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 1-1), which displays the percent of targeted change achieved for objectives and subobjectives with sufficient data to assess progress.

Objectives that met or exceeded their targets. The objective for a single toll-free number for poison control centers (1-12) met its target in 2001. The Poison Control Center Enhancement and Awareness Act was enacted in 2000 to provide a source of supplemental support to poison control centers (PCCs). The Health Resources and Services Administration (HRSA), the Centers for Disease Control and Prevention (CDC), and the American Association of Poison Control Centers have worked to maintain a national toll-free number so that access to the information is ensured.

The targets for representation of the Asian or Pacific Islander population in all health professions (1-8b), medicine (1-8j), dentistry (1-8n), and pharmacy (1-8r) were exceeded at the 1996–97 baseline and continued to improve beyond the baseline. 

Objectives that moved toward their targets. Many objectives and subobjectives progressed toward their targets. Data indicated forward progress for persons with sources of ongoing care (1-4); persons with a usual primary care provider (1-5); difficulties or delays in obtaining needed health care (1-6); representation in health professions of underrepresented racial and ethnic groups (1-8), with the exception of black non-Hispanic representation in medicine (1-8k) and representation in dentistry by the American Indian or Alaska Native population (1-8m), the black non-Hispanic population (1-8o), and the Hispanic population (1-8p); hospitalization for pediatric asthma (1-9a); and pediatric guidelines for online medical direction and emergency and critical care (1-14a and b).

HHS agencies support programs to measure and improve the quality of care for persons living with asthma and to prevent hospitalization for uncontrolled asthma. Examples include the Agency for Healthcare Research and Quality's annual National Healthcare Quality Report³ and National Healthcare Disparities Report ⁴; HRSA's Health Disparities Asthma Collaborative,⁵ which uses the Chronic Care Model⁶ to improve the length and quality of life for patients with chronic diseases, including asthma, and to satisfy patient and caregiver needs; and CDC's Steps to a HealthierUS ⁷ community grant program to prevent and improve the quality of care for chronic diseases, including asthma.

Progress toward the targets for persons with sources of ongoing care (1-4), persons with a usual primary care provider (1-5), and difficulties or delays in obtaining needed health care (1-6) may in part be attributed to the expansion of HRSA's community health center program across the country. The program now serves approximately 14 million people.⁸

Objectives that demonstrated no change. The overall percentage of persons with health insurance (1-1) remained similar to the proportion of persons with health insurance in 1997 with minor fluctuations.

The proportion of the black non-Hispanic population represented in medicine (1-8k) did not change, nor did the percentage of the American Indian or Alaska Native population or the Hispanic population represented in dentistry (1-8m and 1-8p, respectively). Through the Indian Health Service (IHS) programs, HHS strives to increase the proportion of the American Indian or Alaska Native population represented in health professions. The IHS Division of Health Professions Support Service Center houses the Loan Repayment Program and the Scholarship Program.⁹ These programs function collaboratively to provide repayment of health profession education loans for a 2-year service obligation and scholarships to American Indian or Alaska Native health professionals. In addition, HRSA programs are geared toward diversifying the health professions workforce, such as the Centers of Excellence, Scholarships for Disadvantaged Students, and the Health Careers Opportunity Program.¹⁰

Objectives that moved away from their targets. For racial and ethnic representation in health professions (1-8), the black non-Hispanic population moved away from the target for dentistry (1-8o). The percentage of black non-Hispanic persons graduating from dental schools fell from 5.1 percent in 1996–97 to 4.0 percent in 2001–02. However, the percentage of black non-Hispanic persons graduating from schools of nursing (1-8g) and pharmacy (1-8s) increased, achieving 61 percent and 26 percent of the targeted change for these subobjectives, respectively.

HHS agencies continue to support programs that increase the numbers of underrepresented racial and ethnic populations entering the health profession fields so that the health workforce more accurately reflects the populations served. Grant programs fund disadvantaged individuals to compete successfully for health profession training programs.¹¹ The agencies actively seek to inform youth about health profession careers and the critical decision points in a person's life when career choices are made.

Subobjectives 1-9b and 1-9c moved away from their targets, with increases seen in hospitalizations for uncontrolled diabetes in persons aged 18 to 64 years and for immunization-preventable pneumonia or influenza in persons aged 65 years and older. Self-reported reasons for not receiving the influenza vaccination included lack of awareness that the influenza vaccination is needed, concerns that vaccination might cause side effects, vaccine shortages, or unavailability. Further efforts are needed to educate older persons regarding the benefits of the influenza vaccination and to address concerns of vaccine safety.¹²

The HHS-sponsored Task Force on Community Preventive Services recommends these effective interventions to increase the use of recommended immunizations: reminder systems for health care providers, standing orders to allow health professionals who are not physicians (for example, nurses and pharmacists) to administer immunizations without direct physician involvement, consumer reminder and recall systems, reduction of out-of-pocket costs, expanded access to immunizations in health care settings, and provider assessment plus feedback to improve efficiency in administering recommended immunizations.¹³

Objective 1-16 moved away from its target with an increase in pressure ulcers in nursing home residents. Functioning (walking, dressing, eating, and bathing) of nursing home residents decreased between 1977 and 1999. In particular, the proportion of residents able to walk independently decreased from 33 percent to 21 percent.¹⁴ Poorer functioning at older ages may result in increases in the percentage of nursing home residents with pressure ulcers.

Objectives that could not be assessed. The following objectives had only baseline data and could not be assessed: counseling about health behaviors (1-3a through d, f, and h), delay or difficulty in getting emergency care (1-10), rapid prehospital emergency care (1-11), trauma systems (1-13), and long-term care services (1-15). Potential data sources were identified for counseling for sexually transmitted diseases (1-3g) and core competencies in health profession training (1-7a through h).

The Emergency Medical Treatment and Active Labor Act, enacted in 1986, ensures universal access to emergency care without regard to health care insurance coverage.¹⁵ Still, barriers exist to accessing emergency care. The number of emergency departments (EDs) declined 12.3 percent over the past 10 years, but the number of annual visits increased 24 percent to 114 million.¹⁶

With limited resources, EDs are experiencing overcrowding, ambulance diversion, boarding of admitted patients in the department, increased waiting times, and on-call crises. The overcrowding has depleted the surge capacity needed to deal with a natural disaster or a terrorism event.¹⁷

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