Progress Toward Healthy People 2010 Targets

The following discussion highlights objectives that met or exceeded their 2010 targets; moved toward the targets, demonstrated no change, or moved away from the targets; and those that lacked data to assess progress. Progress is illustrated in the Progress Quotient bar chart (see Figure 8-1), which displays the percent of targeted change achieved for objectives and subobjectives with sufficient data to assess progress.

Tracking data were available for harmful air pollutants (8-1a through g), alternate modes of transportation (8-2a, b, and c), cleaner alternative fuels (8-3), safe drinking water (8-5), waterborne disease outbreaks (8-6), elevated blood lead levels in children (8-11), pesticide exposures causing health care visits (8-13), pre-1950s homes tested for lead-based paint (8-22), substandard housing units (8-23), global deaths from poor sanitation, water, or hygiene (8-29), and wastewater service provided in the U.S.-Mexico border region (8-30a, b, e through h, k, and l).

Objectives that met or exceeded their targets. Nine objectives and subobjectives either met or exceeded their targets: harmful air pollutants (8-1d and f), global burden of disease (8-29), and water quality in the U.S.-Mexico border region (8-30a, e, f, g, k, and l).

Within reduction of persons exposed to harmful air pollutants (8-1), for both nitrogen dioxide (8-1d) and lead exposures (8-1f), targets were met for reducing exposed populations. Global deaths from poor sanitation (8-29) exceeded the target, achieving 161 percent of its targeted change.

Multiple subobjectives concerning water quality in the U.S.-Mexico border region (8-30) also met or exceeded their targeted changes. Specifically, the following regions exceeded targeted changes for wastewater service provided and received: Ciudad Acuna (8-30a and g), Piedras Negras (8-30e and k), and Reynosa (8-30f and l). These changes have been due, in part, to the U.S.-Mexico Border Environmental Program: Border 2012 Guiding Principles.^{6, 7} The principles of this collaboration among Federal, State, and local governments in the United States and Mexico include adopting a bottom-up approach for setting priorities and making decisions through partnerships with State, local, and U.S. Tribal governments; addressing disproportionate environmental impacts in border communities; improving stakeholder participation and ensuring broad-based representation from the environmental, public health, and other relevant sectors; and achieving concrete, measurable results while maintaining a long-term vision.

Objectives that moved toward their targets. All subobjectives aimed at reducing populations exposed to harmful air pollutants (8-1) moved toward or exceeded their targets. Within alternative modes of transportation, increasing the number of trips made by walking (8-2b) achieved 59 percent of the targeted change. The use of cleaner alternative fuels (8-3) also moved toward its target, achieving 8 percent of the targeted change. The proportion of the population served by community water systems meeting EPA standards (8-5) increased from 84 percent to 90 percent, achieving 55 percent of its targeted change by 2003. Notably, 90 percent of the U.S. population is served by such water systems. Within the toxics and waste section, reductions in the proportion of children with elevated blood lead levels (8-11) and in pesticide exposures causing health care visits (8-13) made progress toward their targets. Finally, for the healthy homes and communities section, the proportion of the population living in pre-1950 housing that has been tested for lead (8-22) increased, while the proportion of substandard housing units that are occupied (8-23) declined; both objectives moved toward their targets.

Since 1993, the U.S. Department of Housing and Urban Development (HUD) has supported over 200 local and State jurisdictions across the country for control of lead-based paint hazards in privately owned, low-income owner-occupied, and rental housing where young children reside or are expected to reside.⁸ In addition, through CDC, HHS supports nearly 60 State, county, or city health department-based childhood lead poisoning screening and prevention programs. These initiatives identify and control lead paint hazards, identify and care for children with elevated blood lead levels, and institute and maintain proper surveillance of blood levels in children.

Objectives that demonstrated no change. Between 1997 and 2002, the wastewater subobjectives for Matamoros (8-30b and h) remained static. With the active participation of the 10 border States and U.S. Tribal governments, EPA, Mexico's Secretariat of Environment and Natural Resources, Mexico's Secretariat of Health, HHS, and other Federal agencies, new water and wastewater treatment projects have been proposed and will be implemented for these areas. The challenges of this region, however, are abundant. Over the past 20 years, the population in the border region has grown rapidly, to more than 11.8 million people.⁹ This figure is expected to reach 19.4 million by 2020.⁹ Rapid population growth⁹ in urban areas has resulted in unplanned development, greater demand for land and energy, increased traffic congestion, increased waste generation, overburdened or unavailable waste treatment and disposal facilities, and more frequent chemical emergencies. Residents in rural areas suffer from exposure to airborne dust, pesticide use, and inadequate water supply and waste treatment facilities. Border residents also suffer disproportionately from many environmental health problems, including waterborne diseases and respiratory problems.¹⁰

Objectives that moved away from their targets. Although some progress for alternative modes of transportation was noted for walking (8-2b), both percentage of trips made by bicycling (8-2a) and mass transit (8-2c) appeared to move away from their targets; however, this movement away from the targets for subobjectives 8-2a and c was not statistically significant. Between 1995 and 2001, the percentage of trips made by bicycle declined from 0.9 percent to 0.8 percent, while the percentage of trips made by transit declined from 1.8 to 1.6 percent. Also moving away from the target was waterborne disease outbreaks related to community water systems (8-6); however, monitoring of this objective is limited to outbreaks voluntarily reported by State health officials to CDC.

Objectives that could not be assessed. Several objectives and subobjectives could not be assessed for progress at the midcourse review. Data were not available to measure progress for persons who telecommute (8-2d), airborne toxins (8-4), water conservation (8-7), surface water health risks (8-8a and b), beach closings (8-9), fish contamination (8-10a and b), risks posed by hazardous sites (8-12a through d), toxic pollutants (8-14a and b), recycled municipal solid waste (8-15), indoor allergens (8-16a, b, and c), office building air quality (8-17), homes tested for radon (8-18), radon-resistant new home construction (8-19), school policies to protect against environmental hazards (8-20), disaster preparedness plans and protocols (8-21), exposure to pesticides (8-24b, c, and d), exposure to heavy metals and selected environmental chemicals (8-25a through s) information systems used for environmental health (8-26), monitoring environmentally related diseases (8-27a through k and o), and water quality in the U.S.–Mexico border region (8-30c, d, i, and j). Data are anticipated to measure progress for these objectives by the end of the decade.

New data sources were identified and baselines established for subojective 8-2d and objectives 8-8, 8-9, 8-10, 8-20, 8-21, 8-25, and 8-26. Additional data are anticipated for these objectives and this subobjective to assess progress by the end of the decade. The exposure to heavy metals and selected environmental chemicals (8-25a, d, f, h through l, and n) subobjectives did not have baseline data and remained developmental.

One objective—local agencies using surveillance data for vector control (8-28)—and one subobjective—exposure to pesticides (8-24a)—were deleted at the midcourse review because they lacked data sources. Three subobjectives monitoring environmentally related diseases (8-27l, m, and n) were deleted because they are monitored by the cancer objectives in Focus Area 3.

Tracking data are needed for the global environmental health subobjectives of drinking water and wastewater quality in Mexicali and Nogales, Sonora (8-30c, d, i, and j, respectively). The Border 2012 Program ¹¹ mandates that indicators be developed and used to measure real and meaningful results. To ensure this target is met and to improve overall capacity to respond to environmental and health problems at the border, the Border Indicators Task Force (BITF)¹¹ was officially constituted in 2003. BITF is concentrating its activities on preparing a strategy for indicator development to provide a foundation for the identification, development, and use of a binational set of indicators for the Border 2012 Program.

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