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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
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.
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 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 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. 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. 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. 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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