Another year has passed, and December is a time for reflection and looking toward the future. Next year, the U. S. Department of Health and Human Services will release Healthy People (HP) 2020 with objectives and guidance for achieving the next 10-year targets for the health of the nation. Since 1990, the process of development, review, comment, revision, and completion has occurred each decade. The writers of HP2020 state that the document "will reflect assessments of major risks to health and wellness, changing public health priorities, and emerging issues related to our nation's health preparedness and prevention."1 The document is scheduled for release sometime in 2010. The nation, however, has yet to meet all of the objectives identified for any of the previous decades, including HP2010.
Toward long and healthy lives
The vision, mission, and framework have already passed through the stage of public comment. In draft version, the new vision of HP2020 is "a society in which all people live long and healthy lives." The overarching goals for HP2020 are to:
1. Achieve health equity, eliminate disparities, and improve health for all groups.
2. Eliminate preventable disease, disability, injury, and premature death.
3. Create social and physical environments that promote good health for all.
4. Promote healthy development and healthy behaviors across every stage of life.1
These goals are very familiar to nurses; they reflect what our profession has always taught were goals to strive for in practice. Promoting prevention and healthy lifestyle choices is a key skill set of NPs and other advanced practice nurses. These proposed goals are more directive and defined than those of HP2010.
Signs of our times
The preliminary 38 objectives of HP2020 reflect the changing landscape in scientific advances, social responsibility, and healthcare delivery with the additions (to HP2010) of genomics, global health, health communication, and health information technology, as well as social determinants of health. Several proposed objectives target health concerns across the lifespan, specifically early and middle childhood, adolescent health, and older adults.
"Nutrition and Overweight" has been changed to "Nutrition and Weight Status," most likely to encompass health concerns related to weight beyond obesity. "Encouraging" is a new objective that will focus on quality of life and well-being issues. These proposed objectives are also more reflective of the World Health Organization's definition of health: "Health is a state of complete physical, mental, and social well- being and not merely the absence of disease or infirmity."2 The words wellness and prevention used in descriptions of HP2020 are welcome additions in which to frame actions that will help improve the nation's health.
Form your own opinion
Four draft statements define the mission and include actions related to increasing public awareness and understanding, setting nationwide priorities, using the best available evidence, and identifying research needs. Access to health services and the public health infrastructure remain on the proposed list of HP2020 objectives. As they debate the composition of a healthcare reform bill, all legislators in Congress should be required to read the HP2020 draft documents in their entirety and charged to consider what types of reform would be necessary to increase the likelihood of Americans meeting the objectives of HP2020. As NPs, we should also take advantage of opportunities to comment on proposals, legislative or otherwise, that have the ability to influence the health of ourselves, our families, our patients, our communities, and our nation.
Jamesetta Newland, RN, PhD, FNP-BC, FAANP, FNAP
Editor-in-Chief [email protected]
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