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 6-1), which displays the percent of targeted change achieved for objectives and subobjectives with sufficient data to assess progress. Overall, data at the midpoint of the decade reflected progress toward the inclusion of people with disabilities in public health efforts and everyday aspects of life.

Objectives that met or exceeded their targets. The objective for increasing the number of States (14 in 1999) with ongoing disability surveillance (6-13a) met its target of 50 States and the District of Columbia in 2004. Guam, Puerto Rico, and the Virgin Islands also have ongoing disability surveillance. This objective was achieved by adding questions that identify people with disabilities directly into the core questions of the BRFSS.

Objectives that moved toward their targets. Five objectives and subobjectives moved toward their 2010 targets: standard identification of people with disabilities in data sets (6-1), unhappy feelings and depression among children with disabilities (6-2), congregate care of adults with disabilities (6-7a), inclusion of children and youth with disabilities in regular education programs (6-9), and State-based health promotion programs for people with disabilities (6-13c).

Standard identification of people with disabilities (6-1) achieved 33 percent of the targeted change. At the baseline year of 1999, none of the major population-based Healthy People 2010 surveillance instruments had a standard set of questions to identify people with disabilities.² By 2004, however, some of the surveillance instruments included the questions representing movement toward the target of 100 percent.

The proportion of children with disabilities who reported being sad, unhappy, or depressed (6-2) decreased from 31 percent in 1997 to 29 percent in 2003, achieving 14 percent of the targeted change. However, this change was not statistically significant. The target of 17 percent is based on the proportion of children without disabilities who reported being sad, unhappy, or depressed.

The number of adults aged 22 years and older with disabilities living in congregate care settings (6-7a) achieved 45 percent of the targeted change. Specifically, the number of adults in congregate care³ decreased from 93,362 in 1997 to 72,474 in 2003, working toward the target of 46,681 persons.

This target is based on a 50 percent reduction from the baseline. Absolute numbers of adults in congregate care have been steadily declining since the 1980s due to increased availability and choice of community-based services for persons with disabilities.⁴

The proportion of children with disabilities who spend at least 80 percent of their time in regular education programs (6-9) increased from 45 percent in 1995–96 to 50 percent in 2003–04, achieving 33 percent of the targeted change. This increase may be due in part to the use of advanced technology in classrooms, teacher training, and specialized staffing.^{5, 6}

The number of States with health promotion programs for persons with disabilities (6-13c) increased from 14 in 1999 to 17 in 2004, achieving 8 percent of the targeted change. The target is for all 50 States and the District of Columbia to have health promotion programs for persons with disabilities. An example of health promotion programs is Living Well With a Disability.⁷

Objectives that demonstrated no change. Data for surveillance for caregivers (6-13e) and health promotion programs for caregivers (6-13g) were unavailable in 2003. The target for each of these subobjectives is for programs to exist in all 50 States and the District of Columbia. Specifically, the number of States with surveillance for caregivers (6-13e) increased to 23 States in 2000, fell to 14 States in 2001, increased again to 24 States in 2002, and fell back to zero States in 2003 due to the lack of questions in the BRFSS core identifying caregiving.⁸ The number of States with health promotion programs for caregivers (6-13g) was zero in both 1999 and 2004, with data unavailable in between.

Objectives that moved away from their targets. Two objectives moved away from their targets: feelings and depression interfering with activities among adults with disabilities (6-3) and employment parity for adults with disabilities (6-8). The target for both of these objectives is to achieve parity with adults without disabilities.

The proportion of adults with disabilities whose negative feelings interfere with activities (6-3) increased from 28 percent in 1997 to 32 percent in 2003, moving away from the target of 7 percent.

The proportion of adults with disabilities who were employed (6-8) decreased from 43 percent in 1997 to 41 percent in 2003. This data shift represents a move away from the target of 80 percent. Although employment rates for adults with and without disabilities are in decline, people with disabilities were not recovering from the 2001 recession as quickly as those without disabilities.⁹ One reason might be that when individuals with disabilities lose their jobs in a recession, they enter the Supplemental Security Income program rather than the time-limited unemployment insurance program and are less likely to reenter employment.⁹

Objectives that could not be assessed. While single data points were available at the midcourse for several objectives and subobjectives, progress could not be assessed because two data points are needed to assess a trend.

The proportion of adults with disabilities who participate in social activities (6-4) was 61 percent in the 2001 baseline year. The target is 79 percent.

Some baseline data on quality of life are available for people with disabilities. The proportion of adults with disabilities reporting sufficient emotional support (6-5) was 71 percent in 2001, the baseline year. The target is 84 percent to achieve parity with adults without disabilities.

Eighty percent of adults with disabilities reported satisfaction with life (6-6) in 2001, the baseline year. The target for this objective is 96 percent to achieve parity with adults without disabilities.

The number of persons aged 21 years and under with disabilities in congregate care (6-7b) was 24,300 in 1997, the baseline year. The target is zero, consistent with permanency planning.¹⁰

The objective for accessibility of health and wellness programs (6-10) became measurable. In 2002, 48 percent of persons aged 18 and older with disabilities reported having access to health and wellness programs. The target is 63 percent.

The objective for assistive devices and technology (6-11) also became measurable in 2002 when 10 percent of persons aged 18 and older with disabilities reported not having needed devices or technology. The 2010 target is 7 percent.

Baseline data were established for the objective regarding environmental barriers (6-12), and this objective became measurable. In 2002, among adults with disabilities, 11 percent reported barriers in the community (6-12d), 10 percent reported barriers in the home (6-12a), 7.7 percent reported barriers in the workplace (6-12c), and 6.1 percent reported barriers in schools (6-12b).

Surveillance and health promotion programs (6-13) retained developmental subobjectives for Tribes pertaining to surveillance for people with disabilities (6-13b), health promotion programs for people with disabilities (6-13d), surveillance for caregivers (6-13f), and health promotion programs for caregivers (6-13h).

In 2002, baseline data for three objectives (accessibility of health and wellness programs [6-10], assistive devices and technology [6-11], and environmental barriers affecting participation in activities [6-12]) became available through NHIS. Progress will be measured after more data points are collected.

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