Healthy People 2010: Setting the Nation's Public Health Agenda

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This month marks the launch of Healthy People 2010,1 which will set the nation's public health agenda for the next decade. In this article, I describe Healthy People 2010 and discuss ways in which it can be used to link academic health centers to shared goals to improve the nation's health.
Today's medical students are learning to be doctors during an unprecedented time of change in our health care system. Their responsibilities in practice will differ from those of many of their teachers and mentors. In practicing medicine in the future, they will need to consider the patients before them as well as the community from which they have come. Healthy People 2010 provides an opportunity to affirm that responsibility. In outlining the blueprint for health in the next decade, Healthy People posits that the health of individuals and the health of communities are inextricably linked.
Healthy People 2010 is the third iteration of national health goals, first launched in 1979 with the publication of Healthy People: The Surgeon General's Report on Health Promotion and Disease Prevention. The goals for Healthy People 2010 were developed in a national consultative process that took place over a five-year period and included participation of all major medial and public health agencies, both public and private, in the country.
Over the last decade, the nation has made progress toward reaching many of the goals set forth in Healthy People 2000. Mortality has decreased in all age groups, including infant mortality. Deaths from coronary heart disease and cancer have also declined over the decade. Childhood immunization rates are at an all-time high, and breast and cervical cancer screening rates have increased. Despite these and many other achievements, not all goals for the year 2000 have been reached.
Cigarette smoking has increased among young people, and obesity has reached epidemic proportions. Furthermore, not all groups in the country have made equal progress. For example, African American men suffer from heart disease at a rate 25% higher than that of whites. Hispanics and American Indians suffer from diabetes at nearly two to three times the average rate. Vietnamese women living in the United States experience cervical cancer at five times the rate of white women.
To address this unfinished agenda, Healthy People 2010 provides a set of goals that give focus to the efforts of the many partners and institutions that contribute to improving the health of the nation, both inside and outside the government. Two overarching goals have been set for Healthy People 2010 in the next decade. The first is to increase the number of years of healthy life, a goal as related to quality of life as it is to quantity. The second is to eliminate (not reduce, but eliminate) disparities in health—disparities that are associated with race, ethnicity, and socioeconomic status, for example.
The scope and number of goals of Healthy People have grown over the three decades. With 28 chapters and more than 460 objectives it provides a comprehensive road map to improve the nation's health. The growth in the number of objectives is in large part due to the advances in the sciences of medicine and public health. New to this version of Healthy People is a set of ten leading health indicators, intended to serve as a barometer for gauging and forecasting our nation's health. Healthy People 2010 is also an impressive monitoring apparatus that brings together the national statistical information necessary to measure progress toward our goals. Academic health centers will be essential partners if we are to achieve these goals for the year 2010.
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