DM GPRA Performance Plans

Women's Health Information Center, and population-specific sections on 4Woman.gov and healthfinder® (including healthfinder® "espanol") and special resources for racial and ethnic populations.

The tragedy of September 11th, 2001, underscored the urgent need to build a 21st century health support system that connects public health and healthcare professionals and the public to sound information and to each other. These networks of information, services, and people are the connective fabric of health improvement efforts. OPHS plays a vital role in building the data systems for understanding the health problems of our growing minority and ethnic populations; in promoting the integrity of the scientific research enterprise; and in promoting the development of a balanced national health information infrastructure that serves the public as well as professionals and supports prevention as well as treatment and administration.

OPHS activities in support of data development include the National Survey of Family Grouwth and Adolescent Health Survey, management of HP2010 and work with National Center for Health Statistics to collect ana analyze national data on health status and health behaviors, cochairmanship of the HHS Data Council's Working Group on Racial and Ethnic Data, and development of a new HIV/AIDS data methodology joining qualitative and quantitative data collection methods, known as RARE (Rapid Assessment, Response and Evaluation), including training for State and local health departments.

OPHS helps build capacity in State and local agencies and private organizations to support prevention. Some examples include the Leadership Campaign on AIDS to increase the capacity of minority community-based organizations to develop effective and innovative partnerships at the local level to enhance HIV/AIDS services and education and the State Minority Health Infrastructure Study, the National American Indian/Alaska Native Health Forum to identify strategies through which State, tribal, and Federal governments can complement and supplement their respective health systems.

OPHS contributions to the scientific research infrastructure include the Federal Research
Misconduct Officials Network includes representatives from 27 agencies.

OPHS has had a lead role in the development of key documents and activities related to the

DM GPRA Performance Plans

national health information infrastructure (NHII), which includes standards, applications, research with emphasis on linkages among consumers/patients, providers, and public health. ODPHP provides the lead staff to the workgroup on the NHII of the National Committee on Vital and Health Statistics, including development of the landmark report Information for Health: a Strategy for Building the National Health Information Infrastructure and organizing hearings to explore issues and opportunities for implementing the NHII.

the Public Healt

1. Shape policy at the local, State, and
national levels. OPHS will strengthen
the public health, health information, and
research infrastructures as measured by
the number of public and private entities
at all levels that adopt supportive
policies, programs, services, laws,
regulations, and recommendations as a
result of OPHS efforts.

2. Communicate strategically. OPHS
will increase the reach of its
communications that promote stronger
public health, health information, and
research infrastructures, as measured by
customers served through Websites and
clearinghouses, by professional and
community-based outreach activities,
and by targeted communications.

3. Promote effective partnerships.
OPHS will increase substantive
commitments to strengthening the public
health, health information, and research
infrastructures on the part of public and
private entities, as measured by the
number of these entities that change or
strengthen their efforts as a result of
partnership with OPHS.

Most of OPHS'current GPRA measures are derived from Healthy People 2010, the third decadelong national prevention initiative. The objectives in Healthy People 2010 were given ambitious targets; they are intended to represent public health challenges which might be achieved over the decade if all necessary resources of the public and private sectors were mobilized to address the specific issue. The experience of the prior decades demonstrates the difficulties in attaining these high public health goals: for Healthy People 2000, for example, the nation achieved or moved in the right direction on over 60% of the objectives.

Progress toward all the Healthy People 2010 objectives will be monitored throughout the decade by Progress Reviews chaired by the Assistant Secretary for Health.

Current Priority 1: Ensuring a Balanced Community Health System

Section 1(a) FY 2002 Performance Summary: Goals 1.1-1.6

The birth rate for teenagers continued its steady decline since the early 1990s between 1991 and 2001 (the latest year for which data are available) there was a 35% drop in the birth rate for teenagers 15-17. The 2001 birth rate for teenagers 15-17 years fell 8% from 2000. The percent of women who began prenatal care in their first trimester of pregnancy increased slightly for 2000-2001, from 83.2 to 83.4%.

Within the larger public health framework, OPHS's Office of Population Affairs and the programs it administers (the AFL program and the Family Planning Program) play a central role in assuring a healthy start for every child by preventing unintended and adolescent pregnancies, providing abstinence education for adolescents, and providing related preventive health care and counseling.

In an effort to promote effective partnerships to reduce adolescent pregnancy, the AFL prevention projects continue to focus on abstinence as the most effective method of preventing

DM GPRA Performance Plans

adolescent pregnancy and sexually transmitted infections. In FY 2002, the AFL program made available approximately $6.5 million to support an estimated 35 prevention (abstinence education) projects.

In 2002, the family planning program, the primary provider of subsidized family planning services for low-income individuals, provided funding for service delivery grants to 91 public and private organizations supporting a nationwide network of more than 4,500 family planning clinics. Title X provides reproductive health services to approximately 4.4 million persons each year, enabling women to avoid unintended pregnancies. Pregnancy testing is a common and frequent reason for women coming to visit a clinic, and family planning is often an access point for women entering early prenatal care. The program also plays an important role in adolescent pregnancy prevention. In addition to clinical services, outreach and education (including counseling to encourage continued postponement of sexual activity for adolescent clients who are not yet sexually active) are important components of family planning services for adolescents.

The reduction of new perinatally acquired HIV infections has also been a high priority for the Department since the definition of effective treatment options that reduce the risk of transmission from mother to child. OPHS has coordinated a Department-wide effort across the research, prevention and treatment arenas to maximize opportunities to reduce the incidence of new perinatal HIV infections. HRSA, CDC and SAMHSA have extensive program efforts in place to reach and offer pregnant women with HIV infection effective treatment for their own illness and to reduce the risk of perinatal transmission. The US has seen dramatic reductions in perinatal HIV transmission rates in the past decade; these initiatives have been successful in dropping the number of new perinatal AIDS cases diagnosed each year, with 102 cases diagnosed in FY 2000 compared to a target level of 203 cases, well exceeding the target set. Surveillance data reported through December 2000 show sharply declining trends in perinatal AIDS cases, showing a reduction of 69 cases from the FY 1999 level of 171 cases (to 102 cases in FY 2000), or a 40% reduction; this decline was strongly associated with increasing zidovudine (ZDV) use in pregnant women who were aware of their HIV status, at delivery, and in treatment of the infant after birth. More recently, improved treatment also likely delayed onset of AIDS for HIV-infected children. These declines also reflect the success of widespread implementation of PHS recommendations for routine counseling and voluntary HIV testing of pregnant women. With efforts to maximally reduce perinatal HIV transmission and increase treatment of those infected, declines are likely to continue but may be affected by treatment failures and missed opportunities to prevent transmission.

Finally, in the area of influencing national policy, OPHS's Office on Women's Health led the development and publication of the HHS Blueprint for Action on Breast-feeding released by the Surgeon General. The Blueprint establishes a comprehensive policy for the nation to improve children's health by promoting the benefits of breast-feeding through the family and community, workplaces, and the healthcare system. Over 90,000 copies of the Blueprint have been distributed. In addition, collaborations have been formed with the American Association of