Posted on | June 27, 2014 | 2 Comments
We are now in the fourth decade of “Healthy People”, the US Public Health’s strategic road map for both guiding and measuring the success of population wide health initiatives. The scope of the initiative is impressively broad, including 42 different categories and over 1000 touch points.
We’re currently striving to reach goals outlined in Healthy People 2020. In that plan, 26 “leading health indicators” are identified for top priority concentration. A snapshot reveals that, in the first third of this decade, the nation has met or exceeded the goals in 4 areas, and has demonstrated improvement in 14 of the 26.
A recent summary revealed some high points:
1. Age-adjusted homicides have decreased to target amounts.
2. Targets for adult physical activity and muscle strengthening have been met.
3. Childhood exposure to secondhand smoke has declined as hoped for, and environmental efforts have cleansed the air that our children are breathing.
4. Improvement has been shown in the frequency of pre-term births and in infant deaths.
5. Colorectal cancer screening, childhood immunizations, and hypertension control have improved.
6. Adolescent use of drugs and alcohol are down.
7. Adult tobacco use continues to decline.
8. More HIV positive individuals know their serostatus.
9. More kids who reach the 9th grade have gone on to earn a high school diploma.
The summary also revealed 8 areas where no improvement has occurred and 3 areas where we have actually reversed the progressive trend, including:
1. Major depressive episodes and suicides in adolescents.
2. No improvements in the rates of childhood obesity or in the intake of vegetables.
3. A decline in dental visits.
The data reported out precedes the full 2014 implementation of the Affordable Care Act. But recent data has shown that nearly 10 million citizens have gained new access to health insurance, and with it will come higher levels of care coordination and other critical services like dental care and substance abuse treatment. Also built into standard models, and innovative trials occuring throughout the country, are a wide range of health promotion activities whose results will serve to guide future programmatic initiatives. Preventive services at no cost to patients are now available to over 100 million Americans.
As the government’s Public Health experts have reported, “public health always represents unfinished business.” But to this they add, “Further analyses to explain the changes noted herein can amplify national discussions about aspirations for a healthier nation.” With the institution of the Affordable Care Act, and the expansion of electronic medical records, as well as the ability to monitor the results of hundreds of competing approaches to advancing health and human potential, we are clearly on the right track.
To declare success, however, we will need to structurally unite around these gains, deflect naysayers, and maintain momentum. As important, we must demonstrate, as part of our success story, that investing in health and prevention can effectively decrease not only the nation’s chronic disease burden, but also its every expanding financial burden as well.
For Health Commentary, I’m Mike Magee.