Jim Lysen on 9/2/2008 4:54:39 PM
To help frame discussion on Vision, Mission and Values, the National Assembly on School-Based Health Care offers its Vision, Mission and Core Values:

Our Vision:
All children and adolescents are healthy and achieving at their fullest potential. 

Our Mission:
To promote and support school-based health centers to assure that all children receive high quality, comprehensive health care. 

Our Core Values:
Children and adolescents have the right to high quality, accessible, confidential, culturally competent, comprehensive health care. The school setting is a sensible, appropriate and valuable site to deliver health care.
·School success and good health are inextricably linked and health and education partnerships are key to student success.
·Health care for children and adolescents should be interdisciplinary, comprehensive, with an emphasis on prevention and early intervention.
·Diversity among NASBHC’s leadership, membership, staff and volunteers is essential.
·Families are the best advocates for services that benefit their children.
·School-based health centers provide valuable health care and should be appropriately reimbursed.

John Paul on 8/29/2008 4:58:52 PM
I recently attended 
the National Center for Health Statistics Data User Conference.  At the conference, I sat in on the Healthy People 2020 presentation. 

My comments are my own. Though I am an EPA employee, these comments are my own, and do not in any way represent the Agency's position or interest.

I have a very simple question: would you consider expanding the overall vision to include " Healthy People and Healthy Ecosystems"?  The federal agencies are in position to start addressing this inclusive vision: data for both human health and condition of ecological systems are becoming available from federal surveys (probability based). I can follow up if there is interest.

John F. Paul, PhD
USEPA, B343-01
RTP, NC 27711

Anonymous on 8/20/2008 10:00:06 PM
I heard about this organization through my son's health book, and I have noticed that it is extremely fundamentalist.  They state that an important part of good health is not to engage in premarital sex, and I find it very worrisome that Healthy People 2010 is associated with that.  I would like to know whether or not you agree with that.  I hit ctrl-f, and was not able to find any mention of "sex" or "abstinence" on this page, and I would rather not dig through your website for a simple answer to my question.  Also, @"Anonymous on 7/2/2008 10:54:23 AM", you used the wrong homophone.  It should be spelled higher*.

Anonymous on 7/2/2008 10:54:23 AM
Men are dying at a hire rate and their life expectancy is less than that of women. We need to focus more attention in figuring out in ways to change this, because it does affect the future of families, especially financially.

Anonymous on 7/2/2008 10:42:41 AM
I believe not enough attention is giving to prostate cancer as is needed. Although breast cancer is much less common in women that prostate cancer in men it still gets much more attention and funding. This is just one of the cases in which women are given more attention in a health context. These types of gender disparities need to be changed. 

An office of women’s health was created to help increase the focus on women, which is wonderful, but the same should be available for men. There should be an office of men’s health which would put diseases like prostate cancer and testicular cancer on everyone’s radar. I believe there is still a lot of work to be done to address gender disparities.

Anonymous on 6/4/2008 2:08:44 PM
Public Comment on Healthy People 2020
Development Process and Draft Framework
May 2008


The American Psychological Association (APA) is pleased to provide comments as part of the collaborative process of building the framework for Healthy People 2020.  APA is the largest scientific and professional organization representing psychology in the United States and the world’s largest association of psychologists, with 148,000 members and affiliates. APA works to advance psychology as a science, as a profession, and as a means of promoting health, education, and human welfare. 

Since 1979, Healthy People has set and monitored national health objectives to meet a broad range of health needs, encourage collaborations across sectors, guide individuals toward making informed health decisions, and measure the impact of our prevention activity.  Currently, Healthy People 2010 is leading the way to achieve increased quality and years of healthy life and the elimination of health disparities.

In anticipation of the upcoming regional meeting, which will take place on May 28, 2008, in Bethesda, Maryland, APA is grateful to submit comments and questions to help guide the discussions and presentations for Developing the Framework for Healthy People 2020 at this important event.   

Behavioral Research
Psychological scientists are eager to be partners in the development of Healthy People 2020 goals and objectives. Behavioral and social science is needed to inform the conceptualization and planning of the goals, and to measure progress toward achieving them. The National Institutes of Health (NIH) have funded important behavioral studies, such as the Diabetes Prevention Program, a modest lifestyle intervention shown to prevent development of diabetes in people at risk. NIH is now seeking to fund field studies to establish this intervention in communities around the country to measure its effectiveness with different groups and in different settings. In this instance and many others, NIH has clearly worked to fund research that can undergird recommendations for public health.  Are there mechanisms for NIH and its investigators to be informed about specific needs and gaps in knowledge observed by public health practitioners? Ideally translation will work from bench to trench, back to bench again. 

NIH has just added as part of its trans-institute Roadmap a pilot initiative called "The Science of Behavior Change." The purpose of the initiative is to establish the groundwork for a unified science of behavior change that capitalizes on both the emerging basic science and the progress already made in the design of behavioral interventions in specific disease areas. 
By focusing basic research on the initiation, personalization, and maintenance of behavior change, and by integrating work across disciplines, this Roadmap effort and subsequent trans-NIH activity could lead to an improved understanding of the underlying principles of behavior change. This should drive a transformative increase in the efficacy, effectiveness, and (cost) efficiency of many behavioral interventions. A timely question is, can this initiative, which is still in the planning stage, help advance the development of goals of Healthy People 2020? 
Children, Youth, and Families 

The following critical priorities affecting children, youth, and families have been identified to provide guidance to the Department of Health and Human Services (HHS) in its development of the Healthy People 2020 objectives involving this population.  As such, we recommend that in the development of the framework for Healthy People 2020, HHS should pay particular attention to the following areas:

1.	Quality of Life for Children and Families

a.	Quality of life is used an indicator of the effectiveness of health promotion efforts. Quality of life includes not only freedom of movement and access to care but also the ability to fully participate in daily activities without worry or concern about chronic health conditions. When children and family members are unduly concerned about their health, they are less able to fully participate in daily activities (e.g., work, school, leisure) and this concern can affect the well being of other members of the family.
b.	The ways in which we go about measuring quality of life in children, in particular, are underdeveloped. Too often child quality of life is determined by parent report which can be affected by parent mental and physical health status. 
c.	Quality of life is rarely the result of a single factor. Rather, multiple risks such as socioeconomic factors, co-morbidity of mental and physical health conditions, and access to care combine to predict quality of life. Thus, efforts to improve quality of life for children and families must take into consideration the economic, cultural, and social context in which children and families live.

2.	Health Disparities

It is not clear that we have made great strides in reducing health disparities for children, youth, and families.  For children, the higher prevalence rates of chronic health conditions, such as asthma, obesity, and early onset diabetes are just a few of the examples where disparities are not only present but also have been increasing over the past decade. Greater attention to the multiple risks associated with these increases is critical and urgently warranted.  Some prime areas to target include:

a.	Examining the influences of discrimination or oppression on the physical and mental health status of ethnic minority children, adolescents, and families;
b.	Researching the prevalence of disproportionate rates of stress-related illnesses in African Americans and other ethnic minorities; 
c.	Building on the culturally-based strengths and resilience of ethnic minority children and families in the promotion of mental and physical health;
d.	Exploring ways in which the healthy practices and lifestyles of ethnic minority families can be drawn upon to reduce health disparities;
e.	Investigating the influence of the disparate health practices of ethnic minority children, adolescents, and families on persistent health disparities; 
f.	Promoting safe communities and reducing the risk of violence exposure and trauma for children and adolescents; and 
g.	Encouraging healthy eating, active lifestyles, exercise, and movement in ethnic minority children, adolescents, and families. 

3.	Childhood Obesity and Healthy Family Lifestyles

We strongly urge the inclusion of obesity and healthy family lifestyles in Healthy People 2020. This must include coordinated efforts among policy makers, public health officials, and leaders in the private sector. A one size fits all approach has not, will not, and cannot work. Some main areas to target include:

a.	Food advertising to children;
b.	Promotion of physical activity in safe communities;
c.	Promotion of healthy nutrition and accessibility of healthy foods for all families regardless of income;
d.	Supporting home environments and providing families with the skills to create culturally rich home environments that promote healthy interactions; 
e.	Linking home, school, and community in healthy lifestyles;
f.	Promoting understanding of the stigma associated with weight;
g.	Promoting food policies that allow families to make healthy choices; and
h.	Identifying and exploring the complex cultural factors involved in the growing epidemic of childhood obesity.

4. Advertising to Children: Report of the APA Task Force on Advertising and Children

Task Force Report Findings

Commercial practices targeting children have experienced profound changes over recent years, resulting in unprecedented levels of advertising reaching young audiences.  The average child is exposed to more than 40,000 television commercials a year.  Approximately 80 percent of all advertising targeted to children falls within four product categories: toys, cereals, candies, a

John Hewes on 4/30/2008 10:57:56 PM
It is vitally important that a Registered Nurse be included in the committee which is organzing Healthy People 2010. It is a major oversight that this has not yet been done. Nurses represent the largest single group of professional health care givers, and we spend the most time with the patients in most facilities. The nursing process is based on the concept of patient advocacy and when given the tools to do this with, we do it very well! You find nurses on all levels of health care, from the LPN to RN, to the APRN. Our education not provides us with a specialized body of knowledge concerning caring for the whole person, but we also serve as conduits and filters between physicians and patients. We evaluate options, note trends, refer appropriately to other disciplines, measuring outcomes, and we serve as a listening ear for our patients. Who better to be involved in setting goals and working to establish a functional system which may serve as a model for years to come. John Hewes, RN,C

Anonymous on 4/21/2008 10:03:06 AM
With the cesarean section rate in the US climbing to over 30% and looking to continue this trend, despite guidance from the World Health Organization that this rate is over double the recommended numbers, what is being done to help Americans start healthy from birth? 

There are many well documented health issues associated with babies and c-section delivery - just to name 2: Elective c-section babies are nearly 3 times as likely to die than a vaginally born baby (1.77/1000 vs. 0.62/1000). Researchers found that elective caesarean born babies were up to four times more likely to have respiratory problems than those born naturally, or by emergency Caesarean section.  The babies may miss out on hormonal and physiological changes during labour which help mature the lungs (University of Aahrus, as reported in the British Medical Journal).


There are some simple solutions which could help especially about the frightening "trend" of elective - as reported in the British Medical journal (May 2007), a UK team found women who had already had one section were less likely to choose another if they used a computer programme to help make their decision. Researchers say the system also reduced the anxiety of women, which can create problems during and after delivery.

What are your plans to help? After all children are one third of our population and all of our future.  ~Select Panel for the Promotion of Child Health, 1981

Jaya Jung Mahat on 4/3/2008 11:55:33 PM
Although the Government of Nepal in collaboration with many INGOs is carrying out various health projects throughout the rural areas of Nepal, the people of Nepal are living wioth the same health problems as they were living with them during 80's.