Healthy People 2030: Roadmap for Public Health for the Next Decade

Abstract

Pharmacists play key roles in public health activities. The Healthy People initiative is a future-oriented approach to promote health and prevent disease, and serves as a framework for priority areas of intervention. The latest iteration, Healthy People 2030, was released in August 2020. Healthy People 2030 contains 355 specific objectives and raises awareness about gaps between actual and optimal health status. Pharmacists and student pharmacists can directly impact the majority of the objectives to improve the nation’s health. Pharmacy educators should utilize resources including the Clinical Prevention and Population Health Curriculum Framework to ensure they are adequately preparing their students to affect clinical prevention and population health.

BACKGROUND: Pharmacy and Public Health

Pharmacy and public health are a perfect intersection on the health care system roadways. Both pharmacy and public health have the primary goal of ensuring a population of healthy people, “to protect and improve the health of individuals, families, communities and populations, locally and globally.”¹

The pharmacy profession has embraced this goal and its role in the public health arena by providing services in such areas as immunizations, chronic disease management, tobacco cessation counseling, the misuse of opioids and other substances, emergency preparedness and response, and health education. Many of the communities that pharmacists serve are riddled with alarmingly high rates of medical conditions that are treated with medications, justifying the essential role that pharmacists play in comprehensive medication management.^2,3 Public health involves clinical health professionals, such as pharmacists, working alongside government agencies and public health officials to solve and manage these various health problems.^2,4

Additionally, health disparities based on ethnicity, race, and socioeconomic status are also factors that result in populations being disproportionately affected by disease and poor health, as well as limited access to resources to treat, manage and prevent myriad health challenges.⁵ Pharmacists are committed to making health care accessible to all populations and to serving diverse individuals, communities and populations. Pharmacists in community pharmacies, clinics and hospitals are well-positioned to provide a wide range of services, addressing the need for access to affordable health care, and the management and prevention of chronic diseases.⁶

Healthy People 2030: Objectives for the Nation

Healthy People is a national health initiative, coordinated by the Office of Disease Prevention and Health Promotion within the United States Department of Health and Human Services. Healthy People provides measurable public health objectives released at the beginning of each decade to be realized over the next 10 years. This future-oriented approach to promote health and prevent disease was established in 1979. As such, Healthy People 2030, the fifth iteration of the initiative, was released in August 2020 and is available at https://health.gov/healthypeople.⁷

The Healthy People 2030 framework is shown in Table 1. Healthy People 2030 includes significant additions to the past releases. Four of the overarching goals of Healthy People 2030 are similar to Healthy People 2020, with an emphasis on health equity and social determinants of health. However, a fifth overarching goal was added to Healthy People 2030: “[to] engage leadership, key constituents, and the public across multiple sectors to take action and design policies that improve the health and well-being of all.”⁷ This goal reinforces that it is essential to actively involve multiple stakeholders across the public, private, and not-for-profit sectors to achieve health and well-being.⁷ Also, for the first time in the initiative’s history, Healthy People 2030 has an explicit focus on health literacy as stated in its overarching goals and addresses both personal health literacy and organizational health literacy.⁸

Table 1.

Healthy People 2030 Framework⁷

Healthy People 2030 has 355 measurable objectives.⁹ The number of objectives was intentionally reduced from Healthy People 2020, which had over 1,200 objectives. By trimming the number of objectives, the latest version of Healthy People helps users to focus on areas of highest priority.¹⁰ There is a crosswalk available that highlights how objectives changed between Healthy People 2020 and 2030.¹¹

The Healthy People 2030 website (https://health.gov/healthypeople) is easy to navigate, allowing users to browse objectives in multiple ways and by the following categories: health conditions, health behaviors, populations, settings and systems, and social determinants of health.⁹ The site also provides tools for action; communities, states, and organizations are encouraged to identify priority objectives for their populations and to adjust targets as necessary.¹² The website incorporates evidence-based resources, such as systematic and non- systematic reviews of studies and interventions, related to the topic areas.¹³ There is a promotional toolkit that can be utilized to spread the word about Healthy People 2030 through newsletters, blogs, and social media.¹⁴ Healthy People 2030 is a dynamic tool with more resources planned to be released throughout the decade.¹⁰

Pharmacy and Healthy People 2030

Pharmacists, student pharmacists, and pharmacy educators all have an opportunity and obligation to help the nation achieve the Healthy People 2030 objectives. Healthy People 2030 provides a framework and direction for pharmacy’s continued efforts in public health initiatives. By providing individual patient care or outreach and educational programming in the community, pharmacists are taking part at the “micro” level of public health activities which will make an impact on the population (or “macro”) level. Additionally, pharmacy can impact the macro level directly through roles in health planning, evaluation, or administration.^2,3 Of the 355 objectives in Healthy People 2030, there are numerous ones that pharmacists can lead or be significantly involved in. Some of these include:

• Reducing the misuse of drugs and alcohol (substance use disorders)

• Immunizations and control of infectious diseases

• Reducing the inappropriate use antibiotics

• Reducing hospitalizations among older adults for diabetes, pneumonia, urinary tract infections

• Managing chronic illnesses and diseases: hypertension, diabetes, respiratory, cardiovascular, renal, cancer

• Emergency preparedness and response, including natural disasters

• Medical product safety, including decreases in emergency room visits for medication overdoses among young children, overdoses from oral anticoagulants, overdoses from insulin

• Prevention of disease and injury

The intersection of pharmacy and public health clearly can be seen in addressing the Healthy People 2030 objectives pertaining to the clinical management of chronic diseases, health education and primary disease prevention/control programs, and collaborations with state, local governments and community-based organizations. In order to enable pharmacists and student pharmacists to work toward achieving these objectives, pharmacy educators need to make sure that health promotion, disease prevention, population health, and interprofessional learning experiences are integrated into Doctor of Pharmacy curricula.

The Center for Advancement of Pharmacy Education (CAPE) 2013 Educational Outcomes include multiple elements related to public health concepts, theories, or models.¹⁵ In 2016, a white paper was published outlining the public health topics reflected in the CAPE 2013 Educational Outcomes, pedagogical considerations, and assessment practices (https://www.aacp.org/sites/default/files/2017-10/PublicHealthSIGCAPEpaper.pdf).¹⁶

Furthermore, the Clinical Prevention and Population Health Curriculum Framework (https://www.teachpopulationhealth.org/) provides specific guidance regarding the core knowledge areas of individual and population-oriented preventive health and health promotion efforts that should be integrated into health professions education.¹⁷ This framework is guided by the Healthy People Curriculum Task Force (HPCTF), a group of representatives from eight health professional education associations, including the American Association of Colleges of Pharmacy. The HPCTF was convened by the Association for Prevention Teaching and Research in 2002 and has since developed and continuously updated the Framework at least every five years.¹⁸ The latest version, Version 4, was released in February 2020. It aligns well with the recent Healthy People update as it includes a greater emphasis on social determinants of health and health equity, a new domain addressing mental and behavioral health, and 14 new or revised topic areas. All health professions educators, including pharmacy faculty, are encouraged to consult the Framework and review their curricula to ensure they are adequately preparing their students to affect clinical prevention and population health.¹⁷

CALL TO ACTION

With the release of Healthy People 2030, pharmacists, student pharmacists, and pharmacy educators have a new set of priorities for the nation’s health. By working toward the Healthy People objectives, the pharmacy profession can help improve the health of populations and increase resilience to public health threats such as the current COVID-19 pandemic. Healthy People 2030, the Public Health CAPE 2013 Educational Outcomes white paper, and the Clinical Prevention and Population Health Curriculum Framework should be used to guide this important work.