US releases “Healthy People 2020”

The US government today released Healthy People 2020, a blueprint of indicators and targets used to set the country’s health-promotion and disease-prevention agenda.

The framework includes a series of indicators for violence and injury prevention. Most goals are modest – a 10% reduction from baseline rates over 10 years. Some even call for simply stopping the current rate of rise (in unintentional overdose deaths, for example). And other goals are more focused on process (e.g., increasing the number of states with comprehensive e-coded emergency care discharge datasets). But injury is in there, at least, along with ideas about where to find data to monitor our progress.

This is the fourth decennial iteration of the Healthy People framework. It would seem worthwhile to ask what progress, if any, was seen over previous decades. The initial analysis of Healthy People 2010 suggests modest attainment: for many of the objectives identified for the decade, the country has either progressed toward (52%) or met (19%) its target. What is less clear, to me, is whether being a Healthy People target confers any benefit in terms of the likelihood of meaningful, measurable progress.

The more inspiring aspect of the new objectives, to me, are the overarching goals embraced by the project. Two are carried over from previous versions:

  • Attain high-quality, longer lives free of preventable disease, disability, injury, and premature death.
  • Achieve health equity, eliminate disparities, and improve the health of all groups.

But two are new, and both have direct relevance to injury control:

  • Create social and physical environments that promote good health for all.
  • Promote quality of life, healthy development, and healthy behaviors across all life stages.

The challenge and opportunity for injury prevention is to leverage the recognition that “the health of the individual is almost inseparable from the health of the larger community,” to move our concerns and perspectives out of the health sector alone and into realms of development, urban planning, transportation policy, security and child survival.

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