Healthy People 2030 Methods

Key points

  • Healthy People 2030 objectives address health disparities to help improve overall health outcomes for all Americans.
  • The initiative includes tools and methods for tracking disparities among population subgroups.
The Healthy People 2030 logo shows the outline of a skyline. There is a circle over each building to look like people

Overview

This page provides a high-level summary of resources for measuring progress toward Healthy People 2030 targets and for tracking disparities. It highlights the strengths and limitations of Healthy People 2030 measurement practices. It also provides a methodological reference upon which future publications and analyses may expand further.

Progress toward target attainment

Assessing progress

Two measures are used to assess progress toward attaining targets in Healthy People 2030.

Percentage of targeted change achieved is the difference between the baseline and most recent values as a percentage of the targeted change between the baseline and target values. It is calculated for trackable core objectives (measurable objectives with at least two data points) that are moving toward their Healthy People 2030 targets.

Percentage change from baseline is the difference between the baseline and most recent values as a percentage of the baseline value. It can be calculated for all trackable core objectives regardless of the direction of the change. The percentage change from baseline also can be used to assess progress by population subgroups.

Classifying core objectives

Using the two measures above, each trackable core objective is classified into one of four mutually exclusive categories:

  1. Target met or exceeded
  2. Improving
  3. Getting worse
  4. Little or no detectable change

Classification categories

Category
Criteria

Target met or exceeded

  • When the desired direction is an increase, an objective is considered to have met or exceeded its target at the most recent timepoint if its most recent value is at or above the Healthy People 2030 target.
  • When the desired direction is a decrease, an objective has met or exceeded its target if its most recent value is at or below the Healthy People 2030 target.

Improving

  • When the desired direction is an increase, an objective is moving toward its target at the most recent timepoint if its most recent value is higher than the baseline value but lower than the Healthy People 2030 target.
  • When the desired direction is a decrease, an objective is moving toward its target if the most recent value is lower than the baseline value but remains higher than the Healthy People 2030 target.
  • An objective that is moving toward but has not met or exceeded its target at the most recent timepoint is classified as improving if the percentage of targeted change achieved is statistically significant (when standard errors [SEs] are available), regardless of the magnitude of the change, or, when statistical significance cannot be tested, if 10 percent or more of the targeted change is achieved.

Getting worse

  • When the desired direction is an increase, an objective is moving away from the baseline and target values at the most recent timepoint if its most recent value is lower than the baseline value and the Healthy People 2030 target.
  • When the desired direction is a decrease, an objective is moving away from the baseline and target values if the most recent value is higher than its baseline and target values.
  • An objective that is moving away from its baseline and target values at the most recent timepoint is classified as getting worse if the percentage change from baseline is statistically significant (when SEs are available), regardless of the magnitude of the change, or, when statistical significance cannot be tested, if the change from baseline is 10 percent or more in magnitude (absolute value).

Little or no detectable change

Objectives that have not met or exceeded their targets at the most recent timepoint are assigned to this category under any of the following scenarios:

  • Movement toward the target is not statistically significant when measures of variability are available.
  • Movement is toward the target, but the objective has achieved less than 10 percent of the targeted change when measures of variability are unavailable.
  • Movement is away from the baseline and target values and is not statistically significant when measures of variability are available.
  • Movement is away from the baseline and target values, but the objective has moved less than 10 percent relative to its baseline value when measures of variability are unavailable.
  • There was no change between the baseline and most recent timepoints.

Progress by population subgroups

Assessing progress toward target attainment of Healthy People 2030 objectives focuses on the total targeted population. This is the basis for target setting for each objective. Examining progress by population subgroups using the percentage of targeted change achieved has limitations. These limitations are especially present for groups that have already met or exceeded the target at baseline.

Assessing progress by population subgroups using percentage change from baseline may serve as an alternate or supplementary measure. This approach enables comparisons between groups, regardless of their starting position relative to the target at the decade's onset.

Progress toward eliminating health disparities

The following are important concepts when assessing disparities in Healthy People 2030—

  • The term "rate" is used as shorthand for rate, percentage, proportion, or any other measurement for which disparities can be meaningfully assessed. Not all Healthy People objectives are measured using a rate.
  • There is no single, gold-standard measure of health disparities.
  • Healthy People 2030 methodology incorporates six disparities measures, including absolute and relative, between-group and overall, and maximal and summary measures. All measures are calculated relative to a reference group rate.
  • The "reference rate" is the highest group rate if the desired direction for the objective is an increase. The reference rate is the lowest group rate if the desired direction for the objective is a decrease.
See Also Measuring Progress Toward Target Attainment and the Elimination of Health Disparities in Healthy People 2030

  • The between-group rate difference and ratio are absolute and relative between-group measures of disparities, respectively, that allow for comparisons of each population subgroup to the reference rate.
  • The maximal rate difference and ratio are absolute and relative overall measures, respectively, that compare the largest and smallest group rates for a given population characteristic (for example, race and ethnicity). They are useful for providing a high-level overview of disparities.
  • Similarly useful for providing a high-level overview, the summary rate difference and ratio are overall measures that compare the reference group rate to the average rate of all other subgroups.

Changes in disparities measures are assessed over time, primarily on a relative scale (percentage difference). This allows for direct comparisons between the multiple health disparities measures. However, changes over time could be assessed on an absolute scale (simple difference) when considering only a single measure.

Health disparities tracking tool

The Health Promotion Statistics Branch at CDC's National Center for Health Statistics developed the Health Disparities Tracking Tool. The tool allows users to assess and track disparities consistent with Healthy People 2030 practice and methodology.

With this tool, users can—

  • Calculate health disparities from input data
  • Calculate SEs at 95 percent confidence intervals (when SEs of the underlying population group rates are available)
  • Assess changes in disparities over time
  • Generate dot plots (also known as equiplots) and trend (line) charts to track disparities
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Content Source:
National Center for Health Statistics