Measuring Progress Toward Target Attainment and the Elimination of Health Disparities in Healthy People 2030.

Abstract

Introduction: The Healthy People initiative provides science-based, 10-year public health objectives and targets for the U.S. population. As in the previous four initiatives, Healthy People 2030 established overarching goals and objectives (with targets) at the start of the decade and will be monitoring progress toward the attainment of targets and elimination of health disparities among population subgroups over the course of the decade.

Objective: This report outlines Healthy People 2030 measurement practices for both progress toward target attainment and elimination of disparities and compares the 2030 measurement practices with those that were in place in 2020, highlighting strengths and limitations.

Methods: Progress toward target attainment is assessed for the total population. The "percentage of targeted change achieved" quantifies movement toward targets, and the "percentage change from baseline" can be calculated for all core objectives. Based on the percentage of targeted change achieved or percentage change from baseline, as well as the statistical significance of these measures (when applicable), core objectives in Healthy People 2030 are classified into four mutually exclusive categories: TARGET MET OR EXCEEDED, IMPROVING, LITTLE OR NO DETECTABLE CHANGE, or GETTING WORSE. Disparities at a single timepoint are assessed by a suite of six measures: the between-group rate difference and ratio; summary rate difference and ratio; and maximal rate difference and ratio. To enable comparisons among those six measures, changes in disparities over time are assessed using the percentage change from baseline. Variability (standard errors and 95% confidence intervals) and statistical significance for all six measures, when applicable, are derived using a resampling/bootstrap procedure.

Conclusion: Expanding and building on the approaches to measurement in previous decades, methods to measure progress toward target attainment and elimination of health disparities in Healthy People 2030 represent a further evolution of these methods and address methodological issues and limitations previously identified.