Aging Texas Well Plan 2010-2011

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The Aging Texas Well (ATW) Plan is submitted to the governor by the Texas Department of Aging and Disability Services (DADS) as required by Executive Order RP 42.

This 2010-11 Plan is the response to the RP 42 mandate that DADS create and disseminate a comprehensive and effective working plan to identify and discuss aging policy issues, guide state government readiness and promote increased community preparedness for an aging Texas. RP 42 also mandates that DADS update the plan biennially and evaluate and report on its implementation.

The plan details the elements of the ATW initiative and establishes objectives within each of the key focus areas identified by RP 42 mandates. During the />2010-11 biennium, with guidance from the Aging Texas Well Advisory Committee (ATWAC), DADS will address the areas of focus outlined in RP 42.

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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Prevalence of Self-Reported Physically Active Adults

The report, 2008 Physical Activity Guidelines for Americans (2008 Guidelines), released in October by the U.S. Department of Health and Human Services, provides new guidelines for aerobic physical activity (i.e., activity that increases breathing and heart rate) and muscle strengthening physical activity (1). Under the 2008 Guidelines, the minimum recommended aerobic physical activity required to produce substantial health benefits in adults is 150 minutes of moderate-intensity activity per week, or 75 minutes of vigorous-intensity activity per week, or an equivalent combination of moderate- and vigorous-intensity physical activity. Recommendations for aerobic physical activity in the 2008 Guidelines differ from those used in Healthy People 2010 (HP2010) objectives, which call for adults to engage in at least 30 minutes of moderate-intensity activity, 5 days per week, or 20 minutes of vigorous-intensity activity, 3 days per week (2). To establish baseline data for the 2008 Guidelines and compare the percentage of respondents who reported meeting these guidelines with the percentage who reported meeting HP2010 objectives, CDC analyzed data from the 2007 Behavioral Risk Factor Surveillance System (BRFSS) survey. This report summarizes the results of that analysis, which indicated that, overall, 64.5% of respondents in 2007 reported meeting the 2008 Guidelines, and 48.8% of the same respondents reported meeting HP2010 objectives. Public health officials should be aware that, when applied to BRFSS data, the two sets of recommendations yield different results. Additional efforts are needed to further increase physical activity.

Prevalence of Selected Risk Behaviors and Chronic Diseases

Problem: Behavioral risk factors (e.g., tobacco use, poor diet, and physical inactivity) can lead to chronic diseases. In 2005, of the 10 leading causes of death in the United States, seven (heart disease, cancer, stroke, chronic lower respiratory diseases, diabetes, Alzheimer's disease, and kidney disease) were attributable to chronic disease. Chronic diseases also adversely affect the quality of life of an estimated 90 million persons in the United States, resulting in illness, disability, extended pain and suffering, and major limitations in daily living. Description of the System: CDC's Steps Program funds 40 selected U.S. communities to address six leading causes of death and disability and rising health-care costs in the United States: obesity, diabetes, asthma, physical inactivity, poor nutrition, and tobacco use. In 2005, a total of 39 Steps communities conducted a survey to collect adult health outcome data. The survey instrument collected information on health risk behaviors and preventive health practices among noninstitutionalized adults aged >18 years. Results: Prevalence estimates of risk behaviors and chronic conditions varied among the 39 Steps communities that reported data for 2005. The proportion of the population that achieved Healthy People 2010 (HP 2010) objectives also varied among the communities. The estimated prevalence of obesity (defined as having a body mass index [BMI] of >30.0 kg/m² as calculated from self-reported weight and height) ranged from 15.6% to 44.0%. No communities reached the HP2010 objective of reducing the proportion of adults who are obese to 15.0%. The prevalence of diagnosed diabetes (excluding gestational diabetes) ranged from 4.3% to 16.6%. Eighteen communities achieved the HP2010 objective to increase the proportion of adults with diabetes who have at least an annual foot examination to 75.0%; five communities achieved the HP2010 objective to increase the proportion of adults with diabetes who have an annual dilated eye examination to 75.0%. The prevalence of reported asthma ranged from 7.0% to 17.6%. Among those who reported having asthma, the prevalence of having no symptoms of asthma during the preceding 30 days ranged from 15.4% to 40.3% for 10 communities with sufficient data for estimates. The prevalence of respondents who engaged in moderate physical activity for >30 minutes at least five times a week or who reported vigorous physical activity for >20 minutes at least three times a week ranged from 42.0% to 62.2%. The prevalence of consumption of fruits and vegetables at least five times a day ranged from 15.6% to 30.3%. The estimated prevalence among respondents aged >18 years who reported having smoked >100 cigarettes in their lifetime and who were current smokers on every day or some days at the time of the survey ranged from 11.0% to 39.7%. One community achieved the HP2010 objective to reduce the proportion of adults who smoke to 12.0%. Among smokers, the prevalence of having stopped smoking for >1 day as a result of trying to quit smoking during the previous 12 months ranged from 47.8% to 63.3% for 31 communities. No communities reached the HP2010 objective of increasing smoking cessation attempts by adult smokers to 75%.