 Volume 14: Issue 4, 2000 |
HEALTHY
PEOPLE 2010: UNDERSTANDING AND IMPROVING HEALTH With a new century
and a new millennium comes a new set of objectives aimed at improving the
health of everyone in the United States
over the next 10
years. Healthy People 2010,
the Nation’s prevention agenda for the first decade of the 21st century,
was the featured attraction of “Partnerships for Health in the New
Millennium,” a national conference that took place in Washington, D.C.,
January 24-28. Sponsored by the U.S.
Department of Health and Human Services in conjunction with the Healthy People Consortium, Partnerships for Health
in the New Millennium was the first major prevention-related conference of
the new year. The conference marked
the official launch of Healthy People 2010 by Health and Human Services
Secretary Donna E. Shalala and Surgeon General David Satcher. Healthy
People 2010 is the third set of 10-year targets for health improvement in
the United States. Since 1979, Healthy
People has identified the most significant prevention issues in the United
States as a way to focus public and private efforts to address them.
Healthy People 2010’s predecessors set targets for 1990 and 2000. As noted by Secretary
Shalala, “Healthy People is a roadmap to better health that provides
diverse groups with the knowledge they need to work together to improve
the health of all Americans.” More than 4 years in
the making, Healthy People 2010 is based on the latest health-related
research and scientific evidence. It combines medical science and health
information to benefit the largest number of people in the United States. Two Broad Goals Healthy
People 2010 contains two broad goals. The first goal is to increase the years and
quality of healthy life. This goal focuses not
only on length of life, but also on the quality and health of those added
years. In other words, this goal will look at physical and mental health
as well as interactions in one’s social and physical environments. The 30-year increase in
life expectancy since 1900 is perhaps the greatest To meet this challenge,
Healthy People 2010 encourages individuals to gain the knowledge,
motivation, and opportunities needed to make informed decisions about
their health. It also encourages communities (at State and local levels)
to develop efforts that promote healthy behaviors, create healthy
environments, and increase access to high-quality health care. Healthy
People 2010 recognizes that individual and community health are virtually
inseparable, and it is critical that both individuals and communities
play a role if this goal is to be achieved. The second Healthy
People 2010 goal is to eliminate health disparities.
In addition to getting older, the population of the United States
is growing more diverse. Just 10 years ago, when Healthy People 2000 was
released, racial and ethnic minorities made up 24 percent of the
population. Projections indicate that by 2010, their proportion of the
population will increase to more than 33 percent. That proportion is
expected to continue increasing through the end of the decade and beyond. At the same time,
people from some racial and ethnic groups have not enjoyed the same health
status improvements as other Americans. Studies consistently show that some population groups have higher
rates of infant mortality, diabetes, heart disease, HIV/AIDS, and other
health problems. These
conditions translate into poorer general health and reduced life
expectancy. “In many ways,”
says Assistant Secretary for Health and Surgeon General David Satcher,
“Americans of all ages and in every race and ethnic group have better
health today than a decade ago, yet considerable disparities remain. We
should commit our Nation to eliminate disparities in the next decade.” Healthy People 2000
sought only to reduce these health disparities. To eliminate health
disparities, Healthy People 2010 recognizes that communities, States, and
national organizations will need to take a multidisciplinary approach that
involves improving health, education, housing, labor, justice,
transportation, agriculture, and the environment. Healthy People 2010 is
firmly dedicated to the principle that— regardless of age, gender, race,
ethnicity, income, education, geographic location, disability, or sexual
orientation—every person across the Nation deserves equal access to
high-quality health care. New
for 2010 The
two goals are supported by 467 objectives, grouped into 28 focus areas.
Healthy People 2000 had 226 objectives in 22 priority areas. The term
“priority area” was changed to focus area to correct the impression
that topics were listed in order of importance. Two chapters were
recast: Clinical Preventive Services is now Access to Quality Health Care,
and Data and Surveillance Systems is now part of Public Health
Infrastructure. Healthy People 2000’s Food and Drug Safety priority area
is now two separate focus areas: Medical Product Safety addresses the
safety of medical devices and the Nation’s blood supply as well as drugs
used to treat and prevent disease. Food Safety addresses safe
food-handling practices and food-borne infections. The priority area on
Diabetes and Chronic Disabling Diseases has been recast as separate focus
areas dedicated to Arthritis, Osteoporosis, and Chronic Back Conditions;
Chronic Kidney Disease; Diabetes; Disability and Secondary Conditions;
Respiratory Diseases; and Vision and Hearing. In addition to the
focus area, the health status of people with disabilities are included in
many objectives in other focus areas and will be monitored throughout the
decade. The focus areas on
chronic kidney disease and vision and hearing were added as a direct
result of public comment on the 1998 draft document. The Health
Communication focus area was added in recognition of the important role
communication plays in health promotion and disease prevention. Two
objectives in particular address the quality and Population
Group Data Table To
help reinforce the second goal of eliminating disparities, a standard data
table is used to display the status of population groups for all
population-based objectives. This table consists of a set of population
variables, presented in a standard order: Race and Ethnicity; Gender; and
Family Income Level or Education Level. Additional categories—geographic
location; health insurance status; disability status; and select
populations, such as specific age groups, school grade levels, or persons
with select medical conditions—are included when they apply to specific objectives. Target
Setting As
a rule, one target is set for all population groups to reach by the year
2010. This target supports the goal of eliminating health disparities. For
those measures contained in the HHS Initiative to Eliminate Racial and
Ethnic Disparities in Health, the targets are set at “better than the
best” population group. For objectives that in the short term can be
influenced by lifestyle choices, behaviors, and health services (in other
words, using known and existing interventions), the target also is set at
“better than the best” currently achieved by any population group. Monitoring Healthy People Objectives As
in Healthy People 2000, the latest available statistical information on
health status, behaviors, and policies forms the basis for the goals and
objectives in Healthy People 2010. Most of the 467 objectives contain
specific numerical targets. Data for the baselines
and to monitor progress in reaching these targets come from such
well-known sources as National Vital Statistics, the National Health Interview Survey,
the National Health and
Nutrition Examination Survey, and the Behavioral Risk Factor Surveillance
System. Also included are specialized sources such as the National College
Health Risk Behavior Survey, the Monitoring the Future Study, the Mental Health
Statistics Improvement Program, and the Sentinel Counties Study of Viral
Hepatitis. The nearly 190
individual data sources in Healthy People 2010 originate with the
Department of Health and Human Services and other Federal agencies as well
as private organizations. These data sources will supply the statistical
information needed to monitor progress in achieving each measurable
objective over the next 10 years. The “developmental”
objectives—or those that do not yet have national baselines—are
expected to have the data needed to monitor progress by 2005, in time for
the mid-decade review of Healthy People 2010. The National Center for
Health Statistics (NCHS), part of the Centers for Disease Control and
Prevention, is responsible for coordinating the data analysis and
reporting needed to measure progress in achieving the 2010 objectives. Leading Health Indicators To
monitor the overall health of the Nation over the next decade, an
Institute of Medicine committee and a Department of Health and Human
Services working group identified measures that could be used to track
progress over time. These measures are called “Leading Health
Indicators.” The 10 Leading Health
Indicators have each been matched with 1 to 3 objectives from Healthy
People 2010. These measurements reflect the behavioral and environmental
factors and community health interventions that together will provide a
snapshot of the Nation’s health status at regular intervals between now
and 2010. NCHS remains committed to monitoring and reporting periodically on the Leading Health Indicators at the national, Tribal, State, and local levels wherever possible. As with Healthy People 2000, the ability to extend beyond the public health community to reach opinion leaders and the general public will ultimately lead to success in achieving the goals and objectives of Healthy People 2010. Return to Prevention Report Index Go to Spotlight | Leading Health Indicators | How do I get involved |