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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

  1. 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

  1. 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.

  2. 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.

  3. Public Health Service. Promoting health/preventing disease: objectives for the nation. Washington, DC: US Department of Health and Human Services, Public Health Service, 1980.

  4. 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.

  5. 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.

  6. CDC. Year 2000 national health objectives. MMWR 1989;38:629-33.

  7. Mason JO, McGinnis JM. Healthy people 2000: an overview of the national health promotion and disease prevention objectives. Public Health Rep (in press).

  8. 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.

  9. 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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