Report: Atlanta GA

Brief Notes from HP 2020 meeting Atlanta, March 17, 2008

Venue: Tom Harkin Global Communications Center, CDC

By Audrey Naylor

Attendees

The session was intended to solicit input from Regions III and IV (South Eastern states).  There were 395 pre-registered attendees.  Eleven (~3%) were not from the region.  Most participants (296 = 73%) were actually from Georgia and 43 were from CDC.  From the list of attendees included in the packet, nearly everyone was a professional working in some relevant organization or government agency.  

USBC official participant: Joan Meek.  Also attending from USBC:   Audrey Naylor

Observations

This all day meeting followed the published (HP 2020 website) agenda with about 90 minutes devoted to opening remarks and a review of the process and status of the development of the proposed objectives for the 2020 document.  It was evident that the intention of the planners (HHS/Office of Disease Prevention and Health Promotion) was to move from a 2010 focus on Health Care and Services (a disease orientation) to prevention and promotion.  They also suggested that concept of eliminating disparities be changed to creating equity for all sub groups in the US population.  

Two 90 minute sessions were devoted to presentations of the 3 minute public comments.  As attendees registered for the meeting, those who wanted to speak were given a number.  When the public comment sessions were reached in the schedule, presenters were called upon in numerical order. They were quite strict with the time allowed.  Comments were wide ranging and included statements on behalf of subsets of the population (elderly, gays, adolescents etc)the need to continue a focus on care for and research concerning various diseases (heart disease, cancer, diabetes etc)the need for primary care and midwifery services etc, A comment was made by a representative of the IFM (Infant Formula Manufacturers) noting that breastfeeding was best but for those who could or would not breastfeed their infants, the objectives should include a recognition of the need for iron fortified formula.  Three comments were made urging that the objectives continue to include breastfeeding initiation, exclusivity and continuation with the introduction of solids.  Dr. Joan Meek made a very nice presentation about breastfeeding behalf of USBC. This statement will be available on the USBC website. 

In addition to the public comment sessions, one 90 minute session was carried out as breakout work groups.  Every registered attendee was pre-assigned to one of four topics:

• Developmental Stages, Life stages and health outcomes
• Environment and Determinants of Health
• Priorities and New and Emerging Issues
• Health Equity and Disparities  

To keep the size of the groups small enough for useful discussion each topic had two groups. Each workgroup leader had a series of questions to stimulate discussion.  When the final plenary session reconvened, the group leaders summarized the activities of the group.  As I understand it, the public comments and the workgroup summaries will be posted on the HP 2020 website.

My group (Developmental Stages, Life Stages and Health Outcomes) focused on access to and cost of care.  Prevention and promotion received very little attention. It was my impression that many of those in attendance had a vested interest in some disease and it was difficult for them to think Prevention and Promotion.  My own suggestion was that if we are to really move out of the treatment business to prevention and promotion, we will have to increase the education of health care providers regarding prevention rather than treatment and there will have to be significantly greater financial incentives for prevention than for treatment.  I also commented on the need to involve the general public in the 2020 development process (town meetings in every region??)  to understand the process,  solicit their ideas  and achieve enthusiastic buy-in for the resulting .

While locations and attendees will change, it is my understanding that the organization of the rest of the meetings will be a repeat of this first meeting.

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Public Comment Delivered 3/17/08, Healthy People 2020 Atlanta Meeting

By: Melissa Vickers, MEd, IBCLC

Note: I chose the cross-cutting issues to base my public comment on, showing how breastfeeding fits into each of these goals.

I’m Melissa Vickers, and I’m representing La Leche League International, and am also an International Board Certified Lactation Consultant and member of the United States Lactation Consultant Association.

I wanted to put in a plug for breastfeeding—certainly we are moving in the direction of achieving the Healthy People 2010 goals for initiation and duration of breastfeeding, but we still have a long way to go and obstacles to overcome.

I would also like to ask that as we look at the risk-based approach, particularly as it relates to breastfeeding, that we change our language and perspective to one that looks at the risk of formula feeding rather than the benefits of breastfeeding.

Breastfeeding represents a cross-cutting issue, to be sure:

• Breastfeeding rates vary significantly by race and ethnic group, income level, education, etc., and promotional techniques need to be tailored to make all segments of society understand breastfeeding’s importance in the health of the nation.
• Not only is breastfeeding obviously important to the infancy life stage, the health benefits begin with a newborn’s first nursing and continue though the American Academy of Pediatrics’ recommended 6 months of exclusivity, followed by the introduction of appropriate complementary foods, and continued nursing for at least 12 months or as long as mother and baby wish to continue. Breastfeeding’s value is truly dose dependent.
• Breastfeeding is green. There are no manufacturing wastes, no paper or container trash to fill landfills, no need for additional deforestation to make room for pastureland for cows or soybeans.
• Lastly, breastfeeding provides a healthy foundation on which to build a public health infrastructure, and as such deserves a spot of its own as a topic area category. With this national recognition, we can create a society in which all individuals begin life in the way Mother Nature intends.