FY 2024 Annual Performance Plan and Report - Strategic Goal 2: Objective 2.3

Fiscal Year 2024
Released March, 2023

Topics on this page: Objective 2.3: Enhance promotion of healthy behaviors to reduce occurrence of and disparities in preventable injury, illness, and death | Objective 2.3 Table of Related Performance Measures

Objective 2.3: Enhance promotion of healthy behaviors to reduce occurrence of and disparities in preventable injury, illness, and death

HHS supports strategies to promote healthy behaviors to reduce the occurrence of and disparities in preventable injury, illness, and death.  The Department develops, communicates, and disseminates information to improve health literacy about the benefits of healthy behaviors.  HHS leverages resources, partnerships, and collaborations to support healthy behaviors that improve health conditions and reduce disparities in health outcomes.  HHS also advances and applies research and data insights to inform evidence-based prevention, intervention, and policy approaches to address disparities in preventable injury, illness, and death. 

The Office of the Secretary leads this objective.  The following divisions are responsible for implementing programs under this strategic objective: AHRQ, ACF, ACL, ASFR, CDC, CMS, FDA, HRSA, IHS, NIH, OASH, and SAMHSA.  In consultation with OMB, HHS has determined that performance toward this objective is progressing.  The narrative below provides a brief summary of progress made and achievements or challenges, as well as plans to improve or maintain performance.

Objective 2.3 Table of Related Performance Measures

Although cigarette smoking remains the leading cause of preventable disease and death in the United States, the tobacco²³ product use landscape continues to diversify to include multiple combustible tobacco products, including cigars, cigarillos and little cigars, pipe tobacco, roll-your-own tobacco, and hookah.  Per capita combustible tobacco product consumption decreased from 1,004 cigarette equivalents in FY 2020 to 967 cigarette equivalents in FY 2021.  CDC will continue to work to decrease combustible tobacco consumption in the U.S.

CDC recommendations to help reduce tobacco consumption include: raising the price of tobacco products, providing access to cessation services, protecting everyone’s right to breathe clean air, and mass-reach media campaigns warning about the dangers of tobacco use.  CDC strategies to promote these interventions include providing funding to 50 states, Washington, DC, 8 U.S territories and 12 tribal organizations for comprehensive tobacco control efforts through the National Tobacco Control Program, and supporting grantees to implement Best Practices for Comprehensive Tobacco Control Programs.  CDC also funds the Tips From Former Smokers Campaign,® a national campaign profiling real people who live with serious health effects due to smoking and secondhand smoke exposure.

The proportion of adults who engage in leisure-time physical activity increased from 63.8% in FY 2008 to 74.6% in FY 2018.  After FY 2018, the National Health Interview Survey (NHIS) changed the survey question and methodology used for the measure’s data. As a result, new data cannot be compared to previous results, and a new baseline of 73.9% was established in FY 2020. CDC’s Active People, Healthy NationSM is a national initiative to help 27 million Americans become more physically active by 2027.  CDC used percent improvement target setting methodology to set a goal of a 0.4% increase per year for the proportion of adults (age 18 and older) that engage in leisure-time physical activity.  This translates to a 0.8% increase every two years and is consistent with administration of the NHIS, the survey used to collect this data, which is administered every two years instead of annually. 

CDC funds states, communities, and organizations with national reach to design communities that are safe and easy for people of all ages and abilities to be physically active.  In addition, CDC trains states and communities to implement strategies to improve the walkability of communities.  For example, the CDC funded Walkability Action Institute has trained teams in 79 jurisdictions in 32 states and two territories. As a result, the jurisdictions cumulatively achieved over 850 outcomes related to improving walkability with a focus on community and transportation design for over 41 million people.  CDC will continue to promote the critical need for safe and easy places for physical activity to take place and help implement high impact strategies for walking and walkable communities like Complete Streets and Safe Routes to Schools.  As of April 2022, over 1,670 Complete Streets policies, including those adopted by 35 state governments plus the Commonwealth of Puerto Rico, and Washington D.C., have been reported to the National Complete Streets Coalition.

Health centers continue to be a critical element of the health system, largely because they can provide an accessible and dependable source of high quality, affordable, and cost-effective primary health care services in underserved communities.  In particular, health centers emphasize coordinated primary and preventive services that promote reductions in health disparities for low‐income individuals, racial and ethnic minorities, rural communities, and other underserved populations.  Health centers emphasize coordinated and comprehensive care, the ability to manage patients with multiple health care needs, and the use of key quality improvement practices.  Health center patients, including low-income individuals, racial/ethnic minority groups, and persons who are uninsured, are more likely to suffer from chronic diseases such as hypertension and diabetes.  Clinical evidence indicates that access to appropriate care can improve the health status of patients with chronic diseases and thus reduce or eliminate health disparities. 

HRSA set the FY 2024 targets based on historical data trends.  Recovery efforts from COVID-19, including significant use of telemedicine, are expected to bring measure performance back to previous levels.

Footnotes

²² This measure uses the CDC’s National Center for Health Statistics (NCHS)-provided trend setting tool for the Healthy People 2030 targets.  It uses a linear trend to calculate at least 5 options.  Specifically, ordinary least-squares was fit.  The targets were selected from Option 3, there is a 50% chance that the target value will meet or exceed.  2018 was selected as the baseline year since that is the year with the most recent data available.

²³ References to tobacco refer to commercial tobacco and not the sacred and traditional use of tobacco by some American Indian communities.