Healthy People program

Healthy People is a program of a nationwide health-promotion and disease-prevention goals set by the United States Department of Health and Human Services. The goals were first set in 1979 "in response to an emerging consensus among scientists and health authorities that national health priorities should emphasize disease prevention". The Healthy People program was originally issued by the Department of Health, Education and Welfare. This first issue contained "a report announcing goals for a ten-year plan to reduce controllable health risks. In its section on nutrition, the report recommended diets with fewer calories; less saturated fat, cholesterol, salt, and sugar; relatively more complex carbohydrates, fish and poultry; and less red meat." Though this recommended diet consisted of more processed foods rather than fresh produce, the report advised for consumers to "be wary of processed foods".[1] The goals were subsequently updated for Healthy People 2000, Healthy People 2010, Healthy People 2020 and Healthy People 2030.[2]

Science based goals and objectives are reviewed, used and updated by the federal government, states, communities as well as other private institutions to combat and prevent health issues. Using the data collected, broad objectives are created in order to manage the direction of the population's health.[3] These objectives have been used at a national level in industries such as housing and transportation, as well as at a state level as seen Iowa.[3] The Iowa Department of Public Health utilized Healthy People 2020 to develop the Healthy Iowans state health plan.[3] Progress towards objectives is updated regularly and can be seen on their website, where data has shown that between 2010 and 2014, 14 of the 26 indicators have met their targets as part of the Healthy People 2020 plan.[4]

Healthy People 2010, started in January 2000 by the United States Department of Health and Human Services, was a set of nationwide health-promotion and disease-prevention goals to be achieved by the year 2010.[5] Programs such as HealthCorps grew out of this plan.[6]

Healthy People 2010

Healthy People 2010 "was developed through a broad consultation process, built on the best scientific knowledge and designed to measure programs over time".[2] It is composed of 467 specific objectives organized into 28 focus areas, as well as two overarching goals.[5] The two goals are:[7]

To track the Healthy People 2010 objectives, national data are being gathered from 190 sources.[8] Ten "Leading Health Indicators" reflect major health concerns:[9]

The campaign identifies 6 major factors (Social Identities) that contribute to disparities in the health of Americans:[10]

  • gender
  • race or ethnicity
  • education or income
  • disability
  • geographic location
  • sexual orientation

Healthy People 2010 and Healthy People 2020

Healthy People 2010 expanded and updated the 1979 "Healthy People" and 1990 "Healthy People 2000" efforts;[2] for example, the Healthy People 2000 goal of "reducing health disparities" was strengthened in Healthy People 2010 to "eliminate health disparities".[11]

Healthy People 2020 expanded on Healthy People 2010 and was presented on 2 December 2010.[12]

Healthy People 2020's program has 4 overarching goals,[13]

  • Higher quality and longer lives without preventable diseases, disabilities, injury and premature death
  • Health equity, elimination of disparities and improvement of health in all demographic groups
  • Creating social and physical environments that promote good health for all
  • Promoting higher quality of life, healthy development and behaviors across every stage of life

As part of the new Healthy People 2020 approach, 12 topic areas were selected as leading health indicators (LHI's), which address determinants of health affecting quality of life, behaviors and healthy age development[14]

Healthy People 2030

Developed by the HHS Office of Disease Prevention and Health Promotion, Healthy People 2030 is the fifth iteration of the 1979 Surgeon General's initiative.[15] The program launched in April 2020, and increases the focus on health equity, social determinants of health, and health literacy as well as adding a new focus on well-being. [16]

The plan consists of three types of objectives; core, developmental and research. Core objectives are defined as high-priority objectives with an identified data source.[17] Developmental objectives are defined as issues that are high-priority, however lack credible or reliable baseline data to provide support.[18] Research objectives are defined as areas that present health or economic burdens, however research is needed to identify interventions based on evidence to improve health.[19] The total number of objectives were reduced from over 1000 objectives in Healthy People 2020 to only around 360 objectives in Healthy People 2030 so that health practitioners and public health professionals can effectively address social determinants of health within the community.

Differences in objectives between Healthy People 2030 and Healthy People 2020 include a reduction in number of measurable objectives from the previous decade, increases in data sets, inclusion of e-cigarettes, and providing resources in order to adapt to emerging health crisis such as COVID-19.[20] Furthermore, Healthy People 2030 includes 8 overall health and well-being measures (OHMs):[21]

Well Being:

  • Overall well-being

Health Life Expectancy:

  • Life expectancy at birth without activity limitation
  • Life expectancy at birth free of disability
  • Life expectancy at birth in good or better health

Mortality and Health:

  • Life expectancy at birth
  • Free of activity limitation
  • Free of disability
  • Respondent-assessed health status

The focus of the Healthy People 2030 program is on upstream factors, or similar behaviors amongst populations that both effect people's health and their environments.[22] For the first time in the Healthy people program history, Healthy People 2030 includes four objectives regarding adverse childhood experiences, or ACEs, such as poverty and abuse.[23] These four objectives aim to reduce the number of young adults reporting 3 or more ACE's, increase proportion of children with symptoms of trauma who get treatment, increase the proportion of children who show resilience to challenges and stress and increase the number of early childcare educational settings that are informed regarding childhood traumas.[24]

Healthy People 2030 also focuses on elderly populations. The Healthy People 2030's core objectives includes improving the health and quality of life for people with Alzheimer's disease and dementia.[25]

  • Increasing the proportion of older adults with dementia, or their caregivers, who know they have it
  • Reducing the proportion of preventable hospitalizations in older adults with dementia
  • Increasing proportion of adults with subjective cognitive decline (SCD) who have consulted a health care professional regarding their memory loss or confusion.

References
  1. Nestle, Marion (1993). "Food Lobbies, the Food Pyramid, and U.S. Nutrition Policy" (PDF). International Journal of Health Services. 23 (3): 483–95. doi:10.2190/32F2-2PFB-MEG7-8HPU. PMID 8375951. S2CID 7546556. Retrieved 3 April 2015.
  2. U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. What is Healthy People? Archived 2009-01-17 at the Wayback Machine Accessed 2009 Jan 18.
  3. Haskins, Julia (2017-08-01). "Healthy People 2030 to create objectives for health of nation: Process underway for next 10-year plan". The Nation's Health. 47 (6): 1–14. ISSN 0028-0496.
  4. "Healthy People 2020 Leading Health Indicators: Progress Update". www.healthypeople.gov. Retrieved 2021-07-20.
  5. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics. About Healthy People 2010. Accessed 2009 Jan 18.
  6. The Saturday Evening Post, November/December 2007
  7. U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. What are its goals? Archived 2009-01-17 at the Wayback Machine Accessed 2009 Jan 18.
  8. U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. Data overview. Archived 2010-12-01 at the Wayback Machine Accessed 2009 Jan 18.
  9. U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. What are the Leading Health Indicators? Archived 2010-12-18 at the Wayback Machine Accessed 2009 Jan 18.
  10. U.S. Department of Health and Human Services. A systematic approach to health improvement. Archived 2010-12-19 at the Wayback Machine In: Healthy People 2010. 2nd ed. Washington, DC: U.S. Government Printing Office, 2000 November. Accessed 2009 Jan 18.
  11. National Center for Health Statistics. Healthy People 2000 final review. Hyattsville, MD: Public Health Service, 2001. Accessed 2009 Jan 18.
  12. U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. Accessed 2011 Sept 16.
  13. Bolduc, Benjamin; Hodgkins, Suzanne B.; Varner, Ruth K.; Crill, Patrick M.; McCalley, Carmody K.; Chanton, Jeffrey P.; Tyson, Gene W.; Riley, William J.; Palace, Michael; Duhaime, Melissa B.; Hough, Moira A.; Saleska, Scott R.; Sullivan, Matthew B.; Rich, Virginia I. (13 August 2020). "Supplemental Information 3: An excerpt from Data Downloads page, where users can download original datasets". PeerJ. 8: e9467. doi:10.7717/peerj.9467/supp-3. Retrieved 2021-07-20.
  14. Bolduc, Benjamin; Hodgkins, Suzanne B.; Varner, Ruth K.; Crill, Patrick M.; McCalley, Carmody K.; Chanton, Jeffrey P.; Tyson, Gene W.; Riley, William J.; Palace, Michael; Duhaime, Melissa B.; Hough, Moira A.; Saleska, Scott R.; Sullivan, Matthew B.; Rich, Virginia I. (13 August 2020). "Supplemental Information 3: An excerpt from Data Downloads page, where users can download original datasets". PeerJ. 8: e9467. doi:10.7717/peerj.9467/supp-3. Retrieved 2021-07-20.
  15. "Healthy People 2030 Framework - Healthy People 2030 | health.gov". health.gov. Retrieved 2021-07-20.
  16. "History of Healthy People | health.gov". health.gov. Retrieved 2021-07-20.
  17. "Healthy People - HP2020 - Topic Areas". www.cdc.gov. 2020-08-19. Retrieved 2021-07-20.
  18. "Healthy People - HP2020 - Topic Areas". www.cdc.gov. 2020-08-19. Retrieved 2021-07-20.
  19. "Healthy People - HP2020 - Topic Areas". www.cdc.gov. 2020-08-19. Retrieved 2021-07-20.
  20. "Healthy People 2030 Questions & Answers | health.gov". health.gov. Retrieved 2021-07-20.
  21. "Overall Health and Well-Being Measures - Healthy People 2030 | health.gov". health.gov. Retrieved 2021-07-20.
  22. December 16, 2020 (16 December 2020). "Just Released: Healthy People 2030's Leading Health Indicators and Overall Health and Well-Being Measures". HIV.gov. Retrieved 2021-07-20.
  23. Amanda Merck (2021-06-28). "Healthy People 2030 Adds 4 Objectives on Childhood Trauma, Up From 0". Salud America. Retrieved 2021-07-20.
  24. Amanda Merck (2021-06-28). "Healthy People 2030 Adds 4 Objectives on Childhood Trauma, Up From 0". Salud America. Retrieved 2021-07-20.
  25. "Healthy People 2030 Report from CDC Includes Objectives on Dementia, Alzheimer's | Massachusetts Healthy Aging Collaborative". mahealthyagingcollaborative.org. Retrieved 2021-07-20.
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