Institute of Medicine recommends Healthy People 2020 objectives

Of all the ways that the nation could work to improve health, an Institute of Medicine (IOM) committee recently recommended 24 objectives for priority attention in the coming decade.

The Department of Health and Human Services (HHS) requested that the IOM select the Leading Health Indicators as a way of bringing more focus to the Healthy People process, which for 3 decades has set 10-year health objectives.

Many of the 24 objectives have particular relevance for children and pediatrics. One of the goals, for example, is reducing the initiation of tobacco use in the prior 12 months in children and adolescents from 7.7% to 5.7%.

For the 31 Leading Health Indicators chosen for Healthy People for 2010, however, only 3 had statistical indications of meeting their target, and 15 had not moved in the desired direction or had even moved in the wrong direction.

The new IOM recommendations for the Leading Indicators for the coming decade don't shy away from ones that will be tough to meet.

They call, for example, for reducing the proportion of children and adolescents considered obese by 10%. Statistics indicate obesity in children had increased significantly in recent decades, although in the last decade the rates have leveled off.

In other target priorities for 2020, the IOM calls for reducing the proportion of persons who experience major depressive episodes. That includes cutting the proportion of adolescents aged 12 to 17 years who have had such episodes in the past year from 8.3% to 7.4%.

Reducing the pregnancy rate among adolescents by 10% is another objective. That means cutting the 2005 rate of 40.2 to 36.2 per 1,000.

In an area new to Healthy People, the IOM has called for priority emphasis on increasing the proportion of children who are ready for school in all 5 domains of healthy development: physical, social-emotional, language, cognitive, and approaches to learning.

Final decisions on the IOM recommendations for the Leading Health Indicators should be determined by HHS in the next few months.

WHITE HOUSE CONFERENCE FOCUSES ON BULLYING

The White House lent its influence recently to the federal effort to keep a spotlight on bullying and its effects on children. In an address to the White House Conference on Bullying Prevention, President Obama said he had been a bullying target as a child because of his big ears and funny name.

Bullying affects nearly 1 of 3 children in grades 6 through 10, according to a study from the National Institute of Child Health and Human Development.

Youths who are bullied have higher rates of suicide, depression, posttraumatic stress disorder, and substance abuse. Hostile kids who mistrust others are more likely to have future physical problems linked to diabetes and heart disease.

Overall school climate is a significant predictor of a person's likelihood of intervening in bullying, as well as a predictor of the way children respond. Parents are less likely to contact the school if they perceive the school climate less favorably.

Although most kids are doing safe and responsible things online, cyber bullying has added a new dimension. Research indicates that 1 in 5 kids have experienced cyber bullying.

For all kinds of bullying issues, active supervision of children by parents, teachers, or others is one of the most powerful tools available.