Healthy People 2020: The Twelve Greatest Health Care Gaps

Recently, federal health officials released a list of 12 “high priority” indicators of health, which the government will track over the next decade to determine the progress and status of the nation’s health.

According to an article form Medpage Today, Howard Koh, MD, MPH, assistant secretary for health in the Department of Health and Human Services (HHS) released the list at the American Public Health Association annual meeting, in Washington, DC, and said he hopes the indicators will offer policymakers and researchers a guide to which areas of health are most in need of improvement.

The 12 indicators are part of HHS’s Healthy People 2020 initiative.  As the article noted, “The Healthy People initiative began in 1979 with a Surgeon General’s report, which set out public health targets achieved by 1990. It has been revised in 10-year increments ever since.”

However, “many of the Healthy People goals have not been met. In Healthy People 2010, health officials set a target of 3.8 new-onset diabetes cases per 1,000 adults by that year. Instead, new-onset diabetes rates are currently about eight per 1,000.”

The article did note that “there have been some successes, most notably in reducing coronary heart disease deaths. The Healthy People 2010 target was 162 per 100,000 population, down from 203 when that goal was set in 2000. By 2004, the CHD death rate had already fallen below the target to 160 per 100,000, and it has continued to decrease.  Also, life expectancy has increased from 77 years to 78 years, Koh said.”

We previously wrote about the Institute of Medicine’s (IOM) report on the Healthy People 2020 initiative.

Healthy People 2020 was released at the end of 2010 and provided an updated program to reduce health risk factors and disparities. The 2020 version offers new topics and objectives in nearly 42 areas, ranging from homicides to smoking cessation attempts.  And now, it also includes a list of the top 12 health indicators. They are:

• Access to health services
• Clinical preventive services
• Environmental equality
• Injury and violence
• Maternal, infant and child health
• Mental health
• Nutrition, physical activity and obesity
• Oral health
• Reproductive and sexual health
• Social determinants
• Substance abuse
• Tobacco

Each of the 12 topics has a number of indicators. For instance, indicators for clinical preventive services are:

• Adults who receive guidelines-based colorectal cancer screening
• Adults with hypertension whose blood pressure is controlled
• Adult diabetic population with an A1C value of greater than 9%
• Infants and children who received all the recommended vaccinations

“This is the first time that oral health has made a government list for major health determinants, Koh said. Success in that area will be measured in parts by rates of people who have visited a dentist in the past year.”

According to MedPage, “Many in the public health community who were present for the unveiling of the 12 health indicators lauded the inclusion of “social determinants” as a major focus area, which will be largely tracked by high school graduation rates. 

“All of the indicators will be tracked and reported on periodically throughout the next decade.”