A 2020 Vision for Healthy People | Health Care Reform Center

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by Howard K. Koh, M.D., M.P.H.in New England Journal of Medicine

How can we best advance the collective health of the United States, while monitoring our progress? This year offers another opportunity to revisit this fundamental yet profound question through the lens of the Healthy People initiative. In setting the country’s health-promotion and disease-prevention agenda for the past three decades, Healthy People has articulated overarching goals and tracked movement toward established targets. As we prepare for the next decade, the initiative aims to unify national dialogue about health, motivate action, and encourage new directions in health promotion, providing a public health roadmap and compass for the country.

The initiative, launched by the Department of Health and Human Services in 1979 as a systematic approach to health improvement, encompasses the mutually reinforcing tasks of setting goals, identifying baseline data and 10-year targets, monitoring outcomes, and evaluating the collective effects of health-improvement activities nationwide. Since the first iteration, the successive plans of Healthy People 2000 (released in 1990) and Healthy People 2010 (released in 2000) have identified emerging public health priorities and helped to align health-promotion resources, strategies, and research. Each decade, the program has set objectives that were deemed important, understandable, prevention-oriented, actionable, measurable with available high-quality data, and comparable to those in previous versions. Over the years, the responsibility of developing and implementing these objectives has engaged a growing network of professional and public partners, and the priority-setting process includes sifting through thousands of public comments that are routinely submitted through open community meetings and over the Web.

Wrapping up the activities of Healthy People 2010 permits an assessment of the status of the country’s health in relation to targets set a decade ago. The 2010 plan focused on two overarching goals: increasing the quality of life (including years of healthy life) for Americans and eliminating health disparities. Preliminary analyses show that life expectancy has in fact increased (during the period from 2000 to 2006) by 1.2% when measured at birth and by 5.1% when measured at age 65. However, the goal of eliminating disparities remains unmet.

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