

FP–3: Increase the proportion of publicly funded family planning clinics that offer the full-range
of FDA-approved methods of contraception, including emergency contraception, onsite.

FP–3.1 Increase the proportion of publicly funded family planning clinics that offer the full
range of FDA-approved methods of contraception onsite.


Baseline: As reported in 2003, 38.3 percent of publicly funded family planning clinics offered the
full range of FDA-approved methods of contraception onsite.


Data source: Survey of Contraceptive Service Providers, Guttmacher Institute.

FP–3.2 Increase the proportion of publicly funded family planning clinics that offer
emergency contraception onsite.


Baseline: As reported in 2003, 79.7 percent of publicly funded family planning clinics offered
emergency contraception onsite.

FP–2
107


Data source: Survey of Contraceptive Service Providers, Guttmacher Institute.

FP–4: (Developmental) Increase the proportion of health insurance plans that cover
contraceptive supplies and services.

Potential data source: Guttmacher Institute.

FP–5: Reduce the proportion of pregnancies conceived within 18 months of a previous birth.


Baseline: As reported in 2006–08, 35.3 percent of pregnancies were conceived within 18
months of a previous birth.


Data source: National Survey of Family Growth, CDC, NCHS.

FP–6: Increase the proportion of females or their partners at risk of unintended pregnancy who
used contraception at most recent sexual intercourse.


Baseline: As reported in 2006–08, 83.0 percent of females or their partners at risk of unintended
pregnancy used contraception at most recent sexual intercourse.


Data source: National Survey of Family Growth (NSFG), CDC, NCHS.

FP–7: Increase the proportion of sexually active persons who received reproductive health
services.

FP–7.1 Increase the proportion of sexually active females aged 15 to 44 years who received
reproductive health services.


Baseline: As reported in 2006–08, 78.8 percent of sexually active females aged 15 to 44 years
received reproductive health services in the past 12 months.



FP–3
108

FP–7.2 Increase the proportion of sexually active males aged 15 to 44 years who received
reproductive health services.


Baseline: As reported in 2006–08, 14.9 percent of sexually active males aged 15 to 44 years
received reproductive health services in the past 12 months.



FP–8: Reduce pregnancy rates among adolescent females.

FP–8.1 Reduce the pregnancy rate among adolescent females aged 15 to 17 years.

Target: 36.2 pregnancies per 1,000.

Baseline: 40.2 pregnancies per 1,000 females aged 15 to 17 years occurred in 2005.


Data sources: Abortion Provider Survey, Guttmacher Institute; Abortion Surveillance Data, CDC,
NCCDPHP; National Vital Statistics System–Natality (NVSS–N), CDC, NCHS; National Survey
of Family Growth (NSFG), CDC, NCHS.

FP–8.2 Reduce the pregnancy rate among adolescent females aged 18 to 19 years.

Target: 105.9 pregnancies per 1,000.

Baseline: 117.7 pregnancies per 1,000 females aged 18 to 19 years occurred in 2005.


Data sources: Abortion Provider Survey, Guttmacher Institute; National Vital Statistics System
(NVSS), CDC, NCHS; National Survey of Family Growth (NSFG), CDC, NCHS; Abortion
Surveillance Data, CDC, NCCDPHP.

FP–9: Increase the proportion of adolescents aged 17 years and under who have never had
sexual intercourse.

FP–9.1 Female adolescents aged 15 to 17 years.


Baseline: In 2006–08, 72.1 percent of female adolescents aged 15 to 17 years reported they
had never had sexual intercourse.



FP–4
109

FP–9.2 Male adolescents aged 15 to 17 years.


Baseline: In 2006–08, 71.2 percent of male adolescents aged 15 to 17 years reported they had
never had sexual intercourse.



FP–9.3 Female adolescents aged 15 years and under.


Baseline: As reported in 2006–08, 82.9 percent of female adolescents aged 15 years had never
had sexual intercourse.



FP–9.4 Male adolescents aged 15 years and under.


Baseline: As reported in 2006–08, 82.0 percent of male adolescents aged 15 years had never
had sexual intercourse.


Data source: National Survey of Family Growth (NSFG), CDC.

FP–10: Increase the proportion of sexually active persons aged 15 to 19 years who use
condoms to both effectively prevent pregnancy and provide barrier protection against disease.

FP–10.1 Increase the proportion of sexually active females aged 15 to 19 years who use a
condom at first intercourse.


used a condom at first intercourse.


Data source: National Survey of Family Growth (NSFG), CDC.

FP–5
110

FP–10.2 Increase the proportion of sexually active males aged 15 to 19 years who use a
condom at first intercourse.


used a condom at first intercourse.



condom at last intercourse.


used a condom at last intercourse.



condom at last intercourse.


used a condom at last intercourse.



FP–11: Increase the proportion of sexually active persons aged 15 to 19 years who use
condoms and hormonal or intrauterine contraception to both effectively prevent pregnancy and
provide barrier protection against disease.

condom and hormonal or intrauterine contraception at first intercourse.


used a condom and hormonal or intrauterine contraception at first intercourse.



FP–6
111

condom and hormonal or intrauterine contraception at first intercourse.


used a condom and hormonal or intrauterine contraception at first intercourse.



condom and hormonal or intrauterine contraception at last intercourse.


used a condom and hormonal or intrauterine contraception at last intercourse.



a. FP–11.4 Increase the proportion of sexually active males aged 15 to 19 years who use a
condom and hormonal or intrauterine contraception at last intercourse.


used a condom and hormonal or intrauterine contraception at last intercourse.



FP–12: Increase the proportion of adolescents who received formal instruction on reproductive
health topics before they were 18 years old.

FP–12.1 Abstinence—Females.


Baseline: As reported in 2006–08, 87.2 percent of female adolescents received formal
instruction on how to say no to sex before they were 18 years old.



FP–7
112

FP–12.2 Abstinence—Males.


Baseline: As reported in 2006–08, 81.1 percent of male adolescents received formal instruction
on how to say no to sex before they were 18 years old in 2002.



FP–12.3 Birth control methods—Females.


Baseline: As reported in 2006–08, 69.5 percent of females received formal instruction on birth
control methods before they were 18 years old.



FP–12.4 Birth control methods—Males.


Baseline: As reported in 2006–08, 61.9 percent of males received formal instruction on birth
control methods before they were 18 years old.



FP–8
113

FP–12.5 HIV/AIDS prevention—Females.


Baseline: As reported in 2006–08, 88.3 percent of females received formal instruction on
HIV/AIDS prevention before they were 18 years old.



FP–12.6 HIV/AIDS prevention—Males.


Baseline: As reported in 2006–08, 89.0 percent of males received formal instruction on
HIV/AIDS prevention before they were 18 years old.



FP–12.7 Sexually transmitted diseases—Females.


Baseline: As reported in 2006–08, 93.2 percent of females received formal instruction on
sexually transmitted disease prevention methods before they were 18 years old.



FP–9
114

FP–12.8 Sexually transmitted diseases—Males.


Baseline: As reported in 2006–08, 92.2 percent of males received formal instruction on sexually
transmitted disease prevention methods before they were 18 years old.



FP–13: Increase the proportion of adolescents who talked to a parent or guardian about
reproductive health topics before they were 18 years old.

FP–13.1 Abstinence—Females.


Baseline: As reported in 2006–08, 63.1 percent of female adolescents talked with a parent or
guardian about how to say no to sex before they were 18 years old.



FP–13.2 Abstinence—Males.


Baseline: As reported in 2006–08, 41.8 percent of male adolescents talked to a parent or
guardian about how to say no to sex before they were 18 years old.



FP–13.3. Birth control methods—Females.


Baseline: As reported in 2006–08, 50.5 percent of female adolescents talked to a parent or
guardian about birth control methods before they were 18 years old.



FP–10
115

FP–13.4 Birth control methods—Males.


guardian about birth control methods before they were 18 years old.



FP–13.5 HIV/AIDS prevention—Females.


guardian about HIV/AIDS prevention before they were 18 years old.



FP–13.6 HIV/AIDS prevention—Males.


guardian about HIV/AIDS prevention before they were 18 years old.



FP–13.7 Sexually transmitted diseases—Females.


guardian about sexually transmitted diseases before they were 18 years old.



FP–11
116

FP–13.8 Sexually transmitted diseases—Males.


guardian about sexually transmitted diseases before they were 18 years old.



FP–14: Increase the number of States that set the income eligibility level for Medicaid-covered
family planning services to at least the same level used to determine eligibility for Medicaid-
covered, pregnancy-related care.

Target: 32 States.

Baseline: 21 States set the income eligibility level for Medicaid-covered family planning services
to at least the same level used to determine eligibility for Medicaid-covered, pregnancy-related
care in 2010.

Target setting method: Trend analysis.

Data sources: Guttmacher Institute, State Medicaid Family Planning Eligibility Expansions—
national, State-based data (includes data for all 50 States); State Medicaid Family Planning
Eligibility Expansions, Guttmacher Institute; Medicaid Income Eligibility Levels for Pregnant
Women, Kaiser Family Foundation—national, State-based data (includes data for all 50 States).

FP–15: Increase the proportion of females in need of publicly supported contraceptive services
and supplies who receive those services and supplies.


Baseline: 53.8 percent of females in need of publicly supported contraceptive services and
supplies reported receiving those services and supplies in 2006.


Data source: Contraceptive Needs and Services, Guttmacher Institute.

FP–12
117


Food Safety

FS–1 Infections caused by key foodborne pathogens

FS–2 Outbreak-associated infections associated with food commodity groups

FS–3 Antimicrobial resistance

FS–4 Allergic reactions to food

FS–5 Consumer food safety practices

FS–6 Safe food preparation practices in foodservice and retail establishments

FS–1
118

Topic Area: Food Safety
FS–1: Reduce infections caused by key pathogens transmitted commonly through food.

FS–1.1 Campylobacter species.

Target: 8.5 cases per 100,000.

Baseline: 12.7 cases, on average of laboratory-confirmed Campylobacter species infections per
100,000 population per year were reported in 2006–08.


Data source: The Foodborne Disease Active Surveillance Network (FoodNet), CDC.

FS–1.2 Shiga toxin-producing Escherichia coli (STEC) O157:H7.


Baseline: 1.2 cases, on average, of laboratory-confirmed Shiga toxin-producing Escherichia coli
(STEC) O157:H7 infections per 100,000 population per year were reported in 2006–08.



FS–1.3 Listeria monocytogenes.


Baseline: 0.3 cases, on average of laboratory-confirmed Listeria monocytogenes infections per



FS–1.4 Salmonella species.


Baseline: 15.2 cases, on average, of laboratory-confirmed Salmonella species infections per



FS–2
119

FS–1.5 Postdiarrheal hemolytic-uremic syndrome (HUS) in children under 5 years of age.

Target: .0.9 cases per 100,000.

Baseline: 1.8 cases. on average, of postdiarrheal hemolytic-uremic syndrome (HUS) infections
per 100,000 children under 5 years of age per year were reported in 2005–07.



FS–1.6 Vibrio species.


Baseline: 0.3 cases, on average, of laboratory-confirmed Vibrio species infections per 100,000
population per year were reported in 2006–08.



FS–1.7 Yersinia species.


Baseline: 0.4 cases, on average, of laboratory-confirmed Yersinia species infections per



FS–2: Reduce the number of outbreak-associated infections due to Shiga toxin-producing E.
coli O157, or Campylobacter, Listeria, or Salmonella species associated with food commodity
groups:

FS–2.1 Beef.

Target: 180 cases per year.

Baseline: 200 reported outbreak-associated infections, on average, per year due to Shiga toxin-
producing E. coli O157, or Campylobacter, Listeria, or Salmonella species were associated with
beef in 2005–07.


Data source: National Outbreak Reporting System (NORS), CDC and States.

FS–3
120

FS–2.2 Dairy.


dairy products in 2005–07.



FS–2.3 Fruits and nuts.


fruits and nuts in 2005–07.



FS–2.4 Leafy vegetables.


leafy vegetables in 2005–07.



FS–2.5 Poultry.


poultry in 2005–07.



FS–4
121

FS–3: Prevent an increase in the proportion of nontyphoidal Salmonella and Campylobacter
jejuni isolates from humans that are resistant to antimicrobial drugs.

Nontyphoidal Salmonella isolates from humans that are resistant to:

FS–3.1 Nalidixic acid (quinolone).

Target: 2 percent.

Baseline: 2 percent of nontyphoidal Salmonella isolates from humans were resistant to nalidixic
acid (quinolone) in 2006–08.

Target setting method: prevent an increase.

Data source: National Antimicrobial Resistance Monitoring System (NARMS), CDC.

FS–3.2 Ceftriaxone (third-generation cephalosporin).

Target: 3 percent.

Baseline: 3 percent of nontyphoidal Salmonella isolates from humans were resistant to
ceftriaxone (third-generation cephalosporin) in 2006–08.



FS–3.3 Gentamicin.

Target: 2 percent.

gentamicin in 2006–08.



FS–3.4 Ampicillin.

Target: 10 percent.

ampicillin in 2006–08.



FS–5
122

FS–3.5 Three or more classes of antimicrobial agents.

Target: 11 percent.

Baseline: 11 percent of nontyphoidal Salmonella isolates from humans were resistant to three or
more classes of antimicrobial agents in 2006–08.



Campylobacter jejuni isolates from humans that are resistant to:

FS–3.6 Erythromycin.

Target: 2 percent.

Baseline: 2 percent of Campylobacter jejuni isolates from humans were resistant to
erythromycin in 2006–08.



FS–4: Reduce severe allergic reactions to food among adults with a food allergy diagnosis.


Baseline: 29.3 percent of adults with a food allergy diagnosis experienced severe allergic
reactions to food in 2006.


Data sources: Food Safety Survey, FDA; USDA FSIS.

FS–5: Increase the proportion of consumers who follow key food safety practices.

FS–5.1 Clean: wash hands and surfaces often.


Baseline: 67.2 percent of consumers followed the key food safety practice of “Clean: wash
hands and surfaces often.” in 2006.


Data source: Food Safety Survey, FDA and USDA FSIS.

FS–6
123

FS–5.2 Separate: don’t cross-contaminate.

Target: 92 percent.

Baseline: 89 percent of consumers followed the key food safety practice of “Separate: don’t
cross-contaminate.” in 2006.



FS–5.3 Cook: cook to proper temperatures.

Target: 50 percent.

Baseline: 37 percent of consumers followed the key food safety practice of “Cook: cook to
proper temperatures.” in 2006.



FS–5.4 Chill: refrigerate promptly.


Baseline: 88.1 percent of consumers followed the key food safety practice of “Chill: refrigerate
promptly.” in 2006.


Data sources: Food Safety Survey, FDA and USDA FSIS.

FS–6: (Developmental) Improve food safety practices associated with foodborne illness in
foodservice and retail establishments.

Potential data source: Retail Risk Factor Studies, FDA CFSAN.

FS–7
124


Genomics

G–1 Genetic counseling for women with a family history of breast and/or ovarian

G–2 Genetic testing for persons with colorectal cancer to detect Lynch syndrome

G–1
125

Topic Area: Genomics
G–1: Increase the proportion of women with a family history of breast and/or ovarian cancer
who receive genetic counseling.


Baseline: 23.3 percent of women with a family history of breast and/or ovarian cancer received
genetic counseling in 2005.



G–2: (Developmental) Increase the proportion of persons with newly diagnosed colorectal
cancer who receive genetic testing to identify Lynch syndrome (or familial colorectal cancer
syndromes).

Potential data sources: National Program of Cancer Registries (NPCR), CDC; Surveillance,
Epidemiology, and End Results (SEER), NIH, NCI.

G–2
126


Global Health

GH–1 Malaria in the United States

GH–2 Tuberculosis in foreign born persons

Enhance global capacity in support of the International Health Regulations to detect and
contain emerging health threats.

GH–3 Global Disease Detection Regional Centers worldwide

GH–4 Global Disease Detection training for public health professionals

GH–5 Global Disease Detection diagnostic testing capacity

GH–1
127

Topic Area: Global Health
GH–1: Reduce the number of cases of malaria reported in the United States.

Target: 999 new cases.

Baseline: 1,298 new cases of malaria were reported in the United States in 2008.


Data source: National Malaria Surveillance System (NMSS), CDC.

GH-2: Decrease the tuberculosis (TB) case rate for foreign-born persons living in the United
States.

Target: 14.0 cases per 100,000 population.

Baseline: 20.2 cases of tuberculosis (TB) per 100,000 population were reported for foreign-born
persons living in the United States in 2008.


Data source: National Tuberculosis Indicators Project (NTIP), CDC.

Enhance global capacity in support of the International Health Regulations to detect and
contain emerging health threats.

GH-3: Increase the number of Global Disease Detection (GDD) Regional Centers worldwide to
detect and contain emerging health threats.

Target: 13 centers.

Baseline: 7 Global Disease Detection (GDD) Regional Centers worldwide were active in 2009.

Target setting method: Consistency with national programs.

Data source: GDD Monitoring and Evaluation Database, CDC.

GH-4: Increase the number of public health professionals trained by Global Disease Detection
Global Disease Detection (GDD) programs worldwide.

Target: 144,132 public health professionals.

Baseline: 37,132 public health professionals were trained by Global Disease Detection (GDD)
programs in 2009.



GH–2
128

GH-5: Increase diagnostic testing capacity in host countries and regionally through the Global
Disease Detection (GDD) Regional Centers.

Target: 264 tests.

Baseline: 154 tests were established or substantially improved by Global Disease Detection
(GDD) programs in 2009.



GH–3
129


Health Communication and Health IT

HC/HIT–1 Health literacy

HC/HIT–2 Satisfaction with health care providers’ communication skills

HC/HIT–3 Individuals’ involvement in their health care decision making

HC/HIT–4 Receipt of providers’ recommendations for personalized health care resources

HC/HIT–5 Electronic personal health management tools

HC/HIT–6 Internet access

HC/HIT–7 Social support

HC/HIT–8 Quality of Internet health information sources

HC/HIT–9 Access to online health information

HC/HIT–10 Electronic health records in medical practices

HC/HIT–11 Users of health information technology

HC/HIT–12 Best practices in health protection messages

HC/HIT–13 Social marketing in health promotion and disease prevention

HC/HIT–1
130

Topic Area: Health Communication and Health IT
HC/HIT-1: (Developmental) Improve the health literacy of the population.

HC/HIT–1.1 Increase the proportion of persons who report their health care provider always
gave them easy-to-understand instructions about what to do to take care of their illness or
health condition.

Potential data source: Medical Expenditure Survey (MEPS), AHRQ.

HC/HIT–1.2 Increase the proportion of persons who report their health care provider always
asked them to describe how they will follow the instructions.

Potential data source: Medical Expenditure Survey (MEPS), AHRQ.

HC/HIT–1.3 Increase the proportion of persons who report their health care providers’ office
always offered help in filling out a form.


HC/HIT–2: Increase the proportion of persons who report that their health care providers have
satisfactory communication skills.

HC/HIT–2.1 Increase the proportion of persons who report that their health care provider
always listened carefully to them.

Target: 65 percent.

Baseline: In 2007, 59 percent of persons reported that their health care provider always listened
carefully to them.



always explained things so they could understand them.

Target: 66 percent.

Baseline: In 2007, 60 percent of persons reported that their health care provider always
explained things so they could understand them.



HC/HIT–2
131

always showed respect for what they had to say.


Baseline: In 2007, 62 percent of persons reported that their health care provider always showed
respect for what they had to say.



always spent enough time with them.

Target: 54 percent.

Baseline: In 2007, 49 percent persons reported that their health care provider always spent
enough time with them.


Data source: Medical Expenditure Survey (MEPS), AHRQ.

HC/HIT–3: Increase the proportion of persons who report that their health care providers always
involved them in decisions about their health care as much as they wanted.


Baseline: In 2007, 51.6 percent of persons reported that their health care providers always
involved them in decisions about their health care as much as they wanted.


Data source: Health Information National Trends Survey (HINTS), NIH, NCI.

HC/HIT-4: (Developmental) Increase the proportion of patients whose doctor recommends
personalized health information resources to help them manage their health.

Potential data source: Pew Internet and American Life Project, PEW.

HC/HIT-5: Increase the proportion of persons who use electronic personal health management
tools.

HC/HIT–5.1 Increase the proportion of persons who use the Internet to keep track of
personal health information, such as care received, test results, or upcoming medical
appointments.


HC/HIT–3
132

Baseline: In 2007, 14.3 percent of persons reported using the Internet to keep track of personal
health information, such as care received, test results, or upcoming medical appointments.



HC/HIT–5.2 Increase the proportion of persons who use the Internet to communicate with
their provider.


Baseline: In 2007, 13.6 percent of persons reported using the Internet to communicate with their
provider.



HC/HIT-6: Increase individuals’ access to the Internet.

HC/HIT– 6.1 Increase the proportion of persons with access to the Internet.


Baseline: In 2007, 68.5 percent of persons reported having access to the Internet.


Data source: Health Information National Trends Survey (HINTS), NCI.

HC/HIT– 6.2 Increase the proportion of persons with broadband access to the Internet.


Baseline: In 2007, 75.6 percent of persons reported having broadband access to the Internet.



HC/HIT– 6.3 Increase the proportion of persons who use mobile devices.


Baseline: In 2007, 6.7 percent of persons reported using mobile devices.



HC/HIT–4
133

HC/HIT-7: Increase the proportion of adults who report having friends or family members whom
they talk with about their health.


Baseline: In 2007, 79.5 percent of adults reported having friends or family members that they
talk to about their health.



HC/HIT–8: Increase the proportion of quality, health-related Websites.

HC/HIT–8.1 Increase the proportion of health-related Websites that meet three or more
evaluation criteria disclosing information that can be used to assess information reliability.


Baseline: In 2009, 52 percent of health-related Websites met three or more evaluation criteria
disclosing information that can be used to assess information reliability.


Data source: Office of Disease Prevention and Health Promotion survey, HHS.

HC/HIT– 8.2 (Developmental) Increase the proportion of health-related Websites that follow
established usability principles.

Potential data source: Office of Disease Prevention and Health Promotion survey, HHS.

HC/HIT–9: Increase the proportion of online health information seekers who report easily
accessing health information.


Baseline: In 2007, 37.3 percent of online health information seekers reported easily accessing
health information.



HC/HIT–10: Increase the proportion of medical practices that use electronic health records.


Baseline: In 2007, 25.0 percent of medical practices reported using electronic health records.


HC/HIT–5
134

Data source: National Ambulatory Medical Care Survey (NAMCS), CDC, NCHS.

HC/HIT–11: (Developmental) Increase the proportion of meaningful users of health information
technology (HIT).

Potential data source: Centers for Medicare and Medicaid Services (CMS) Update/Report on
Meaningful Use.

HC/HIT-12: (Developmental) Increase the proportion of crisis and emergency risk messages
intended to protect the public’s health that demonstrate the use of best practices.

Potential data source: CDC Risk Communication Message Survey, CDC.

HC/HIT-13: (Developmental) Increase social marketing in health promotion and disease
prevention.

HC/HIT–13.1 Increase the proportion of State health departments that report using social
marketing in health promotion and disease prevention programs.

Potential data source: The National Public Health Information Coalition (NPHIC/CDC
Cooperative Agreement Healthy People 2020 Survey), CDC.

HC/HIT–13.2 Increase the proportion of schools of public health and accredited master of
public health (MPH) programs that offer one or more courses in social marketing.

Potential data sources: National Survey of Public Health Competencies in Social Marketing:
Survey of Association of Schools of Public Health (ASPH) member schools and accredited MPH
programs (Florida Prevention Research Center, University of South Florida).

HC/HIT–13.3 Increase the proportion of schools of public health and accredited MPH
programs that offer workforce development activities in social marketing for public health
practitioners.

Potential data sources: National Survey of Public Health Competencies in Social Marketing:
Survey of ASPH member schools and accredited MPH programs (Florida Prevention Research
Center, University of South Florida).

HC/HIT–6
135


Healthcare-Associated Infections

HAI–1 Central line-associated bloodstream infections

HAI–2 Methicillin-resistant Staphylococcus aureus infections

HAI–1
136

Topic Area: Healthcare-Associated Infections
HAI–1: Reduce central line-associated bloodstream infections (CLABSI).

Target: 0.25 Standardized Infection Ratio (SIR) or 75 percent reduction.

Baseline: 1.00 SIR was reported in 2006–08.


Data source: National Healthcare Safety Network (NHSN), CDC.

HAI–2: Reduce invasive healthcare-associated methicillin-resistant Staphylococcus aureus
(MRSA) infections.

Target: 6.56 infections per 100,000 persons or 75 percent reduction.

Baseline: 26.24 infections per 100,000 persons were reported in 2007–08.


Data source: Emerging Infections Program (EIP) network Active Bacterial Core surveillance
(ABCs), CDC.

HAI–2
137


Hearing and Other Sensory or Communication Disorders
(Ear, Nose, and Throat—Voice, Speech, and Language)


Newborn Hearing Screening

ENT–VSL–1 Newborn hearing screening, evaluation, and intervention

Ear Infections (Otitis Media)

ENT–VSL–2 Otitis media

Hearing

ENT–VSL–3 Hearing aids, assistive listening devices, and cochlear implants

ENT–VSL–4 Hearing examination

ENT–VSL–5 Evaluation and treatment referrals

ENT–VSL–6 Hearing protection

ENT–VSL–7 Noise-induced hearing loss in adolescents

ENT–VSL–8 Noise-induced hearing loss in adults

Tinnitus (Ringing in the Ears or Head)

ENT–VSL–9 Health care for tinnitus

ENT–VSL–10 Treatment for moderate to severe tinnitus

Balance and Dizziness

ENT–VSL–11 Healthcare for balance or dizziness problems

ENT–VSL–12 Referrals for balance or dizziness problems

ENT–VSL–13 Treatment for balance or dizziness problems

ENT–VSL–14 Improve balance and dizziness outcomes

ENT–VSL–15 Falls and injuries associated with balance and dizziness problems

Smell and Taste (Chemosenses)

ENT–VSL–16 Health care for chemosensory (smell or taste) disorders

ENT-VSL–1
138

ENT–VSL–17 Treatment for chemosensory (smell or taste) disorders

ENT–VSL–18 Improve outcomes associated with chemosensory (smell or taste)
disorders

Voice, Speech, and Language

ENT–VSL–19 Evaluation and treatment by speech-language pathologist (SLP)
or other health professional

ENT–VSL–20 Rehabilitation services for VSL/communication disorders

ENT–VSL–21 Participation in speech-language or other intervention services

ENT–VSL–22 Improved outcomes following speech-language therapy or other
rehabilitative and intervention services

Internet HealthCare Resources for ENT-VSL

ENT–VSL–23 Use of Internet health care information resources for
communication disorders

ENT-VSL–2
139

Topic Area: Hearing and Other Sensory or Communication Disorders
(Ear, Nose, and Throat—Voice, Speech, and Language)
Newborn Screening

ENT–VSL–1: Increase the proportion of newborns who are screened for hearing loss by no later
than age 1 month, have audiologic evaluation by age 3 months, and are enrolled in appropriate
intervention services no later than age 6 months.

ENT–VSL–1.1 Screening for hearing loss no later than age 1 month.


Baseline: 82.0 percent of newborns aged 1 month or less had screening for hearing loss in
2007.


Data source: State-based Early Hearing Detection and Intervention (EHDI) Program Network,
CDC, and/or specific State data.

ENT–VSL–1.2 Receipt of audiologic evaluation no later than age 3 months for infants who
did not pass the hearing screening.


Baseline: 66.0 percent of infants aged 3 months and under who did not pass the hearing
screening received audiologic evaluation in 2007.



ENT–VSL–1.3 Enrollment of infants with confirmed hearing loss for intervention services no
later than age 6 months.


Baseline: 50.0 percent of infants aged 6 months and under with confirmed hearing loss were
enrolled for intervention services in 2007.



ENT-VSL–3
140

Ear Infections (Otitis Media)

ENT–VSL–2: Decrease otitis media in children and adolescents.

Target: 221.5 persons per 1,000 population.

Baseline: 246.1 per 1,000 persons under age 18 years had otitis media in 2007.


Data sources: National Ambulatory Medical Care Survey (NAMCS), CDC, NCHS; National
Hospital Ambulatory Medical Care Survey (NHAMCS), CDC, NCHS; National Health Interview
Survey (NHIS), CDC, NCHS.

Hearing

ENT–VSL–3: Increase the proportion of persons with hearing impairments who have ever used
a hearing aid or assistive listening devices or who have cochlear implants.

ENT–VSL–3.1 Adults aged 20 to 69 years with hearing loss who have ever used a hearing
aid.

Target: 179.0 adults per 1,000 population.

Baseline: 162.7 per 1,000 adults aged 20 to 69 years had ever used a hearing aid in 2006.


Data sources: National Health Interview Survey (NHIS), CDC, NCHS; National Health and
Nutrition Examination Survey (NHANES), CDC, NCHS.

ENT–VSL–3.2 Persons who are deaf or very hard of hearing and who have new cochlear
implants.

Target: 84.7 persons per 10,000 persons.

Baseline: 77.0 per 10,000 persons who are deaf or very hard of hearing had new cochlear
implants in 2004.


Data sources: Healthcare Cost and Utilization Project (HCUP), AHRQ; National Health Interview
Survey (NHIS), CDC, NCHS.

ENT–VSL–3.3 Adults aged 70 years and older with hearing loss who have ever used a
hearing aid.


Baseline: 289.1 per 1,000 adults aged 70 years and older had ever used a hearing aid in 2007.

ENT-VSL–4
141


Data sources: National Health Interview Survey (NHIS), CDC, NCHS; National Health and
Nutrition Examination Survey (NHANES), CDC, NCHS.

ENT–VSL–3.4 Adults aged 70 years and older with hearing loss who use assistive listening
devices.


Baseline: 100.0 per 1,000 adults aged 70 years and older used assistive listening devices in
2005–06.



ENT–VSL–4: Increase the proportion of persons who have had a hearing examination on
schedule.

ENT–VSL–4.1 Adults aged 20 to 69 years who have had a hearing examination in the past
5 years.


Baseline: 28.6 percent of adults aged 20 to 69 years had a hearing examination in the past
5 years in 2003–04.



ENT–VSL–4.2 Adults aged 70 years and older who have had a hearing examination in the
past 5 years.


Baseline: 38.5 percent of adults aged 70 years and older had had a hearing examination in the
past 5 years in 2003–04.



ENT–VSL–4.3 Adolescents aged 12 to 19 years who have had a hearing examination in the
past 5 years.


ENT-VSL–5
142

Baseline: 79.3 percent of adolescents aged 12 to 19 years had had a hearing examination in the
past 5 years in 2005–06.



ENT–VSL–5: Increase the number of persons who are referred by their primary care physician
or other health care provider for hearing evaluation and treatment.


Baseline: 283.4 per 1,000 adults aged 18 years and older were referred by their primary care
physician or other health care provider for hearing evaluation and treatment in 2007.



ENT–VSL–6: Increase the use of hearing protection devices.

ENT–VSL–6.1 Adults aged 20 to 69 years who have ever used hearing protection devices
(earplugs, earmuffs) when exposed to loud sounds or noise (age adjusted to the year 2000


Baseline: 483.0 per 1,000 adults aged 20 to 69 years had ever used hearing protection devices
(earplugs, earmuffs) when exposed to loud sounds or in 2003–04.



ENT–VSL–6.2 Adolescents aged 12 to 19 years who have ever used hearing protection
devices (earplugs, earmuffs) when exposed to loud sounds or noise.


Baseline: 410.7 per 1,000 adolescents 12 to 19 years had ever used hearing protection devices
(earplugs, earmuffs) when exposed to loud sounds or noise in 2005–06.



ENT-VSL–6
143

ENT–VSL–7: Reduce the proportion of adolescents who have elevated hearing thresholds, or
audiometric notches, in high frequencies (3, 4, or 6 kHz) in both ears, signifying noise-induced
hearing loss.


Baseline: 45.9 per 1,000 adolescents aged 12 to 18 years had elevated hearing thresholds, or
hearing loss in 2005–06.



ENT–VSL–8: Reduce the proportion of adults who have elevated hearing thresholds, or
hearing loss.


Baseline: 121.4 per 1,000 adults aged 20 to 69 years had elevated hearing thresholds, or
hearing loss in 2003–04.



Tinnitus (Ringing in the Ears or Head)

ENT–VSL–9: Increase the proportion of adults bothered by tinnitus who have seen a doctor or
other health care professionals.

ENT–VSL–9.1 Increase the proportion of adults bothered by tinnitus in the past 12 months
who have seen a doctor.


Baseline: 44.5 percent of adults aged 18 years and older bothered by tinnitus in the past 12
months had seen a doctor in 2007.



ENT–VSL–9.2 Increase the proportion of adults bothered by the onset of tinnitus in the past
5 years, for whom it is a moderate, big, or very big problem, who have seen or been referred
to an audiologist or otolaryngologist (ENT physician).


ENT-VSL–7
144

Baseline: 45.8 percent of adults 18 years and older bothered by the onset of tinnitus in the past
5 years, for whom it is a moderate, big, or very big problem, had seen or been referred to an
audiologist or otolaryngologist (ENT physician) in 2007.



ENT–VSL–10: Increase the proportion of adults for whom tinnitus is a moderate to severe
problem who have tried appropriate treatments.


Baseline: 80.9 percent of adults aged 18 years and older for whom tinnitus is a moderate to
severe problem tried appropriate treatments in 2007.



Balance and Dizziness

ENT–VSL–11: Increase the proportion of adults with balance or dizziness problems in the past
12 months who have ever seen a health care provider about their balance or dizziness
problems.


Baseline: 48.4 percent of adults aged 18 years and older with balance or dizziness problems in
the past 12 months had ever seen a health care provider in 2008.



ENT–VSL–12: Increase the proportion of adults with moderate to severe balance or dizziness
problems who have seen or been referred to a health care specialist for evaluation or treatment.


Baseline: 65.4 percent of adults aged 18 years and older with moderate to severe balance or
dizziness problems had seen or been referred to a health care specialist for evaluation or
treatment in 2008.



ENT-VSL–8
145

ENT–VSL–13: Increase the proportion of persons who have tried recommended methods for
treating their balance or dizziness problems.

ENT–VSL–13.1 (Developmental) Increase the proportion of children who have tried
recommended methods for treating their balance or dizziness problem.


ENT–VSL–13.2 Increase the proportion of adults who have tried recommended methods for
treating their balance or dizziness problem.


Baseline: 24.4 percent of adults aged 18 years and older tried recommended methods for
treating their balance or dizziness problem in 2008.



ENT–VSL–14: Reduce the proportion of adults with balance and dizziness problems who
experienced negative or adverse outcomes in the past 12 months.

ENT–VSL–14.1 Reduce the proportion of adults with balance and dizziness problems in the
past 12 months who reported their condition got worse or did not improve.


Baseline: 61.5 percent of adults aged 18 years and older with balance and dizziness problems
in the past 12 months reported their condition got worse or did not improve in 2008.



ENT–VSL–14.2 Reduce the proportion of adults with balance and dizziness problems in the
past 12 months who were prevented from doing regular activities within the home or outside.


in the past 12 months were prevented from doing regular activities within the home or outside in
2008.



ENT-VSL–9
146

ENT–VSL–14.3 Reduce the proportion of adults who have missed days of work or school in
the past 12 months because of balance and dizziness problems.


Baseline: 14.5 percent of adults aged 18 years and older missed days of work or school in the
past 12 months because of balance and dizziness problems in 2008.



ENT-VSL–15: Reduce the proportion of adults with balance and dizziness problems who have
fallen and been injured.

ENT–VSL–15.1 Reduce the proportion of adults with balance and dizziness problems who
have fallen in the past 5 years while experiencing symptoms of dizziness, vertigo, or
imbalance.


fell in the past 5 years while experiencing symptoms of dizziness, vertigo, or imbalance in 2008.



ENT–VSL–15.2 Reduce the proportion of adults with balance and dizziness problems who
have been injured as a result of a fall for any reason in the past 12 months.


were injured as a result of a fall for any reason in the past 12 months in 2008.



Smell and Taste (Chemosenses)

ENT-VSL–16: (Developmental) Increase the proportion of adults with chemosensory (smell or
taste) disorders who have seen a health care provider about their disorder in the past 12
months.

NCHS.

ENT-VSL–10
147

ENT-VSL–17: (Developmental) Increase the proportion of adults who have tried recommended
methods of treating their smell or taste disorders in the past 12 months to improve their
condition.

NCHS.

ENT-VSL–18: (Developmental) Reduce the proportion of adults with chemosensory (smell or
taste) disorders who as a result have experienced a negative impact on their general health
status, work, or quality of life in the past 12 months.

NCHS.

Voice, Speech, and Language

ENT-VSL–19: (Developmental) Increase the proportion of persons with communication
disorders of voice, swallowing, speech, or language who have seen a speech-language
pathologist (SLP) for evaluation or treatment.


disorders of voice, swallowing, speech, or language who have participated in rehabilitation
services.


ENT-VSL–21: (Developmental) Increase the proportion of young children with phonological
disorders, language delay, or other developmental language problems who have participated in
speech-language or other intervention services.


disorders of voice, swallowing, speech, or language in the past 12 months whose personal or
social functioning at home, school, or work improved after participation in speech-language
therapy or other rehabilitative or intervention services.


ENT-VSL–11
148

Internet Health Care Resources for ENT-VSL

ENT-VSL–23: (Developmental) Increase the proportion of persons with hearing loss and other
sensory or communication disorders who have used Internet resources for health care
information, guidance, or advice in the past 12 months.


ENT-VSL–12
149


Heart Disease and Stroke

HDS–1 Cardiovascular health
HDS–2 Coronary heart disease deaths
HDS–3 Stroke deaths
HDS–4 Blood pressure screening
HDS–5 Hypertension
HDS–6 Blood cholesterol screening
HDS–7 High total blood cholesterol levels
HDS–8 Mean total blood cholesterol levels
HDS–9 Prehypertension lifestyle guidelines
HDS–10 Hypertension lifestyle guidelines
HDS–11 Hypertension medication compliance
HDS–12 High blood pressure control
HDS–13 Advice on elevated LDL cholesterol treatment
HDS–14 Compliance with elevated LDL cholesterol treatment
HDS-15 Aspirin use for primary cardiovascular disease prevention
HDS–16 Awareness of and response to early warning symptoms of heart attack
HDS–17 Awareness of and response to early warning symptoms of stroke
HDS–18 Bystander and emergency medical services response to cardiac arrest
HDS–19 Timely artery-opening therapy
HDS–20 Adults with heart disease or stroke who meet recommended low-density
lipoprotein cholesterol levels
HDS-21 Aspirin or antiplatelet therapy for secondary cardiovascular disease
prevention
HDS-22 Referral to cardiac rehabilitation program at discharge
HDS-23 Referral to stroke rehabilitation program at discharge
HDS–24 Heart failure hospitalizations

HDS–1
150

Topic Area: Heart Disease and Stroke
HDS–1: (Developmental) Increase overall cardiovascular health in the U.S. population.

NCHS.

HDS–2: Reduce coronary heart disease deaths.


Baseline: 126.0 coronary heart disease deaths per 100,000 population occurred in 2007 (age

Target setting method: Projection (20 percent improvement).

Data source: National Vital Statistics System–Mortality (NVSS–M), CDC, NCHS.

HDS–3: Reduce stroke deaths.


Baseline: 42.2 stroke deaths per 100,000 population occurred in 2007 (age adjusted to the year



HDS–4: Increase the proportion of adults who have had their blood pressure measured within
the preceding 2 years and can state whether their blood pressure was normal or high.


Baseline: 92.9 percent of adults aged 18 years and older had their blood pressure measured
within the preceding 2 years and could state whether it was normal or high in 2008 (age



HDS–5: Reduce the proportion of persons in the population with hypertension.

HDS–5.1 Reduce the proportion of adults with hypertension.


HDS–2
151

Baseline: 29.9 percent of adults aged 18 years and older had high blood pressure/hypertension
in 2005–08 (age adjusted to the year 2000 standard population).



HDS–5.2 Reduce the proportion of children and adolescents with hypertension.


Baseline: 3.5 percent of children and adolescents aged 8 to 17 years had high blood pressure/
hypertension in 2005–08.



HDS–6: Increase the proportion of adults who have had their blood cholesterol checked within
the preceding 5 years.


Baseline: 74.6 percent of adults aged 18 years and older had their blood cholesterol checked
within the preceding 5 years in 2008 (age adjusted to the year 2000 standard population).



HDS–7: Reduce the proportion of adults with high total blood cholesterol levels.


Baseline: 15.0 percent of adults aged 20 years and older had total blood cholesterol levels of
240 mg/dL or greater in 2005–08 (age adjusted to the year 2000 standard population).



HDS–8: Reduce the mean total blood cholesterol levels among adults.

Target: 177.9 mg/dl (mean).

Baseline: 197.7 mg/dl was the mean total blood cholesterol level for adults aged 20 years and
older in 2005–08 (age adjusted to the year 2000 standard population).


HDS–3
152


HDS–9: (Developmental) Increase the proportion of adults with prehypertension who meet the
recommended guidelines.

HDS–9.1 (Developmental) Body mass index (BMI).

NCHS.

HDS–9.2 (Developmental) Saturated fat consumption.

NCHS.

HDS–9.3 (Developmental) Sodium intake.

NCHS.

HDS–9.4 (Developmental) Physical activity.


NCHS.

HDS–9.5 (Developmental) Moderate alcohol consumption.


NCHS.

HDS–10: (Developmental) Increase the proportion of adults with hypertension who meet the
recommended guidelines.

HDS–10.1 (Developmental) BMI.

NCHS.

HDS–10.2 (Developmental) Saturated fat consumption.

NCHS.

HDS–4
153

HDS–10.3 (Developmental) Sodium intake.

NCHS.


NCHS.

HDS–10.5 (Developmental) Moderate alcohol consumption.

NCHS.

HDS–11: Increase the proportion of adults with hypertension who are taking the prescribed
medications to lower their blood pressure.


Baseline: 70.4 percent of adults aged 18 years and older with high blood pressure/hypertension
were taking the prescribed medications to lower their blood pressure in 2005–08 (age adjusted



HDS–12: Increase the proportion of adults with hypertension whose blood pressure is under
control.


Baseline: 43.7 percent of adults aged 18 years and older with high blood pressure/hypertension
had it under control in 2005–08 (age adjusted to the year 2000 standard population).



HDS–13: (Developmental) Increase the proportion of adults with elevated LDL cholesterol who
have been advised by a health care provider regarding cholesterol lowering management
including lifestyle changes and, if indicated, medication.

HDS–13.1 (Developmental) Cholesterol lowering diet.

NCHS.

HDS–5
154


NCHS.

HDS–13.3 (Developmental) Weight control.

NCHS.

HDS–13.4 (Developmental) Prescribed drug therapy.

NCHS.

HDS–14: (Developmental) Increase the proportion of adults with elevated LDL-cholesterol who
adhere to the prescribed LDL-cholesterol lowering management lifestyle changes and, if
indicated, medication.

HDS–14.1 (Developmental) Cholesterol-lowering diet.

NCHS.


NCHS.

HDS–14.3 (Developmental) Weight control.

NCHS.

HDS–14.4 (Developmental) Prescribed drug therapy.

NCHS.

HDS–15: (Developmental) Increase aspirin use as recommended among adults with no history
of cardiovascular disease.

HDS– 15.1 (Developmental) Women aged 55 to 79 years.

Potential data source: National Ambulatory Medical Care Survey (NAMCS)/National Hospital
Ambulatory Medical Care Survey (NHAMCS), CDC, NCHS.

HDS–6
155

HDS– 15.2 (Developmental) Men aged 45 to 79 years.


HDS–16: Increase the proportion of adults aged 20 years and older who are aware of, and
respond to, early warning symptoms and signs of a heart attack.

HDS–16.1 Increase the proportion of adults aged 20 years and older who are aware of the
early warning symptoms and signs of a heart attack and the importance of accessing rapid
emergency care by calling 9–1–1 or another emergency number.


Baseline: 39.2 percent of adults aged 20 years and older were aware of the early warning
symptoms and signs of a heart attack and the importance of accessing rapid emergency care by
calling 9–1–1 or another emergency number in 2008 (age adjusted to the year 2000 standard
population).



early warning symptoms and signs of a heart attack.


Baseline: 42.0 percent of adults aged 20 years and older were aware of the early warning
symptoms and signs of a heart attack in 2008 (age adjusted to the year 2000 standard
population).



importance of accessing rapid emergency care by calling 9–1–1 or another emergency
number.


Baseline: 92.9 percent of adults aged 20 years and older were aware of the importance of
accessing rapid emergency care by calling 9–1–1 or another emergency number in 2008 (age



HDS–7
156

HDS–17: (Developmental) Increase the proportion of adults aged 20 years and older who are
aware of and respond to early warning symptoms and signs of a stroke.

HDS– 17.1 (Developmental) Increase the proportion of adults who are aware of the early
warning symptoms and signs of a stroke and the importance of accessing rapid emergency
care by calling 9–1–1 or another emergency number.


HDS–17.2 (Developmental) Increase the proportion of adults aged 20 years and older who
are aware of the early warning symptoms and signs of a stroke.


HDS–17.3 (Developmental) Increase the proportion of adults aged 20 years and older who
are aware of the importance of accessing rapid emergency care by calling 9–1–1 or another
emergency number.


HDS–18: (Developmental) Increase the proportion of out-of-hospital cardiac arrests in which
appropriate bystander and emergency medical services (EMS) were administered.

Potential data source: National Emergency Medical Services Information System (NEMSIS),
National Highway Traffic Safety Administration (NHTSA), Department of Transportation (DOT).

HDS–19: Increase the proportion of eligible patients with heart attacks or strokes who receive
timely artery-opening therapy as specified by current guidelines.

HDS–19.1 Fibrinolytic therapy within 30 minutes of hospital arrival for patients with heart
attacks.


Baseline: 68.3 percent of eligible heart attack patients received fibrinolytics within 30 minutes of
hospital arrival in 2009.


Data source: Acute Coronary Treatment and Intervention Outcomes Network Registry─Get with
the Guidelines (ACTION Registry-GWTG), American College of Cardiology Foundation and
American Heart Association.

HDS–19.2 Percutaneous intervention (PCI) within 90 minutes of hospital arrival for patients
with heart attacks.


HDS–8
157

Baseline: 88.6 percent of eligible heart attack patients received percutaneous intervention within
90 minutes of hospital arrival in 2009.


Data source: Acute Coronary Treatment and Intervention Outcomes Network Registry─Get with
the Guidelines (ACTION Registry-GWTG), American College of Cardiology Foundation and
American Heart Association.

HDS–19.3 (Developmental) Acute reperfusion therapy within 3 hours from symptom onset
for patients with strokes.

Potential data sources: Get with The Guidelines─Stroke Module (GWTG–Stroke), American
Heart Association/American Stroke Association.

HDS–20: (Developmental) Increase the proportion of adults with coronary heart disease or
stroke who have their low-density lipoprotein (LDL) cholesterol level at or below recommended
levels.

HDS– 20.1 (Developmental) Increase the proportion of adults with coronary heart disease
who have their low-density lipoprotein (LDL) cholesterol at or below recommended levels.

NCHS.

HDS– 20.2 (Developmental) Increase the proportion of adults who have had a stroke who
have their low-density lipoprotein (LDL) cholesterol at or below recommended levels.

NCHS.

HDS–21: (Developmental) Increase the proportion of adults with a history of cardiovascular
disease who are using aspirin or antiplatelet therapy to prevent recurrent cardiovascular events.


HDS–22: (Developmental) Increase the proportion of adult heart attack survivors who are
referred to a cardiac rehabilitation program at discharge.

Potential data source: Acute Coronary Treatment and Intervention Outcomes Network
Registry─Get with the Guidelines (ACTION Registry-GWTG), American College of Cardiology
Foundation and American Heart Association.

HDS–9
158

HDS–23: (Developmental) Increase the proportion of adult stroke survivors who are referred to
a stroke rehabilitation program at discharge.

Potential data source: Acute Coronary Treatment and Intervention Outcomes Network
Registry─Get with the Guidelines Program–Stroke Module (GWTG-Stroke), American Heart
Association/American Stroke Association.

HDS–24: Reduce hospitalizations of older adults with heart failure as the principal diagnosis.

HDS–24.1 Adults aged 65 to 74 years.


Baseline: 9.8 hospitalizations for heart failure per 1,000 population aged 65 to 74 years
occurred in 2007.


Data source: Chronic Conditions Warehouse (CCW), CMS.

HDS–24.2 Adults aged 75 to 84 years.


Baseline: 22.4 hospitalizations for heart failure per 1,000 population aged 75 to 84 years
occurred in 2007.



HDS–24.3 Adults aged 85 years and older.


Baseline: 42.9 hospitalizations for heart failure per 1,000 population aged 85 years and older
occurred in 2007.



HDS–10
159


HIV

Diagnosis of HIV Infection and AIDS

HIV–1 HIV diagnoses

HIV–2 New HIV infection

HIV–3 HIV transmission rate

HIV–4 AIDS

HIV–5 AIDS among heterosexuals

HIV–6 AIDS among men who have sex with men

HIV–7 AIDS among injection drug users

HIV–8 Perinatally acquired HIV and AIDS

Death, Survival and Medical Healthcare After Diagnosis of HIV Infection and AIDS

HIV–9 Early HIV diagnosis

HIV–10 HIV care and treatment

HIV–11 Survival after AIDS diagnosis

HIV–12 HIV deaths

HIV Testing

HIV–13 Awareness of HIV serostatus

HIV–14 HIV testing

HIV–15 HIV testing in TB patients

HIV Prevention

HIV–16 HIV/AIDS education in substance abuse treatment programs

HIV–17 Condom use

HIV–18 (Developmental) Unprotected sex among men who have sex with men

HIV–1
160

Topic Area: HIV

HIV–1: (Developmental) Reduce the number of new HIV diagnoses among adolescents
and adults.

Potential data source: HIV Surveillance System, CDC, NCHHSTP.

HIV–2: (Developmental) Reduce new (incident) HIV infections among adolescents and
adults.


HIV–3: Reduce the rate of HIV transmission among adolescents and adults.

Target: 3.5 new infections per 100 persons living with HIV.

Baseline: The HIV transmission rate was 5.0 new infections per 100 persons living with
HIV in 2006.

Target setting method: Consistent with the National HIV/AIDS Strategy.

Data source: HIV Surveillance System, CDC, NCHHSTP.

HIV–4: Reduce the number of new AIDS cases among adolescents and adults.


Baseline: 14.4 new cases of AIDS per 100,000 population aged 13 years and older
were diagnosed in 2007.



HIV–5: Reduce the number of new AIDS cases among adolescent and adult
heterosexuals.

Target: 10,000 new cases.

Baseline: 11,110 new cases of AIDS were diagnosed among persons 13 years and
older who reported specific heterosexual contact with a person known to have, or be at
high risk for, HIV infection in 2007.



HIV–2
161

HIV–6: Reduce the number of new AIDS cases among adolescent and adult men who
have sex with men.


Baseline: 16,749 new AIDS cases were diagnosed among males aged 13 years and
older who reported sexual contact with other men or with both men and women in 2007.



HIV–7: Reduce the number of new AIDS cases among adolescents and adults who
inject drugs.


Baseline: 6,010 new AIDS cases were diagnosed among injection drug users 13 years
and older in 2007.



HIV–8: Reduce the number of perinatally acquired HIV and AIDS cases.
HIV–8.1 (Developmental) Number of newly diagnosed perinatally acquired HIV cases.


HIV–8.2 Number of new cases of perinatally acquired AIDS.

Target: 25 cases.

Baseline: 28 perinatally acquired AIDS cases were diagnosed in 2007.



HIV–9: (Developmental) Increase the proportion of new HIV infections diagnosed before
progression to AIDS.


HIV–3
162

HIV–10: (Developmental) Increase the proportion of HIV-infected adolescents and
adults who receive HIV care and treatment consistent with current standards.

Potential data source: Medical Monitoring Project (MMP), CDC, NCHHSTP.

HIV–11 Increase the proportion of persons surviving more than 3 years after a
diagnosis with AIDS.


Baseline: 82.0 percent of persons diagnosed with AIDS survived more than 3 years
after diagnosis in 2002.



HIV–12: Reduce deaths from HIV infection.


Baseline: 3.7 deaths due to HIV infection per 100,000 population occurred in 2007 (age


Data source: National Vital Statistics System, CDC, NCHS.

HIV–13: Increase the proportion of people living with HIV who know their serostatus.


Baseline: 79.0 percent of persons aged 13 years and older living with HIV were aware
of their HIV infection in 2006.

Target setting method: Consistent with the National HIV/AIDS Strategy.


HIV–14: Increase the proportion of adolescents and adults who have been tested for
HIV in the past 12 months.
HIV–14.1 Adolescents and adults.


Baseline: 15.4 percent of persons 15 to 44 years of age reported that they had an HIV
test in the past 12 months, outside of blood donation in 2006–08.

HIV–4
163



HIV–14.2 (Developmental) Men who have sex with men (MSM).

Potential data source: National Survey of Family Growth (NSFG), CDC, NCHS.

HIV–14.3 Pregnant women.


Baseline: 67.4 percent of women 15 to 44 years of age who completed a pregnancy in
the past 12 months reported that they had an HIV test as part of prenatal care in 2006–
08.



HIV–14.4 Adolescents and young adults.


Baseline: 15.6 percent of persons 15 to 24 years of age reported that they had an HIV
test in the past 12 months, outside of blood donation in 2006–08.



HIV–15: Increase the proportion of adults with tuberculosis (TB) who have been tested
for HIV.


Baseline: 65.0 percent of persons aged 25 to 44 years with TB were tested for HIV in
2005.


Data source: National TB Surveillance System, CDC, NCHHSTP.

HIV–16: Increase the proportion of substance abuse treatment facilities that offer
HIV/AIDS education, counseling, and support.


HIV–5
164

Baseline: 54.4 percent of publicly and privately funded treatment facilities known to
SAMHSA reported that they offer HIV testing, HIV/AIDS education, counseling, and
support, or have special substance abuse treatment programs for persons living with
HIV/AIDS in 2008.


Data source: National Survey of Substance Abuse Treatment Services (N–SSATS),
SAMHSA.

HIV–17: Increase the proportion of sexually active persons who use condoms.
HIV–17.1 Unmarried females aged 15 to 44 years.


Baseline: 34.5 percent of sexually active, unmarried females aged 15 to 44 years
reported using a condom at last sexual intercourse in 2006–2008.



HIV–17.2 Unmarried males aged 15 to 44 years.


Baseline: 55.2 percent of sexually active, unmarried males aged 15 to 44 years reported
using a condom at last sexual intercourse in 2006–08.



HIV–18: (Developmental) Decrease the proportion of men who have sex with men who
reported unprotected anal sex in the past 12 months.

Potential data source: National HIV Behavioral Surveillance System, CDC, NCHHSTP.

HIV–6
165


Immunization and Infectious Diseases

IID–1 Vaccine-preventable diseases
IID–2 Group B streptococcal disease among newborns
IID–3 Meningococcal disease
IID–4 Invasive pneumococcal infections
IID–5 Antibiotics misuse for ear infections
IID–6 Antibiotics misuse for common cold
IID–7 Vaccination coverage among young children
IID–8 Complete vaccination coverage among young children
IID–9 Zero doses of vaccination
IID–10 Vaccination coverage among kindergartners
IID–11 Vaccination coverage among adolescents
IID–12 Seasonal influenza vaccination coverage
IID–13 Pneumococcal vaccination coverage
IID–14 Shingles vaccination coverage
IID–15 Hepatitis B vaccination coverage among high-risk populations
IID–16 Vaccine safety
IID–17 Provider vaccination coverage assessment
IID–18 Immunization Information Systems (IIS)
IID–19 States collecting kindergarten vaccination records
IID–20 State participation in Immunization Information Systems (IIS)
IID–21 Electronic surveillance of rabies
IID–22 Monitoring of influenza-virus resistance to antiviral agents
IID–23 Hepatitis A
IID–24 Chronic hepatitis B perinatal infections
IID–25 Hepatitis B
IID–26 Hepatitis C
IID–27 Awareness of hepatitis C infection status in minority communities
IID–28 Hepatitis B testing
IID–29 TB
IID–30 Curative therapy for TB
IID–31 Treatment for latent TB
IID–32 Timeliness of TB test confirmation

IID–1
166

Topic Area: Immunization and Infectious Diseases
IID–1: Reduce, eliminate, or maintain elimination of cases of vaccine-preventable diseases.

IID–1.1 Congenital Rubella Syndrome (CRS) (children less than one year of age) (U.S.-
acquired cases).

Target: Zero cases.

Baseline: Zero cases of confirmed and probable U.S.-acquired cases of congenital rubella
syndrome were reported among children aged 1 year and under in 2008.

Target setting method: Total elimination.

Data source: National Notifiable Diseases Surveillance System (NNDSS), CDC.

IID–1.2 Serotype b cases of Haemophilus influenzae (Hib) invasive disease (children aged
5 years and under).

Target: 0.27 cases per 100,000 children under age 5 years.

Baseline: 0.3 confirmed and probable cases of Haemophilus influenzae invasive disease were
reported per 100,000 children under age 5 years in 2008.


Data source: National Notifiable Diseases Surveillance System (NNDSS), CDC, Active Bacterial
Core Surveillance (ABCs), CDC, NCIRD.

IID–1.3 New hepatitis B cases (persons aged 2 to 18 years).

Target: Zero cases.

Baseline: 0.06 cases of new symptomatic hepatitis B per 100,000 population aged 2 to 18 years
were reported in 2007.


Data source: National Notifiable Diseases Surveillance System (NNDSS), CDC,.

IID–1.4 Measles (U.S.-acquired cases).

Target: 30 cases.

Baseline: 115 confirmed U.S.-acquired measles cases were reported in 2008.

Target setting method: Projection.


IID–2
167

IID–1.5 Mumps (U.S.-acquired cases).

Target: 500 cases.

Baseline: 421 confirmed and probably U.S.-acquired cases of mumps were reported in 2008.



IID–1.6 Pertussis (children under age 1 year).

Target: 2,500 cases.

Baseline: An annual average of 2,777 confirmed and probable cases of pertussis (including
cases identified in outbreak settings) were reported among children under age 1 year during
2004–08.



IID–1.7 Pertussis among adolescents aged 11 to 18 years.

Target: 2,000 cases.

Baseline: An annual average of 3,995 confirmed and probable cases of pertussis (including
cases identified in outbreak settings) was reported among adolescents aged 11 to 18 years
during 2000–04.


Data source: National Notifiable Disease Surveillance System (NNDSS), CDC.

IID–1.8 Acute paralytic poliomyelitis (U.S.-acquired cases).

Target: Zero cases.

Baseline: Zero cases of U.S.-acquired acute paralytic poliomyelitis were reported in 2008.



IID–1.9 Rubella (U.S.-acquired cases).

Target: 10 cases.

Baseline: 10 confirmed U.S.-acquired cases of rubella were reported in 2008.

IID–3
168



IID–1.10 Varicella (chicken pox) (persons aged 17 years of age or under).

Target: 100,000 persons.

Baseline: 582,535 persons aged 17 years of age and under were reported to have had chicken
pox (varicella) in the past year in 2008.


Data sources: National Health Interview Survey (NHIS), CDC, NCHS.

IID–2: Reduce early onset group B streptococcal disease.

Target: 0.25 new cases among newborns aged 0 through 6 days per 1,000 live births.

Baseline: 0.28 newly reported cases of laboratory-confirmed early onset group B streptococcal
disease were diagnosed among newborns aged 0 to 6 days per 1,000 live births in 2008.


Data sources: Active Bacterial Core Surveillance (ABCs), CDC, NCIRD.

IID–3: Reduce meningococcal disease.


Baseline: An annual average of 0.34 cases of new laboratory-confirmed meningococcal disease
per 100,000 population were reported in 2004–08.


Data sources: National Notifiable Diseases Surveillance System (NNDSS), CDC.

IID–4: Reduce invasive pneumococcal infections.

IID–4.1 New invasive pneumococcal infections among children under age 5 years.

Target: 12 cases per 100,000 children under age 5 years.

Baseline: 20.3 cases of laboratory-confirmed invasive pneumococcal infection were reported
per 100,000 children under age 5 years in 2008.


Data source: Active Bacterial Core Surveillance (ABCs), NCIRD, Emerging Infections Program
Network, CDC.

IID–4
169

IID–4.2 New invasive pneumococcal infections among adults aged 65 years and older.

Target: 31 new cases per 100,000 adults aged 65 years and older.

Baseline: 40.4 new cases of laboratory-confirmed invasive pneumococcal infection per 100,000
adults aged 65 years and older were diagnosed in 2008.


Data source: Active Bacterial Core Surveillance (ABCs), NCIRD, Emerging Infections Program
Network, CDC.

IID–4.3 Invasive penicillin-resistant pneumococcal infections among children under age 5
years.

Target: 3 new cases per 100,000 children under age 5 years.

Baseline: 4.3 new cases of laboratory-confirmed invasive penicillin-resistant pneumococcal
infection per 100,000 children under age 5 years were diagnosed in 2008.


Data source: Active Bacterial Core surveillance (ABCs), NCIRD, Emerging Infections Program
Network, CDC.

IID–4.4 Invasive penicillin-resistant pneumococcal infections among adults aged 65 years
and older.

Target: 2 new cases per 100,000 population adults aged 65 years and older.

Baseline: 2.6 new cases of laboratory-confirmed invasive penicillin-resistant pneumococcal
infection per 100,000 adults aged 65 years and older were diagnosed in 2008.


Data sources: Active Bacterial Core Surveillance (ABCs), CDC, NCIRD, Emerging Infections
Program Network, CDC.

IID–5: Reduce the number of courses of antibiotics for ear infections for young children.

Target: 35 courses per 100 children.

Baseline: 47 percent of children under age 5 years who had an ear infection were prescribed
antibiotic courses in 2007.


Hospital Ambulatory Medical Care Survey (NHAMCS), CDC, NCHS.

IID–5
170

IID–6: Reduce the number of courses of antibiotics prescribed for the sole diagnosis of the
common cold.

Target: 864 courses of antibiotics per 100,000 population.

Baseline: An annual average of 1,728 courses of antibiotics per 100,000 persons diagnosed
with the common cold was prescribed in 2007.


Hospital Ambulatory Medical Care Survey (NHAMCS), CDC, NCHS.

IID–7: Achieve and maintain effective vaccination coverage levels for universally recommended
vaccines among young children.

IID–7.1 4 doses diphtheria-tetanus-acellular pertussis (DTaP) vaccine by 19 to 35 months.

Target: 90 percent.

Baseline: 85 percent of children aged 19 to 35 months received 4 or more doses of the
combination of diphtheria, tetanus, and acellular pertussis antigens in 2008.


Data source: National Immunization Survey (NIS), CDC, NCIRD.

IID–7.2 3 doses Haemophilus influenzae type b (Hib) vaccine by 19 to 35 months.

Target: 90 percent.

Baseline: 57 percent of children aged 19 to 35 months received 3 or more doses of Hib vaccine
in the first and second quarter of 2009.



IID–7.3 3 doses hepatitis B (hep B) vaccine by age 19 to 35 months.

Target: 90 percent.

Baseline: 94 percent of children aged 19 to 35 months received at least 3 doses of the hepatitis
B antigen in 2008.



IID–6
171

IID–7.4 1 dose measles-mumps-rubella (MMR) vaccine by 19 to 35 months.

Target: 90 percent.

Baseline: 92 percent of children aged 19 to 35 months received 1 dose of measles-mumps-
rubella (MMR) vaccine in 2008.



IID–7.5 3 doses polio vaccine by 19 to 35 months.

Target: 90 percent.

Baseline: 94 percent of children aged 19 to 35 months received at least 3 doses of polio vaccine
in 2008.



1 IID–7.6 1 dose varicella vaccine by 19 to 35 months.

Target: 90 percent.

Baseline: 91 percent of children aged 19 to 35 months received at least 1 dose of the varicella
antigen in 2008.



IID–7.7 4 doses pneumococcal conjugate vaccine (PCV) by 19 to 35 months.

Target: 90 percent.

Baseline: 80 percent of children aged 19 to 35 months received at least 4 doses of the
pneumococcal conjugate vaccine in 2008.



IID–7.8 2 doses hepatitis A vaccine by 19 to 35 months.

Target: 60 percent.

Baseline: 40 percent of children aged 19 to 35 months received 2 or more doses of hepatitis A
vaccine in 2008.

IID–7
172



IID–7.9 A birth dose of hepatitis B vaccine (0 to 3 days between birth date and date of
vaccination, reported by annual birth cohort).

Target: 85 percent.

Baseline: 51 percent of the 2005 birth cohort received the first dose of hepatitis B vaccine within
3 days of birth between 2006 and 2008.



IID–7.10 2 or more doses rotavirus vaccine by aged 19 to 35 months.

Target: 80 percent.

Baseline: 38 percent of children aged 19 to 35 months received 2 or more doses of rotavirus
vaccine in the first and second quarter of 2009.



IID–8: Increase the proportion of children aged 19 to 35 months who receive the recommended
doses of DTaP, polio, MMR, Hib, hepatitis B, varicella and PCV vaccines.

Target: 80 percent.

Baseline: 68 percent children aged 19 to 35 months received the recommended doses of DTaP,
polio, MMR, Hib, hepatitis B, varicella and PCV in 2008.


Data source: National Immunization Survey (NIS), CDC, NCIRD, and NCHS.

IID–9: Proportion of children in the United States who receive zero doses of recommended
vaccines by 19 to 35 months.

Target: This measure is being tracked for informational purposes. If warranted, a target will be
set during the decade.

Baseline: 0.6 percent of children in the United States received zero doses of recommended
vaccines by age 19 to 35 months in 2008.


IID–8
173

Statistics System–Natality (NVSS–N), CDC, NCHS.

IID–10: Maintain vaccination coverage levels for children in kindergarten.

IID–10.1 DTaP vaccine (4 or more doses).

Target: 95 percent.

Baseline: 95 percent of children enrolled in kindergarten received 4 doses of DTaP vaccine in
the 2007–08 school year.


Data source: School Immunization Assessment Survey, CDC, NCIRD.

IID–10.2 MMR vaccine (2 or more doses).

Target: 95 percent.

Baseline: 95 percent of children enrolled in kindergarten received 2 doses of MMR vaccine in
the 2007–08 school year.



IID–10.3 Polio vaccine (3 or more doses).

Target: 95 percent.

Baseline: 96 percent of children enrolled in kindergarten received 3 or more doses of polio
vaccine in the 2007–08 school year.



IID–10.4 Hepatitis B vaccine (3 or more doses).

Target: 95 percent.

Baseline: 96 percent of children enrolled in kindergarten received 3 or more doses of hepatitis B


Data Source: School Immunization Assessment Survey, CDC, NCIRD.

IID–9
174

IID–10.5 Varicella vaccine (2 or more doses).

Target: 95 percent.

Baseline: 94 percent of children enrollees in kindergarten received 2 or more doses of varicella



IID–11: Increase routine vaccination coverage levels for adolescents.

IID–11.1 1 dose of tetanus-diphtheria-acellular pertussis (Tdap) booster vaccine by 13 to
15 years.

Target: 80 percent.

Baseline: 47 percent of adolescents aged 13 to 15 years reported having been vaccinated with
1 or more doses of a tetanus-diphtheria-acellular pertussis (Tdap) booster in 2008.


Data source: National Immunization Survey (NIS) Teen, CDC, NCIRD, and NCHS.

IID–11.2 2 doses of varicella vaccine by age 13 to 15 years (excluding children who have
had varicella).

Target: 90 percent.

Baseline: 37 percent of adolescents aged 13 to 15 years reported having been vaccinated with
at least 2 doses of varicella (excluding adolescents who have had varicella) in 2008.



IID–11.3 1 dose Meningococcal vaccine (MCV) by age 13 to 15 years.

Target: 80 percent.

Baseline: 44 percent of persons aged 13 to 15 years reported having been vaccinated with 1 or
more doses of Meningococcal conjugate vaccine in 2008.



IID–10
175

IID–11.4 3 doses Human papillomavirus vaccine (HPV) for females by age 13 to 15 years.

Target: 80 percent.

Baseline: 17 percent of females aged 13 to 15 years reported having been vaccinated with 3 or
more doses of the human papillomavirus (HPV) vaccine in 2008.



IID–12: Increase the proportion of children and adults who are vaccinated annually against
seasonal influenza.

IID–12.1 Children aged 6 to 23 months (1 or 2 doses, depending on age-appropriateness
and previous doses received).

Target: 80 percent.

Baseline: 23 percent of children aged 6 to 23 months received 1 or 2 doses in 2008.



IID–12.2 Children aged 2 to 4 years.

Target: 80 percent.

Baseline: 40 percent of children aged 2 to 4 years were vaccinated against seasonal influenza
in 2008.




Target: 80 percent.

Baseline: 26 percent of children aged 5 to 12 years were vaccinated against seasonal influenza
in 2008.




Target: 80 percent.

IID–11
176

Baseline: 10 percent of children aged 13 to 17 years were vaccinated against seasonal
influenza in 2008.


Data source: National Immunization Survey (NIS)- Teen.

IID–12.5 Noninstitutionalized adults aged 18 to 64 years.

Target: 80 percent.

Baseline: 25 percent of noninstitutionalized adults aged 18 to 64 years were vaccinated against
seasonal influenza in 2008.


Data source: National Health Interview survey (NHIS), CDC, NCHS.

IID–12.6 Noninstitutionalized high-risk adults aged 18 to 64 years.

Target: 90 percent.

Baseline: 39 percent of noninstitutionalized high-risk adults aged 18 to 64 years were
vaccinated against seasonal influenza in 2008.



IID–12.7 Noninstitutionalized adults aged 65 years and older.

Target: 90 percent.

Baseline: 67 percent of noninstitutionalized high-risk adults aged 65 years and older were
vaccinated against seasonal influenza in 2008.



IID–12.8 Institutionalized adults aged 18 years and older in long-term or nursing homes.

Target: 90 percent.

Baseline: 62 percent of institutionalized adults 18 years and older in long-term or nursing homes
were vaccinated against seasonal influenza in 2006.


Data source: Minimum Data Set (MDS), CMS.

IID–12
177

IID–12.9 Health care personnel.

Target: 90 percent.

Baseline: 45 percent of health care personnel were vaccinated against seasonal influenza in
2008.



IID–12.10 Pregnant women.

Target: 80 percent.

Baseline: 28 percent of pregnant women were vaccinated against seasonal influenza in 2008.



IID–13: Increase the percentage of adults who are vaccinated against pneumococcal disease.

IID–13.1 Noninstitutionalized adults aged 65 years and older.

Target: 90 percent.

Baseline: 60 percent of persons aged 65 years and older reported ever receiving a
pneumococcal vaccination in 2008.



IID–13.2 Noninstitutionalized high-risk adults aged 18 to 64 years.

Target: 60 percent.

Baseline: 17 percent of high-risk persons aged 18 to 64 years reported ever receiving a
pneumococcal vaccination in 2008.



IID–13.3 Institutionalized adults (persons aged 18 years and older in long-term or nursing
homes).

Target: 90 percent.

IID–13
178

Baseline: 66 percent of persons in long-term care facilities and nursing homes certified by the
Centers for Medicare and Medicaid Services (CMS) reported having up-to-date pneumococcal
vaccinations in 2006.


Data source: Minimum Data Set (MDS), CMS.

IID–14: Increase the percentage of adults who are vaccinated against zoster (shingles).

Target: 30 percent.

Baseline: 7 percent of adults aged 60 years and older reported having ever received zoster
(shingles) vaccine in 2008.



IID–15: Increase hepatitis B vaccine coverage among high-risk populations.

IID–15.1 (Developmental) Long-term hemodialysis patients.

Potential data source: Healthcare Quality Survey, DHQP, CDC.

IID–15.2 (Developmental) Men who have sex with men.

Potential data source: National Notifiable Disease Surveillance System (NNDSS) CDC.

IID–15.3 Health care personnel.

Target: 90 percent.

Baseline: 64 percent of health care workers reported they had had at least 3 doses of
hepatitis B vaccine in 2008.



IID–15.4 (Developmental) Injection drug users.

Potential data sources: National HIV Behavioral Surveillance System (NHBS) CDC.

IID–14
179

IID–16: (Developmental) Increase the scientific knowledge on vaccine safety and adverse
events.

Potential data sources: FDA Sentinel Initiative, Vaccine Adverse Event Reporting System
(VAERS), Vaccine Safety Datalink Project (VSD), and the Vaccine Analytic Unit (VAU), DHQP,
CDC.

IID–17: Increase the proportion of providers who have had vaccination coverage levels among
children in their practice population measured within the past year.

IID–17.1 Public health providers.

Target: 50 percent.

Baseline: 40 percent of public provider sites that routinely provided immunizations to children
aged 6 years and under participated in a provider assessment at least once in the past year in
2009.

Target setting method: .Consistency with national programs.

Data source: Annual Immunization Assessment Reports, CDC, NCIRD.

IID–17.2 Private providers.

Target: 50 percent.

Baseline: 33 percent of private provider sites that routinely provided immunizations to children
aged 6 years and under participated in a provider assessment at least once in the past year in
2009.


Data source: Annual Immunization Assessment Reports, CDC, NCIRD.

IID–18: Increase the proportion of children under age 6 years of age whose immunization
records are in fully operational, population-based immunization information systems.

Target: 95 percent.

Baseline: 75 percent of children under 6 years of age had two or more immunizations recorded
in the immunization information system in 2008.


Data source: Immunization Program Annual Reports, CDC, NCIRD.

IID–19: Increase the number of States collecting kindergarten vaccination coverage data
according to CDC minimum standards.

Target: 51 (States and the District of Columbia).

IID–15
180

Baseline: 13 States (including the District of Columbia) collected kindergarten vaccination
coverage data according to CDC minimum standards in 2009.



IID–20: Increase the number of States that have 80 percent of adolescents with two or more
age-appropriate immunizations recorded in immunization information systems (adolescents
aged 11 to 18 years).

Target: 40 (States and the District of Columbia).

Baseline: 14 States (including the District of Columbia) recorded 80 percent of adolescents with
two or more age-appropriate immunizations in immunization information systems in 2009.

Target setting method: Consistency with national programs/regulations/polices/laws.

Data source: Immunization Program Annual Reports, CDC, NCIRD.

IID–21: Increase the number of States that use electronic data from rabies animal surveillance
to inform public health prevention programs.

Target: 49 States (excluding Hawaii), the District of Columbia, Puerto Rico, and New York City.

Baseline: 8 States used electronic data from rabies animal surveillance to inform public health
prevention programs in 2010.


Data source: Rabies Surveillance Network (RSN), CDC, NCEZID.

IID–22: Increase the number of public health laboratories monitoring influenza-virus resistance
to antiviral agents.

Target: 25 public health laboratories.

Baseline: 3 public health laboratories monitored influenza virus resistance to antiviral agents in
2009.

Target setting method: Consistency with national programs/regulations/laws.

Data source: State Laboratory Reports, Influenza Division, National Center for Immunization
and Respiratory Diseases, CDC.

IID–23: Reduce hepatitis A.


Baseline: 1.0 cases of hepatitis A virus per 100,000 population were reported in 2007.

IID–16
181



IID–24: Reduce chronic hepatitis B virus infections in infants and young children (perinatal
infections).

Target: 400 cases.

Baseline: 799 cases of chronic hepatitis B virus (HBV) infection are estimated among infants
and children aged 1 to 24 months who were born to mothers with HBV infections in 2007.


Data sources: Perinatal Hepatitis B Prevention Program, CDC, NCHHSTP; National Vital
Statistics System-Natality (NVSS-N), CDC, NCHS.

IID–25: Reduce hepatitis B.

IID–25.1 Reduce new hepatitis B infections in adults aged 19 and older.


Baseline: 2.0 symptomatic cases of hepatitis B per 100,000 persons aged 19 years and older


Data sources: National Notifiable Diseases Surveillance System (NNDSS).

IID–25.2 Reduce new hepatitis B infections among high-risk populations—Injection drug
users.

Target: 215 cases.

Baseline: 285 symptomatic cases of hepatitis B were reported among injection drug users in
2007.


Data sources: National Notifiable Diseases Surveillance System (NNDSS); Viral Hepatitis Active
Surveillance Sites.

IID–25.3 Reduce new hepatitis B infections among high-risk populations—Men who have
sex with men.

Target: 45 new infections.

Baseline: 62 new hepatitis B infections were reported among men who indicated homosexual or
bisexual preference in 2007.

IID–17
182


Data sources: National Notifiable Diseases Surveillance System (NNDSS).

IID–26: Reduce new hepatitis C infections.

Target: 0.2 new cases per 100,000.

Baseline: 0.3 new symptomatic hepatitis C cases per 100,000 population were reported in the
past 12 months in 2007.


Data sources: National Notifiable Disease Surveillance System (NNDSS), CDC, Funded Viral
Hepatitis Surveillance Sites.

IID–27: Increase the proportion of persons aware they have a hepatitis C infection.

Target: 60 percent.

Baseline: 49 percent of NHANES survey respondents, who tested positive for chronic hepatitis
C and reported that they were aware of their hepatitis C infection status prior to the laboratory
confirmation in 2002–07.



IID–28: (Developmental) Increase the proportion of persons who have been tested for hepatitis
B virus within minority communities experiencing health disparities.

Potential data source: Racial and Ethnic Approaches to Community Health (REACH) U.S. Risk
Factor Survey.

IID–29: Reduce tuberculosis (TB).

Target: 1.0 new case per 100,000 population.

Baseline: 4.9 confirmed new cases of tuberculosis per 100,000 population were reported to
CDC by local health departments in all 50 States and the District of Columbia in 2005.


Data source: National Tuberculosis Indicators Project (NTIP), NCHHSTP, CDC.

IID–30: Increase treatment completion rate of all tuberculosis patients who are eligible to
complete therapy.

Target: 93 percent.

IID–18
183

Baseline: 83.8 percent of persons with confirmed tuberculosis completed curative therapy in
2006.


Data source: National TB Surveillance System and national Tuberculosis Indicators Project
(NTIP), CDC, NCHHSTP.

IID–31: Increase the treatment completion rate of contacts to sputum smear-positive cases who
are diagnosed with latent tuberculosis infection and started LTBI treatment.


Baseline: 68.1 percent of contact to sputum smear-positive patients who are diagnosed with
latent tuberculosis infection completed a course of treatment in 2007.


Data source: Aggregate Reports for Tuberculosis Program Evaluation and National
Tuberculosis Indicators Project (NTIP), CDC, NCHHSTP.

IID–32: Reduce the average time for a laboratory to confirm and report tuberculosis cases.

Target: 75 percent.

Baseline: 32 percent of patients with a positive nucleic acid amplification test (NAAT) had their
test results confirmed within 2 days of specimen collection in 2008.


Data source: CDC Electronic Report of Verified Case of Tuberculosis, NCHHSTP, CDC.

IID–19
184


Injury and Violence Prevention

Injury Prevention

IVP–1 Total injury

IVP–2 Traumatic brain injury

IVP–3 Traumatic spinal cord injury

IVP–4 Child fatality review of child deaths due to external causes

IVP–5 Child fatality review of sudden and unexpected infant deaths

IVP–6 Emergency department routine E-code collection

IVP–7 Hospital discharge routine E-code collection

IVP–8 Trauma care access

IVP–9 Poisoning deaths

IVP–10 Nonfatal poisonings

IVP–11 Unintentional injury deaths

IVP–12 Nonfatal unintentional injuries

IVP–13 Deaths from motor vehicle crashes

IVP–14 Nonfatal injuries from motor vehicle crashes

IVP–15 Safety belt use

IVP–16 Age-appropriate child restraint use

IVP–17 Graduated driver licensing laws

IVP–18 Pedestrian deaths

IVP–19 Nonfatal pedestrian injuries

IVP–20 Pedalcyclist deaths

IVP–21 Bicycle helmet laws

IVP–22 Motorcycle helmet use

IVP–1
185

IVP–23 Deaths from falls

IVP–24 Unintentional suffocation deaths

IVP–25 Drownings

IVP–26 Sports and recreation injuries

IVP–27 Protective gear in school physical activities

IVP–28 Residential fire deaths

Violence Prevention

IVP–29 Homicides

IVP–30 Firearm-related deaths

IVP–31 Nonfatal firearm-related injuries

IVP–32 Nonfatal physical assault injuries

IVP–33 Physical assaults

IVP–34 Physical fighting among adolescents

IVP–35 Bullying among adolescents

IVP–36 Weapon carrying by adolescents on school property

IVP–37 Child maltreatment deaths

IVP–38 Nonfatal child maltreatment

IVP–39 Intimate partner violence

IVP–40 Sexual violence

IVP–41 Nonfatal intentional self-harm injuries

IVP–42 Children’s exposure to violence

IVP–43 Violent death surveillance system

IVP–2
186

Topic Area: Injury and Violence Prevention
Injury Prevention

IVP–1: Reduce fatal and nonfatal injuries.

IVP–1.1.Reduce fatal injuries.


Baseline: 59.2 deaths per 100,000 population were caused by injuries in 2007 (age adjusted to



IVP–1.2 Reduce hospitalization for nonfatal injuries.


Baseline: 617.6 hospitalizations for nonfatal injuries per 100,000 population occurred in 2007


Data source: National Hospital Discharge Survey (NHDS), CDC, NCHS.

IVP–1.3 Reduce emergency department visits for nonfatal injuries.

Target: 7,533.4 emergency department visits per 100,000 population.

Baseline: 8,370.4 emergency department for nonfatal injuries per 100,000 population occurred
in 2007 (age adjusted to the year 2000 standard population).


Data sources: National Hospital Ambulatory Medical Care Survey (NHAMCS), CDC, NCHS.

IVP–2: Reduce fatal and nonfatal traumatic brain injuries.

IVP–2.1 Reduce fatal traumatic brain injuries.


Baseline: 17.3 deaths per 100,000 population were caused by traumatic brain injuries in 2007


Data source: National Vital Statistics System–Mortality (NVSS-M), CDC, NCHS.

IVP–3
187

IVP–2.2 Reduce hospitalization for nonfatal traumatic brain injuries.


Baseline: 85.6 hospitalizations for nonfatal traumatic brain injuries per 100,000 population
occurred in 2007 (age adjusted to the year 2000 standard population).



IVP–2.3 Reduce emergency department visits for nonfatal traumatic brain injuries.

Target: 366.5 emergency department visits per 100,000 population.

Baseline: 407.2 emergency department visits for nonfatal traumatic brain injuries per 100,000
population occurred in 2007 (age adjusted to the year 2000 standard population).


Data sources: National Hospital Ambulatory Medical Care Survey (NHAMCS), CDC, NCHS.

IVP–3: Reduce fatal and nonfatal spinal cord injuries.

IVP–3.1 Reduce fatal spinal cord injuries.


Baseline: 0.53 deaths per 100,000 population were caused by spinal cord injuries in 2007 (age



IVP–3.2 Reduce hospitalization for nonfatal traumatic spinal cord injuries.


Baseline: 3.6 hospitalizations for nonfatal spinal cord injuries per 100,000 population occurred in



IVP–4
188

IVP–4: (Developmental) Increase the number of States and the District of Columbia where 90
percent of deaths among children aged 17 years and under that are due to external causes are
reviewed by a child fatality review team.

Potential data sources: National Center for Child Death Review; National Vital Statistics
System–Mortality (NVSS–M), CDC, NCHS.

IVP–5: (Developmental) Increase the number of States and the District of Columbia where 90
percent of sudden and unexpected deaths to infants are reviewed by a child fatality review
team.

Potential data sources: National Center for Child Death Review; National Vital Statistics
System–Mortality (NVSS–M), CDC, NCHS.

IVP–6: Increase the proportion of States and the District of Columbia with statewide emergency
department data systems that routinely collect external-cause-of injury codes for 90 percent or
more of injury-related visits.


Baseline: 75.0 percent of States had statewide emergency department data systems that
routinely collected external-cause-of injury codes for 90 percent or more of injury-related visits
(21 of 28 participating States in HCUP SEDD) in 2008.

Target setting method: Threshold analysis.

Data source: Healthcare Cost and Utilization Project State Emergency Department Databases
(HCUP SEDD).

IVP–7: Increase the proportion of States and the District of Columbia with statewide hospital
discharge data systems that routinely collect external-cause-of injury codes for 90 percent or
more of injury-related discharges.


Baseline: 66.7 percent of States had statewide hospital discharge data systems that routinely
collect external-cause-of injury codes for 90 percent or more of injury-related discharges (28 of
42 participating States in HCUP SID) in 2008.

Target setting method: Threshold analysis.

Data source: Healthcare Cost and Utilization Project State Inpatient Databases (HCUP SIDS).

IVP–5
189

IVP–8: Increase access to trauma care in the United States.

IVP–8.1 Proportion of the population residing within the continental United States with
access to trauma care.


Baseline: 83.1 percent of the population residing within the continental United States had
access to trauma care in 2009.


Data sources: Trauma Information Exchange Program, American Trauma Society.

IVP–8.2 Proportion of the land mass of the continental United States with access to
trauma care.


Baseline: 28.7 percent of the land mass of the continental United States had access to trauma
care in 2009.


Data sources: Trauma Information Exchange Program, American Trauma Society.

IVP–9: Prevent an increase in the rate of poisoning deaths.

IVP–9.1 All persons.


Baseline: 13.1 deaths per 100,000 population were caused by poisonings in 2007 (age adjusted

Target setting method: Maintain the baseline rate.


IVP–9.2 Persons aged 35 to 54 years.


Baseline: 25.5 deaths per 100,000 population aged 35 to 54 years were caused by poisonings
in 2007.



IVP–6
190

IVP–9.3 Unintentional or undetermined intent among all persons.


Baseline: 11.1 deaths per 100,000 population were caused by unintentional and undetermined
poisonings in 2007 (age adjusted to the year 2000 standard population).



IVP–9.4 Unintentional or undetermined intent among persons aged 35 to 54 years.


Baseline: 21.6 deaths per 100,000 population aged 35 to 54 years were caused by unintentional
and undetermined poisonings in 2007.



IVP–10: Prevent an increase in the rate of nonfatal poisonings.

Target: 304.4 nonfatal poisonings per 100,000 population.

Baseline: 304.4 nonfatal poisonings per 100,000 population occurred in 2008 (age adjusted to


Data source: National Electronic Injury Surveillance System–All Injury Program (NEISS–AIP),
CDC, NCIPC, US Consumer Product Safety Commission (CPSC).

IVP–11: Reduce unintentional injury deaths.


Baseline: 40.0 deaths per 100,000 population were caused by unintentional injuries in 2007



IVP–12: Reduce nonfatal unintentional injuries.

Target: 8,297.4 injuries per 100,000 population.

IVP–7
191

Baseline: 9,219.3 emergency department visits for nonfatal unintentional injuries per 100,000


Data source: National Electronic Injury Surveillance System–All Injury Program (NEISS–AIP),

IVP–13: Reduce motor vehicle crash-related deaths.

IVP–13.1 Deaths per 100,000 population.


Baseline: 13.8 deaths per 100,000 population were caused by motor vehicle crashes in 2007



IVP–13.2 Deaths per 100 million vehicle miles traveled.

Target: 1.2 deaths per 100 million vehicle miles traveled.

Baseline: 1.3 motor vehicle crash-related deaths per 100 million vehicle miles traveled occurred
in 2008.


Data source: Fatality Analysis Reporting System (FARS), DOT, NHTSA.

IVP–14: Reduce nonfatal motor vehicle crash-related injuries.

Target: 694.4 nonfatal injuries per 100,000 population.

Baseline: 771.5 nonfatal injuries per 100,000 population were caused by motor vehicle crashes
in 2008.


Data source: General Estimates System (GES), DOT, NHTSA.

IVP–15: Increase use of safety belts.


Baseline: 84.0 percent of motor vehicle drivers and right-front seat passengers used safety belts
in 2009.

IVP–8
192


Data sources: National Occupant Protection Use Survey (NOPUS), DOT, NHTSA..

IVP–16: Increase age-appropriate vehicle restraint system use in children.

IVP–16.1 Birth to 12 months.

Target: 95 percent.

Baseline: 86 percent of children aged 0 to 12 months were restrained in rear-facing child safety
seats in 2008.


Data source: National Survey of the Use of Booster Seats (NSUBS), DOT, NHTSA.

IVP–16.2 Children aged 1 to 3 years.

Target: 79 percent.

Baseline: 72 percent of children aged 1 to 3 years were restrained in front-facing child safety
seats in 2008.




Target: 47 percent.

Baseline: 43 percent of children aged 4 to 7 years were restrained in booster seats in 2008.




Target: 86 percent.

Baseline: 78 percent of children aged 8 to 12 years used safety belts in 2008.



IVP–9
193

IVP–17: Increase the number of States and the District of Columbia with “good” graduated
driver licensing (GDL) laws.

Target: 51 States (including the District of Columbia).

Baseline: 35 States (including the District of Columbia) had “good” graduated driver licensing
laws in 2009.

Target setting method: Trend analysis and total coverage.

Data source: U.S. Licensing Systems for Young Drivers, Insurance Institute for Highway Safety.

IVP–18: Reduce pedestrian deaths on public roads.


Baseline: 1.4 pedestrian deaths per 100,000 population occurred on public roads in 2008.



IVP–19: Reduce nonfatal pedestrian injuries on public roads.

Target: 20.3 injuries per 100,000 population.

Baseline: 22.6 nonfatal pedestrian injuries per 100,000 population occurred on public roads in
2008.



IVP-20: Reduce pedalcyclist deaths on public roads.


Baseline: 0.24 pedalcyclist deaths per 100,000 population occurred on public roads in 2008.



IVP–21: Increase the number of States and the District of Columbia with laws requiring bicycle
helmets for bicycle riders.

Target: 27 (including District of Columbia).

Baseline: 19 States (including the District of Columbia) had laws requiring bicycle helmets for
bicycle riders under age 15 years in 2009.

IVP–10
194


Data source: Bicycle Helmet Safety Institute.

IVP–22: Increase the proportion of motorcycle operators and passengers using helmets.


Baseline: 67.0 percent of all motorcycle operators and passengers used helmets in 2009.


Data sources: National Occupant Protection Use Survey (NOPUS), DOT, NHTSA

IVP–23: Prevent an increase in the rate of fall-related deaths.



Baseline: 7.0 deaths per 100,000 population were caused by falls in 2007 (age adjusted to the



IVP–23.2 Adults aged 65 years and older.


Baseline: 45.3 deaths per 100,000 population aged 65 years and older were caused by falls in



IVP–24: Reduce unintentional suffocation deaths.



Baseline: 1.9 deaths per 100,000 population were caused by unintentional suffocation in 2007



IVP–11
195

IVP–24.2 Infants 0 to 12 months.


Baseline: 22.5 deaths per 100,000 infants 0 to 12 months were caused by unintentional
suffocation in 2007.



IVP–24.3 Persons aged 65 years and older.


Baseline: 8.0 deaths per 100,000 population aged 65 years and older were caused by
unintentional suffocation in 2007 (age adjusted to the year 2000 standard population).



IVP–25: Reduce drowning deaths.

Target: 1.1 drownings per 100,000 population.

Baseline: 1.2 drownings per 100,000 population occurred in 2007 (age adjusted to the year



IVP–26: Reduce sports and recreation injuries.


Baseline: 45.6 medically consulted injuries per 1,000 population resulted from engaging in
sports and exercise or leisure activities in 2008 (age adjusted to the year 2000 standard
population).



IVP–12
196

IVP–27: Increase the proportion of public and private schools that require students to wear
appropriate protective gear when engaged in school-sponsored physical activities.

IVP–27.1 Physical education.


Baseline: 76.8 percent of public and private schools required students to wear appropriate
protective gear when engaged in physical education in 2006.



IVP–27.2 Intramural activities or physical activity clubs.


Baseline: 85.8 percent of public and private schools required students to wear appropriate
protective gear when engaged in school-sponsored intramural activities or physical activity clubs
in 2006.



IVP–28: Reduce residential fire deaths.


Baseline: 0.95 deaths per 100,000 population were caused by residential fires in 2007 (age



Violence Prevention

IVP–29: Reduce homicides.

Target: 5.5 homicides per 100,000 population.

Baseline: 6.1 homicides per 100,000 population occurred in 2007 (age adjusted to the year



IVP–13
197

IVP–30: Reduce firearm-related deaths.


Baseline: 10.2 firearm-related deaths per 100,000 population occurred in 2007 (age adjusted to



IVP–31: Reduce nonfatal firearm-related injuries.


Baseline: 20.7 nonfatal firearm-related injuries per 100,000 population occurred in 2007.


Data source: National Electronic Injury Surveillance System (NEISS), US Consumer Product Safety
Commission (CPSC).

IVP–32: Reduce nonfatal physical assault injuries.


Baseline: 514.1 emergency department visits for nonfatal physical assault injuries per 100,000


Data source: National Electronic Injury Surveillance System—All Injury Program (NEISS-AIP),

IVP–33: Reduce physical assaults.

Target: 14.7 physical assaults per 1,000 population.

Baseline: 16.3 physical assaults per 1,000 population aged 12 years and older occurred in
2008.


Data source: National Crime Victimization Survey (NCVS), DOJ, BJS.

IVP–34: Reduce physical fighting among adolescents.


IVP–14
198

Baseline: 31.5 percent of students in grades 9 through 12 reported that they engaged in
physical fighting in the previous 12 months in 2009.



IVP–35: Reduce bullying among adolescents.


Baseline: 19.9 percent of students in grades 9 through 12 reported that they were bullied on
school property in the previous 12 months in 2009.



IVP–36: Reduce weapon carrying by adolescents on school property.


Baseline: 5.6 percent of students in grades 9 through 12 reported that they carried weapons on
school property during the past 30 days in 2009.



IVP–37: Reduce child maltreatment deaths.

Target: 2.2 deaths per 100,000 children.

Baseline: 2.4 child maltreatment deaths per 100,000 children under age 18 years occurred in
2008.


Data source: National Child Abuse and Neglect Data System (NCANDS), ACYF, ACF, HHS.

IVP–38: Reduce nonfatal child maltreatment.

Target: 8.5 maltreatment victims per 1,000 children aged 17 years and under.

Baseline: 9.4 victims of nonfatal child maltreatment per 1,000 children under age 18 years were
reported in 2008.


Data source: National Child Abuse and Neglect Data System (NCANDS), ACYF, ACF, HHS.

IVP–15
199

IVP–39: (Developmental) Reduce violence by current or former intimate partners.

IVP–39.1 (Developmental) Reduce physical violence by current or former intimate partners.

Potential data source: National Intimate Partner and Sexual Violence Surveillance (NISVS)
System, CDC, NCIPC.

IVP–39.2 (Developmental) Reduce sexual violence by current or former intimate partners.

System, CDC, NCIPC.

IVP–39.3 (Developmental) Reduce psychological abuse by current or former intimate
partners.

System, CDC, NCIPC.

IVP–39.4 (Developmental) Reduce stalking by current or former intimate partners.

System, CDC, NCIPC.

IVP–40: (Developmental) Reduce sexual violence.

IVP–40.1 (Developmental) Reduce rape or attempted rape.

System, CDC, NCIPC.

IVP–40.2 (Developmental) Reduce abusive sexual contact other than rape or attempted
rape.

System, CDC, NCIPC.

IVP–40.3 (Developmental) Reduce non-contact sexual abuse.

System, CDC, NCIPC.

IVP–41: Reduce nonfatal intentional self-harm injuries.


Baseline: 125.3 emergency department visits for nonfatal intentional self-harm injuries per
100,000 population occurred in 2008 (age adjusted to the year 2000 standard population).

IVP–16
200


Data source: National Electronic Injury Surveillance System—All Injury Program (NEISS–AIP),

IVP-42: Reduce children’s exposure to violence.


Baseline: 60.6 percent of children were exposed to any form of violence, crime and abuse
measured in 2008.


Data Source: National Survey of Children’s Exposure to Violence (NatSCEV), DOJ, OJJDP.

IVP–43: Increase the number of States and the District of Columbia that link data on violent
deaths from death certificates, law enforcement, and coroner and medical examiner reports to
inform prevention efforts at the State and local levels.


Baseline: 16 States linked data on violent deaths from death certificates, law enforcement, and
coroner and medical examiner reports to inform prevention efforts at the State and local levels
in 2009.


Data source: National Violent Death Reporting System (NVDRS), CDC, NCIPC.

IVP–17
201


Maternal, Infant, and Child Health

Morbidity and Mortality

MICH–1 Fetal and infant deaths

MICH–2 Deaths among infants with Down syndrome

MICH–3 Child deaths

MICH–4 Adolescent and young adult deaths

MICH–5 Maternal deaths

MICH–6 Maternal illness and complications due to pregnancy

MICH–7 Cesarean births

MICH–8 Low birth weight and very low birth weight

MICH–9 Preterm births

Pregnancy Health and Behaviors

MICH–10 Prenatal care

MICH–11 Prenatal substance exposure

MICH–12 Childbirth classes

MICH–13 Weight gain during pregnancy

Preconception Health and Behaviors

MICH–14 Optimum folic acid levels

MICH–15 Low red blood-cell folate concentrations

MICH–16 Preconception care services and behaviors

MICH–17 Impaired fecundity

Postpartum Health and Behavior

MICH–18 Postpartum relapse of smoking

MICH–19 Postpartum care visit with a health worker

MICH–1
202

Infant Care

MICH–20 Infants put to sleep on their backs

MICH–21 Breastfeeding

MICH–22 Worksite lactation support programs

MICH–23 Formula supplementation in breastfed newborns

MICH–24 Lactation care in birthing facilities

Disability and Other Impairments

MICH–25 Fetal alcohol syndrome

MICH–26 Disorders diagnosed through newborn bloodspot screening

MICH–27 Birth weight of children with cerebral palsy

MICH–28 Neural tube defects

MICH–29 Children with Autism Spectrum Disorder and developmental delay screening

Health Services

MICH–30 Access to medical home

MICH–31 Care in family-centered, comprehensive, coordinated systems

MICH–32 Newborn bloodspot screening and follow-up testing

MICH–33 Very low birth weight infants born at level III hospitals

MICH–2
203

Topic Area: Maternal, Infant, and Child Health
Morbidity and Mortality

MICH–1: Reduce the rate of fetal and infant deaths.

MICH–1.1 Fetal deaths at 20 or more weeks of gestation.

Target: 5.6 fetal deaths per 1,000 live births and fetal deaths.

Baseline: 6.2 fetal deaths at 20 or more weeks of gestation per 1,000 live births and fetal deaths
occurred in 2005.



MICH–1.2 Fetal and infant deaths during perinatal period (28 weeks of gestation to 7
days after birth).

Target: 5.9 perinatal deaths per 1,000 live births and fetal deaths.

Baseline: 6.6 fetal and infant deaths per 1,000 live births and fetal deaths occurred during the
perinatal period (28 weeks of gestation to 7 days after birth) in 2005.



MICH–1.3 All infant deaths (within 1 year).

Target: 6.0 infant deaths per 1,000 live births.

Baseline: 6.7 infant deaths per 1,000 live births occurred within the first year of life in 2006.



MICH–1.4 Neonatal deaths (within the first 28 days of life).

Target: 4.1 neonatal deaths per 1,000 live births.

Baseline: 4.5 neonatal deaths per 1,000 live births occurred within the first 28 days of life in
2006.



MICH–3
204

MICH–1.5 Postneonatal deaths (between 28 days and 1 year).

Target: 2.0 postneonatal deaths per 1,000 live births.

Baseline: 2.2 postneonatal deaths per 1,000 live births occurred between 28 days and 1 year of
life in 2006.



MICH–1.6 Infant deaths related to birth defects (all birth defects).


Baseline: 1.4 Infant deaths per 1,000 live births were attributed to birth defects (all birth defects)
in 2006.



MICH–1.7 Infant deaths related to birth defects (congenital heart defects).


Baseline: 0.38 infant deaths per 1,000 live births were attributed to congenital heart and
vascular defects in 2006.



MICH–1.8 Infant deaths from sudden infant death syndrome (SIDS).


Baseline: 0.55 infant deaths per 1,000 live births were attributed to sudden infant death
syndrome in 2006.



MICH–1.9 Infant deaths from sudden unexpected infant deaths (includes SIDS,
Unknown Cause, Accidental Suffocation, and Strangulation in Bed).


MICH–4
205

Baseline: 0.93 infant deaths per 1,000 live births were attributed to sudden
unexpected/unexplained causes in 2006.



MICH–2: Reduce the 1-year mortality rate for infants with Down syndrome.

Target: 43.7 deaths within the first year of life per 1,000 infants with Down syndrome.

Baseline: 48.6 deaths within the first year of life per 1,000 infants diagnosed with Down
syndrome occurred in 2005–06.


Data source: National Birth Defects Prevention Network (NBDPN), CDC, NCBDDD.

MICH–3: Reduce the rate of child deaths.

MICH–3.1 Children aged 1 to 4 years.


Baseline: 28.6 deaths among children aged 1 to 4 years per 100,000 population occurred in
2007.





Baseline: 13.7 deaths among children aged 5 to 9 years per 100,000 population occurred in
2007.



MICH–4: Reduce the rate of adolescent and young adult deaths.

MICH–4.1 Adolescents aged 10 to 14 years.


Baseline: 16.9 deaths among adolescents aged 10 to 14 years per 100,000 population occurred
in 2007.

MICH–5
206



MICH–4.2 Adolescents aged 15 to 19 years.


Baseline: 61.9 deaths among adolescents aged 15 to 19 years per 100,000 population occurred
in 2007.



MICH–4.3 Young adults aged 20 to 24 years.


Baseline: 98.3 deaths among young adults aged 20 to 24 years per 100,000 population
occurred in 2007.



MICH–5: Reduce the rate of maternal mortality.

Target: 11.4 maternal deaths per 100,000 live births.

Baseline: 12.7 maternal deaths per 100,000 live births occurred in 2007.



MICH–6: Reduce maternal illness and complications due to pregnancy (complications during
hospitalized labor and delivery).


Baseline: 31.1 percent of pregnant females suffered complications during hospitalized labor and
delivery in 2007.



MICH–6
207

MICH–7: Reduce cesarean births among low-risk (full-term, singleton, vertex presentation)
women.

MICH–7.1 Women giving birth for the first time.


Baseline: 26.5 percent of low-risk females giving birth for the first time had a cesarean birth in
2007.



MICH–7.2 Prior cesarean birth.


Baseline: 90.8 percent of low-risk females giving birth with a prior cesarean birth had a
cesarean birth in 2007.



MICH–8: Reduce low birth weight (LBW) and very low birth weight (VLBW).

MICH–8.1 Low birth weight (LBW).


Baseline: 8.2 percent of live births were low birth weight in 2007.



MICH–8.2 Very low birth weight (VLBW).


Baseline: 1.5 percent of live births were very low birth weight in 2007.



MICH–7
208

MICH–9: Reduce preterm births.

MICH–9.1 Total preterm births.


Baseline: 12.7 percent of live births were preterm in 2007.



MICH–9.2 Late preterm or live births at 34 to 36 weeks of gestation.


Baseline: 9.0 percent of live births were late preterm or occurred at 34 to 36 weeks of gestation
in 2007.



MICH–9.3 Live births at 32 to 33 weeks of gestation.


Baseline: 1.6 percent of live births occurred at 32 to 33 weeks of gestation in 2007.



MICH–9.4 Very preterm or live births at less than 32 weeks of gestation.


Baseline: 2.0 percent of live births occurred at less than 32 weeks of gestation in 2007.



MICH–8
209

Pregnancy Health and Behaviors

MICH–10: Increase the proportion of pregnant women who receive early and adequate prenatal
care.

MICH–10.1 Prenatal care beginning in first trimester.


Baseline: 70.8 percent of females delivering a live birth received prenatal care beginning in the
first trimester in 2007.



MICH–10.2 Early and adequate prenatal care.


Baseline: 70.5 percent of pregnant females received early and adequate prenatal care in 2007.



MICH–11: Increase abstinence from alcohol, cigarettes, and illicit drugs among pregnant
women.

MICH–11.1 Alcohol.


Baseline: 89.4 percent of pregnant females aged 15 to 44 years reported abstaining from
alcohol in the past 30 days in 2007–08.



MICH–11.2 Binge drinking.


Baseline: 95.0 percent of pregnant females aged 15 to 44 years reported abstaining from binge
drinking during the past 30 days in 2007–08.



MICH–9
210

MICH–11.3 Cigarette smoking.


Baseline: 89.6 percent of females delivering a live birth reported abstaining from smoking
cigarettes during pregnancy in 2007.



MICH–11.4 Illicit drugs.


Baseline: 94.9 percent of pregnant females aged 15 to 44 years reported abstaining from illicit
drugs in the past 30 days in 2007–08.



MICH–12: (Developmental) Increase the proportion of pregnant women who attend a series of
prepared childbirth classes.

Potential data sources: Pregnancy Risk Assessment Monitoring System (PRAMS), CDC,
NCCDPHP; California’s Maternal and Infant Health Assessment (MIHA), Maternal, Child and
Adolescent Health Department, California State Health Department.

MICH–13: (Developmental) Increase the proportion of mothers who achieve a recommended
weight gain during their pregnancies.

Potential data source: National Vital Statistics System (NVSS), CDC, NCHS.

Preconception Health and Behaviors

MICH–14: Increase the proportion of women of childbearing potential with intake of at least 400
μg of folic acid from fortified foods or dietary supplements.


Baseline: 23.8 percent of non-pregnant females aged 15 to 44 years reported a usual daily total
intake of at least 400 μg of folic acid from fortified foods or dietary supplements in 2003–06.



MICH–10
211

MICH–15: Reduce the proportion of women of childbearing potential who have low red blood
cell folate concentrations.


Baseline: 24.5 percent of non-pregnant females aged 15 to 44 years had low red blood cell
folate concentrations in 2003–06.


Data source: National Health and Nutrition Examination Survey (NHANES) CDC, NCHS.

MICH–16: Increase the proportion of women delivering a live birth who received preconception
care services and practiced key recommended preconception health behaviors.

MICH–16.1 (Developmental) Discussed preconception health with a health care worker prior
to pregnancy.


MICH–16.2 Took multivitamins/folic acid prior to pregnancy.


Baseline: 30.1 percent of females delivering a recent live birth took multivitamins/folic acid every
day in the month prior to pregnancy as reported in 2007.


Data sources: Pregnancy Risk Assessment Monitoring System (PRAMS), CDC, NCCDPHP;
California’s Maternal and Infant Health Assessment (MIHA), Maternal, Child and Adolescent
Health Department, California State Health Department.

MICH–16.3 Did not smoke prior to pregnancy.


Baseline: 77.6 percent of females delivering a recent live birth did not smoke in the 3 months
prior to pregnancy as reported in 2007.



MICH–11
212

MICH–16.4 Did not drink alcohol prior to pregnancy.


Baseline: 51.3 percent of females delivering a recent live birth did not drink alcohol in the
3 months prior to pregnancy as reported in 2007.



MICH–16.5 Had a healthy weight prior to pregnancy.


Baseline: 48.5 percent of females delivering a recent live birth had a normal weight (i.e., a BMI
of 18.5-24.9) prior to pregnancy as reported in 2007.



MICH–16. 6 (Developmental) Used contraception to plan pregnancy.


MICH–17: Reduce the proportion of persons aged 18 to 44 years who have impaired fecundity
(i.e., a physical barrier preventing pregnancy or carrying a pregnancy to term).

MICH–17.1 Reduce the proportion of women aged 18 to 44 years who have impaired
fecundity.


Baseline: 12.0 percent of females aged 18 to 44 years had impaired fecundity in 2006-08.



MICH–17.2 (Developmental) Reduce the proportion of men aged 18 to 44 years who have
impaired fecundity.

Potential data source: National Survey of Family Growth (NSFG), CDC, NCHS.

MICH–12
213

Postpartum Health and Behavior

MICH–18: (Developmental) Reduce postpartum relapse of smoking among women who quit
smoking during pregnancy.


MICH–19: (Developmental) Increase the proportion of women giving birth who attend a
postpartum care visit with a health worker.


Infant Care

MICH–20: Increase the proportion of infants who are put to sleep on their backs.


Baseline: 69.0 percent of infants were put to sleep on their backs in 2007.



MICH–21: Increase the proportion of infants who are breastfed.

MICH–21.1 Ever.


Baseline: 74.0 percent of infants born in 2006 were ever breastfed as reported in 2007–09.



MICH–21.2 At 6 months.


Baseline: 43.5 percent of infants born in 2006 were breastfed at 6 months as reported in
2007–09.


MICH–13
214


MICH–21.3 At 1 year.


Baseline: 22.7 percent of infants born in 2006 were breastfed at 1 year as reported in 2007–09.



MICH–21.4 Exclusively through 3 months.


Baseline: 33.1 percent of infants born in 2006 were breastfed exclusively through 3 months as
reported in 2007–09.



MICH–21.5 Exclusively through 6 months.


Baseline: 13.6 percent of infants born in 2006 were breastfed exclusively through 6 months as
reported in 2007–09.



MICH–22: Increase the proportion of employers that have worksite lactation support programs.

Target: 38 percent.

Baseline: 25 percent of employers reported providing an on-site lactation/mother’s room in
2009.


Data source: Employee Benefits Survey, Society for Human Resource Management (SHRM).

MICH–23: Reduce the proportion of breastfed newborns who receive formula supplementation
within the first 2 days of life.


MICH–14
215

Baseline: 24.2 percent of breastfed newborns born in 2006 received formula supplementation
within the first 2 days of life as reported in 2007–09.



MICH–24: Increase the proportion of live births that occur in facilities that provide recommended
care for lactating mothers and their babies.


Baseline: 2.9 percent of 2007 live births occurred in facilities that provide recommended care for
lactating mothers and their babies as reported in 2009.


Data source: Breastfeeding Report Card, CDC, NCCDPHP.

Disability and Other Impairments

MICH–25: Reduce the occurrence of fetal alcohol syndrome (FAS).


Baseline: 3.6 cases of fetal alcohol syndrome per 10,000 live births in 2006 were suspected or
confirmed among children born in 2001–04.

Target setting method: This measure is being tracked for informational purposes. If warranted a

Data source: Fetal Alcohol Syndrome Surveillance Network (FASSnet), CDC, NCBDDD.

MICH–26: Reduce the proportion of children diagnosed with a disorder through newborn blood
spot screening who experience developmental delay requiring special education services.


Baseline: 15.1 percent of children aged 3 to 10 years diagnosed with a disorder through
newborn bloodspot screening experienced developmental delay requiring special education
services in 1991–2004.


Data sources: The Metropolitan Atlanta Developmental Disabilities Surveillance Program
(MADDSP), CDC, NCBDDD.

MICH–15
216

MICH–27: Reduce the proportion of children with cerebral palsy born as low birth weight infants
(less than 2,500 grams).


Baseline: 50.0 percent of children aged 8 years with cerebral palsy were born as low birth
weight infants (less than 2,500 grams) as reported in 2006.


Data source: Autism and Developmental Disabilities Monitoring (ADDM) Network, CDC,
NCBDDD.

MICH–28: Reduce occurrence of neural tube defects.

MICH–28.1 Reduce the occurrence of spina bifida.

Target: 30.8 live births and/or fetal deaths with spina bifida per 100,000 live births.

Baseline: 34.2 live births and/or fetal deaths with spina bifida per 100,000 live births were
diagnosed in 2005–06.



MICH–28.2 Reduce occurrence of anencephaly.

Target: 22.1 live births and/or fetal deaths with anencephaly per 100,000 live births.

Baseline: 24.6 live births and/or fetal deaths with anencephaly per 100,000 live births were
diagnosed in 2005–06.



MICH–29: Increase the proportion of young children with an Autism Spectrum Disorder (ASD)
and other developmental delays who are screened, evaluated, and enrolled in early intervention
services in a timely manner.

MICH–29.1 Increase the proportion of young children who are screened for an Autism
Spectrum Disorder (ASD) and other developmental delays by 24 months of age.


Baseline: 19.5 percent of children aged 10 to 36 months who were screened for an Autism
Spectrum Disorder (ASD) and other developmental delays were screened by 24 months of age
as reported in 2007.


MICH–16
217

Data source: National Survey on Children’s Health (NSCH), HRSA, MCHB and CDC, NCHS.

MICH–29.2 Increase the proportion of children with an ASD with a first evaluation by 36
months of age.


Baseline: 39.0 percent of children aged 8 years with an ASD had a first evaluation by 36 months
of age as reported in 2006.


Data source: The Autism and Developmental Disabilities Monitoring (ADDM) Network, CDC,
NCBDDD.

MICH–29.3 Increase the proportion of children with an ASD enrolled in special services by
48 months of age.


Baseline: 52.4 percent of children aged 8 years with an ASD were enrolled in special services
by 48 months of age as reported in 2006.


Data source: Metropolitan Atlanta Developmental Disabilities Surveillance Program (MADDSP),
CDC, NCBDDD.

MICH–29.4 (Developmental) Increase the proportion of children with a developmental delay
with a first evaluation by 36 months of age.

Potential data source: National Survey of Child’s Health (NSCH), HRSA, MCHB and CDC,
NCHS.

MICH–29.5 (Developmental) Increase the proportion of children with a developmental delay
enrolled in special services by 48 months of age.

Potential data sources: National Survey of Child’s Health (NSCH), HRSA, MCHB and CDC,
NCHS.

Health Services

MICH–30: Increase the proportion of children, including those with special health care needs,
who have access to a medical home.

MICH–30.1 Increase the proportion of children who have access to a medical home.


MICH–17
218

Baseline: 57.5 percent of children under age 18 years had access to a medical home in 2007.


Data source: National Survey of Children’s Health (NSCH), HRSA, MCHB and CDC, NCHS.

MICH–30.2 Increase the proportion of children with special health care needs who have
access to a medical home.


Baseline: 49.8 percent of children under age 18 years with special health care needs had
access to a medical home in 2007.


Data source: National Survey of Children’s Health (NSCH), HRSA, MCHB and CDC, NCHS.

MICH–31: Increase the proportion of children with special health care needs who receive their
care in family-centered, comprehensive, coordinated systems.



Baseline: 20.4 percent of children aged 0 through 11 years with special health care needs
received their care in family-centered, comprehensive, coordinated systems in 2005–06.


Data source: National Survey of Children with Special Health Care Needs (NS-CSHCN), HRSA,
MCHB and CDC, NCHS.



Baseline: 13.8 percent of children aged 12 through 17 years with special health care needs
received their care in family-centered, comprehensive, coordinated systems in 2005–06.


Data source: National Survey of Children with Special Health Care Needs (NS-CSHCN), HRSA,
MCHB and CDC, NCHS.

MICH–18
219

MICH–32: Increase appropriate newborn blood-spot screening and followup testing.

MICH–32.1 Increase the number of States and the District of Columbia that verify through
linkage with vital records that all newborns are screened shortly after birth for conditions
mandated by their State-sponsored screening program.

Target: 45 States (44 States and the District of Columbia).

Baseline: 21 States verified through linkage with vital records that all newborns were screened
shortly after birth for conditions mandated by their State-sponsored screening program in 2010.


Data source: National Newborn Screening and Genetics Resource Center, HRSA, MCHB.

MICH–32.2 Increase the proportion of screen-positive children who receive follow-up testing
within the recommended time period.


Baseline: 98.3 percent of screen-positive children received follow-up testing within the
recommended time period in 2006–08.


Data source: Title V Information System, HRSA, MCHB.

MICH–32. 3 (Developmental) Increase the proportion of children with a diagnosed condition
identified through newborn screening who have an annual assessment of services needed
and received.

Potential data source: National Newborn Screening and Genetic Resource Center, HRSA,
MCHB.

MICH–33: Increase the proportion of very low birth weight (VLBW) infants born at level III
hospitals or subspecialty perinatal centers.


Baseline: 75.0 percent of VLBW infants were born at level III hospitals or subspecialty perinatal
centers in 2003–06.


Potential data source: Title V Information System, HRSA, MCHB.

MICH–19
220


Medical Product Safety
MPS–1 Monitoring and analysis of adverse events associated with medical therapies

MPS–2 Pain treatment

MPS–3 Adverse events from medical products

MPS–4 Medical products associated with predictive biomarkers

MPS–5 Emergency department visits for adverse events from medications

MPS-1
221

Topic Area: Medical Product Safety
MPS-1: Increase the proportion of health care organizations that are monitoring and analyzing
adverse events associated with medical therapies within their systems.


Baseline: 60.7 percent of general and children’s hospital systems reported adverse drug events
externally in 2009.


Data source: National Survey of Pharmacy Practice in Acute Care Settings, American Society of
Health System Pharmacists (ASHP).

MPS-2: (Developmental) Increase the safe and effective treatment of pain.

MPS-2.1 (Developmental) Reduce the proportion of patients suffering from untreated pain
due to a lack of access to pain treatment.


MPS-2.2 Reduce the number of non-FDA-approved pain medications.

Target: 518 non-FDA-approved pain medications on the market for the year 2007.

Baseline: 575 non-FDA-approved pain medications (opioids, NSAIDs, and acetaminophen used
to treat pain) are on the market in one year beginning January, in 2007.

Target setting method: 10 percent improvement

Potential data source: The FDA Drug Registration and Listing database, FDA; Intercontinental
Marketing Services (IMS).

MPS-2.3 (Developmental) Reduce serious injuries from the use of pain medicines.

Potential data source: FDA Adverse Event Reporting System (FAERS), FDA.

MPS-2.4 (Developmental) Reduce deaths from the use of pain medicines.

Potential data source: FDA Adverse Event Reporting System (FAERS), FDA.

MPS-3: (Developmental) Reduce the number of adverse events from medical products.

Potential data source: Sentinel Initiative, FDA.

MPS-2
222

MPS-4: (Developmental) Increase the use of safe and effective medical products which are
associated with predictive biomarkers.

Potential data sources: FDA’s Pre-Market Approval (PMA) database and device application
tracking database (the “510(k) database”); Electronic Medical Records, CMS; U.S. System of
Oversight of Genetic Testing: A Response to the Charge of the Secretary of Health and Human
Services Report of the Secretary’s Advisory Committee on Genetics, Health, and Society, April
2008” available http://oba.od.nih.gov/oba/SACGHS/reports/SACGHS_oversight_report.pdf.

MPS-5: Reduce emergency department (ED) visits for common, preventable adverse events
from medications.

MPS-5.1 Reduce emergency department (ED) visits for overdoses from oral anticoagulants.

Target: 35.9 ED visits per 10,000 outpatient prescription visits.

Baseline: 39.9 ED visits per 10,000 outpatient prescription visits for overdoses from oral
anticoagulants occurred in 2007.


Data sources: National Electronic Injury Surveillance System-Cooperative Adverse Drug Event
Project (NEISS-CADES), CDC, National Ambulatory Care Survey (NAMCS) and National
Hospital Ambulatory Medical Care Surveys (NHAMCS), CDC.

MPS-5.2 Reduce emergency department (ED) visits for overdoses from injectable
antidiabetic agents.


Baseline: 51.3 ED visits per 10,000 outpatient prescription visits for overdoses from injectable
antidiabetic agents occurred in 2007.



MPS-5.3 Reduce emergency department (ED) visits for overdoses from narrow-therapeutic-
index medications.


Baseline: 9.2 ED visits per 10,000 outpatient prescription visits for overdoses from narrow-
therapeutic-index medications occurred in 2007.


MPS-3
223


MPS-5.4 Reduce emergency department (ED) visits for medication overdoses among
children less than 5 years of age.

Target: 29.5 ED visits per 10,000 children less than 5 years of age.

Baseline: 32.8 ED visits per 10,000 children less than 5 years of age occurred in 2008.


Surveillance Project (NEISS-CADES), CDC; Annual Estimates of the Resident Population, U.S.
Census Bureau.

MPS-4
224


Mental Health and Mental Disorders

Mental Health Status Improvement

MHMD–1 Suicide

MHMD–2 Adolescent suicide attempts

MNMD–3 Eating disorders

MHMD–4 Major depressive episodes

Treatment Expansion

MHMD–5 Mental health treatment provided in primary care facilities

MHMD–6 Treatment for children with mental health problems

MHMD–7 Juvenile justice facility screening

MHMD–8 Employment of persons with serious mental illness

MHMD–9 Treatment of adults with mental health disorders

MHMD–10 Treatment for co-occurring substance abuse and mental disorders

MHMD–11 Depression screening by primary care providers

MHMD–12 Receipt of mental health services among homeless adults

MHMD–1
225

Topic Area: Mental Health and Mental Disorders
Mental Health Status Improvement

MHMD–1: Reduce the suicide rate.

Target: 10.2 suicides per 100,000.

Baseline: 11.3 suicides per 100,000 occurred in 2007.



MHMD–2: Reduce suicide attempts by adolescents.

Target: 1.7 suicide attempts per 100.

Baseline: 1.9 suicide attempts per 100 occurred in 2009.


Data source: Youth Risk Behavior Surveillance System (YRBSS), CDC.

MHMD–3: Reduce the proportion of adolescents who engage in disordered eating behaviors in
an attempt to control their weight.


Baseline: 14.3 percent of adolescents engaged in disordered eating behaviors in an attempt to
control their weight in 2009.



MHMD–4: Reduce the proportion of persons who experience major depressive episodes
(MDE).

MHMD–4.1 Adolescents aged 12 to 17 years.


Baseline: 8.3 percent of adolescents aged 12 to 17 years experienced a major depressive
episode in 2008.


Data source: National Survey on Drug Use and Health, SAMHSA.

MHMD–2
226

MHMD–4.2 Adults aged 18 years and older.


Baseline: 6.8 percent of adults aged 18 years and older experienced a major depressive
episode in 2008.


Data source: National Survey on Drug Use and Health, SAMHSA.

Treatment Expansion

MHMD–5: Increase the proportion of primary care facilities that provide mental health treatment
onsite or by paid referral.

Target: 87 percent.

Baseline: 79 percent of primary care facilities provided mental health treatment onsite or by paid
referral in 2006.


Data source: Uniform Data System (UDS), HRSA.

MHMD–6: Increase the proportion of children with mental health problems who receive
treatment.


Baseline: 68.9 percent of children with mental health problems received treatment in 2008.



MHMD–7: Increase the proportion of juvenile residential facilities that screen admissions for
mental health problems.

Target: 64 percent.

Baseline: 58 percent of juvenile residential facilities screened admissions for mental health
problems in 2006.


Data source: National Juveniles in Residential Facilities Census (JFRC), National Center for
Juvenile Justice.

MHMD–3
227

MHMD–8: Increase the proportion of persons with serious mental illness (SMI) who are
employed.


Baseline: 58.5 percent of persons with serious mental illness (SMI) were employed in 2008.



MHMD–9: Increase the proportion of adults with mental disorders who receive treatment.

MHMD–9.1 Adults aged 18 years and older with serious mental illness (SMI).


Baseline: 58.7 percent of adults aged 18 years and older with serious mental illness (SMI)
received treatment in 2008.

Target setting method: 10 percent Improvement.


MHMD–9.2 Adults aged 18 years and older with major depressive episodes.


Baseline: 68.3 percent of adults aged 18 years and older with major depressive episodes
received treatment in 2008.



MHMD–10: Increase the proportion of persons with co-occurring substance abuse and mental
disorders who receive treatment for both disorders.


Baseline: 3.0 percent of persons with co-occurring substance abuse and mental disorders
received treatment for both disorders in 2008.

Target setting method: 10 percent Improvement.


MHMD–4
228

MHMD–11: Increase depression screening by primary care providers.

MHMD–11.1 Increase the proportion of primary care physician office visits that screen adults
aged 19 years and older for depression.


Baseline: 2.2 percent of primary care physician office visits screened adults aged 19 years and
older for depression in 2007.



MHMD–11.2 Increase the proportion of primary care physician office visits that screen youth
aged 12 to 18 years for depression.


Baseline: 2.1 percent of primary care physician office visits screened for depression in 2005–07.



MHMD–12: Increase the proportion of homeless adults with mental health problems who
receive mental health services.

Target: 41 percent.

Baseline: 37 percent of homeless adults with mental health problems received mental health
services in 2006.


Data source: Projects for Assistance in Transition from Homelessness (PATH), SAMHSA.

MHMD–5
229


Nutrition and Weight Status

Healthier Food Access

NWS–1 State nutrition standards for child care

NWS–2 Nutritious foods and beverages offered outside of school meals

NWS–3 State-level incentive policies for food retail

NWD–4 Retail access to foods recommended by Dietary Guidelines for Americans

Health Care and Worksite Settings

NWS–5 Primary care physicians who measure patients’ body mass index (BMI)

NWS–6 Physician office visits with nutrition or weight counseling or education

NWS–7 Worksite nutrition and weight management classes and counseling

Weight Status

NWS–8 Healthy weight in adults

NWS–9 Obesity in adults

NWS–10 Obesity in children and adolescents

NWS–11 Inappropriate weight gain

Food Insecurity

NWS–12 Food insecurity among children

NWS–13 Food insecurity among households

Food and Nutrient Consumption

NWS–14 Fruit intake

NWS–15 Vegetable intake

NWS–16 Whole grain intake

NWS–17 Solid fat and added sugar intake

NWS–18 Saturated fat intake

NWS–1
230

NWS–19 Sodium intake

NWS–20 Calcium intake

Iron Deficiency

NWS–21 Iron deficiency in young children and in females of childbearing age

NWS–22 Iron deficiency in pregnant females

NWS–2
231

Topic Area: Nutrition and Weight Status
Healthier Food Access

NWS–1: Increase the number of States with nutrition standards for foods and beverages
provided to preschool-aged children in child care.

Target: 34 States (can include the District of Columbia).

Baseline: 24 States had nutrition standards for foods and beverages provided to preschool-aged
children in child care in 2006.

Target setting method: 1 State per year improvement (can include the District of Columbia).

Data sources: National Resource Center for Health and Safety in Child Care and Early
Education, and child care licensing websites from each State government and the District of
Columbia.

NWS–2: Increase the proportion of schools that offer nutritious foods and beverages outside of
school meals.

NWS–2.1 Increase the proportion of schools that do not sell or offer calorically sweetened
beverages to students.


Baseline: 9.3 percent of schools did not sell or offer calorically sweetened beverages to
students in 2006.

Target setting method: Modeled on previous data: 12 percentage point increase.

Data source: School Health Policies and Programs Study, CDC.

NWS–2.2 Increase the proportion of school districts that require schools to make fruits or
vegetables available whenever other food is offered or sold.


Baseline: 6.6 percent of school districts required schools to make fruits or vegetables available
whenever other foods are offered or served in 2006.

Target setting method: 12.0 percentage point increase.

Data source: School Health Policies and Program Study, CDC.

NWS–3: Increase the number of States that have State-level policies that incentivize food retail
outlets to provide foods that are encouraged by the Dietary Guidelines.


NWS–3
232

Baseline: 8 States (including the District of Columbia) had State-level policies that incentivized
food retail outlets to provide foods that are encouraged by the Dietary Guidelines in 2009.

Target setting method: Modeled on previous data; 1 State per year improvement.

Data sources: CDC State Indicator Report on Fruits and Vegetables. The report gathers data
from three data sources: (1) CDC Nutrition, Physical Activity, and Obesity Legislative Database,
(2) National Conference of State Legislatures Health Community Design and Access to Healthy
Food Legislative Database, (3) The Food Trust.

NWS–4: (Developmental) Increase the proportion of Americans who have access to a food
retail outlet that sells a variety of foods that are encouraged by the Dietary Guidelines for
Americans.

Proposed data source: To be determined.

Health Care and Worksite Settings

NWS–5: Increase the proportion of primary care physicians who regularly measure the body
mass index of their patients.

NWS–5.1 Increase the proportion of primary care physicians who regularly assess body
mass index (BMI) in their adult patients.


Baseline: 48.7 percent of primary care physicians regularly assessed body mass index (BMI) in
their adult patients in 2008.


Data source: National Survey on Energy Balance Related Care among Primary Care
Physicians.

NWS–5.2 Increase the proportion of primary care physicians who regularly assess body
mass index (BMI) for age and sex in their child or adolescent patients.


Baseline: 49.7 percent of primary care physicians regularly assessed body mass index (BMI) for
age and sex in their child or adolescent patients in 2008.


Data source: National Survey on Energy Balance Related Care Among Primary Care
Physicians.

NWS–4
233

NWS–6: Increase the proportion of physician office visits that include counseling or education
related to nutrition or weight.

NWS–6.1 Increase the proportion of physician office visits made by patients with a diagnosis
of cardiovascular disease, diabetes, or hyperlipidemia that include counseling or education
related to diet and nutrition.


Baseline: 20.8 percent of physician office visits of adult patients with a diagnosis of
cardiovascular disease, diabetes, or hyperlipidemia included counseling or education related to
diet and nutrition in 2007 (age adjusted to the year 2000 standard population).


Data source: National Ambulatory Medical Care Survey, CDC, NCHS.

NWS–6.2 Increase the proportion of physician office visits made by adult patients who are
obese that include counseling or education related to weight reduction, nutrition, or physical
activity.


Baseline: 28.9 percent of physician office visits of adult patients who are obese included
counseling or education related to weight reduction, nutrition, or physical activity in 2007 (age



NWS–6.3 Increase the proportion of physician visits made by all child or adult patients that
include counseling about nutrition or diet.


Baseline: 12.2 percent of physician office visits of all child or adults patients included counseling
about nutrition or diet in 2007 (age adjusted to the year 2000 standard population).



NWS–7: (Developmental) Increase the proportion of worksites that offer nutrition or weight
management classes or counseling.

Potential data source: A followup survey to the 2004 National Worksite Health Promotion
Survey.

NWS–5
234

Weight Status

NWS–8: Increase the proportion of adults who are at a healthy weight.


Baseline: 30.8 percent of persons aged 20 years and over were at a healthy weight in 2005–08



NWS–9: Reduce the proportion of adults who are obese.


Baseline: 34.0 percent of persons aged 20 years and over were obese in 2005–08 (age



NWS–10 Reduce the proportion of children and adolescents who are considered obese.

NWS–10.1 Children aged 2 to 5 years.


Baseline: 10.7 percent of children aged 2 to 5 years were considered obese in 2005–08.





Baseline: 17.4 percent of children aged 6 to 11 years were considered obese in 2005–08.



NWS–10.3 Adolescents aged 12 to 19 years.


NWS–6
235

Baseline: 17.9 percent of adolescents aged 12 to 19 years were considered obese in 2005–08.



NWS–10.4 Children and adolescents aged 2 to 19 years.


Baseline: 16.2 percent of children and adolescents aged 2 to 19 years were considered obese
in 2005–08.



NWS–11: (Developmental) Prevent inappropriate weight gain in youth and adults.


NCHS.


NCHS.

NWS–11.3 Adolescents aged 12 to 19 years.

NCHS.

NWS–11.4 Children and adolescents aged 2 to 19 years.

NCHS.

NWS–11.5 Adults aged 20 years and older.

NCHS.

NWS–7
236

Food Insecurity

NWS–12: Eliminate very low food security among children.


Baseline: 1.3 percent of households with children had very low food security among children in
2008.

Target setting method: Consistent with the Department of Agriculture’s policy to eliminate
childhood hunger by 2015.

Data source: Food Security Supplement to the Current Population Survey, U.S. Department of
Commerce, Bureau of the Census.

NWS–13: Reduce household food insecurity and in so doing reduce hunger.


Baseline: 14.6 percent of households were food insecure in 2008.

Target setting method: Retain 2010 target.

Data source: Food Security Supplement to the Current Population Survey, U.S. Department of
Commerce, Bureau of the Census.

Food and Nutrient Consumption

NWS–14: Increase the contribution of fruits to the diets of the population aged 2 years and
older.

Target: 0.9 cup equivalents per 1,000 calories.

Baseline: 0.5 cup equivalents of fruits per 1,000 calories was the mean daily intake by persons
aged 2 years and older in 2001–04.

Target setting method: Evidence-based approach (Considered the baseline in relation to 2005
Dietary Guidelines for Americans [DGA] recommendations, past trends and potentially
achievable shift in the usual intake distribution, and applicability of the target to subpopulations).

Data source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS and
USDA, ARS.

NWS–15: Increase the variety and contribution of vegetables to the diets of the population aged
2 years and older.

NWS–15.1 Increase the contribution of total vegetables to the diets of the population aged 2
years and older.


NWS–8
237

Baseline: 0.8 cup equivalents of total vegetables per 1,000 calories was the mean daily intake
by persons aged 2 years and older in 2001–04 (age adjusted to the year 2000 standard
population).

DGA recommendations, past trends and potentially achievable shift in the usual intake
distribution, and applicability of the target to subpopulations).

USDA, ARS.

NWS–15.2 Increase the contribution of dark green vegetables, orange vegetables, and
legumes to the diets of the population aged 2 years and older.


Baseline: 0.1 cup equivalents of dark green or orange vegetables or legumes per 1,000 calories
was the mean daily intake by persons aged 2 years and older in 2001–04 (age adjusted to the

Target setting method: Evidence-based approach (Considered the baseline in relation to USDA
Food Guide recommendations, past trends and potentially achievable shift in the usual intake

USDA, ARS.

NWS–16 Increase the contribution of whole grains to the diets of the population aged 2 years
and older.

Target: 0.6 ounce equivalents per 1,000 calories.

Baseline: 0.3 ounce equivalents of whole grains per 1,000 calories was the mean daily intake by
persons aged 2 years and older in 2001–04 (age adjusted to the year 2000 standard
population).

DGA recommendation, past trends and potentially achievable shift in the usual intake

USDA, ARS.

NWS–17: Reduce consumption of calories from solid fats and added sugars in the population
aged 2 years and older.

NWS–17.1 Reduce consumption of calories from solid fats.


NWS–9
238

Baseline: 18.9 percent was the mean percentage of total daily calorie intake provided by solid
fats for the population aged 2 years and older in 2001–04 (age adjusted to the year 2000

Food Guide recommendations, potentially achievable shift in the usual intake distribution, and
applicability of the target to subpopulations).

USDA, ARS.

NWS–17.2 Reduce consumption of calories from added sugars.


Baseline: 15.7 percent was the mean percentage of total daily calorie intake provided by added
sugars for the population aged 2 years and older in 2001–04 (age adjusted to the year 2000

Target setting method: Evidence- based approach (Considered the baseline in relation to USDA

USDA, ARS.

NWS–17.3 Reduce consumption of calories from solid fats and added sugars.


Baseline: 34.6 percent was the mean percentage of total daily calorie intake provided by solid
fats and added sugars for the population aged 2 years and older in 2001–04 (age adjusted to


USDA, ARS.

NWS–18: Reduce consumption of saturated fat in the population aged 2 years and older.


Baseline: 11.3 percent was the mean percentage of total daily calorie intake provided by
saturated fat for the population aged 2 years and older in 2003–06 (age adjusted to the year

NWS–10
239

DGA recommendation, past trends and potentially achievable shift in the usual intake

USDA, ARS.

NWS–19: Reduce consumption of sodium in the population aged 2 years and older.

Target: 2,300 milligrams.

Baseline: 3,641 milligrams of sodium from foods, dietary supplements and antacids, drinking
water, and salt use at the table was the mean total daily intake by persons aged 2 years and
older in 2003–06 (age adjusted to the year 2000 standard population).

Target setting method: Evidence-based approach (Considered the baseline in relation to the
2005 DGA recommendations and Institute of Medicine [IOM] Dietary Reference Intakes [DRIs],
past trends and potentially achievable shift in the usual intake distribution, and applicability of
the target to subpopulations).

USDA, ARS.

NWS–20: Increase consumption of calcium in the population aged 2 years and older.

Target: 1,300 milligrams.

Baseline: 1,118 milligrams of calcium from foods, dietary supplements and antacids, and
drinking water was the mean total daily intake by persons aged 2 years and older in 2003–06

Target setting method: Evidence-based approach (Considered the baseline in relation to IOM
DRIs, past trends and potentially achievable shift in the usual intake distribution, and

USDA, ARS.

Iron Deficiency

NWS–21: Reduce iron deficiency among young children and females of childbearing age.



Baseline: 15.9 percent of children aged 1 to 2 years were iron deficient in 2005–08.


NWS–11
240




Baseline: 5.3 percent of children aged 3 to 4 years were iron deficient in 2005–08.



NWS–21.3 Females aged 12 to 49 years.


Baseline: 10.4 percent of females aged 12 to 49 years old were iron deficient in 2005–08.



NWS–22: Reduce iron deficiency among pregnant females.


Baseline: 16.1 percent of pregnant females were iron deficient in 2003–06.



NWS–12
241


Occupational Safety and Health

OSH–1 Work-related injury deaths

OSH–2 Nonfatal work-related injuries

OSH–3 Overexertion or repetitive motion

OSH–4 Pneumoconiosis deaths

OSH–5 Work-related homicides

OSH–6 Work-related assaults

OSH–7 Elevated blood lead concentrations from work exposures

OSH–8 Occupational skin diseases or disorders

OSH–9 Worksite stress reduction programs

OSH–10 Work-related, noise-induced hearing loss

OSH–1
242

Topic Area: Occupational Safety and Health
OSH–1: Reduce deaths from work-related injuries.

OSH–1.1 All industry.

Target: 3.6 deaths per 100,000 full-time equivalent workers.

Baseline: 4.0 work-related injury deaths per 100,000 full-time equivalent workers occurred in
2007.


Data sources: Census of Fatal Occupational Injuries (CFOI), DOL, BLS; Current Population
Survey (CPS), U.S. Bureau of the Census.

OSH–1.2 Mining.


Baseline: 21.4 mining work-related injury deaths per 100,000 full-time equivalent workers
occurred in 2007.



OSH–1.3 Construction.


Baseline: 10.8 construction work-related injury deaths per 100,000 full-time equivalent workers
occurred in 2007.



OSH–1.4 Transportation and warehousing.


Baseline: 16.5 transportation and warehousing work-related injury deaths per 100,000 full-time
equivalent workers occurred in 2007.


OSH–2
243


OSH–1.5 Agriculture, forestry, fishing, and hunting.

Target: 24.3 deaths per 100,000 fulltime equivalent workers.

Baseline: 27.0 agriculture, forestry, fishing, and hunting work-related injury deaths per 100,000
fulltime equivalent workers occurred in 2007.



OSH–2: Reduce nonfatal work-related injuries.

OSH–2.1 Injuries in private sector industries resulting in medical treatment, lost time from
work, or restricted work activity, as reported by employers.

Target: 3.8 injuries per 100 full-time equivalent workers.

Baseline: 4.2 injuries per 100 full-time equivalent workers in private sector industries resulted in
medical treatment, lost time from work, or restricted work activity, as reported by employers in
2008.


Data source: Survey of Occupational Injuries and Illnesses (SOII), DOL, BLS.

OSH–2.2 Injuries treated in emergency departments.


Baseline: 2.4 injuries per 100 full-time equivalent workers were treated in emergency
departments in 2007.


Data source: National Electronic Injury Surveillance System- Work Supplement (NEISS-Work),
CDC, NIOSH; Current Population Survey, U.S. Bureau of the Census.

OSH–2.3 Adolescent workers aged 15 to 19 years.


Baseline: 5.5 injuries per 100 full-time equivalent workers occurred among adolescent workers
aged 15 to 19 years in 2007.


OSH–3
244

Data source: National Electronic Injury Surveillance System-Work Supplement (NEISS-Work),
CDC, NIOSH, Current Population Survey, U.S. Bureau of the Census

OSH–3: Reduce the rate of injury and illness cases involving days away from work due to
overexertion or repetitive motion.

Target: 26.64 injury and illness cases per 10,000 workers.

Baseline: 29.6 injury and illness cases per 10,000 workers involved days away from work due to
overexertion or repetitive motion in 2008.


Data source: Survey of Occupational Injuries and Illnesses, DOL, BLS.

OSH–4: Reduce pneumoconiosis deaths.

Target: 2,187 deaths.

Baseline: 2,430 pneumoconiosis deaths occurred in 2005.


Data source: National Surveillance System for Pneumoconiosis Mortality (NSSPM), CDC,
NIOSH.

OSH–5: Reduce deaths from work-related homicides.

Target: 565 deaths.

Baseline: 628 deaths were work-related homicides in 2007.


Data source: Census of Fatal Occupational Injuries (CFOI), DOL, BLS.

OSH–6: Reduce work-related assaults.

Target: 7.6 assaults per 10,000 full-time equivalent workers.

Baseline: 8.4 assaults per 10,000 fulltime equivalent workers occurred in 2007.


Data source: National Electronic Injury Surveillance System–Work Supplement (NEISS–Work),
CDC, NIOSH.

OSH–4
245

OSH–7: Reduce the proportion of persons who have elevated blood lead concentrations from
work exposures.

Target: 20.2 persons per 100,000 employed adults.

Baseline: 22.5 persons per 100,000 employed adults had elevated blood lead concentrations
from work exposures in 2008.


Data source: Adult Blood Lead Epidemiology and Surveillance (ABLES) Program, CDC, NIOSH.

OSH–8: Reduce occupational skin diseases or disorders among full-time workers.

Target: 4.0 occupational skin diseases or disorders per 10,000 full-time workers.

Baseline: 4.4 occupational skin diseases or disorders per 10,000 full-time workers occurred in
2008.



OSH–9: (Developmental) Increase the proportion of employees who have access to workplace
programs that prevent or reduce employee stress.

Potential data source: Quality of Worklife (QWL) module, CDC, NIOSH.

OSH–10: Reduce new cases of work-related, noise-induced hearing loss.

Target: 2.0 new cases of work-related, noise-induced hearing loss per 10,000 workers.

Baseline: 2.2 new cases of work-related, noise-induced hearing loss per 10,000 workers
occurred in 2008.



OSH–5
246


Older Adults

Prevention
OA–1 Use of Welcome to Medicare benefit

OA–2 Older adults up to date on clinical preventive services

OA–3 Older adults’ confidence in managing their chronic conditions

OA–4 Receipt of Diabetes Self-Management Benefits by older adults

OA–5 Functional limitations in older adults

OA–6 Leisure-time physical activities among older adults

OA–7 Pressure ulcer-related hospitalizations among older adults

Long-Term Services and Supports

OA–8 Need for long-term services and support

OA–9 Caregiver support services

OA–10 Health care workforce with geriatric certification

OA–11 Emergency department visits due to falls among older adults

OA-12 Information on elder abuse, neglect, and exploitation

OA–1
247

Topic Area: Older Adults
Prevention

OA–1: Increase the proportion of older adults who use the Welcome to Medicare benefit.


Baseline: 7.3 percent of older adults used the Welcome to Medicare benefit in 2008.


Data source: Medicare Claims Data, CMS.

OA–2: Increase the proportion of older adults who are up to date on a core set of clinical
preventive services.

OA–2.1 Males.


Baseline: 46.3 percent of males aged 65 years and older were up to date on a core set of
clinical preventive services in 2008.


Data source: Behavioral Risk Factor Surveillance System (BRFSS), CDC, Office of
Surveillance, Epidemiology, and Laboratory Services (proposed office).

OA–2.2 Females.


Baseline: 47.9 percent of females aged 65 years and older were up to date on a core set of
clinical preventive services in 2008.


Data source: Behavioral Risk Factor Surveillance System (BRFSS), CDC, Office of
Surveillance, Epidemiology, and Laboratory Services (proposed office).

OA–3: (Developmental) Increase the proportion of older adults with one or more chronic health
conditions who report confidence in managing their conditions.

Potential data source: Behavioral Risk Factor Surveillance System, CDC, NCHS.

OA–4: Increase the proportion of older adults who receive Diabetes Self-Management Benefits.


OA–2
248

Baseline: 2.2 percent of adults aged 65 years and older received Diabetes Self-Management
Benefits in 2008.


Data source: Medicare Claims Data, CMS.

OA–5 Reduce the proportion of older adults who have moderate to severe functional limitations.


Baseline: 28.3 percent of older adults had moderate to severe functional limitations (age-
adjusted) in 2007.


Data source: Medicare Current Beneficiary Survey (MCBS), CMS.

OA–6: Increase the proportion of older adults with reduced physical or cognitive function who
engage in light, moderate, or vigorous leisure-time physical activities.


Baseline: 33.7 percent of older adults with reduced physical or cognitive function engaged in
light, moderate, or vigorous leisure-time physical activities in 2008.



OA–7: Increase the proportion of the health care workforce with geriatric certification.

OA–7.1 Physicians.


Baseline: 2.7 percent of physicians had geriatric certification in 2009.


Data source: American Board of Internal Medicine, American Board of Family Medicine,
American Osteopathic Organization, and American Medical Association (Physician
Characteristics and Distribution in the US, 2009).

OA–7.2 Geriatric psychiatrists.


Baseline: 4.3 percent of geriatric psychiatrists had geriatric certification in 2009.

OA–3
249


Data source: American Board of Psychiatry and Neurology and American Medical Association
(Physician Characteristics and Distribution in the US, 2009).

OA–7.3 Registered nurses.


Baseline: 1.4 percent of registered nurses had geriatric certification in 2004.


Data source: 2004 National Sample Survey of Registered Nurses (HRSA); Census Data:
Employed Civilians by Occupation, Sex, Race, and Hispanic Origin: 2003.

OA–7.4 Dentists.


Baseline: 0.20 percent of dentists had geriatric certification in 2007.


Data source: Special Care Dentistry Association (SCDA); 2007 Distribution of Dentists in the
U.S. by Region and State (American Dental Association).

OA–7.5 Physical therapists.


Baseline: 0.6 percent of physical therapists had geriatric certification in 2009.


Data source: Statistics provided by American Physical Therapy Association and American
Board of Physical Therapy Specialties (ABPTS) that coordinates and oversees the specialist
certification process.

OA–7.6 Registered dieticians.


Baseline: 0.30 percent of registered dieticians had geriatric certification in 2009.


Data source: Statistics provided by American Dietetic Association (ADA) on the number of
registered dieticians with geriatric certification offered by the Commission on Dietetic
Registration (CDR), the credentialing agency for the ADA.

OA–4
250

Long-Term Services and Supports

OA–8: (Developmental) Reduce the proportion of noninstitutionalized older adults with
disabilities who have an unmet need for long-term services and supports.

Potential data source: National Health and Aging Trends Study (NHATS).

OA–9: (Developmental) Reduce the proportion of unpaid caregivers of older adults who report
an unmet need for caregiver support services.

Potential data source: National Health and Aging Trends Study (NHATS).

OA–10: Reduce the rate of pressure ulcer-related hospitalizations among older adults.

Target: 887.3 pressure ulcer-related hospitalizations per 100,000 persons aged 65 years and
over.

Baseline: 985.8 pressure ulcer-related hospitalizations per 100,000 persons aged 65 years and
over occurred in 2007.


Data source: Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample
(NIS), AHRQ.

OA–11 Reduce the rate of emergency department visits due to falls among older adults.

Target: 4,711.6 emergency department visits per 100,000 due to falls among older adults.

Baseline: 5,235.1 emergency department visits per 100,000 due to falls occurred among older
adults in 2007(age adjusted to year 2000 standard population).


Data source: National Hospital Ambulatory Medical Care Survey, CDC, NCHS.

OA–12: Increase the number of States, the District of Columbia, and Tribes that collect and
make publicly available information on the characteristics of victims, perpetrators, and cases of
elder abuse, neglect, and exploitation.

OA–12.1 States and the District of Columbia.


Baseline: 3 States collected and made publicly available information on the characteristics of
victims, perpetrators, and cases of elder abuse, neglect, and exploitation in 2004.


Data source: National Center on Elder Abuse, AoA.

OA–5
251

OA–12.2 (Developmental) Tribes.

Potential data source: National Center on Elder Abuse, AoA.

OA–6
252


Oral Health

Oral Health of Children and Adolescents
OH–1 Dental caries experience

OH–2 Untreated dental decay in children and adolescents

Oral Health of Adults
OH–3 Untreated dental decay in adults

OH–4 No permanent tooth loss

OH–5 Destructive periodontal disease

OH–6 Early detection of oral and pharyngeal cancers

Access to Preventive Services
OH–7 Use of oral health care system

OH–8 Dental services for low-income children and adolescents

OH–9 School-based centers with an oral health component

OH–10 Health centers with oral health component

OH–11 Receipt of oral health services at health centers

Oral Health Interventions
OH–12 Dental sealants

OH–13 Community water fluoridation

OH–14 Preventive dental screening and counseling

Monitoring, Surveillance Systems
OH–15 Systems that record cleft lip or palate and referrals

OH–16 Oral and craniofacial State-based health surveillance system

Public Health Infrastructure
OH–17 Health agencies with a dental professional directing their dental program

OH–1
253

Topic Area: Oral Health

Oral Health of Children and Adolescents
OH–1: Reduce the proportion of children and adolescents who have dental caries experience in
their primary or permanent teeth.

OH–1. Reduce the proportion of young children aged 3 to 5 years with dental caries
experience in their primary teeth.


Baseline: 33.3 percent of children aged 3 to 5 years had dental caries experience in at least one
primary tooth in 1999–2004.



OH–1.2 Reduce the proportion of children aged 6 to 9 years with dental caries experience in
their primary and permanent teeth.


Baseline: 54.4 percent of children aged 6 to 9 years had dental caries experience in at least one
primary or permanent tooth in 1999–2004.



OH–1.3 Reduce the proportion of adolescents aged 13 to 15 years with dental caries
experience in their permanent teeth.


Baseline: 53.7 percent of adolescents aged 13 to 15 years had dental caries experience in at
least one permanent tooth in 1999–2004.



OH–2: Reduce the proportion of children and adolescents with untreated dental decay.

OH–2.1 Reduce the proportion of young children aged 3 to 5 years with untreated dental
decay in their primary teeth.


OH–2
254

Baseline: 23.8 percent of children aged 3 to 5 years had untreated dental decay in at least one
primary tooth in 1999–2004.



OH–2.2 Reduce the proportion of children aged 6 to 9 years with untreated dental decay in
their primary and permanent teeth.


Baseline: 28.8 percent of children aged 6 to 9 years had untreated dental decay in at least one
primary or permanent tooth in 1999–2004.



OH–2.3 Reduce the proportion of adolescents aged 13 to 15 years with untreated dental
decay in their permanent teeth.


Baseline: 17.0 percent of adolescents aged 13 to 15 years had untreated dental decay in at



Oral Health of Adults
OH–3: Reduce the proportion of adults with untreated dental decay.

OH–3.1 Reduce the proportion of adults aged 35 to 44 years with untreated dental decay.


Baseline: 27.8 percent adults aged 35 to 44 years had untreated dental decay in at least one
permanent tooth in 1999–2004.



OH–3
255

OH–3.2 Reduce the proportion of older adults aged 65 to 74 years with untreated coronal
caries.


Baseline: 17.1 percent of adults aged 65 to 74 years had untreated coronal caries in at least
one permanent tooth in 1999–2004.



OH–3.3 Reduce the proportion of older adults aged 75 years and older with untreated root
surface caries.


Baseline: 37.9 percent of adults aged 75 years and older had untreated root surface caries in at



OH–4: Reduce the proportion of adults who have ever had a permanent tooth extracted
because of dental caries or periodontal disease.

OH–4.1 Reduce the proportion of adults aged 45 to 64 years who have ever had a
permanent tooth extracted because of dental caries or periodontitis.


Baseline: 76.4 percent of adults aged 45 to 64 years have ever had a permanent tooth extracted
because of dental caries or periodontitis in 1999–2004.



OH–4.2 Reduce the proportion of older adults aged 65 to 74 years who have lost all of their
natural teeth.


Baseline: 24.0 percent of adults aged 65 to 74 years had lost all of their natural teeth in
1999–2004.



OH–4
256

OH–5: Reduce the proportion of adults aged 45 to 74 years with moderate or severe
periodontitis.


Baseline: 12.7 percent of adults aged 45 to 74 years had moderate or severe periodontitis in
2001–04.



OH–6: Increase the proportion of oral and pharyngeal cancers detected at the earliest stage.


Baseline: 32.5 percent of oral and pharyngeal cancers were diagnosed at the localized stage
(stage 1) in 2007.



Access to Preventive Services
OH–7: Increase the proportion of children, adolescents, and adults who used the oral health
care system in the past year.


Baseline: 44.5 percent of persons aged 2 years and older had a dental visit in the past
12 months in 2007.



OH–8: Increase the proportion of low-income children and adolescents who received any
preventive dental service during the past year.


Baseline: 26.7 percent of children and adolescents aged 2 to 18 years at or below 200 percent
of the Federal poverty level received a preventive dental service during the past year in 2007.



OH–5
257

OH–9: Increase the proportion of school-based health centers with an oral health component.

OH–9.1 Increase the proportion of school-based health centers with an oral health
component that includes dental sealants.


Baseline: 24.1 percent of school-based health centers with an oral health component included
dental sealants in 2007–08.


Data source: School-based Health Care Census, National Assembly of School Based Health
Care (NASBHC).

component that includes dental care.


fillings and extractions in 2007–08.


Care (NASBHC).

component that includes topical fluoride.


fluoride rinses, varnish, or supplements in 2007–08.


Care (NASBHC).

OH–10: Increase the proportion of local health departments and Federally Qualified Health
Centers (FQHCs) that have an oral health component.

OH–10.1 Increase the proportion of Federally Qualified Health Centers that have an oral
health care program.

Target: 83 percent.

Baseline: 75 percent of Federally Qualified Health Centers had an oral health care component
in 2007.

OH–6
258


Data source: Uniform Data System (UDS), HRSA, BPHC.

OH–10.2 Increase the proportion of local health departments that have oral health
prevention or care programs.


Baseline: 25.8 percent of local health departments had an oral health prevention or care
program in 2008.


Data sources: Association of State and Territorial Dental Directors (ASTDD); National
Association of County and City Health Officials.

OH–11: Increase the proportion of patients who receive oral health services at Federally
Qualified Health Centers each year.


Baseline: 17.5 percent of patients at Federally Qualified Health Centers received oral health
services in 2007.


Data source: Uniform Data System (UDS), HRSA, BPHC.

Oral Health Interventions
OH–12: Increase the proportion of children and adolescents who have received dental sealants
on their molar teeth.

OH–12.1 Increase the proportion of children aged 3 to 5 years who have received dental
sealants on one or more of their primary molar teeth.


Baseline: 1.4 percent of children aged 3 to 5 years received dental sealants on one or more of
their primary molars in 1999–2004.



OH–12.2 Increase the proportion of children aged 6 to 9 years who have received dental
sealants on one or more of their permanent first molar teeth.


OH–7
259

Baseline: 25.5 percent children aged 6 to 9 years received dental sealants on one or more of
their first permanent molars in 1999–2004.



OH–12.3 Increase the proportion of adolescents aged 13 to 15 years who have received
dental sealants on one or more of their permanent molar teeth.


Baseline: 19.9 percent of adolescents aged 13 to 15 years received dental sealants on one or
more of their first permanent molars and one or more second permanent molars in 1999–2004.



OH–13: Increase the proportion of the U.S. population served by community water systems with
optimally fluoridated water.


Baseline: 72.4 percent of the U.S. population served by community water systems received
optimally fluoridated water in 2008.


Data source: CDC Water Fluoridation Reporting System (WFRS), CDC, ONDIEH, NCCDPHP.

OH–14: (Developmental) Increase the proportion of adults who receive preventive interventions
in dental offices.

OH– 14.1 (Developmental) Increase the proportion of adults who received information from
a dentist or dental hygienist focusing on reducing tobacco use or smoking cessation in the
past year.

NCHS.

OH– 14.2 (Developmental) Increase the proportion of adults who received an oral and
pharyngeal cancer screening from a dentist or dental hygienist in the past year.

NCHS.

OH–8
260

OH–14.3 (Developmental) Increase the proportion of adults who are tested or referred for
glycemic control from a dentist or dental hygienist in the past year.

NCHS.

Monitoring, Surveillance Systems
OH–15: (Developmental) Increase the number of States and the District of Columbia that have
a system for recording and referring infants and children with cleft lips and cleft palates to
craniofacial anomaly rehabilitative teams.

OH– 15.1 (Developmental)Increase the number of States and the District of Columbia that
have a system for recording cleft lips and cleft palates.

Potential data source: Annual Synopses of State and Territorial Dental Public Health Programs,
Association of State and Territorial Dental Directors (ASTDD).

OH– 15.2 (Developmental)Increase the number of States and the District of Columbia that
have a system for referral for cleft lips and cleft palates to rehabilitative teams.

Potential data source: Annual Synopses of State and Territorial Dental Public Health Programs,

OH–16: Increase the number of States and the District of Columbia that have an oral and
craniofacial health surveillance system.


Baseline: 32 States had an oral and craniofacial health surveillance system in 2009.

Target setting method: Total coverage (all 50 States and the District of Columbia).

Data source: Annual Synopses of State and Territorial Dental Public Health Programs,

OH–17: Increase health agencies that have a dental public health program directed by a dental
professional with public health training.

OH–17.1 Increase the proportion of States (including the District of Columbia) and local
health agencies that serve jurisdictions of 250,000 or more persons with a dental public
health program directed by a dental professional with public health training.


OH–9
261

Baseline: 23.4 percent of States (including the District of Columbia) and local health agencies
that served jurisdictions of 250,000 or more persons had a dental public health program directed
by a dental professional with public health training in 2009.


Data source: Annual Synopses of State and Territorial Dental Public Health Programs,

OH–17.2 Increase the number of Indian Health Service Areas and Tribal health programs
that serve jurisdictions of 30,000 or more persons with a dental public health program
directed by a dental professional with public health training.

Target: 12 programs.

Baseline: 11 Indian Health Service Areas and Tribal health programs that served jurisdictions of
30,000 or more persons had a dental public health program directed by a dental professional
with public health training in 2010.


Data source: Indian Health Service, Division of Oral Health.

OH–10
262


Physical Activity

PA–1 No leisure-time physical activity

PA–2 Adult aerobic physical activity and muscle-strengthening activity

PA–3 Adolescent aerobic physical activity and muscle-strengthening activity

PA–4 Daily physical education in schools

PA–5 Adolescent participation in daily school physical education

PA–6 Regularly scheduled recess

PA–7 Time for recess

PA–8 Child and adolescent screen time

PA–9 Physical activity policies in child care settings

PA–10 Access to school physical activity facilities

PA–11 Physician counseling about physical activity

PA–12 Worksite physical activity

PA–13 Active transportation – walking

PA–14 Active transportation – bicycling

PA–15 Built environment policies

PA–1
263

Topic Area: Physical Activity
PA–1: Reduce the proportion of adults who engage in no leisure-time physical activity.


Baseline: 36.2 percent of adults engaged in no leisure-time physical activity in 2008.



PA–2: Increase the proportion of adults who meet current Federal physical activity guidelines
for aerobic physical activity and for muscle-strengthening activity.

PA–2.1 Increase the proportion of adults who engage in aerobic physical activity of at least
moderate intensity for at least 150 minutes/week, or 75 minutes/week of vigorous intensity,
or an equivalent combination.


Baseline: 43.5 percent of adults engaged in aerobic physical activity of at least moderate
intensity for at least 150 minutes/week, or 75 minutes/week of vigorous intensity, or an
equivalent combination in 2008.



PA–2.2 Increase the proportion of adults who engage in aerobic physical activity of at least
moderate intensity for more than 300 minutes/week, or more than 150 minutes/week of
vigorous intensity, or an equivalent combination.


Baseline: 28.4 percent of adults engaged in aerobic physical activity of at least moderate
intensity for more than 300 minutes/week, or more than 150 minutes/week of vigorous intensity,
or an equivalent combination in 2008.



PA–2.3 Increase the proportion of adults who perform muscle-strengthening activities on 2
or more days of the week.


Baseline: 21.9 percent of adults performed muscle-strengthening activities on 2 or more days of
the week in 2008.

PA–2
264



PA–2.4 Increase the proportion of adults who meet the objectives for aerobic physical
activity and for muscle-strengthening activity.


Baseline: 18.2 percent of adults met the objectives for aerobic physical activity and for muscle-
strengthening activity in 2008.



PA–3: Increase the proportion of adolescents who meet current Federal physical activity
guidelines for aerobic physical activity and for muscle-strengthening activity.

PA–3.1 Aerobic physical activity.


Baseline: 18.4 percent of adolescents met current physical activity guidelines for aerobic
physical activity in 2009.



PA–3.2 (Developmental) Muscle-strengthening activity.

Potential data source: Youth Risk Behavior Surveillance System (YRBSS), CDC, NCCDPHP.

PA–3.3 (Developmental) Aerobic physical activity and muscle-strengthening activity.

Potential data source: Youth Risk Behavior Surveillance System (YRBSS), CDC, NCCDPHP.

PA–4: Increase the proportion of the Nation’s public and private schools that require daily
physical education for all students.

PA–4.1 Elementary schools.


Baseline: 3.8 percent of public and private elementary schools required daily physical education
for all students in 2006.


PA–3
265


PA–4.2 Middle and junior high schools.


Baseline: 7.9 percent of public and private middle and junior high schools required daily physical
education for all students in 2006.



PA–4.3 Senior high schools.


Baseline: 2.1 percent of public and private senior high schools required daily physical education
for all students in 2006.



PA–5: Increase the proportion of adolescents who participate in daily school physical education.


Baseline: 33.3 percent of adolescents participated in daily school physical education in 2009.



PA–6: Increase regularly scheduled elementary school recess in the United States.

PA–6.1 Increase the number of States that require regularly scheduled elementary school
recess.

Target: 17 States.

Baseline: 7 States required regularly scheduled elementary school recess in 2006.

Target setting method: One State per year.


PA–4
266

PA–6.2 Increase the proportion of school districts that require regularly scheduled
elementary school recess.


Baseline: 57.1 percent of school districts required regularly scheduled elementary school recess
in 2006.



PA–7: Increase the proportion of school districts that require or recommend elementary school
recess for an appropriate period of time.


Baseline: 61.5 percent of school districts required or recommended elementary school recess
for an appropriate period of time in 2006.



PA–8: Increase the proportion of children and adolescents who do not exceed recommended
limits for screen time.

PA–8.1 Increase the proportion of children aged 0 to 2 years who view no television or
videos on an average weekday.


Baseline: 40.6 percent of children aged 0 to 2 years viewed no television or videos on an
average weekday in 2007.


Data source: National Survey of Children’s Health (NSCH), HRSA, MCHB.

PA–8.2 Increase the proportion of children and adolescents aged 2 years through 12th
grade who view television, videos, or play video games for no more than 2 hours a day.

PA–8.2.1 Children aged 2 to 5 years.


Baseline: 75.6 percent of children aged 2 to 5 years viewed television, videos, or played video
games for no more than 2 hours a day in 2005–08 (NHANES).


PA–5
267

Data source: National Health and Nutrition Examination Survey (NHANES).

PA–8.2.2 Children and adolescents aged 6 to 14 years.


Baseline: 78.9 percent of children and adolescents aged 6 to 14 years viewed television, videos,
or played video games for no more than 2 hours a day in 2007 (NSCH).


Data source: National Survey of Children’s Health (NSCH).

PA–8.2.3 Adolescents in grades 9 through 12.


Baseline: 67.2 percent of adolescents in grades 9 through 12 viewed television, videos, or
played video games for no more than 2 hours a day in 2009 (YRBSS).


Data source: Youth Risk Behavior Surveillance System (YRBSS).

PA–8.3 Increase the proportion of children and adolescents aged 2 years to 12th grade who
use a computer or play computer games outside of school (for nonschool work) for no more
than 2 hours a day.



Baseline: 97.4 percent of children aged 2 to 5 years used a computer or played computer
games outside of school (for nonschool work) for no more than 2 hours a day in 2005–08
(NHANES).


Data source: National Health and Nutrition Examination Survey (NHANES).



Baseline: 93.3 percent of children and adolescents aged 6 to 14 years used a computer or
played computer games outside of school (for nonschool work) for no more than 2 hours a day
in 2007 (NSCH).

PA–6
268


Data source: National Survey of Children’s Health (NSCH).

PA–8.3.3 Adolescents in grades 9 through 12.


Baseline: 75.1 percent of adolescents in grades 9 through 12 used a computer or played
computer games outside of school (for nonschool work) for no more than 2 hours a day in 2009
(YRBSS).


Data source: Youth Risk Behavior Surveillance System (YRBSS).

PA–9: Increase the number of States with licensing regulations for physical activity provided in
child care.

PA–9.1 Require activity programs providing large muscle or gross motor activity,
development, and/or equipment.

Target: 35 States.

Baseline: 25 States required activity programs providing large muscle or gross motor activity,
development, and/or equipment in 2006.

Target setting method: One State per year for each measure.

Data source: National Resource Center for Health and Safety in Child Care and Early Education
maintain a public access database of licensing regulations for all 50 U.S. States and the District
of Columbia.

PA–9.2 Require children to engage in vigorous or moderate physical activity.

Target: 13 States.

Baseline: 3 States required children to engage in vigorous or moderate physical activity in 2006.


of Columbia.

PA–9.3 Require number of minutes of physical activity per day or by length of time in care.

Target: 11 States.

PA–7
269

Baseline: 1 State required a number of minutes of physical activity per day or by length of time
in care in 2006.


of Columbia.

PA–10: Increase the proportion of the Nation’s public and private schools that provide access to
their physical activity spaces and facilities for all persons outside of normal school hours (that is,
before and after the school day, on weekends, and during summer and other vacations).


Baseline: 28.8 percent of the Nation’s public and private schools provided access to their
physical activity spaces and facilities for all persons outside of normal school hours (that is,
before and after the school day, on weekends, and during summer and other vacations) in
2006.



PA–11: Increase the proportion of physician office visits that include counseling or education
related to physical activity.

PA–11.1 Increase the proportion of office visits made by patients with a diagnosis of
cardiovascular disease, diabetes, or hyperlipidemia that include counseling or education
related to exercise.


Baseline: 13.0 percent of physician office visits made by patients with a diagnosis of
cardiovascular disease, diabetes, or hyperlipidemia included counseling or education related to
exercise in 2007.



PA–11.2 Increase the proportion of physician visits made by all child and adult patients that
include counseling about exercise.


Baseline: 7.9 percent of physician office visits made by all child and adult patients included
counseling or education related to exercise in 2007.


PA–8
270


PA–12: (Developmental) Increase the proportion of employed adults who have access to and
participate in employer-based exercise facilities and exercise programs.


PA–13: (Developmental) Increase the proportion of trips made by walking.

PA–13.1.Adults aged 18 years and older, trips of 1 mile or less.

Potential data source: National Household Travel Survey (NHTS), Department of Transportation
(DOT), Federal Highway Administration (FHWA).

PA–13.2 Children and adolescents aged 5 to 15 years, trips to school of 1 mile or less.


PA–14: (Developmental) Increase the proportion of trips made by bicycling.

PA–14.1 Adults aged 18 years and older, trips of 5 miles or less.

Potential data source: National Household Travel Survey (NHT), Department of Transportation

PA–14.2 Children and adolescents aged 5 to 15 years, trips to school of 2 miles or less.


PA–15: (Developmental) Increase legislative policies for the built environment that enhance
access to and availability of physical activity opportunities.

PA–15.1 Community-scale policies.

Potential data source: CDC Division of Nutrition, Physical Activity, and Obesity Legislative
Database.

PA–15.2 Street-scale policies.

Database.

PA–9
271

PA–15.3 Transportation and travel policies.

Database.

PA–10
272


Preparedness

PREP–1 Public health emergency alert

PREP–2 Emergency personnel activation

PREP–3 Laboratory proficiency

PREP–4 Improvement plans

PREP–1
273

Topic Area: Preparedness
PREP–1: (Developmental) Reduce the time necessary to issue official information to the public
about a public health emergency.

Potential data source: Centers for Disease Control and Prevention (CDC), Division of State and
Local Readiness (DSLR) data.

PREP–2: Reduce the time necessary to activate designated personnel in response to a public
health emergency.

Target: 60 minutes.

Baseline: 66 minutes were needed for designated personnel to report for immediate duty with
no advance notice in 2009.


Data source: Centers for Disease Control and Prevention (CDC), Division of State and Local
Readiness (DSLR) data.

PREP–3: Increase the proportion of Laboratory Response Network (LRN) laboratories that meet
proficiency standards.

PREP–3.1 (Developmental) Proportion of LRN biological laboratories that meet proficiency
standards for Category A and B threat agents.

Potential data source: Centers for Disease Control and Prevention (CDC), Division of
Preparedness and Emerging Infections data collected annually from LRN biological laboratories.

PREP–3.2 Proportion of LRN chemical laboratories that meet proficiency standards for
chemical threat agents.

Target: 95 percent.

Baseline: 92 percent of LRN chemical laboratories met proficiency standards for chemical threat
agents in 2008.


Data source: Centers for Disease Control and Prevention, CDC National Center for
Environmental Health (NCEH) data collected annually from LRN chemical laboratories.

PREP–2
274

PREP–4: Reduce the time for State public health agencies to establish after-action reports and
improvement plans following responses to public health emergencies and exercises.

Target: 41 days.

Baseline: 46 days were required for State public health agencies to establish after-action reports
and improvement plans following responses to public health emergencies and exercises in
2009.


Data source: Centers for Disease Control and Prevention (CDC), Division of State and Local
Readiness (DSLR) data.

PREP–3
275


Workforce

PHI–1 Competencies for public health professionals

PHI–2 Continuing education of public health personnel

PHI–3 Integration of core competencies in public health into curricula

PHI–4 Public health majors and minors

PHI–5 Public health majors and minors consistent with core competencies

PHI–6 Associate degrees and certificate programs in public health

Data and Information Systems

PHI–7 National data for Healthy People 2020 objectives

PHI–8 National tracking of Healthy People 2020 objectives

PHI–9 Timely release of national data for Healthy People 2020 objectives

PHI–10 State vital event reporting

Public Health Organizations

PHI-11 Public health agencies laboratory services

PHI–12 Public health laboratory systems performance of essential services

PHI–13 Epidemiology services

PHI–14 Public health system assessment

PHI–15 Health improvement plans

PHI–16 Public health agency quality improvement program

PHI–17 Accredited public health agencies

PHI-1
276

Topic Area: Public Health Infrastructure

WORKFORCE
PHI-1: Increase the proportion of Federal, Tribal, State, and local public health agencies that
incorporate Core Competencies for Public Health Professionals into job descriptions and
performance evaluations.

PHI-1.1 (Developmental) Federal agencies.

Potential data source: Office of Personnel Management.

PHI-1.2 (Developmental) Tribal agencies.

Potential data source: Indian Health Service.

PHI-1.3 (Developmental) State public health agencies.

Potential data source: State and Territorial Public Health Survey, Association of State and
Territorial Health Officials (ASTHO).

PHI-1.4 Local public health agencies.*

Target: 25 percent.

Baseline: 15 percent of local public health agencies incorporated Core Competencies for Public
Health Professionals into job descriptions in 2008.


Data source: National Profile of Local Health Departments, National Association of County and City
Health Officials (NACCHO). (*data for local public health agencies include only data on job descriptions.)

PHI-2: (Developmental) Increase the proportion of Tribal, State, and local public health
personnel who receive continuing education consistent with Core Competencies for Public
Health Professionals.

Potential data sources: Indian Health Service, the Public Health Foundation TRAIN database,
and HRSA’s Public Health Training Centers.

PHI-3: Increase the proportion of Council on Education for Public Health (CEPH) accredited
schools of public health, CEPH accredited academic programs, and schools of nursing (with a
public health or community health component) that integrate Core Competencies for Public
Health Professionals into curricula.

Target: 94 percent.

PHI-2
277

Baseline: 91 percent of Council on Education for Public Health (CEPH) accredited schools of
public health, CEPH accredited academic programs, and schools of nursing (with a public
health or community health component) integrated Core Competencies for Public Health
Professionals into curricula for public health professionals in 2006.


Data source: Council on Linkages Study, Council on Linkages Between Academic and Public
Health Practice.

PHI-4: Increase the proportion of 4-year colleges and universities that offer public health or
related majors and/or minors.

PHI-4.1 Majors.

Target: 10 percent.

Baseline: 7 percent of 4-year colleges and universities offered public health or related majors in
2008.


Data source: Catalog Scan of Undergraduate Public Health Programs, the Association of
American Colleges and Universities (AAC&U).

PHI-4.2 Minors.

Target: 15 percent.

Baseline: 11 percent of 4-year colleges and universities offered public health or related minors
in 2008.


Data source: Catalog Scan of Undergraduate Public Health Programs, the Association of
American Colleges and Universities (AAC&U).

PHI-5: (Developmental) Increase the proportion of 4-year colleges and universities that offer
public health or related majors and/or minors which are consistent with the core competencies
of undergraduate public health education.

Potential data source: Association of Schools of Public Health (ASPH) in collaboration with the
American Association of Colleges and Universities (AAC&U).

PHI-6: Increase the proportion of 2-year colleges that offer public health or related associate
degrees and/or certificate programs.

PHI-6.1 Associate degrees.

Target: 3 percent.

PHI-3
278

Baseline: 2 percent of 2-year colleges offered public health or related associate degrees in
2009.


Data source: American Association of Colleges and Universities (AAC&U); American
Association of Community Colleges (AACC).

PHI-6.2 Certificate programs.

Target: 1 percent.

Baseline: 0 percent of 2-year colleges offered public health or related associate certificate
programs in 2009.


Data source: American Association of Colleges and Universities (AAC&U); American
Association of Community Colleges (AACC).

DATA AND INFORMATION SYSTEMS

PHI-7: (Developmental) Increase the proportion of population-based Healthy People 2020
objectives for which national data are available for all major population groups.

Potential data source: Assessment of Objective Data Availability (AODA), CDC, NCHS.

PHI-8: Increase the proportion of Healthy People 2020 objectives that are tracked regularly at
the national level.

PHI-8.1 (Developmental) Increase the proportion of objectives that originally did not have
baseline data but now have at least baseline data.


PHI-8.2 (Developmental) Increase the proportion of objectives that have at least a baseline
and one additional data point.


PHI-8.3 (Developmental) Increase the proportion of objectives that are tracked at least every
3 years.


PHI-4
279

PHI-9: (Developmental) Increase the proportion of Healthy People 2020 objectives for which
national data are released within 1 year of the end of data collection.


PHI-10: Increase the number of States that record vital events using the latest U.S. standard
certificates and report.

PHI-10.1 States using the standard certificate of birth.

Target: 52 (50 States, the District of Columbia, and New York City.)

Baseline: 28 States used the 2003 U.S. standard birth certificate in 2008.


Data source: National Vital Statistics System-Natality (NVSS-N), CDC, NCHS.

PHI-10.2 States using the standard certificate of death.

Target: 52 (50 States, the District of Columbia, and New York City.)

Baseline: 30 States used the 2003 U.S. standard death certificate in 2008.


Data source: National Vital Statistics System-Mortality (NVSS-M), CDC, NCHS.

PHI-10.3 States using the standard report of fetal death.

Target: 52 (50 States, the District of Columbia, and New York City).

Baseline: 22 States used the 2003 U.S. standard report of fetal death in 2008.


Data source: National Vital Statistics System-Fetal Death (NVSS-Fetal Death), CDC, NCHS.

PUBLIC HEALTH ORGANIZATIONS

PHI-11: Increase the proportion of Tribal and State public health agencies that provide or
assure comprehensive laboratory services to support essential public health services.

PHI-11.1 Disease prevention, control, and surveillance.

Target: 97 percent.

Baseline: 88 percent of State public health agencies provided or assured comprehensive
laboratory services to support disease prevention, control, and surveillance in 2008.

PHI-5
280


Data source: Comprehensive Laboratory Services Survey (CLSS), Association of Public Health
Laboratories (APHL).

PHI-11.2 Integrated data management.

Target: 61 percent.

laboratory services that had integrated data management in 2008.



PHI-11.3 Reference and specialized testing.

Target: 86 percent.

laboratory services that had reference and specialized testing in 2008.



PHI-11.4 Environmental health and protection.

Target: 61 percent.

laboratory services for environmental health and protection in 2008.



PHI-11.5 Food safety.

Target: 34 percent.

laboratory services for food safety in 2008.


PHI-6
281


PHI-11.6 Laboratory improvement and regulation.

Target: 45 percent.

laboratory services that had laboratory improvement or regulation in 2008.



PHI-11.7 Policy development.

Target: 74 percent.

laboratory services for policy development in 2008.



PHI-11.8 Emergency response.

Target: 67 percent.

laboratory services for emergency response in 2008.



PHI-11.9 Public health-related research.

Target: 32 percent.

laboratory services for public health-related research in 2008.



PHI-7
282

PHI-11.10 Training and education.

Target: 52 percent.

laboratory services training and education in 2008.



PHI-11.11 Partnerships and communication.

Target: 67 percent.

laboratory services partnerships and communication in 2008.


Data source: Comprehensive Laboratory Services Survey, Association of Public Health

PHI-12: (Developmental) Increase the proportion of public health laboratory systems (including
State, Tribal, and local) which perform at a high level of quality in support of the 10 Essential
Public Health Services.

Potential data source: Association of Public Health Laboratories.

PHI-13: Increase the proportion of Tribal, State, and local public health agencies that provide or
assure comprehensive epidemiology services to support essential public health services.

PHI-13.1 State epidemiologists with formal training in epidemiology.


Baseline: 87 percent of State epidemiologists had received formal training in epidemiology, as
reported in 2009.


Data source: Epidemiology Capacity Assessment (ECA), Council of State and Territorial
Epidemiologists (CSTE).

PHI-13.2 (Developmental) Tribal public health agencies.

Potential data source: Survey of Regionally Based Public Health Services/Infrastructure in
Indian Country, Tribal Epidemiology Centers (Epi Centers), CDC, and IHS.

PHI-8
283

PHI-13.3 State public health agencies.


epidemiology services to support essential public health services in 2009.


Data source: Epidemiology Capacity Assessment (ECA), Council of State and Territorial
Epidemiologists (CSTE).

PHI-13.4 Local public health agencies.


Baseline: 64 percent of local public health agencies provided or assured comprehensive
epidemiology services to support essential public health services in 2008.



PHI-14: Increase the proportion of State and local public health jurisdictions that conduct a
public health system assessment using national performance standards.

PHI-14.1 State public health systems.

Target: 78 percent.

Baseline: 49 percent of State public health systems had ever submitted State Public Health
System Performance Assessment data to the National Public Health Performance Standards
Program in 2009.


Data source: National Public Health Performance Standards Program, CDC, Office for State,
Tribal, Local and Territorial Support.

PHI-14.2 Local public health systems.

Target: 50 percent.

Baseline: 28 percent of local public health systems had ever submitted Local Public Health
System Performance Assessment data to the National Public Health Performance Standards
Program in 2009.


PHI-9
284

Data source: National Public Health Performance Standards Program, CDC, Office for State,
Tribal, Local and Territorial Support.

PHI- 14.3 (Developmental) Local boards of health.

Potential data source: National Public Health Performance Standards Program, CDC, Office for
State, Tribal, Local and Territorial Support.

PHI-15: Increase the proportion of Tribal, State, and local public health agencies that have
implemented a health improvement plan and increase the proportion of local health jurisdictions
that have implemented a health improvement plan linked with their State plan.

PHI-15.1 (Developmental) Tribal agencies.

Potential data source: Indian Health Service.

PHI-15.2 (Developmental) State public health agencies.

Potential data source: State and Territorial Public Health Survey, Association of State and
Territorial Health Officials (ASTHO).

PHI-15.3 (Developmental) Local public health agencies.

Potential data source: National Profile of Local Health Departments, National Association of
County and City Health Officials (NACCHO).

PHI-15.4 (Developmental) Local jurisdictions that have linked health improvement plans to
the State plans.

Potential data source: National Profile of Local Health Departments, National Association of
County and City Health Officials (NACCHO).

agencies that have implemented an agency-wide quality improvement process.

Potential data sources: State and Territorial Public Health Survey, Association of State and
Territorial Health Officials (ASTHO); National Profile of Local Health Departments, National
Association of County and City Health Officials (NACCHO) and the Indian Health Service.

agencies that are accredited.

Potential data source: Public Health Accreditation Board.

PHI-10
285


Respiratory Diseases

Asthma

RD–1 Deaths from asthma

RD–2 Hospitalizations for asthma

RD–3 Emergency department visits for asthma

RD–4 Asthma activity limitations

RD–5 School or workdays missed

RD–6 Patient education

RD–7 Appropriate asthma care

RD–8 Asthma surveillance systems

Chronic Obstructive Pulmonary Disease (COPD)

RD–9 Chronic obstructive pulmonary disease activity limitations

RD–10 Deaths from chronic obstructive pulmonary disease

RD–11 Hospitalizations for chronic obstructive pulmonary disease

RD–12 Emergency department visits for chronic obstructive pulmonary disease

RD–13 Diagnosis of underlying obstructive disease

RD–1
286

Topic Area: Respiratory Diseases
Asthma

RD–1: Reduce asthma deaths.

RD–1.1 Children and adults under age 35 years.


Baseline: 3.4 asthma deaths per million children and adults under age 35 years occurred in
2007.



RD–1.2 Adults aged 35 to 64 years old.

Target: 6.0 deaths per million.

Baseline: 11.0 asthma deaths per million adults aged 35 to 64 years occurred in 2007.



RD–1.3 Adults aged 65 years and older.

Target: 22.9 deaths per million.

Baseline: 43.3 asthma deaths per million adults aged 65 years and older occurred in 2007.


RD–2: Reduce hospitalizations for asthma.

RD–2.1 Children under age 5 years.

Target: 18.1 hospitalizations per 10,000.

Baseline: 41.4 hospitalizations for asthma per 10,000 children under age 5 years occurred in
2007.

Target setting method: Minimal statistical significance. i


RD–2
287

RD–2.2 Children and adults aged 5 to 64 years.


Baseline: 11.1 hospitalizations for asthma per 10,000 children and adults aged 5 to 64 years
occurred in 2007 (age adjusted to the year 2000 standard population).

Target setting method: Minimal statistical significance.i




Baseline: 25.3 hospitalizations for asthma per 10,000 adults aged 65 years and older occurred
in 2007 (age adjusted to the year 2000 standard population).



RD–3: Reduce hospital emergency department visits for asthma.

RD–3.1 Children under age 5 years.

Target: 95.5 emergency department visits per 10,000.

Baseline: 132.7 emergency department visits for asthma per 10,000 children under age 5 years
occurred in 2005–07.


Data source: National Hospital Ambulatory Medical Care Survey (NHAMCS), CDC, NCHS.

RD–3.2 Children and adults aged 5 to 64 years.


Baseline: 56.4 emergency department visits for asthma per 10,000 children and adults aged 5
to 64 years occurred in 2005–07.





RD–3
288

Baseline: 21.0 emergency department visits for asthma per 10,000 adults aged 65 years and
older occurred in 2005–07.



RD–4: Reduce activity limitations among persons with current asthma.


Baseline: 12.7 percent of persons with current asthma experienced activity limitations due to
chronic lung and breathing problems in 2008 (age adjusted to the year 2000 standard
population).



RD–5: Reduce the proportion of persons with asthma who miss school or work days.

RD–5.1 Reduce the proportion of children aged 5 to 17 years with asthma who miss school
days.


Baseline: 58.7 percent of children aged 5 to 17 years who had an asthma episode or attack in
the past 12 months missed school days due to asthma in the past 12 months in 2008.



RD–5.2 Reduce the proportion of adults aged 18 to 64 years with asthma who miss work
days.


Baseline: 33.2 percent of adults aged 18 to 64 years who had an asthma episode or attack in
the past 12 months missed work days due to asthma in the past 12 months in 2008.



RD–6: Increase the proportion of persons with current asthma who receive formal patient
education.


RD–4
289

Baseline: 12.1 percent of persons with current asthma received formal patient education in 2008



RD–7: Increase the proportion of persons with current asthma who receive appropriate asthma
care according to National Asthma Education and Prevention Program (NAEPP) guidelines.

RD–7.1 Persons with current asthma who receive written asthma management plans from
their health care provider.


Baseline: 33.4 percent of persons with current asthma received written asthma management
plans from their health care provider in 2008 (age adjusted to the year 2000 standard
population).



RD–7.2 Persons with current asthma with prescribed inhalers who receive instruction on
their use.


Baseline: 95.9 percent of persons with current asthma with prescribed inhalers received
instruction on their use in 2008 (age adjusted to the year 2000 standard population).



RD–7.3 Persons with current asthma who receive education about appropriate response to
an asthma episode, including recognizing early signs and symptoms or monitoring peak flow
results.


Baseline: 64.8 percent of persons with current asthma received education about appropriate
response to an asthma episode, including recognizing early signs and symptoms or monitoring
peak flow results in 2008 (age adjusted to the year 2000 standard population).



RD–5
290

RD–7.4 Increase the proportion of persons with current asthma who do not use more than
one canister of short-acting inhaled beta agonist per month.


Baseline: 87.9 percent of persons with current asthma did not use more than one canister of
short-acting inhaled beta agonist per month in 2008 (age adjusted to the year 2000 standard
population).



RD–7.5 Persons with current asthma who have been advised by a health professional to
change things in their home, school, and work environments to reduce exposure to irritants
or allergens to which they are sensitive.


Baseline: 50.8 percent of persons with current asthma were advised by a health professional to
change things in their home, school, and work environments to reduce exposure to irritants or
allergens to which they are sensitive in 2008 (age adjusted to the year 2000 standard
population).



RD– 7.6 (Developmental) Persons with current asthma who have had at least one routine
follow-up visit in the past 12 months.


RD– 7.7 (Developmental) Persons with current asthma whose doctor assessed their asthma
control in the past 12 months.


RD– 7.8 (Developmental) Adults with current asthma who have discussed with a doctor or
other health professional whether their asthma was work related.


RD–8: Increase the numbers of States, Territories, and the District of Columbia with a
comprehensive asthma surveillance system for tracking asthma cases, illness, and disability at
the State level.

Target: 47 areas.

RD–6
291

Baseline: 43 areas (41 States, the District of Columbia, and Puerto Rico) had a comprehensive
asthma surveillance system for tracking asthma cases, illness, and disability at the State level in
2009.


Data source: National Asthma Control Program, NCEH, CDC.

Chronic Obstructive Pulmonary Disease (COPD)

RD–9: Reduce activity limitations among adults with chronic obstructive pulmonary disease
(COPD).


Baseline: 23.2 percent of adults with COPD aged 45 years and older experienced activity
limitations due to chronic lung and breathing problems in 2008 (age adjusted to the year 2000



RD–10: Reduce deaths from chronic obstructive pulmonary disease (COPD) among adults.

Target: 98.5 deaths per 100,000.

Baseline: 112.4 COPD deaths per 100,000 adults aged 45 years and older occurred in 2007



RD–11: Reduce hospitalizations for chronic obstructive pulmonary disease (COPD).


Baseline: 56.0 hospitalizations for COPD per 10,000 adults aged 45 years and older occurred in



RD–12: Reduce hospital emergency department visits for chronic obstructive pulmonary
disease (COPD).


RD–7
292

Baseline: 79.6 emergency department visits for COPD per 10,000 adults aged 45 years and
older occurred in 2007 (age adjusted to the year 2000 standard population).



RD–13: (Developmental) Increase the proportion of adults with abnormal lung function whose
underlying obstructive disease has been diagnosed.

NCHS.

i
Minimal statistical significance: the smallest improvement that results in a statistically significant
difference when tested against the baseline value.

RD–8
293


Sexually Transmitted Diseases

STD–1 Chlamydia

STD–2 Chlamydia among females

STD–3 Annual screening for genital Chlamydia by Medicaid

STD–4 Annual screening for genital Chlamydia by insurance plans

STD–5 Pelvic inflammatory disease

STD–6 Gonorrhea

STD–7 Primary and secondary syphilis

STD–8 Congenital syphilis

STD–9 Human papillomavirus infection

STD–10 Genital herpes

STD–1
294

Topic Area: Sexually Transmitted Diseases
STD–1: Reduce the proportion of adolescents and young adults with Chlamydia trachomatis
infections.

STD–1.1 Among females aged 15 to 24 years attending family planning clinics.


Baseline: In 2008, 7.4 percent of females aged 15 to 24 years who attended family planning
clinics in the past 12 months tested positive for Chlamydia trachomatis infections.


Data source: STD Surveillance System (STDSS), CDC, NCHHSTP.

STD–1.2 Among females aged 24 years and under enrolled in a National Job Training
Program.


Baseline: In 2008, 12.8 percent of females aged 24 years and under who enrolled in a National
Job Training Program in the past 12 months tested positive for Chlamydia trachomatis
infections.


Data source: STD Surveillance System (STDSS), CDC, NCHHSTP; National Job Training
Program.

STD–1.3 Among males aged 24 years and under enrolled in a National Job Training
Program.


Baseline: In 2008, 7.0 percent of males aged 24 years and under who enrolled in a National Job
Training Program in the past 12 months tested positive for Chlamydia trachomatis infections.


Data sources: STD Surveillance System (STDSS), CDC, NCHHSTP; National Job Training
Program.

STD–2: (Developmental) Reduce Chlamydia rates among females aged 15 to 44 years.

Potential data source: STD Surveillance System (STDSS), CDC, NCHHSTP.

STD–2
295

STD–3: Increase the proportion of sexually active females aged 24 years and under enrolled in
Medicaid plans who are screened for genital Chlamydia infections during the measurement
year.

STD–3.1 Females aged 16 to 20 years.


Baseline: As reported in 2008, 52.7 percent of sexually active females aged 16 to 20 years
enrolled in Medicaid plans were screened for genital Chlamydia infections during the
measurement year.


Data source: Healthcare Effectiveness Data and Information Set (HEDIS), National Committee
for Quality Assurance (NCQA).



Baseline: 59.4 percent of sexually active females aged 21 to 24 years enrolled in Medicaid
plans were screened for genital Chlamydia infections during the measurement year, as reported
in 2008.



STD–4: Increase the proportion of sexually active females aged 24 years and under enrolled in
commercial health insurance plans who are screened for genital Chlamydia infections during the
measurement year.



enrolled in commercial health insurance plans were screened for genital Chlamydia infections
during the measurement year.





STD–3
296

enrolled in commercial health insurance plans were screened for genital Chlamydia infections
during the measurement year.



STD–5: Reduce the proportion of females aged 15 to 44 years who have ever required
treatment for pelvic inflammatory disease (PID).


Baseline: In 2006–08, 3.99 percent of females aged 15 to 44 years reported that they had ever
required treatment for pelvic inflammatory disease (PID).



STD–6: Reduce gonorrhea rates.


Target: 257 new cases per 100,000 population.

Baseline: 285 new cases of gonorrhea per 100,000 females aged 15 to 44 years were reported
in 2008.



STD–6.2 Males aged 15 to 44 years.

Target: 198 new cases per 100,000 population.

Baseline: 220 new cases of gonorrhea per 100,000 males aged 15 to 44 years were reported in
2008.



STD–7: Reduce sustained domestic transmission of primary and secondary syphilis.

STD–7.1 Among females.


STD–4
297

Baseline: 1.5 new cases of primary and secondary syphilis per 100,000 females were reported
in 2008.



STD–7.2 Among males.


Baseline: 7.6 new cases of primary and secondary syphilis per 100,000 males were reported in
2008.



STD–8: Reduce congenital syphilis.

Target: 9.1 new cases per 100,000 live births.

Baseline: 10.1 new cases of congenital syphilis per 100,000 live births were reported in 2008.



STD–9: (Developmental) Reduce the proportion of females with human papillomavirus (HPV)
infection.

STD–9.1 Females with types 6 and 11.

Potential data sources: National Health and Nutrition Examination Survey (NHANES), CDC,
NCHS; National Health Interview Study (NHIS), CDC, NCHS.

STD–9.2 Females with types 16 and 18.

Potential data sources: National Health and Nutrition Examination Survey (NHANES), CDC,
NCHS; National Health Interview Study (NHIS), CDC, NCHS.

STD–9.3 Females with other types.

NCHS.

STD–5
298

STD–10: Reduce the proportion of young adults with genital herpes infection due to herpes
simplex type 2.


Baseline: 10.5 percent of young adults tested positive for herpes simplex virus type 2 in
2005–08.



STD–6
299


Sleep Health

SH–1 Evaluation for obstructive sleep apnea

SH–2 Vehicular crashes due to drowsy driving

SH–3 Sufficient sleep among 9th to 12th graders

SH–4 Sufficient sleep among adults

SH–1
300

Topic Area: Sleep Health
SH–1: Increase the proportion of persons with symptoms of obstructive sleep apnea who seek
medical evaluation.


Baseline: 25.5 percent of persons with symptoms of obstructive sleep apnea sought medical
evaluation in 2005–08 (age adjusted to the year 2000 standard population).

Target setting method: Minimal statistical significance. i


SH–2: Reduce the rate of vehicular crashes per 100 million miles traveled that are due to
drowsy driving.

Target: 2.1 vehicular crashes per 100 million miles traveled.

Baseline: 2.7 vehicular crashes per 100 million miles traveled were due to drowsy driving in
2008.



SH–3: Increase the proportion of students in grades 9 through 12 who get sufficient sleep.


Baseline: 30.9 percent of students in grades 9 through 12 got sufficient sleep (defined as 8 or
more hours of sleep on an average school night) in 2009.



SH–4: Increase the proportion of adults who get sufficient sleep.


Baseline: 69.6 percent of adults got sufficient sleep (defined as ≥ 8 hours for those aged 18 to
21 years and ≥ 7 hours for those aged 22 years and older on average during a 24-hour period)
in 2008.



i
Minimal statistical significance: the smallest improvement that results in a statistically significant
difference when tested against the baseline value.

SH–2
301


Substance Abuse

Policy and Prevention

SA–1 Adolescents riding with a driver who has been drinking

SA–2 Substance-free adolescents

SA–3 Adolescent disapproval of substance abuse

SA–4 Adolescent perception of risk associated with substance abuse

SA–5 Specialty courts

SA–6 Mandatory ignition interlock laws

Screening and Treatment

SA–7 Admissions for injection drug use

SA–8 Receipt of specialty treatment for substance abuse or dependence

SA–9 Referral for care and treatment

SA–10 Trauma centers implementing alcohol Screening and Brief Intervention

Epidemiology and Surveillance

SA–11 Cirrhosis deaths

SA–12 Drug-induced deaths

SA–13 Recent use of illicit substances

SA–14 Binge drinking

SA–15 Excessive drinking

SA–16 Average annual alcohol consumption

SA–17 Alcohol-impaired driving deaths

SA–18 Steroid use among adolescents

SA–19 Prescription drug abuse

SA–20 Alcohol-attributable deaths

SA–1
302

SA–21 Inhalant use among adolescents

SA–2
303

Topic Area: Substance Abuse
Policy and Prevention

SA–1: Reduce the proportion of adolescents who report that they rode, during the previous 30
days, with a driver who had been drinking alcohol.


Baseline: 28.3 percent of students in grades 9 through 12 reported that they rode, during the
previous 30 days, with a driver who had been drinking alcohol in 2009.



SA–2: Increase the proportion of adolescents never using substances.

SA–2.1 Increase the proportion of at risk adolescents aged 12 to 17 years who, in the past
year, refrained from using alcohol for the first time.


Baseline: 85.8 percent of adolescents aged 12 to 17 years who had never used alcohol in their
lives refrained from using alcohol for the first time in 2008.



SA–2.2 Increase the proportion of at risk adolescents aged 12 to 17 years who, in the past
year, refrained from using marijuana for the first time.


Baseline: 94.4 percent of adolescents aged 12 to 17 years who had never used marijuana in
their lives refrained from using marijuana for the first time in 2008.



SA–2.3 Increase the proportion of high school seniors never using substances—Alcoholic
beverages.


Baseline: 27.7 percent of high school seniors reported never using alcoholic beverages in 2009.


SA–3
304

Data source: Monitoring the Future Survey (MTF), NIH.

SA–2.4 Increase the proportion of high school seniors never using substances—Illicit drugs.


Baseline: 53.3 percent of high school seniors reported never using illicit drugs in 2009.



SA–3: Increase the proportion of adolescents who disapprove of substance abuse.

SA–3.1 Increase the proportion of adolescents who disapprove of having one or two
alcoholic drinks nearly every day—8th graders.


Baseline: 78.5 percent of 8th graders reported that they disapproved of people having one or
two alcoholic drinks nearly every day in 2009.













SA–4
305

SA–3.4 Increase the proportion of adolescents who disapprove of trying marijuana or
hashish once or twice—8th graders.


Baseline: 75.3 percent of 8th graders reported that they disapproved of people trying marijuana
or hashish once or twice in 2009.





Baseline: 60.1 percent of 10th graders reported that they disapproved of people trying
marijuana or hashish once or twice in 2009.





Baseline: 54.8 percent of 12th graders reported that they disapproved of people trying
marijuana or hashish once or twice in 2009.



SA–4: Increase the proportion of adolescents who perceive great risk associated with
substance abuse.

SA–4.1 Increase the proportion of adolescents aged 12 to 17 years perceiving great risk
associated with substance abuse—Consuming five or more alcoholic drinks at a single
occasion once or twice a week.


Baseline: 40.5 percent of adolescents aged 12 to 17 years reported that they perceived great
risk associated with consuming five or more alcoholic drinks at a single occasion once or twice a
week in 2008.


SA–5
306


associated with substance abuse—Smoking marijuana once per month.


risk associated with smoking marijuana once per month in 2008.



associated with substance abuse—Using cocaine once per month.


risk associated with using cocaine once per month in 2008.



SA–5: (Developmental) Increase the number of drug, driving while impaired (DWI), and other
specialty courts in the United States.

Potential data source: National Association of Drug Court Professionals (NADCP) database.

SA–6: Increase the number of States with mandatory ignition interlock laws for first and repeat
impaired driving offenders in the United States.


Baseline: 13 States had mandatory ignition interlock laws for first and repeat impaired driving
offenders in 2009.


Data source: Mothers Against Drunk Driving (MADD).

Screening and Treatment

SA–7: Increase the number of admissions to substance abuse treatment for injection drug use.

Target: 279,706 admissions.

SA–6
307

Baseline: 254,278 admissions to substance abuse treatment programs for injection drug use


Data source: Treatment Episodes Data Set (TEDS), SAMHSA.

SA–8: Increase the proportion of persons who need alcohol and/or illicit drug treatment and
received specialty treatment for abuse or dependence in the past year.

SA–8.1 Illicit drug treatment.


Baseline: 16.0 percent of persons aged 12 years and older who needed illicit drug treatment
reported that they received specialty treatment for abuse or dependence in the past year in
2008.



SA–8.2 Alcohol and/or illicit drug treatment.


Baseline: 9.9 percent of persons aged 12 years and older who needed alcohol treatment and/or
illicit drug treatment reported that they received specialty treatment for abuse or dependence in
the past year in 2008.



SA–8.3 Alcohol abuse or dependence treatment.


Baseline: 8.2 percent of persons aged 12 years and older who needed alcohol treatment
reported that they received specialty treatment for abuse or dependence in the past year in
2008.



SA–7
308

SA–9: (Developmental) Increase the proportion of persons who are referred for follow-up care
for alcohol problems, drug problems after diagnosis, or treatment for one of these conditions in
a hospital emergency department.

NCHS.

SA–10: Increase the number of Level I and Level II trauma centers and primary care settings
that implement evidence-based alcohol Screening and Brief Intervention (SBI).

Target: 358 Level I and Level II trauma centers.

Baseline: 325 Level I and Level II trauma centers met the criteria for implementing evidence-
based alcohol Screening and Brief Intervention in 2009.


Data source: National Trauma Verification Registry, American College of Surgeons.

Epidemiology and Surveillance

SA–11: Reduce cirrhosis deaths.


Baseline: 9.1 cirrhosis deaths per 100,000 population occurred in 2007 (age adjusted per
100,000 standard population).



SA–12: Reduce drug-induced deaths.


Baseline: 12.6 drug-induced deaths per 100,000 population occurred in 2007 (age adjusted per
100,000 standard population).



SA–13: Reduce past-month use of illicit substances.

SA–13.1 Reduce the proportion of adolescents reporting use of alcohol or any illicit drugs
during the past 30 days.


SA–8
309

Baseline: 18.3 percent of adolescents aged 12 to 17 years reported use of alcohol or any illicit
drugs during the past 30 days in 2008.



SA–13.2 Reduce the proportion of adolescents reporting use of marijuana during the past
30 days.


Baseline: 6.7 percent of adolescents aged 12 to 17 years reported use of marijuana during the
past 30 days in 2008.



SA–13.3 Reduce the proportion of adults reporting use of any illicit drug during the past 30
days.


Baseline: 7.9 percent of adults aged 18 years and older reported use of any illicit drug during
the past 30 days in 2008.



SA–14: Reduce the proportion of persons engaging in binge drinking of alcoholic beverages.

SA–14.1 Reduce the proportion of students engaging in binge drinking during the past 2
weeks—High school seniors.


Baseline: 25.2 percent of high school seniors reported that they engaged in binge drinking
during the past 2 weeks in 2009.



SA–14.2 Reduce the proportion of students engaging in binge drinking during the past 2
weeks—College students.


SA–9
310

Baseline: 40.0 percent of college students reported that they engaged in binge drinking during
the past 2 weeks in 2008.



SA–14.3 Reduce the proportion of persons engaging in binge drinking during the past
month—Adults aged 18 years and older.


Baseline: 27.0 percent of adults aged 18 years and older reported that they engaged in binge
drinking during the past month in 2008.



SA–14.4 Reduce the proportion of persons engaging in binge drinking during the past
month—Adolescents aged 12 to 17 years.


Baseline: 9.4 percent of adolescents aged 12 to 17 years reported that they engaged in binge
drinking during the past month in 2008.



SA–15: Reduce the proportion of adults who drank excessively in the previous 30 days.


Baseline: 28.1 percent of adults aged 18 years and older reported that they drank excessively in
the previous 30 days in 2008.



SA–16: Reduce average annual alcohol consumption.

Target: 2.1 gallons.

Baseline: 2.3 gallons of ethanol per person aged 14 years and older were consumed in 2007.


SA–10
311

Data source: Alcohol Epidemiologic Data System (AEDS), NIH.

SA–17: Decrease the rate of alcohol-impaired driving (.08+ blood alcohol content [BAC])
fatalities.

Target: 0.38 deaths per 100 million vehicle miles traveled.

Baseline: 0.40 deaths per 100 million vehicle miles traveled involved a driver or motorcycle rider
with a BAC of .08 or greater in 2008.


Data source: Fatality Analysis Reporting System (FARS), DOT.

SA–18: Reduce steroid use among adolescents.

SA–18.1 Among 8th graders.


Baseline: 1.3 percent of 8th graders reported that they used steroids in the past year in 2009.













SA–11
312

SA–19: Reduce the past-year nonmedical use of prescription drugs.

SA–19.1 Pain relievers.


Baseline: 4.8 percent of persons aged 12 years and older reported nonmedical use of pain
relievers in the past year in 2008.



SA–19.2 Tranquilizers.


Baseline: 2.0 percent of persons aged 12 years and older reported nonmedical use of
tranquilizers in the past year in 2008.



SA–19.3 Stimulants.


stimulants in the past year in 2008.



SA–19.4 Sedatives.


sedatives in the past year in 2008.



SA–12
313

SA–19.5 Any psychotherapeutic drug (including any of those noted above).


Baseline: 6.1 percent of persons aged 12 years and older reported nonmedical use of any
psychotherapeutic drug in 2008.



SA–20: Decrease the number of deaths attributable to alcohol.

Target: 71,681 deaths.

Baseline: 79,646 deaths attributable to the harmful effects of excessive alcohol use occurred in
2001–05 (average annual number).


Data source: Alcohol Related Disease Impact (ARDI) System, CDC.

SA–21: Reduce the proportion of adolescents who use inhalants.


Baseline: 3.9 percent of adolescents aged 12 to 17 years reported that they used inhalants in
the past year in 2008.





SA–13
314


Tobacco Use

Tobacco Use

TU–1 Adult tobacco use

TU–2 Adolescent tobacco use

TU–3 Initiation of tobacco use

TU–4 Smoking cessation attempts by adults

TU–5 Adult success in smoking cessation

TU–6 Smoking cessation during pregnancy

TU–7 Smoking cessation attempts by adolescents

Health Systems Change

TU–8 Medicaid coverage for smoking cessation

TU–9 Tobacco screening in health care settings

TU–10 Tobacco cessation counseling in health care settings

Social and Environmental Changes

TU–11 Exposure to secondhand smoke

TU–12 Indoor worksite smoking policies

TU–13 Smoke-free indoor air laws

TU–14 Smoke-free homes

TU–15 Tobacco-free schools

TU–16 Preemptive tobacco control laws

TU–17 Tobacco tax

TU–18 Exposure of adolescents and young adults to advertising and promotion

TU–19 Enforcement of illegal sales to minors laws

TU–20 Evidence-based tobacco control programs

TU–1
315

Topic Area: Tobacco Use
Tobacco Use

TU–1: Reduce tobacco use by adults.

TU–1.1 Cigarette smoking.


Baseline: 20.6 percent of adults aged 18 years and older were current cigarette smokers in

Target setting method: Retain Healthy People 2010 target of 12 percent.


TU–1.2 Smokeless tobacco products.


Baseline: 2.3 percent of adults aged 18 years and older were current users of snuff or chewing
tobacco products in 2005 (age adjusted to the year 2000 standard population).



TU–1.3 Cigars.


Baseline: 2.2 percent of adults aged 18 years and older were current cigar smokers in 2005



TU–2: Reduce tobacco use by adolescents.

TU–2.1 Tobacco products (past month).


Baseline: 26.0 percent of adolescents in grades 9 through 12 used cigarettes, chewing tobacco,
snuff, or cigars in the past 30 days in 2009.

Target setting method: Retain Healthy People 2010 target.


TU–2
316

TU–2.2 Cigarettes (past month).


Baseline: 19.5 percent of adolescents in grades 9 through 12 smoked cigarettes in the past
30 days in 2009.



TU–2.3 Smokeless tobacco products (past month).


Baseline: 8.9 percent of adolescents in grades 9 through 12 used smokeless (chewing tobacco
or snuff) tobacco products in the past 30 days in 2009.



TU–2.4 Cigars (past month).


Baseline:14.0 percent of adolescents in grades 9 through 12 smoked cigars in the past 30 days
in 2009.



TU–3: Reduce the initiation of tobacco use among children, adolescents, and young adults.

TU–3.1 Children and adolescents aged 12 to 17 years—Tobacco products.


Baseline: 7.7 percent of children and adolescents aged 12 to 17 years who had not previously
used tobacco products in their lifetime first used tobacco products in the past 12 months in
2008.



TU–3.2 Children and adolescents aged 12 to 17 years—Cigarettes.


TU–3
317

smoked cigarettes in their lifetime first smoked cigarettes in the past 12 months in 2008.



TU–3.3 Children and adolescents aged 12 to 17 years—Smokeless tobacco products.


used smokeless tobacco in their lifetime first used smokeless tobacco in the previous 12 months
in 2008.



TU–3.4 Children and adolescents aged 12 to 17 years—Cigars.


smoked cigars in their lifetime first smoked cigars in the previous 12 months in 2008.



TU–3.5 Young adults aged 18 to 25 years—Tobacco products.


Baseline: 10.8 percent of young adults aged 18 to 25 years who had not previously used
tobacco products in their lifetime first used tobacco products in the past 12 months in 2008.



TU–3.6 Young adults aged 18 to 25 years—Cigarettes.


Baseline: 8.3 percent of young adults aged 18 to 25 years who had not previously smoked
cigarettes in their lifetime first smoked cigarettes in the past 12 months in 2008.


TU–4
318


TU–3.7 Young adults aged 18 to 25 years—Smokeless tobacco products.


Baseline: 2.2 percent of young adults aged 18 to 25 years who had not previously used
smokeless tobacco in their lifetime first used smokeless tobacco products in the previous
12 months in 2008.



TU–3.8 Young adults aged 18 to 25 years—Cigars.


Baseline: 6.1 percent of young adults aged 18 to 25 years who had not previously smoked
cigars in their lifetime first smoked cigars in the previous 12 months in 2008.



TU–4: Increase smoking cessation attempts by adult smokers.

TU–4.1 Increase smoking cessation attempts by adult smokers.


Baseline: 48.3 percent of adult smokers aged 18 years and older attempted to stop smoking in
the past 12 months in 2008 (age adjusted to the year 2000 standard population).



TU– 4.2 (Developmental) Increase smoking cessation attempts using evidence-based
strategies by adult smokers.


TU–5: Increase recent smoking cessation success by adult smokers.

5.1 Increase recent smoking cessation success by adult smokers.


TU–5
319

Baseline: 6.0 percent of adult smokers aged 18 years and older last smoked 6 months to 1 year
ago in 2008 (age adjusted to the year 2000 standard population).



TU– 5.2 (Developmental) Increase recent smoking cessation success using evidence-based
strategies by adult smokers.


TU–6: Increase smoking cessation during pregnancy.


Baseline: 11.3 percent of women aged 18 to 49 years (who reported having a live birth in the
past 5 years and smoking at any time during their pregnancy with their last child), stopped
smoking during the first trimester of their pregnancy and stayed off cigarettes for the rest of their
pregnancy in 2005.

Target setting method: Retain the Healthy People 2010 target.


TU–7: Increase smoking cessation attempts by adolescent smokers.


Baseline: 58.5 percent of adolescent smokers in grades 9 through 12 tried to stop smoking in
the past 12 months in 2009.



Health Systems Change

TU–8: Increase comprehensive Medicaid insurance coverage of evidence-based treatment for
nicotine dependency in States and the District of Columbia.


Baseline: 6 States had comprehensive Medicaid insurance coverage of evidence-based
treatment for nicotine dependency in 2007.


Data source: State Medicaid Coverage Survey for Tobacco-Dependence Treatments, CDC.

TU–6
320

TU–9: Increase tobacco screening in health care settings.

TU–9.1 Increase tobacco screening in office-based ambulatory care settings.


Baseline: 62.8 percent of office-based ambulatory care setting visits among patients aged 12
years and older had tobacco screening in 2007.


Data source: National Ambulatory Medical Care Survey (NAMCS), NCHS.

TU–9.2 Increase tobacco screening in hospital ambulatory care settings.


Baseline: 60.3 percent of hospital ambulatory care setting visits among patients aged 12 years
and older had tobacco screening in 2007.


Data source: National Hospital Ambulatory Medical Care Survey (NHAMCS), NCHS.

TU– 9.3 (Developmental) Increase tobacco screening in dental care settings.

Potential data source: American Dental Association’s Survey of Dental Practice.

TU– 9.4 (Developmental) Increase tobacco screening in substance abuse care settings.

Potential data source: National Survey of Substance Abuse Treatment Services.

TU–10: Increase tobacco cessation counseling in health care settings.

TU–10.1 Increase tobacco cessation counseling in office-based ambulatory care settings.


Baseline: 19.3 percent of visits to an office-based ambulatory care setting among current
tobacco users aged 12 years and older had tobacco cessation counseling ordered or provided
during that visit in 2007.


Data source: National Ambulatory Medical Care Survey (NAMCS), NCHS.

TU–10.2 Increase tobacco cessation counseling in hospital ambulatory care settings.


TU–7
321

Baseline: 22.5 percent of visits to a hospital ambulatory care setting among current tobacco
users aged 12 years and older had tobacco cessation counseling ordered or provided during
that visit in 2007.


Data source: National Hospital Ambulatory Medical Care Survey (NHAMCS), NCHS.

TU–10.3 (Developmental) Increase tobacco cessation counseling in dental care settings.

Potential data source: American Dental Association’s Survey of Dental Practice.

TU–10.4 (Developmental) Increase tobacco cessation counseling in substance abuse care
settings.

Potential data source: National Survey of Substance Abuse Treatment Services.

Social and Environmental Changes

TU–11: Reduce the proportion of nonsmokers exposed to secondhand smoke.

TU–11.1 Children aged 3 to 11 years.


Baseline: 52.2 percent of children aged 3 to 11 years were exposed to secondhand smoke in
2005–08.



TU–11.2 Adolescents aged 12 to 17 years.


Baseline: 45.5 percent of nonsmoking adolescents aged 12 to 17 years were exposed to
secondhand smoke in 2005–08.



TU–11.3 Adults aged 18 years and older.


TU–8
322

Baseline: 37.6 percent of nonsmoking adults aged 18 years and older were exposed to
secondhand smoke in 2005–08 (age adjusted to the year 2000 standard population).



TU–12: Increase the proportion of persons covered by indoor worksite policies that prohibit
smoking.


Baseline: 75.3 percent of the employed population aged 18 years and older (who worked in
indoor public workplaces) were covered by indoor worksite policies that prohibited smoking in
2006–07.

Target setting method: Projected trend data.

Data source: Tobacco Use Supplement to the Current Population Survey (TUS-CPS),
U.S. Bureau of the Census and BLS.

TU–13: Establish laws in States, District of Columbia, Territories, and Tribes on smoke-free
indoor air that prohibit smoking in public places and worksites.

TU–13.1 Private workplaces.


Baseline: 30 (29 States and the District of Columbia) had smoke-free indoor air laws that
prohibit smoking in private workplaces in 2009.


Data source: State Tobacco Activities Tracking and Evaluation System (STATE), CDC,
NCCDPHP, OSH.

TU–13.2 Public workplaces.


prohibit smoking in public workplaces in 2009.


NCCDPHP, OSH.

TU–9
323

TU–13.3 Restaurants.


prohibit smoking in restaurants in 2009.


NCCDPHP, OSH.

TU–13.4 Bars.


prohibit smoking in bars in 2009.


NCCDPHP, OSH.

TU– 13.5 (Developmental) Gaming halls.

Potential data source: State Tobacco Activities Tracking and Evaluation System (STATE), CDC,
NCCDPHP, OSH.

TU–13.6 Commercial daycare centers.


prohibit smoking in commercial daycare centers in 2009.


NCCDPHP, OSH.

TU–13.7 Home-based daycare centers.


prohibit smoking in home-based daycare centers in 2009.


TU–10
324

NCCDPHP, OSH.

TU–13.8 Public transportation.


prohibit smoking in public transportation in 2009.


NCCDPHP, OSH.

TU–13.9 Hotels and motels.


Baseline: Zero States or the District of Columbia had smoke-free indoor air laws that prohibit
smoking in hotels and motels in 2009.


NCCDPHP, OSH.

TU–13.10 Multiunit housing.


Baseline: Zero States or the District of Columbia had smoke-free indoor air laws that prohibit
smoking in multiunit housing in 2009.


NCCDPHP, OSH.

TU–13.11 Vehicles with children.


Baseline: 4 States had smoke-free indoor air laws that prohibit smoking in vehicles with children
in 2009.


NCCDPHP, OSH.

TU–11
325

TU–13.12 Prisons and correctional facilities.


Baseline: 8 States had smoke-free indoor air laws that prohibit smoking in prisons and
correctional facilities in 2009.


NCCDPHP, OSH.

TU– 13.13 (Developmental) Substance abuse treatment facilities.

NCCDPHP, OSH.

TU– 13.14 (Developmental) Mental health treatment facilities.

NCCDPHP, OSH.

TU– 13.15 (Developmental) Entrances and exits of all public places.

NCCDPHP, OSH.

TU–13.16 (Developmental) Hospital campuses.

NCCDPHP, OSH.

TU– 13.17 (Developmental) College and university campuses.

NCCDPHP, OSH.

TU–14: Increase the proportion of smoke-free homes.


Baseline: 79.1 percent of adults aged 18 years and older reported that no smoking is allowed in
their home in 2006–07.

Target setting method: 10 percent improvement

Data source: Tobacco Use Supplement to the Current Population Survey (TUS-CPS),
U.S. Bureau of the Census and BLS.

TU–12
326

TU–15: Increase tobacco-free environments in schools, including all school facilities, property,
vehicles, and school events.

15.1 Junior high school.


Baseline: 65.4 percent of junior high schools had tobacco-free environments, including all
school facilities, property, vehicles, and school events, in 2006.



TU–15.2 Middle school.


Baseline: 58.7 percent of middle schools had tobacco-free environments, including all school
facilities, property, vehicles, and school events, in 2006.



TU–15.3 High school.


Baseline: 66.1 percent of high schools had tobacco-free environments, including all school
facilities, property, vehicles, and school events in 2006.



TU– 15.4 (Developmental) Head Start.

Potential data sources: To be determined.

TU–16: Eliminate State laws that preempt stronger local tobacco control laws.

TU–16.1 Preemption on smoke-free indoor air.

Target: Zero States and the District of Columbia.

Baseline: 12 States preempted stronger local tobacco control laws on smoke-free indoor air in
2009.

TU–13
327


NCCDPHP, OSH.

TU–16.2 Preemption in advertising.


Baseline: 18 States preempted stronger local tobacco control laws in advertising in 2009.


NCCDPHP, OSH.

TU–16.3 Preemption on youth access.


Baseline: 22 States preempted stronger local tobacco control laws on youth access to tobacco
products in 2009.


NCCDPHP, OSH.

TU–17: Increase the Federal and State tax on tobacco products.

TU–17.1 Cigarettes.

Target: 52 (50 States, the District of Columbia, and the Federal Government).

Baseline: Zero States increased tax on cigarettes by $1.50 over the tracking decade in 2010
(States, the District of Columbia, and the Federal Government).

Target setting method: Consistency with national programs and policies.

NCCDPHP, OSH.

TU–17.2 Smokeless tobacco products.

Target: 52 (50 States, the District of Columbia, and the Federal Government).

Baseline: Zero States increased tax on smokeless tobacco products by $1.50 over the tracking
decade in 2010 (States, the District of Columbia, and the Federal Government).

TU–14
328

Target setting method: Consistency with national programs and policies.

NCCDPHP, OSH.

TU–17.3 (Developmental) Other smoked tobacco products.

NCCDPHP, OSH.

TU–18: Reduce the proportion of adolescents and young adults grades 6 through 12 who are
exposed to tobacco advertising and promotion.

TU–18.1 Internet advertising and promotion.


Baseline: 36.8 percent of adolescents and young adults in grades 6 through 12 were exposed to
tobacco advertising and promotion on the Internet in 2009.


Data source: National Youth Tobacco Survey (NYTS), CDC.

TU–18.2 Magazine and newspaper advertising and promotion.


Baseline: 48.6 percent of adolescents and young adults in grades 6 through 12 were exposed to
tobacco advertising and promotion in magazines and newspapers in 2009.

Target setting method: Projected trend data.

Data source: National Youth Tobacco Survey (NYTS), CDC.

TU– 18.3 (Developmental) Movies.

Potential data source: To be determined.

TU– 18.4 (Developmental) Point of purchase (convenience store, supermarket, or gas
station).

Potential data source: To be determined.

TU–15
329

TU–19: Reduce the illegal sales rate to minors through enforcement of laws prohibiting the sale
of tobacco products to minors.

TU–19.1 States and the District of Columbia.


Baseline: 5 States reported an illegal sales rate to minors of 5 percent or less in compliance
checks in 2009.

Target setting method: Retain the Healthy People 2010 target of total coverage.

Data source: State Synar Enforcement Reporting, SAMHSA, CSAP.

TU–19.2 Territories.

Target: 8 Territories.

Baseline: 1 Territory reported an illegal sales rate to minors of 5 percent or less in compliance
checks in 2009.

Target setting method: Retain the Healthy People 2010 target of total coverage.

Data source: State Synar Enforcement Reporting, SAMHSA, CSAP.

TU–20: (Developmental) Increase the number of States and the District of Columbia, Territories,
and Tribes with sustainable and comprehensive evidence-based tobacco control programs.

TU–20.1(Developmental) States and the District of Columbia.

NCCDPHP, OSH.

TU– 20.2 (Developmental) Territories.

NCCDPHP, OSH.

TU–20.3 (Developmental) Tribes.

NCCDPHP, OSH.

TU–16
330


Vision

V–1 Vision screening for children

V–2 Visual impairment in children and adolescents

V–3 Occupational eye injury

V–4 Dilated eye examinations

V–5 Visual impairment

V–6 Protective eyewear use

V–7 Vision rehabilitation

V–8 Comprehensive vision health services in Federally Qualified Health Centers

V–1
331

Topic Area: Vision
V–1: Increase the proportion of preschool children aged 5 years and under who receive vision
screening.


Baseline: 40.1 percent of preschool children aged 5 years and under received vision screening
in 2008.



V–2: Reduce blindness and visual impairment in children and adolescents aged 17 years and
under.

Target: 25.4 per 1,000.

Baseline: 28.2 per 1,000 children and adolescents aged 17 years and under were blind or
visually impaired in 2008.



V–3: Reduce occupational eye injuries.

V–3.1 Reduce occupational eye injuries resulting in lost work days.

Target: 2.6 per 10,000 full-time workers.

Baseline: 2.9 per 10,000 full-time workers had occupational eye injuries resulting in lost work
days in 2008.


Data source: Survey of Occupational Injuries and Illnesses (SOII), Bureau of Labor Statistics
(BLS), U.S. Department of Labor.

V–3.2 Reduce occupational eye injuries treated in emergency departments.

Target: 11.6 per 10,000 full-time workers.

Baseline: 12.9 per 10,000 full-time workers were treated for occupational eye injuries in
emergency departments in 2008.

V–2
332


Data sources: National Electronic Injury Surveillance System (NEISS), Consumer Product
Safety Commission (CPSC) and National Institute for Occupational Safety and Health (NIOSH),
CDC; Annual Survey of Occupational Injuries and Illnesses (ASOII), ED.

V–4: Increase the proportion of adults who have a comprehensive eye examination, including
dilation, within the past 2 years.


Baseline: 55.0 percent of adults aged 18 years and older had a comprehensive eye
examination, including dilation, within the past 2 years in 2008.



V–5: Reduce visual impairment.

V–5.1 Reduce visual impairment due to uncorrected refractive error.

Target: 122.5 per 1,000.

Baseline: 136.1 per 1,000 population aged 12 years and older had uncorrected refractive errors
in 2005–08.



V–5.2 Reduce visual impairment due to diabetic retinopathy.

Target: 30.7 per 1,000.

Baseline: 34.1 per 1,000 population aged 18 years and over with diabetes had visual
impairment due to diabetic retinopathy in 2008.



V–5.3 Reduce visual impairment due to glaucoma.

Target: 12.3 per 1,000.

Baseline: 13.7 per 1,000 population aged 45 years and over had visual impairment due to
glaucoma in 2008.

V–3
333



V–5.4 Reduce visual impairment due to cataract.

Target: 98.6 per 1,000.

Baseline: 109.6 per 1,000 population aged 65 years and over had visual impairment due to
cataract in 2008.



V–5.5 Reduce visual impairment due to age-related macular degeneration (AMD).

Target: 14.0 per 1,000 population.

Baseline: 15.6 per 1,000 population aged 45 years and over had visual impairment due to age-
related macular degeneration (AMD) in 2008.



V–6: Increase the use of personal protective eyewear in recreational activities and hazardous
situations around the home.

V–6.1 Increase the use of personal protective eyewear in recreational activities and
hazardous situations around the home among children and adolescents aged 6 to 17 years.


Baseline: 16.5 percent of children and adolescents aged 6 to 17 years used personal protective
eyewear in recreational activities and hazardous situations around the home in 2008.



V–6.2 Increase the use of protective eyewear in recreational activities and hazardous
situations around the home among adults aged 18 years and over.


Baseline: 39.7 percent of adults aged 18 years and over used protective eyewear in recreational
activities and hazardous situations around the home in 2008.

V–4
334



V–7: Increase vision rehabilitation.

V–7.1 Increase the use of vision rehabilitation services by persons with visual impairment.

Target: 33.1 per 1,000.

Baseline: 30.1 per 1,000 persons with visual impairment used vision rehabilitation services in
2008.



V–7.2 Increase the use of assistive and adaptive devices by persons with visual impairment.


Baseline: 11.2 percent of persons with visual impairment used assistive and adaptive devices in
2008.



V–8 (Developmental) Increase the proportion of Federally Qualified Health Centers (FQHCs)
that provide comprehensive vision health services.

Potential data source: Health Center Management Information System, Bureau of Primary
Health Care, Health Resources and Services Administration (HRSA).

V–5
335

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