Healthy
People 2000 Review 1998-99. 246 pp.
(PHS) 99-1256. View/download PDF 2.9 MB
HHS Secretary Donna E.
Shalala today released the most recent data from the Healthy People 2000
initiative, showing continued improvement in the health of Americans
during the current decade.
The
report, "Healthy People 2000 Review, 1998-99," shows that the
nation is on track to reach, or has already reached, the targets for more
than half its health objectives.
"As
the century draws to a close, we can be proud that we have made
significant strides in improving the health of Americans. Healthy People
2000 lets us measure the overall progress we have achieved in preventing
disease and promoting health during this decade," said Secretary
Shalala. "These achievements are the result of a partnership effort,
with more than 350 national organizations in the Healthy People coalition.
We enter the new millennium as a team working together."
The
Healthy People initiative, first begun in 1979 and reformulated each
decade, provides an annual review of the progress of the health of
Americans during the latter part of the century. Healthy People 2000
defines the nation’s health agenda for the current decade through more
than 300 objectives in disease prevention and health promotion.
Overall,
15 percent of the objectives have met their targets, including many in
such diverse areas as nutrition, maternal and child health, heart disease,
and mental health. Targets to reduce outbreaks of waterborne diseases and
food borne infections and oral and breast cancer deaths were also met.
An
additional 44 percent of the objectives are progressing on schedule
towards the target, including child immunizations, breastfeeding, regular
dental visits, mammography screening, and consumption of five fruits and
vegetables a day. Some objectives, such as the reduction in infant
mortality, are only a fraction away from their targets.
"In
many ways, Americans of all ages and in every race and ethnic group have
better health today than a decade ago," said Dr. David Satcher,
Assistant Secretary for Health and Surgeon General. "Yet considerable
disparities remain. We should commit our nation to eliminate disparities
in the next decade, for through prevention we can improve the health of
all Americans." Dr. Satcher leads the initiative to establish goals
for the first decade of the next century, called Healthy People 2010,
which will be launched in January 2000.
However,
the report also shows that a fifth of the Healthy People objectives are
moving away from their targets. Some key objectives, such as reducing the
number of overweight individuals and increasing physical activity have
either moved in the wrong direction or improved little. A prime example of
this can be seen in the objectives related to diabetes where incidence,
prevalence, complications, and mortality are all on the rise.
To
complete the picture, 6 percent of the objectives showed mixed results, 3
percent had no change from the baseline figure, and 11 percent of the
objectives lack sufficient data to assess progress.
"Healthy
People 2000 Review, 1998-99," groups objectives by four life stages,
from infants/children, through older adults in a special chartbook.
Highlights show:
Infants
and Children: Infant mortality has declined steadily throughout the 1990s
and the death rate for children, 1-14 years of age, has dropped by 26
percent to surpass the objective. Substantial progress in reducing
drowning and motor vehicle crash deaths, and meeting the target for
fire-related deaths, contributed to this success. When comparing the
overall mortality rates for infants and children from the inception of the
initiative in 1979 to these new data, the improvement is dramatic, with a
drop of 50 percent for infants and 40 percent for children.
However,
hospitalization for asthma in children has been on the rise most of the
past decade and is a major cause of morbidity.
Adolescents
and young adults: For those 15-24 years of age, death rates have declined
substantially to meet this important year 2000 target of 85 deaths per
100,000. Since the inception of the Healthy People initiative 20 years ago
the mortality rate for adolescents and young adults has dropped 26
percent. Alcohol-related motor vehicle crash deaths and suicides are down,
helping to meet the objective. Students are now also less likely to engage
in such risky behaviors as fighting and weapon carrying. On the other
hand, after declining somewhat, heavy drinking among high school seniors
has increased recently and there has been little progress on reducing
heavy drinking among college students.
Adults:
The death rate for the 25-64 age group has declined steadily and is near
the year 2000 target. Since the beginning of the initiative in 1979, the
mortality rate has dropped 31 percent for this age group. Cancer death
rates are now below the year 2000 target due in great part to the drop in
breast cancer and colorectal cancer death rates as well as the slowing of
the rise in lung cancer death rates.
Older
Adults: Life expectancy rates are up, reflecting the continuing decline in
deaths from heart disease and stroke; the reduction in mortality since the
inception of the initiative is 6 percent. As Americans live longer,
however, more people over 70 years of age are having difficulty performing
critical functions, such as dressing, bathing or getting out of bed.
Although the decrease in the suicide rate for white males--the group at
greatest risk--has met the year 2000 target, rates for deaths resulting
from falls and motor vehicle crashes have increased over the last decade.
By
identifying the most significant opportunities to improve the health of
all Americans, the Healthy People process helps focus action on common
goals and enables diverse groups to combine their efforts. Currently, all
states and many localities use this framework to guide local health
policies and programs. The report was prepared by the National Center for
Health Statistics, Centers for Disease Control and Prevention. More
information on the results in each of these areas, data by states, and
copies of the progress review can be viewed or downloaded from the NCHS
Web site at www.cdc.gov/nchs.
For more information on the new initiative for the first decade of the new
century, Healthy People 2010, go to web.health.gov/healthypeople/.
NOTE: HHS press
releases are available on the World Wide Web at: www.hhs.gov