HEALTHY PEOPLE 2000

National Health Promotion And Disease Prevention Objectives

This set of objectives for the year 2000 makes an important, compelling point to us and to all health policy makers: We can no longer afford not to invest in prevention. From the perspective of avoiding human suffering as well as saving wasteful costs for treating disease and injuries that could have been prevented, the l990s should be the decade of prevention in the United States.

Janes 0. Mason, M.D., Dr. P.H.
Assistant Secretary Department of Health and Human Services

First, personal responsibility, which is to say responsible and enlightened behavior by each and every individual, truly is the key to good health. Evidence of this still-evolving perspective abounds in our concern about the dangers of smoking and the abuse of alcohol and drugs; in the emphasis that we are placing on physical and emotional fitness; in our growing interest in good nutritional practices; and in our concern about the quality of our environment. We have become, in a word, increasingly health-conscious, increasingly appreciative of the extent to which our physical and emotional well-being is dependent upon measures that only we, ourselves, can affect.

Louis W. Sullivan, M.D.
Secretary Department of Health and Human Services

The year 2000 appears ahead on the calendar of our Nation's history as a turning point. It may well be like any other year in the ongoing lives of people who inhabit this country and the world. But from the perspective of history, the year 2000 will bring to its conclusion a tumultuous century, characterized by astounding scientific achievements, devastating world wars, and explosive population growth. It will inaugurate at once a new century and a new millennium, a future so vast in its human and historic dimensions that it defies prediction while posing momentous questions about social and economic viability and human vitality in the face of a new era.

The year 2000 connotes change. Its arrival contains enough power to shape that change, motivating actions that can improve American lives. The beginning of the Twenty-First Century beckons both with challenge and opportunity for improved health of Americans. We began the current century with a sense of fatalism about the Nation's health problems. As we reach its conclusion, we do so with confidence in our ability to control many of the events that form our health prospects. A century of biomedical research has made available sophisticated techniques for diagnosing and intervening against disease. Scientific studies of even the last generation have revealed much about the factors that predispose to various health threats and therefore about actions that each of us can take to control our risks for disease or disability.

We have learned that a fuller measure of health, a better quality of life, is within our personal grasp. If tobacco use in this country stopped entirely today, an estimated 390,000 fewer Americans would die before their time each year. If all Americans reduce their consumption of foods high in fat to well below current levels and engaged in physical activity no more strenuous than sustained walking for 30 minutes a day, additional results of a similar magnitude could be expected. If alcohol were never carelessly used in our society, about 100,000 fewer people would die from unnecessary illness and injury. Together, deaths from these causes comprise a sizable share of the 2.1 million deaths that occur annually and are examples of the impact of personal lifestyle choices on the health destiny of individual Americans and the future of the Nation.

New knowledge has brought with it both a keen sense of potential and a keen appreciation of how far most Americans, especially those with low incomes, are from that potential. Moreover, we are already feeling the effects of momentous new issues emerging on the horizon -- the aging of our society, the prohibitive costs of many of the technologies developed for diagnosing and treating disease, and the ecologic consequences of industrialization and population growth.

These problems compel careful engagement of the national agenda. This report frames the elements of that agenda from the perspective of the potential to prevent unnecessary disease and disability and to achieve a better quality of life for all Americans. It grows out of a health strategy initiated in 1979 with the publication of Healthy People: The Surgeon General's Report on Health Promotion and Disease Prevention and expanded with publication in 1980 of Promoting Health/Preventing Disease: Objectives for the Nation, which set out an agenda for the ten years leading up to 1990.

This report does not reflect the policies or opinions of any one organization, including the Federal government, or any one individual. It is the product of a national process. It is deliberately comprehensive in addressing health promotion and disease prevention opportunities in order to allow local communities and States to choose from among its recommendations in addressing their own highest priority needs.

Promoting Health and Preventing Disease: Progress
Ten years is also long enough to bring about marked changes in the Nation's health. During the 1980s, there were major declines in death rates for three of the leading causes of death among Americans: heart disease, stroke, and unintentional injuries. Infant mortality also decreased, and some childhood infectious diseases were nearly eliminated. Gains in these areas give hope that the 1990s will see more progress, especially for diseases such as cancer that have so far not declined.

Much of our progress mirrors reductions in risk factors. The more than 40-percent drop in heart disease mortality since 1970 reflects dramatic increases in high blood pressure detection and control, a decline in cigarette smoking, and increasing awareness of the role of blood cholesterol and dietary fats. The precipitous drop in stroke death rates -- over 50 percent in the same period also reflects gains in hypertension control and declines in smoking.

Unintentional injuries have declined. In the last decade and a half, traffic fatalities dropped by one third, partly reflecting increased use of seatbelts, lower speed limits, and declines in alcohol abuse. Recent reductions in fatal occupational injuries have been facilitated by enhanced occupational safety standards. Studies are beginning to yield promising approaches to alcohol and other drug problems.

Healthy People 2000: The Challenge and Goals
The Nation has within its power the ability to save many lives lost prematurely and needlessly. Implementation of what is already known about promoting health and preventing disease is the central challenge of Healthy People 2000. But Healthy People 2000 also challenged the Nation to move beyond merely saving lives. The health of a people is measured by more than death rates. Good health comes from reducing unnecessary suffering, illness, and disability. It comes as well from an improved quality of life. Health is thus best measured by citizens' sense of well-being. The health of a nation is measured by the extent to which the gains are accomplished for all the people.

The challenge of Healthy People 2000 is to use the combined strength of scientific knowledge, professional skill, individual commitment, community support, and political will to enable people to achieve their potential to live full, active lives. It means preventing premature death and preventing disability, preserving a physical environment that supports human life, cultivating family and community support, enhancing each individual's inherent abilities to respond and to act, and assuring that all Americans achieve and maintain a maximum level of functioning.

The purpose of Healthy People 2000 is to commit the Nation to the attainment of three broad goals that will help bring us to our full potential.

* Increase the span of healthy life for Americans

* Reduce health disparities among Americans

* Achieve access to preventive services for all Americans

Healthy People: The Vision
Clearly, to meet the challenge of the Healthy People 2000 goals and objectives, we must work both individually and collectively. Alone, no one person, family, business, organization, or government has the resources to bring about the changes needed to implement this broad program, and yet the program cannot succeed unless each of us contributes individually. In essence, Healthy People 2000 offers hope that through cooperative efforts all Americans can live longer, healthier lives.

There are existing examples of cooperative programs which, if replicated, could propel us toward our health goals for the year 2000. Promising efforts are emerging in programs that have taken deep roots in neighborhoods across America and focus upon the early developmental needs of children. In many areas, these programs are the chief, if not the only, agents of family and community. Through these efforts, parents can both receive support and become active participants and leaders within the community. Where such programs are successful, they demonstrate that by working together -- by mobilizing families, neighborhoods, schools, businesses, churches, the media, and government -- we can make great strides toward helping Americans become healthier, more productive, and more fulfilled.

Thus, the final message of this report is one of shared responsibility -- among the many partners in prevention. It is what we do collectively and personally that will move us as individuals and as a Nation towards a healthier future.

This article consists of excerpts from Healthy People 2000: National Health Promotion and Disease Prevention Objectives, Summary Report.

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The office of the U.S. Department of Health and Human Services most responsible for implementing this report and the best first contact point is:

Office of Disease Prevention and Health Promotion,
Room 2132, Switzer Building,
330 C Street, S.W., Washington, D.C. 20201.
Phone: 202-472-5583. Fax: 202-245-1478.