amednews: Healthy People 2010 misses targets on obesity and health disparities :: Oct. 24, 2011 ... American Medical News

amednews: Healthy People 2010 misses targets on obesity and health disparities :: Oct. 24, 2011 ... American Medical News


The nation's health improved during the past decade as adult cholesterol levels decreased and fewer people smoked cigarettes, according to the final review of Healthy People 2010. Such improvements led to an increase in life expectancy.

But the country fell short of meeting Healthy People 2010 goals in some of the most critical areas, including reducing obesity and health disparities.

Obesity prevalence increased across all age groups during the last decade. Minorities, people with low incomes and those with limited education experienced widening disparities in areas such as coronary heart disease deaths and exposure to tobacco smoke.

"Overall, we did a fabulous job in terms of moving forward and improving health in the past decade. ... I'm proud we made progress, but we still have so much work to do," said Carter Blakey, acting deputy director of the Office of Disease Prevention and Health Promotion in the Dept. of Health and Human Services.

Blakey said primary care physicians play an integral role in improving public health and are key to helping the nation meet the Healthy People 2020 targets, which were released in December 2010. She encourages doctors to counsel patients on good nutrition, physical activity and smoking cessation.

"Physicians are busy and see a long list of patients every day, but ... if they could really counsel on these issues at the individual level, they can help make a difference," Blakey said.

The Healthy People program has been issued by HHS every decade since 1980. The initiative provides benchmarks to track and monitor progress that can guide action to improve the nation's health.

The final review of Healthy People 2010, released Oct. 6, shows that targets were met for 23% of the 733 objectives. For objectives in which the goal was not achieved, progress was made in nearly half of the cases.

The nation's health got worse for 24% of objectives, and there was no change for 5% of the initiatives.

Among the key findings: Life expectancy for the U.S. population increased from 76.8 years in 2000-01 to 77.8 years in 2006-07. That improvement reflects declining death rates for a variety of conditions, including female breast cancer, coronary heart disease, prostate cancer and stroke, the report shows.

Deaths due to prostate cancer decreased beyond the Healthy People target, falling from 31.1 deaths per 100,000 people in 1999 to 23.5 deaths per 100,000 in 2007. Death rates related to other cancers improved, but did not exceed the goals set for them.

The number of adults and teenagers who smoke also declined. In 2008, 21% of adults 18 and older smoked cigarettes compared with nearly one in four in 1998. In 2009, 19% of students in grades nine through 12 smoked, down from 35% in 1999.

"Despite many areas for optimism, addressing health disparities continues to be our greatest challenge," said Edward Sondik, PhD, director of the National Center for Health Statistics.

Reducing health inequalities
Overall, disparities remained unchanged for about 80% of the objectives, according to the report.

For example, minority and low-income groups continue to be less likely to have a regular source of medical care. Cigarette smoking also remains more common among the poor and those with less education compared with college graduates who have higher incomes.

Health disparities worsened in 13% of the objectives. Deaths due to coronary heart disease is one area where disparities increased for minorities and people with no more than a high school degree.

Also concerning to public health experts is that little progress was made meeting nutrition and weight targets.

The amount of obese adults 20 and older climbed from 23% between 1988 and 1994 to 34% between 2005 and 2008. During that period, obesity among children 6 to 11 increased from 11% to 17%.

To help remedy the problem, physicians should give patients more practical ways to improve their nutrition and physical activity, said Thomas LaVeist, PhD, director of the Hopkins Center for Health Disparities Solutions in the Johns Hopkins Bloomberg School of Public Health in Baltimore.

Rather than instructing patients to eat less salt, sugar and fat, he encourages doctors to give them examples of nutritious alternatives.

"We need to do a better job of providing people with information in a way they can understand," LaVeist said.