Health Objectives for the Nation
Healthy People 2000: National Health Promotion and Disease
Prevention Objectives for the Year 2000
On September 6, 1990, the U.S. Department of Health and Human
Services released the report Healthy People 2000, the national
public health goals and objectives for the 1990s (1). Healthy
People 2000 outlines three broad goals for public health over the
next 10 years: 1) to increase the span of healthy life, 2) to
reduce disparities in health status among different populations,
and 3) to provide access to preventive health-care services for
all persons. To help meet these goals, 298 specific objectives
have been identified in 22 priority areas (Table 1, page 695).
Healthy People 2000 succeeds both the 1979 report Healthy People:
The Surgeon General's Report on Health Promotion and Disease
Prevention (2) and the 1990 health objectives published in
Promoting Health/Preventing Disease: Objectives for the Nation in
1980 (3).* This report summarizes the major goals and priority
areas of Healthy People 2000.
At least two themes distinguish the year 2000 objectives from
the 1990 objectives. First, greater emphasis is placed on quality
of life. This emphasis is evident through the parallel targets of
preventing morbidity and disability and 2) preserving
functional capacity. Second, the year 2000 health objectives
place greater emphasis on targeting high-risk groups. Separate
targets have been established to improve the risk and health
profile of population groups (e.g., minorities, persons with low
incomes, and persons in certain age groups) who have a
disproportionate share of illness, injury, disability, and
premature death.Development Process
The year 2000 objectives represent a collaborative effort of
the Institute of Medicine of the National Academy of Sciences,
more than 300 national organizations, state and territorial
health departments, and the Public Health Service. In 1987 and
1988, 25 public hearings were held to solicit public and
professional testimony before the drafting of the objectives (6).
Criteria for objectives were that they 1) address issues of
highest priority, 2) target improvements in health status, risk
reduction, prevention services, and health protection, 3) be
quantifiable and measurable, and 4) be scientifically based and
attainable. The objectives were also to address disparities in
rates of morbidity and mortality among different populations.
In early 1989, a draft of the objectives was sent to panels of
reviewers for comment and to ensure that the needs of special
populations were being addressed. In September 1989, 13,000
copies of the full set of draft objectives were circulated for
public and professional review (7).Priority Areas
Of the 22 priority areas, 21 are grouped into three broad
categories: health promotion, health protection, and preventive
services. The remaining priority area addresses surveillance and
data systems, including improved data collection at every level
to ensure accurate monitoring of progress toward each of the
objectives.
Health Promotion. Although health promotion strategies target
risk behaviors, objectives in these priority areas also address
environmental factors that influence personal choices. Priorities
include physical activity and fitness, nutrition, tobacco,
alcohol and other drugs, family planning, mental health and
mental disorders, violent and abusive behavior, and educational
and community-based programs. For example, objectives in these
areas target substantial increases in the level of physical
activity throughout the population, worksite health promotion
programs, and school health education in kindergarten through
12th grade.
Health Protection. Health protection objectives primarily
relate to environmental or regulatory measures that confer
broad-based protection. Priority areas include unintentional
injuries, occupational safety and health, environmental health,
food and drug safety, and oral health. Objectives in these areas
include increases in the use of automobile safety restraints and
radon testing of homes and decreases in Salmonella outbreaks and
dental caries in children.
Preventive Services. Priority areas for preventive services
are maternal and infant health, heart disease and stroke, cancer,
diabetes and chronic disabling conditions, human immunodeficiency
virus infection, sexually transmitted diseases, immunization and
infectious diseases, and clinical preventive services. These
areas target a range of interventions (e.g., counseling,
screening, immunization, and chemoprophylaxis), as well as access
and delivery considerations.
Reported by: Office of Disease Prevention and Health Promotion,
Office of the Assistant Secretary for Health, US Dept of Health
and Human Svcs.
Editorial Note
Editorial Note: Some states (e.g., Oregon and Wisconsin (8,9))
have developed or are developing their own year 2000 health
objectives. To assist states and communities, a companion report,
Healthy Communities 2000: Model Standards, is being prepared for
release in early 1991. This report is being drafted by the
American Public Health Association, the Association of State and
Territorial Health Officials, the National Association of County
Health Officials, the United States Conference of Local Health
Officers, and CDC.
Copies of Healthy People 2000 (stock number 017-001-00474-0)
and/or the summary report (stock number 017-001-00473-1) are
available from the Superintendent of Documents, Government
Printing Office, Washington, DC 20402-9235. The full report is
$31; the summary report is $9.
References
Public Health Service. Healthy people 2000: national health
promotion and disease prevention objectives. Washington, DC: US
Department of Health and Human Services, Public Health Service,
1990; DHHS publication no. (PHS)90-50212.
Public Health Service. Healthy people: the Surgeon General's
report on health promotion and disease prevention. Washington,
DC: US Department of Health, Education, and Welfare, Public
Health Service, 1979; DHEW publication no. (PHS)79-55071.
Public Health Service. Promoting health/preventing disease:
objectives for the nation. Washington, DC: US Department of
Health and Human Services, Public Health Service, 1980.
Office of Disease Prevention and Health Promotion. The 1990
health objectives for the nation: a midcourse review. Washington,
DC: US Department of Health and Human Services, Public Health
Service, 1986.
NCHS. Health, United States, 1989. Hyattsville, Maryland: US
Department of Health and Human Services, Public Health Service,
CDC, 1990; DHHS publication no. (PHS)90-1232.
CDC. Year 2000 national health objectives. MMWR
1989;38:629-33.
Mason JO, McGinnis JM. Healthy people 2000: an overview of the
national health promotion and disease prevention objectives.
Public Health Rep (in press).
The Oregon Health 2000 Project Team. Health objectives for the
year 2000: report of the Oregon Health 2000 Project. Portland,
Oregon: Oregon Department of Human Resources, State Health
Division, 1990.
Wisconsin Department of Health and Social Services. Healthier
people in Wisconsin: a public health agenda for the year 2000.
Madison, Wisconsin: Wisconsin Department of Health and Social
Services, Division of Health, 1990.
Of the 226 objectives set for achievement by 1990, nearly half
have been achieved or are likely to be achieved by the end of
1990, and one quarter are unlikely to be achieved; the status of
the remaining objectives is uncertain because of lack of
appropriate data to track their progress (4,5).(Continued on page
695)
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