November 20, 2023:
We appreciate the opportunity to comment on the US Department of Health and Human Services’ (HHS) document: “Healthy People 2030 Objectives.” The National Center for Health Research (NCHR) is a nonprofit think tank that conducts, analyzes, and scrutinizes research on a range of health issues, with a particular focus on which prevention strategies and treatments are most effective for which patients and consumers. We do not accept funding from companies that make products that are the subject of our work, so we have no conflicts of interest.
NCHR strongly supports the addition of social determinants of health to the Healthy People 2030 Objectives. The promotion of healthy behaviors without addressing root cause socioeconomic and environmental conditions has long been a superficial solution to profound systemic inequities that contribute to poor health outcomes in individuals and communities. Creating social, physical, and economic environments that promote health and well-being is crucial to disease prevention, longevity, and a more equitable health system. Thus, we strongly support these additions and urge the HHS to make achieving these objectives a priority.
As part of these efforts, NCHR also recommends including health literacy objectives that aim to increase both personal health literacy and organizational health literacy. While it is important for individuals to access, understand, and use healthcare services and information, the degree to which individuals will be successful is largely based on organizational health literacy. Focusing on improving organizational health literacy has the potential to empower individuals to not only access, understand, and use health services and information, but to also make informed health decisions and play a more central role in their healthcare. Accordingly, we strongly recommend adding individual and organizational health literacy objectives as this will strengthen HHS’ ultimate goal of achieving health equity and improving the well-being of all.
NCHR also recommends applying a similar construct of equity and inclusion to the stakeholders involved in the design, implementation, and assessment of the Healthy People 2030 Objectives. Too often, the only stakeholders involved in national public health policy are public health experts, academics, investors, and policymakers, and there is limited involvement of community leaders and those with lived expertise of health inequity. Yet, these diverse perspectives are vital to ensuring the success of major public interventions. Thus, we urge the HHS to ensure that stakeholder involvement is made up of a diverse range of experts across multiple disciplines and includes community members with lived expertise.
In summary, we are strongly in support of the addition of social determinants of health to the Healthy People 2030 Objectives as it has been well documented that socioeconomic status, education level, physical environment, and community networks impact health outcomes and are a major source of health disparity. To strengthen HHS’ ultimate goal of improving community health and achieving health equity, we strongly recommend including individual and organizational health literacy objectives and forming inclusive, diverse stakeholder committees, specifically including community leaders and those with lived expertise of health inequity.