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Introduction

Healthy People 2010

Healthy People 2010 provides a vision for achieving improved health for all Americans. Developed through a national process, Healthy People 2010 identifies a set of 10-year health objectives to achieve during the first decade of the 21st century. It has two overarching goals—to increase quality and years of healthy life and to eliminate health disparities. These goals are supported by specific objectives in 28 focus areas.

Healthy People 2010 builds on initiatives pursued over the past few decades. Initiated in 1979 with the publication of Healthy People: The Surgeon General's Report on Health Promotion and Disease Prevention, established in 1980 with the publication of Healthy People: Objectives for the Nation, and followed in 1990 by the publication of Healthy People 2000: National Health Promotion and Disease Prevention Objectives, Healthy People 2010 continues a management-by-objective planning process.

Through Healthy People 2010, the U.S. Department of Health and Human Services (HHS) sets out objectives addressing improvements in health status, risk reduction, public and professional awareness of prevention, delivery of health services, protective measures, surveillance, and evaluation, expressed in terms of measurable targets to be achieved by the year 2010. Like its predecessors, Healthy People 2010 was developed through a broad consultative process, makes use of the best scientific knowledge available, and is designed to measure progress over time.

Full achievement of the goals and objectives of Healthy People 2010 depends on a health system reaching all Americans and integrating personal health care and population-based public health. The vision of Healthy People in healthy communities involves broad-based prevention efforts and moves beyond what happens in physicians' offices, clinics, and hospitals—beyond the traditional medical care system—to the neighborhoods, schools, workplaces, and families in which people live their daily lives. These are the environments in which a large portion of prevention occurs.

The 28 focus areas of Healthy People 2010 were developed by the lead Federal agencies with the most relevant scientific expertise. The development process was informed by the Healthy People Consortium—an alliance of more than 350 national membership organizations and 250 State health, mental health, substance abuse, and environmental agencies. In addition, through a series of regional and national meetings and an interactive website, more than 11,000 public comments on the draft objectives were received. The Secretary's Council on National Health Promotion and Disease Prevention Objectives for 2010 also provided leadership and advice in the development of national health objectives. More information is available at www.healthypeople.gov.

Healthy People 2010 Midcourse Review

Midway through the decade, the midcourse review assessed the status of the national objectives. The midcourse review is the process through which HHS, Federal agencies, and other experts across the Nation assessed the data trends during the first half of the decade, considered new science and available data, and made changes to ensure that Healthy People 2010 remains current, accurate, and relevant, while concurrently assessing emerging public health priorities. The midcourse review uses data made available by January 1, 2005. Public comments on the changes at the midcourse to the Healthy People 2010 objectives and subobjectives were solicited in August and September 2005.

Changes to Healthy People 2010 Objectives at the Midcourse Review

The changes to the Healthy People 2010 objectives and subobjectives included establishing baselines and targets for developmental objectives, changing the wording of objectives and subobjectives, deleting objectives and subobjectives, adding new subobjectives, and revising baselines and targets. At the beginning of the decade, baseline data were not available for a number of Healthy People 2010 objectives. These developmental objectives provided a vision for a desired outcome or health status. As stated in Healthy People 2010: "Most developmental objectives have a potential data source with a reasonable expectation of data points by the year 2004 to facilitate setting 2010 targets in the mid-decade review." Many developmental objectives and subobjectives (that is, objectives and subobjectives without baselines) became measurable at the midcourse based on the identification of baseline data since the beginning of the decade. Where the objective or subobjective became measurable, the "developmental" designation was removed. Developmental objectives and subobjectives with no national baseline data source were deleted as part of the midcourse review assessment. Those developmental objectives and subobjectives that remained developmental through the midcourse review and were not deleted have had a data source identified for them, with baseline data anticipated before the end of the decade. Other objectives and subobjectives were revised to reflect the most current science, more accurately reflect the data, or provide a more logical or understandable presentation.

Measuring Healthy People 2010 Progress Throughout the Decade

Progress Reviews
In addition to the midcourse review, progress reviews on the individual focus areas are conducted, 1 each month, until the full cycle of 28 is completed. Two cycles of these reviews are held during the decade. The progress reviews are formal meetings, chaired by the Assistant Secretary for Health, where the National Center for Health Statistics (NCHS) within HHS provides data updates for the focus area under review, and Federal lead agencies for the focus area report on their progress and initiatives. More information is available at www.healthypeople.gov/data/progrvw.

DATA2010
A critical part of Healthy People 2010 is measuring progress toward the targets for the year 2010. The compilation and management of current health data sources are central to assessing and implementing the national disease prevention and health promotion goals and objectives. DATA2010, developed by the Health Promotion Statistics Branch at NCHS, is an interactive database system and contains the most recent monitoring data for tracking Healthy People 2010. Data are included for all the measurable objectives and subobjectives. DATA2010 contains primarily national data. State-based data are provided when available. The data on which the midcourse review is based are available on DATA2010. More information is available at http://wonder.cdc.gov/data2010.

Initiatives Related to Healthy People 2010

HealthierUS
HealthierUS and Healthy People 2010 share the overarching goal of helping people live longer and healthier lives. HealthierUS aims to achieve this goal through four basic components called pillars. The pillars are "physical fitness," "nutrition," "prevention," and "make healthy choices." Healthy People 2010 directly addresses physical fitness and nutrition in Physical Activity and Fitness (Focus Area 22) and in Nutrition and Overweight (Focus Area 19), respectively. While Healthy People 2010 broadly addresses the HealthierUS prevention pillar, it is explicitly addressed by a number of objectives within the Healthy People 2010 focus areas that highlight preventive screenings, such as those identified in Cancer (Focus Area 3). The make healthy choices pillar is also addressed in several Healthy People 2010 focus areas, including Tobacco Use (Focus Area 27), Injury and Violence Prevention (Focus Area 15), and Substance Abuse (Focus Area 26). More information is available at www.healthierus.gov.

Steps to a HealthierUS
Steps to a HealthierUS supports evidence-based community programs and interventions focused on reducing the burden of chronic diseases, including diabetes, obesity, and asthma, and related risk behaviors throughout the Nation. Like Healthy People 2010, this initiative aims to help people live longer and healthier lives. It also links to Healthy People 2010 directly through DATA2010 by explicitly using Healthy People objectives to assess progress. Programs under Steps to a HealthierUS work together to guide States and communities throughout the Nation toward improving health status. More information is available at www.healthierus.gov/steps.

Secretary's Top Priorities
HHS Secretary Mike Leavitt's 500-Day Plan and Priority Activities are management tools for HHS on areas of primary focus. One of the areas is prevention. The prevention priority recognizes that the risk of many diseases and health conditions is reduced through preventive actions and that a culture of wellness deters or diminishes debilitating and costly health events. The prevention priority will, therefore, build on HHS prevention policy and programs that are based on the best available evidence on how to prevent or mitigate chronic disease through promotion of healthy lifestyle choices, medical screenings, and avoidance of risky behaviors. Healthy People 2010 objectives and subobjectives can serve as a means of measuring progress in achieving the Secretary's prevention priority. The 500-Day Plan, Priority Activities, and 250-Day Update are located at www.hhs.gov/secretaryspage.html.

Guide to Clinical Preventive Services
The Guide to Clinical Preventive Services includes U.S. Preventive Services Task Force (USPSTF) recommendations on screening, counseling, and preventive medication topics, as well as clinical considerations for each topic. Sponsored since 1998 by the Agency for Healthcare Research and Quality, the USPSTF is an independent panel of experts in primary care and prevention that systematically reviews the evidence of effectiveness and develops recommendations for clinical preventive services.  The task force rigorously evaluates clinical research to assess the merits of preventive measures. The clinical categories are cancer; heart and vascular disease; injury and violence; infectious diseases; mental health conditions and substance abuse; metabolic, nutrition, and endocrine conditions; musculoskeletal conditions; obstetrics and gynecologic conditions; pediatric disorders; and vision and hearing disorders. More information is available at www.ahrq.gov/clinic/cps3dix.htm.

Guide to Community Preventive Services
The Guide to Community Preventive Services serves as a filter for scientific literature on specific health problems that can have a large-scale impact on groups of people who share a common community setting. This guide summarizes what is known about the effectiveness, economic efficiency, and feasibility of interventions to promote community health and prevent disease. The Task Force on Community Preventive Services, an independent decisionmaking body convened by HHS, makes recommendations for the use of various interventions based on the evidence gathered in rigorous and systematic scientific reviews of published studies conducted by review teams for the guide. The findings from the reviews are published in peer-reviewed journals and also are made available online. The task force has published over 100 findings across 16 topic areas, including tobacco use, physical activity, cancer, oral health, diabetes, motor vehicle occupant injury, vaccine-preventable diseases, prevention of injuries due to violence, and social environment. More information is available at www.thecommunityguide.org.

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