AAMC Reporter: January 2000: Viewpoint

Volume 9,
Number 4

Jordan J. Cohen, M.D., President

January 2000

The Nation's Prevention Agenda for 2010
by Nicole Lurie, M.D., M.S.P.H.
Principal Deputy Assistant Secretary for Health, HHS Office of Public Health & Science

Photo of Kenneth Kizer, M.D., M.P.H.

The Healthy People initiative, which began in 1979, sets national health goals for each decade and then annually reviews the health of Americans in regard to those goals. Instead of simply assessing health status, the Healthy People initiative allows us to project and forecast what is possible to achieve through preventive interventions and proven clinical preventive services. This initiative has allowed us to identify and address disparities in health status and outcomes between population groups, and it has helped us recognize opportunities at the national, state, local, and community levels to address significant health issues.

The public-private partnership that makes up the Healthy People Consortium is critical to this effort. The participation of more than 600 private, state, and local organizations has taken this effort beyond the bounds of government and tapped the resources, skills, and knowledge of individual and group participants in communities, health care delivery systems, volunteer groups, and public- and private-sector organizations and agencies. In addition, every state in the union and many localities use the Healthy People framework to guide local health policies and programs.

We will be launching Healthy People 2010 -- goals for the next decade -- in January at the "Partnerships for Health in the New Millennium" conference in Washington, D.C.

There will be some important differences between the 2010 goals and previous efforts. Healthy People 2010 will address the scenarios and trends of a larger, more diverse, and aging population, as well as a host of new health risks such as emerging infectious diseases. The initiative has grown to 28 priority areas and more than 550 objectives. The two overarching focuses will be to increase quality and years of healthy life, and eliminate racial and ethnic health disparities.

While we have found that Americans of all ages and in every racial and ethnic group have, in many ways, better health today than a decade ago, there are still a number of areas where disparities exist. For example, a black infant has more than twice the chance of dying in its first year of life as its white counterpart; Hispanic infants are one-and-a-half times as likely to die. Vietnamese women are five times more likely to die of cervical cancer than white women. And the incidence of diabetes in certain Native American tribes is the highest in the world.

We have had success in reducing the disparities in many areas. But for the year 2010, we are changing the goal from that of reducing disparities to that of eliminating disparities. It is an ambitious goal, but one that is worth pursuing. In the process of eliminating these disparities, we will develop systems that will help everyone. This is not a zero-sum game. We don't have to take anything away from anybody to achieve these goals.

Also at the launch, we will be releasing newly developed leading health indicators that focus on a small number of key health and social issues. This should help make Healthy People more accessible to the public, as well as business and opinion leaders. Earlier this year, we asked the Institute of Medicine to examine the use of such indicators, and the IOM found that "a small set of leading health indicators can create a national identity for the full-scale implementation of Healthy People 2010 and expand the traditional Healthy People community to include a wide variety of agencies, organizations, diverse population groups, community organizations, and individuals."

The Healthy People process helps focus action on common goals and enables diverse groups to combine their efforts. We can be proud of the progress we have made during its 20-year history. But many challenges remain, and these challenges form the foundation of Healthy People 2010.

We must enter the new millennium as a team, working together to improve the health of all Americans. As leaders of medical schools and teaching hospitals, you can play a critical role by involving your institutions in addressing the goals of the Healthy People 2010 initiative -- and I hope you will do so.