Introduction

Healthy People 2010: Midcourse Review
Executive Summary

Summary and Future Directions

Healthy People 2010 can be assessed in terms of its specific objectives and its overarching goals. Progress toward the target is evident for 70 percent of the 507 objectives and subobjectives with tracking data in Healthy People 2010. Greater numbers of objectives and subobjectives are moving toward the target than are moving away for all population groups except the Native Hawaiian or other Pacific Islander group.

The first goal of Healthy People 2010 is to help individuals of all ages increase quality and years of healthy life. A review of the data reveals that years of life—measured in terms of life expectancy—continue to increase. However, significant gender and racial and ethnic differences remain. Women continue to live longer than men. Black men and women still lag behind white men and women in overall life expectancy even though black men and women have seen an increase in the average number of years lived. While life expectancy has continued to increase, the United States continues to have lower life expectancy than many other developed nations. Data for two measures of healthy life expectancy—expected years in good or better health and expected years free of activity limitations—showed slight improvements between 1999–2000 and 2001–02. On the other hand, a third measure of healthy life expectancy—expected years free of selected chronic diseases—declined slightly. Identifying the best approaches for measuring years of healthy life is an evolving field. The three healthy life expectancies selected for use in Healthy People 2010 will provide tracking data for an assessment of progress at the end of the decade. Future research will build on these initial measures of healthy life expectancy.

The second goal of Healthy People 2010 calls for eliminating disparities among segments of the population. While there have been widespread improvements in rates for most of the populations associated with the social and demographic characteristics included in Goal 2, there is little evidence of systematic reductions in disparity. There were very few reductions in disparity among populations by education level, income level, geographic location, and disability status. While there were reductions in disparity among racial and ethnic populations for 24 objectives and subobjectives, and reductions in disparity between gender groups for 25 objectives and subobjectives, these reductions were offset by increases in disparity between racial and ethnic populations for 14 objectives and subobjectives and between men and women for 15 objectives and subobjectives. The lack of data for American Indian or Alaska Native, Asian, and Native Hawaiian or other Pacific Islander populations limits the assessment of disparity. This report is based on a large quantity of information that is useful for planning programs to eliminate racial, ethnic, and gender disparities. However, the lack of data on education, income, or other socioeconomic factors for many Healthy People 2010 objectives limits the ability to plan programs to eliminate disparities.

Another challenge in measuring the quality and years of healthy life is the collection of data on the institutionalized populations, such as those in prisons and nursing homes. Household-based surveys, the source of data used to measure the health components of healthy life expectancy, do not collect information on these populations or on homeless persons. Many of these individuals are likely to experience poor health, and estimates of healthy life that do not include these populations may be biased.

Focusing on Disease Prevention and Health Promotion

Healthy People 2010's first overarching goal of increasing years and quality of healthy life challenges the Nation to assess and measure the complex interactions of health, disease, disability, and early death. Continued commitment to implementing effective disease prevention and health promotion interventions will facilitate progress toward this goal by the end of the decade.

Healthy People 2010's second overarching goal of eliminating health disparities represents a further challenge. The data presented here indicate that rates are improving for most populations. However, disparities—measured in terms of relative differences from the best group rate—are generally not declining. It may be more difficult or more costly to implement effective disease prevention and health promotion programs for some populations. However, unless greater reductions occur for the populations with the highest rates, disparities will not be eliminated. Tracking progress toward the goals and objectives of Healthy People 2010 remains one of the most important contributions of this national initiative to improve the length and quality of life in this Nation.

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