FY 2022 Annual Performance Plan and Report - Goal 2 Objective 1

Fiscal Year 2022
Released June, 2021

Topics on this page: Goal 2. Objective 1 | Objective 2.1 Table of Related Performance Measures

Goal 2. Objective 1: Empower people to make informed choices for healthier living

Health promotion and wellness activities involve providing information and education to motivate individuals, families, and communities to adopt healthy behaviors, which ultimately can improve overall public health.  However, the lack of access to and understanding of health information can lead people to make uninformed decisions and engage in risky behavior.  The Department supports a series of programs and initiatives aimed at improving nutrition; increasing physical activity; reducing environmental hazards; increasing access to preventive services; and reducing the use of tobacco, alcohol, and illicit drugs and prescription drug abuse.  HHS achieves these outcomes through culturally competent and linguistically appropriate health education, services, and supports made possible through strategic partnerships.

In the previous administration, the Office of the Secretary led this objective.  The following divisions are responsible for implementing programs under this strategic objective: ACF, ACL, ATSDR, CDC, FDA, HRSA, IHS, NIH, OASH, OCR, OGA, and SAMHSA.  HHS has determined that performance toward this objective is progressing. The narrative below provides a brief summary of progress made and achievements or challenges, as well as plans to improve or maintain performance.

Objective 2.1 Table of Related Performance Measures

Reduce the annual adult per-capita combustible tobacco consumption in the United States (Lead Agency - CDC; Measure ID - 4.6.2a)

Measure FY 2015 FY 2016 FY 2017 FY 2018 FY 2019 FY 2020 FY 2021 FY 2022
Target N/A 1,145 1,128 967 903 838 817 755
Result 1,211 1,164 1,114 1,061 1,004 7/31/21 7/31/22 7/31/23
Status Actual Target Not Met but Improved Target Exceeded Target Not Met but Improved Target Not Met but Improved Pending Pending Pending

Although cigarette smoking remains the leading cause of tobacco-related disease, tobacco users are increasingly shifting consumption to other tobacco products and dual use with other combusted tobacco, which include cigars, cigarillos and little cigars, pipe tobacco, roll-your-own tobacco, and hookah.  This has resulted in a slowing of the decline in the consumption of all combustible tobacco, and indicates that the use of non-cigarette combustible products has become more common in recent years and that some smokers may be switching to other combustible tobacco products rather than quitting smoking cigarettes completely.  Per capita combustible tobacco product consumption continued to decline from 1,061 cigarette equivalents in FY 2018 to 1,004 cigarette equivalents in FY 2019, nearly reaching the FY 2019 target.

To address these challenges and continue improving performance, recipients of CDC's National Tobacco Control Program (NTCP) cooperative agreement will focus on statewide prevention efforts to support the achievement of the four NTCP goals:  1) Prevent initiation of commercial tobacco use among youth and young adults; 2) Eliminate exposure to secondhand smoke (SHS); 3) Promote quitting among adults and youth; and 4) Identify and eliminate tobacco-related disparities.  Achievement of these goals will reduce chronic disease morbidity, mortality, and disability related to commercial tobacco use and dependence and SHS exposure in the United States.  Additionally, in January 2020, in coordination with the Office of the Surgeon General, CDC's released Smoking Cessation: A Report of the Surgeon General – the 34th tobacco-related Surgeon General's report published since 1964.

The 2020 report is the first Surgeon General's Report to focus on cessation in over 30 years.  The 2020 report summarizes the latest science on individual, health system, and population-based interventions proven to help people quit smoking.  CDC developed a variety of communication products to promote the findings of the report to a variety of stakeholders, including consumers, health care professionals, and partners.  Moreover, the 2020 Tips from Former Smokers® (Tips®) aired a new round of hard-hitting ads which will run for 28 consecutive weeks.  CDC also continued the successful nationwide Tips® TV promotion offering free nicotine replacement therapy to eligible 1-800-QUIT-NOW callers.  Population-based strategies, including mass-reach public education campaigns like CDC's Tips® campaign, are a proven way to promote tobacco cessation treatments and increase utilization.  In FY 2021 and FY 2022, CDC will continue to monitor combustible tobacco consumption to inform its strategies on reducing tobacco-related disease.

Reduce the age-adjusted proportion of adults (age 20 years and older) who are obese (Lead Agency - CDC; Measure ID - 4.11.10a)11, 12

Measure FY 2015 FY 2016 FY 2017 FY 2018 FY 2019 FY 2020 FY 2021 FY 2022
Target N/A 33.2% N/A 33% N/A 32.3% N/A 32.3%
Result N/A 39.6% N/A 42.4% N/A 5/30/22 N/A 5/30/24
Status N/A Target Not Met N/A Target Not Met N/A Pending N/A Pending

In adults, National Health and Nutrition Examination Survey (NHANES) data show 42.4 percent of adults were obese in 2017-2018, which is above the target of 33 percent.  Some community factors that affect diet and physical activity include the affordability and availability of healthy food options, peer and social supports, marketing and promotion, and policies that determine whether a community is designed to support healthy food access and physical activity.

CDC will continue work to improve overall health and wellbeing of all people, including those most impacted by risk factors for obesity and other chronic disease across the lifespan.  This approach begins with preventing and managing obesity risk in children, which has the potential to impact adult obesity in the long term.  CDC focuses on increasing breastfeeding support; promoting the introduction and availability of healthy, affordable foods; and creating safe, easily accessible places where children can be physically active.  CDC also works with national, state, territorial, tribal, and community partners to increase the availability of healthy, affordable foods in worksite and community retail; create safe, easily accessible  places where people can be physically active in urban and rural communities; and ensure that health care settings help adults with obesity and other chronic diseases manage their conditions.

Adult obesity rates have been on the rise since 1999-2000.  The proportion of adults (aged 20 years and older) who have obesity increased from 30.5 percent in 1999-2000 to 42.4 percent in 2017-2018.  Disparities exist by race/ethnicity, age, sex, education, and income level.  Obesity is a complex health issue resulting from a combination of causes including individual and environmental factors.  Individual behaviors such as unhealthy diet and lack of physical activity contribute to obesity, and environmental factors can make it easier or harder to make these behaviors changes.  Many states and communities do not have supports in place that encourage healthy eating and active living.  These supports require societal will to establish healthier standards so all adults have access to healthy foods and opportunities to be physically active where they live, learn, work, and play.

In FY 2021 and FY 2022 CDC will continue to support recipients in implementing evidence-based strategies to help increase healthy eating and active living through partnerships with states, territories, tribes, and communities throughout the United States.

11 Data for this measure are collected and reported every other year.

12 There was a delay in publication of CDC's NHANES data, and FY 2018 results will not be available until spring 2020. CDC anticipates that subsequent NHANES data may also be delayed and has adjusted the reporting dates.

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