Measuring Progress Toward Target Attainment and the Elimination of Health Disparities in Healthy People 2020

Details

• Personal Author:
  Talih, Makram ; Huang, David T.
• Corporate Authors:
  National Center for Health Statistics (U.S.). Office of Analysis and Epidemiology.
• Description:
  Introduction—Healthy People is an initiative of the U.S. Department of Health and Human Services that provides science-based, 10-year national objectives for improving the health of all Americans. As in the previous three decades, Healthy People 2020 (HP2020) has established overarching goals and objectives, and is monitoring progress toward the attainment of its targets as well as the elimination of health disparities among population groups. This Statistical Note discusses the HP2020 measurement practices, contrasting them with those that were in place in Healthy People 2010 (HP2010) and highlighting their strengths and limitations.
  
  Objective—This Statistical Note documents the HP2020 methodology for measuring progress toward target attainment and the elimination of health disparities, with a particular focus on methodological considerations for the interpretation of findings.
  
  Progress toward target attainment— For HP2020, the “percent of targeted change achieved” still measures movement of objectives that are moving from their baselines toward their targets. However, for objectives moving away from their baselines and targets, the “absolute value of the percent change from baseline” is used to measure movement. In addition, unlike in HP2010, both the extent of the movement and its statistical significance (when measures of variability are available) are used to determine progress status in HP2020 (e.g., “improving,” “little or no detectable change,” or “getting worse”).
  
  Comparisons to the best group rate— As in HP2010, all groups composing a population domain (e.g., race and ethnicity, education, or income) are compared to the group with the “best” (i.e., most favorable or least adverse) rate. However, HP2020 uses the ratio instead of the percent difference between the rates. In addition, HP2020 objectives that are expressed in terms of favorable outcomes to be increased no longer need to be re-expressed using the complementary adverse outcomes for comparisons to the best group rate.
  
  Measures of overall health disparity— In addition to detailed comparisons to the best group rate, HP2020 provides measures that quantify the degree of disparity overall across all groups composing a population domain. Unlike in HP2010, where a single relative measure, the summary index, was used, HP2020 uses three measures that include both absolute and relative measures of overall disparity: a) the simple difference between the highest and lowest rates, irrespective of intermediate rates; b) the ratio between the highest and lowest rates, irrespective of intermediate rates; c) and a summary rate ratio between the best group rate and the average rate for all other groups in a population domain. For objectives expressed in terms of adverse outcomes, the HP2010 “index of disparity” is obtained by subtracting 1 from the HP2020 summary rate ratio and multiplying by 100.
  
  Conclusion—The multipronged approach to measurement in HP2020 addresses some of the complex methodological issues and limitations identified in the past decade as well as elsewhere in the literature.
  
  Suggested citation: Talih M, Huang DT. Measuring progress toward target attainment and the elimination of health disparities in Healthy People 2020. Healthy People Statistical Notes, no 27. Hyattsville, MD: National Center for Health Statistics. 2016.
  
  CS261587
  
  statnt27.pdf
  
  
• Subjects:
  Demography Ethnicity Healthcare Disparities Health Status Disparities Healthy People Programs Program Development Racial Groups Socioeconomic Disparities In Health
• Series:
  Healthy People 2020
• Document Type:
  Journal Issue
• Name as Subject:
  Healthy People 2020 ; Healthy People 2020
• Place as Subject:
  United States
• Pages in Document:
  19 Pages
• Volume:
  27
• Collection(s):
  National Center for Health Statistics
• Main Document Checksum:
  urn:sha-512:a171b04bf9dd801f0bbcaee558edcb50d4791040bb47da666efe3ce5d8ac048fd28586d8be947e03dfcf13c0623ff65a0ca4630a708bca0b28433e564953852f
• Download URL:
  https://stacks.cdc.gov/view/cdc/134359/cdc_134359_DS1.pdf
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