Diabetes is a chronic disease that usually manifests itself as one of two major Type 1 diabetes has been sometimes referred to as juvenile or insulin-dependent …
Healthy Virginians 2010 Objectives
The principal goals recommended for the Healthy Virginians 2010 initiative
are the same two that are advanced in the nationwide agenda:
Increase quality and years of healthy life
Eliminate health disparities
In setting forth 28 focus areas and 467 objectives under these two main
goals in Healthy People 2010, those who developed the nationwide document
were being deliberately comprehensive That allows individual states and
local communities to select those targets that are relevant to their most
pressing needs
The Healthy Virginians 2010 Advisory Team in the Virginia Department of
Health VDH believes that in order to be effective and manageable, the
emphasis in Virginia should be on approximately fifty statewide objectives
for the decade To get to that number, the Advisory Team reviewed all of
the national focus areas and objectives to determine those that it feels
are the most important to Virginians
The Advisory Team has selected 54 objectives
Access to Quality Health Services
Goal: Improve access to comprehensive, high-quality health care services
Overview: Increasing the quality and
years of healthy life, and
eliminating health disparities are the primary goals of Healthy Virginians
2010 For progress toward these goals to be realized, it is imperative
that there be improved access to a comprehensive health care system Such
a system must underscore the importance of prevention and be able to
provide high quality care in a culturally and linguistically sensitive
manner
Note: All listed objectives are numbered as they appear in Healthy People
2010
Objectives
1-1 Increase the proportion of persons with health insurance
1-4a Increase the proportion of persons who have a specific source
of ongoing care
1-8 In the health professions, allied and associated health
profession fields, and the nursing field, increase the proportion of
all degrees awarded to members of underrepresented racial and ethnic
groups
1-9 Reduce hospitalization rates for three ambulatory-care-sensitive
conditions-pediatric asthma, uncontrolled diabetes, and immunization-
preventable pneumonia and influenza in older adults
Cancer
Goal: Reduce the number of new cancer cases as well
as the illness,
disability, and death caused by cancer
Overview: Cancer is the second leading cause of death in the United
States During 1999, an estimated 1,221,800 persons in the United States
were diagnosed with cancer; 563,100 persons were expected to die from
cancer These estimates did not include most skin cancers, and new cases
of skin cancer are estimated to exceed 1 million per year One-half of new
cases of cancer occur in people aged 65 years and over
About 491,400 Americans who get cancer in a given year, or 4 in 10
patients, are expected to be alive 5 years after diagnosis When adjusted
for normal life expectancy accounting for factors such as dying of heart
disease, injuries, and diseases of old age, a relative 5-year survival
rate of 60 percent is seen for all cancers This rate means that the
chance of a person recently diagnosed with cancer being alive in 5 years is
60 percent of the chance of someone not diagnosed with cancer Five-year
relative survival rates commonly are used to monitor progress in the early
detection and treatment of cancer and include persons who are living 5
years after diagnosis, whether in remission, disease free, or
under
treatment
Objectives
3-11 Increase the proportion of women who receive a Pap test
3-12 Increase the proportion of adults who receive colorectal cancer
screening examination
3-13 Increase the proportion of women aged 40 years and older who
have received a mammogram within the preceding 2 years
Diabetes
Goal: Through prevention programs, reduce the disease and economic burden
of diabetes, and improve the quality of life for all persons who have or
are at risk for diabetes
Overview: Diabetes poses a significant public health challenge for the
United States Some 800,000 new cases are diagnosed each year, or 2,200
per day The changing demographic patterns in the United States are
expected to increase the number of people who are at risk for diabetes and
who eventually develop the disease Diabetes is a chronic disease that
usually manifests itself as one of two major types: type 1, mainly
occurring in children and adolescents 18 years and younger, in which the
body does not produce insulin and thus insulin administration is required
to sustain life; or type 2 occurring usually in adults over 30
years of age
in which the bodys tissues become unable to use its own limited amount of
insulin effectively While all persons with diabetes require self-
management training, treatment for type 2 diabetes usually consists of a
combination of physical activity, proper nutrition, oral tablets and
insulin Type 1 diabetes has been sometimes referred to as juvenile or
insulin-dependent diabetes; and type 2 diabetes has been referred to as
adult-onset or noninsulin dependent diabetes
Objective
5-1 Increase the proportion of persons with diabetes who receive
formal diabetes education
Educational and Community-Based Programs
Goal: Increase the quality, availability, and effectiveness of educational
and community-based programs designed to prevent disease and improve health
and quality of life
Overview: Educational and community-based programs have played an integral
role in the attainment of Healthy People 2000 objectives and will continue
to contribute to the improvement of health outcomes in the United States by
the year 2010 These programs, developed to reach people outside
traditional health care settings, are fundamental for health
promotion and
quality of life
Objectives
7-2 Increase the proportion of middle, junior high, and senior high
schools that provide comprehensive school health education to prevent
health problems in the following areas: unintentional injury;
violence; suicide; tobacco use and addiction; alcohol or other drug
use; unintended pregnancy, HIV/AIDS, and STD infection; unhealthy
dietary patterns; inadequate physical activity; and environmental
health
7-4 Increase the proportion of the elementary, middle, junior high
and senior high schools that have a nurse-to-student ratio of a least
1:750
7-11 Increase the proportion of local health departments that have
established culturally appropriate and linguistically competent
community health promotion and disease prevention programs for racial
and ethnic minority health populations
Environmental Health
Goal: Promote health for all through a healthy environment
Overview: According to the World Health Organization, In its broadest
sense, environmental health comprises those aspects of human health,
disease, and injury
that are determined or influenced by factors in the
environment This includes the study of both the direct pathological
effects of various chemical, physical, and biological agents, as well as
the effects on health of the broad physical and social environment, which
includes housing, urban development, land-use and transportation, industry,
and agriculture The term environment may also be used to refer to air,
water, and soil This more narrow definition ignores the man-made
environment created by a society Where and how a society chooses to grow
and develop affects the quality of life by determining how long people
spend traveling to work, shopping, or going to school Where and how a
society builds its houses, schools, parks, and roadways can also limit the
ability of some people to move about and lead a normal life
Objectives
8-1a Reduce the proportion of persons exposed to air that does not
meet the US Environmental Protection Agencys EPAs health-based
standards for ozone
8-5 Increase the proportion of persons served by community water
systems who receive a supply of drinking water that meets the
regulations of the Safe Drinking
Water Act
8-23 Reduce the proportion of occupied housing units that are
substandard
8-11 Eliminate elevated blood lead levels in children
Family Planning
Goal: Improve pregnancy planning and spacing and prevent unintended
pregnancy
Overview: In an era when technology should enable couples to have
considerable control over their fertility, half of all pregnancies in the
United States are unintended Although between 1987 and 1994, the
proportion of pregnancies that were unintended declined in the United
States from 57 to 49 percent, other industrialized nations report fewer
unintended pregnancies, suggesting that the number of unintended
pregnancies can be reduced further Family planning remains a keystone in
attaining a national goal aimed at achieving planned, wanted pregnancies
and preventing unintended pregnancies Family planning services provide
opportunities for individuals to receive medical advice and assistance in
controlling if and when they get pregnant and for health providers to offer
health education and related medical care
Objectives
9-1 Increase the proportion of pregnancies that are
intended
9-9 Increase the proportion of adolescents who have never engaged in
sexual Intercourse
9-6 Increase male involvement in pregnancy prevention and family
planning efforts
Food Safety
Goal: Reduce foodborne illnesses
Overview: Foodborne illness imposes a burden on public health It
contributes significantly to the cost of health care
Between 1988-92, outbreaks of foodborne illness caused an annual average of
more than 15,000 cases of illness in the United States, as reported to the
Centers for Disease Control and Prevention CDC The actual illness rate
may be higher because a count is taken only when the microorganism that
caused the illness is identified by a laboratory and reported by a
physician
When unreported cases are taken into account, an estimated 76 million
illnesses, 325,000 hospitalizations, and 5,000 deaths each year may be
associated with microorganisms in food Hospitalizations due to foodborne
illnesses are estimated to cost over 3 billion each year The cost of
lost productivity is estimated at between 20 billion and 40 billion each
year In addition to acute illness, some
microorganisms can cause delayed
or chronic illness Foodborne chemical contaminants may cause chronic
rather than acute problems and specific estimates of their impact on health
and the economy are not available
Objectives
10-6 Improve food employee behaviors and food preparation practices
that directly relate to foodborne illnesses in retail food
establishments
Health Communication
Goal: Use communication strategically to improve health
Overview: Health communication links the domains of communication and
health and is increasingly recognized as a necessary element of efforts to
improve personal and public health Health communication can contribute to
all aspects of disease prevention and health promotion and is relevant in a
number of contexts, including: 1 health professional-patient relations;
2 individuals exposure to, search for, and use of health information;
3 individuals adherence to clinical recommendations and regimens; 4
the construction of public health messages and campaigns; 5 the
dissemination of individual and population health risk information, that
is, risk communication; 6 images of health in the mass
media and the
culture at large; 7 the education of consumers about how to gain access
to the public health and health care systems; and 8 the development of
telehealth applications
Objective
11-6 Increase the proportion of persons who report that their health
care providers have satisfactory communication skills
Heart Disease and Stroke
Goal: Improve cardiovascular health and quality of life through the
prevention, detection, and treatment of risk factors; early identification
and treatment of heart attacks and strokes; and prevention of recurrent
cardiovascular events
Overview: Heart disease is the leading cause of death for all Americans
Stroke is the third leading cause of death Heart disease and stroke
continue to be a major cause of disability and a significant contributor to
increases in health care costs in the United States
Epidemiologic and statistical studies have identified a number of actors
that increase the risk of heart disease and stroke In addition, clinical
trials and prevention research studies have demonstrated effective
strategies to prevent and control these risk factors and thereby reduce
illnesses,
disabilities, and deaths caused by heart disease and stroke
Objectives
12-10 Increase the proportion of adults with high blood pressure whose
blood pressure is under control
12-14 Reduce the proportion of adults with high total blood cholesterol
levels
HIV
Goal: Prevent HIV infection and its related illness and death
Overview: Beginning in 1981, a new infectious disease, AIDS, or acquired
immunodeficiency syndrome, was identified in the United States Several
years later, the causative agent of AIDS-human immunodeficiency virus HIV-
was discovered This discovery coincided with the growing recognition of
AIDS in the United States as part of a global infectious disease pandemic
Currently, HIV/AIDS has been reported in virtually every racial and ethnic
population, every age group, and every socioeconomic group in every State
and most large cities in the United States Initially identified among men
who have sex with men on the East and West Coasts, the AIDS epidemic is
composed of diverse multiple subepidemics that vary by region and
community By the end of 1998, more than 680,000 cases of AIDS had been
reported, and nearly
410,800 people had died from HIV disease or AIDS
Objectives
13-5 Reduce the number of cases of HIV infection among adolescents
and adults
13-6 Increase the proportion of sexually active persons who use
condoms
Immunization and Infectious Diseases
Goal: Prevent disease, disability, and death from infectious diseases,
including vaccine-preventable diseases
Overview: Infectious diseases remain major causes of illness, disability,
and death Moreover, new infectious agents and diseases are being
detected, and some diseases considered under control have reemerged in
recent years In addition, antimicrobial resistance is evolving rapidly in
a variety of hospital- and community-acquired infections These trends
suggest that many challenges still exist in the prevention and control of
infectious diseases
Objectives
14-12 Increase the proportion of all tuberculosis patients who
complete curative therapy within 12 months
14-24 Increase the proportion of young children who receive all
vaccines that have recommended for universal administration for at
least 5 years
14-29 a-f Increase the
proportion of noninstitutionalized adults
aged 65 or older who are vaccinated annually against influenza and
ever vaccinated against pneumococcal disease
Injury and Violence Prevention
Goal: Reduce injuries, disabilities, and deaths due to unintentional
injuries and violence
Overview: The risk of injury is so great that most persons sustain a
significant injury at some time during their lives Nevertheless, this
widespread human damage too often is taken for granted, in the erroneous
belief that injuries happen by chance and are the result of unpreventable
accidents In fact, many injuries are not accidents, or random,
uncontrollable acts of fate; rather, most injuries are predictable and
preventable
Objectives
15-3 Reduce firearm-related deaths
15-13 Reduce deaths caused by unintentional injuries
15-32 Reduce homicides
15-33 Reduce maltreatment and maltreatment fatalities of children
15-37 Reduce physical assaults
Maternal, Infant, and Child Health
Goal: Improve the health and well-being of women, infants, children, and
families
Overview: The health of mothers,
infants, and children is of critical
importance, both as a reflection of the current health status of a large
segment of the US population and as a predictor of the health of the next
generation This focus area addresses a range of indicators of maternal,
infant, and child health-those primarily affecting pregnant and postpartum
women including indicators of maternal illness and death and
preconceptional health and those that affect infants health and survival
including infant death; birth outcomes; prevention of birth defects;
access to preventive care; and fetal, perinatal, and infant deaths
Objectives
16-6 Increase the proportion of pregnant women who receive early and
adequate prenatal care
16-10a Reduce low birth weight LBW
16-19 Increase the proportion of mothers who breastfeed their
babies
Mental Health and Mental Disorders
Goal: Improve mental health and ensure access to appropriate, quality
mental health services
Overview: Mental health is a state of successful performance of mental
function, resulting in productive activities, fulfilling relationships with
other people, and the ability to adapt to
change and to cope with
adversity Mental health is indispensable to personal well-being, family
and interpersonal relationships, and contribution to community or society
Mental illness is the term that refers collectively to all diagnosable
mental disorders Mental disorders are health conditions that are
characterized by alterations in thinking, mood, or behavior or some
combination thereof, which are associated with distress and/or impaired
functioning and spawn a host of human problems that may include disability,
pain, or death
Objectives
18-2 Reduce the rate of suicide attempts by adolescents
18-7 Increase the proportion of children with mental health problems
who receive treatment
18-8 Increase the proportion of adults with mental disorders who
receive treatment
Nutrition and Overweight
Goal: Promote health and reduce chronic disease associated with diet and
weight
Overview: Nutrition is essential for growth and development, health, and
well-being Behaviors to promote health should start early in life with
breastfeeding and continue through life with the development of healthful
eating habits
Nutritional, or dietary, factors contribute substantially to
the burden of preventable illnesses and premature deaths in the United
States Indeed, dietary factors are associated with 4 of the 10 leading
causes of death: coronary heart disease CHD, some types of cancer,
stroke, and type 2 diabetes These health conditions are estimated to cost
society over 200 billion each year in medical expenses and lost
productivity Dietary factors also are associated with osteoporosis, which
affects more than 25 million persons in the United States and is the major
underlying cause of bone fractures in postmenopausal women and elderly
persons
Objectives
19-2 Reduce the proportion of adults who are obese
19-3c Reduce the proportion of children and adolescents who are
overweight or obese
19-18 Increase food security among US households and in so doing
reduce hunger
Oral Health
Goal: Prevent and control oral and craniofacial diseases, conditions, and
injuries and improve access to related services
Overview: Oral health is an essential and integral component of health
throughout life No one can be truly healthy
unless he or she is free from
the burden of oral and craniofacial diseases and conditions Millions of
people in the United States experience dental caries, periodontal diseases,
and cleft lip and cleft palate, resulting in needless pain and suffering;
difficulty in speaking, chewing, and swallowing; increased costs of care;
loss of self-esteem; decreased economic productivity through lost work and
school days; and, in extreme cases, death Further, oral and pharyngeal
cancers, which primarily affect adults over age 55 years, result in
significant illnesses and disfigurement associated with treatment,
substantial cost, and more than 8,000 deaths annually
Poor oral health and untreated oral diseases and conditions can have a
significant impact on quality of life Millions of people in the United
States are at high risk for oral health problems because of underlying
medical or handicapping conditions, ranging from very rare genetic diseases
to more common chronic diseases such as arthritis and diabetes Oral and
facial pain affects a substantial proportion of the general population
Objective
21-10 Increase the proportion of children and adults who use the
oral
health care system each year
Physical Activity and Fitness
Goal: Improve health, fitness, and quality of life through daily physical
activity
Overview: The 1990s brought a historic new perspective to exercise,
fitness, and physical activity by shifting the focus from intensive
vigorous exercise to a broader range of health-enhancing physical
activities Research has demonstrated that virtually all individuals will
benefit from regular physical activity The Surgeon Generals Report on
Physical Activity and Health concluded that moderate physical activity can
reduce substantially the risk of developing or dying from heart disease,
diabetes, colon cancer, and high blood pressure Physical activity also
may protect against lower back pain and some forms of cancer for example,
breast cancer, but the evidence is not yet conclusive
Recommended Objectives
22-2 Increase the proportion of adults who engage regularly,
preferably daily, in moderate physical activity for at least 30
minutes per day
22-7 Increase the proportion of adolescents who engage in vigorous
physical activity that promotes cardiorespiratory fitness 3
or more
days per week for 20 or more minutes per occasion
Public Health Infrastructure
Goal: Ensure that Federal, Tribal, State, and local health agencies have
the infrastructure to provide essential public health services effectively
Overview: The mission of public health is to fulfill societys interest
in assuring conditions in which persons can be healthy Public health
engages both private and public organizations and individuals in
accomplishing this mission Responsibilities encompass preventing epidemics
and the spread of disease, protecting against environmental hazards,
preventing injuries, encouraging healthy behavior, helping communities to
recover from disasters, and ensuring the quality and accessibility of
health services
Objective
23-5 Increase the proportion of Leading Health Indicators, Health
Status Indicators, and Priority Data Needs for which data-especially
for select populations-are available at the Tribal, State, and local
levels
Respiratory Diseases
Goal: Promote respiratory health through better prevention, detection,
treatment, and education
Overview:
Asthma, chronic obstructive pulmonary disease COPD, and
obstructive sleep apnea OSA are a significant public health burden to the
United States Specific methods of detection, intervention, and treatment
exist that may reduce this burden Several behaviors and diseases that
affect the respiratory system, such as tuberculosis, acquired
immunodeficiency syndrome AIDS, pneumonia, occupational lung disease,
lung cancer, and smoking, are covered in other focus area chapters
Certain other important respiratory diseases, such as respiratory distress
syndromes, sarcoidosis, and chronic sinusitis, which are difficult to
define, detect, prevent, or treat, are not discussed in this chapter
Their omission, however, is not a reflection on the magnitude of the health
problems associated with them
Asthma and COPD are among the 10 leading chronic conditions causing
restricted activity After chronic sinusitis, asthma is the most common
cause of chronic illness in children Methods are available to treat these
respiratory diseases and promote respiratory health
Objective
24-3 Reduce hospital emergency visits for asthma
Sexually Transmitted Diseases
Goal:
Promote responsible sexual behaviors, strengthen community capacity,
and increase access to quality services to prevent sexually transmitted
diseases STDs and their complications
Overview: Sexually transmitted diseases STDs refer to the more than 25
infectious organisms transmitted primarily through sexual activity STDs
are one of many related factors that affect the broad continuum of
reproductive health agreed on in 1994 by 180 governments at the
International Conference on Population and Development ICPD At ICPD,
all governments were challenged to strengthen their STD programs STD
prevention as an essential primary care strategy is integral to improving
reproductive health
Despite the burdens, costs, complications, and preventable nature of STDs,
they remain a significant public health problem, largely unrecognized by
the American public, policymakers, and public health and health care
professionals STDs cause many harmful, often irreversible, and costly
clinical complications, such as reproductive health problems, fetal and
perinatal health problems, and cancer In addition, studies of the
worldwide human immunodeficiency virus HIV pandemic link other STDs to a
causal
chain of events in the sexual transmission of HIV infection
Objectives
25-1 Reduce the proportion of adolescents and young adults with
Chlamydia trachomatis
25-11 Increase the proportion of adolescents who abstain from sexual
intercourse or use condoms if currently sexually active
Substance Abuse
Goal: Reduce substance abuse to protect the health, safety, and quality of
life for all, especially children
Overview: Substance abuse and its related problems are among societys
most pervasive health and social concerns Each year, about 100,000 deaths
in the United States are related to alcohol consumption Illicit drug
abuse and related acquired immunodeficiency syndrome AIDS deaths account
for at least another 12,000 deaths In 1995, the economic cost of alcohol
and drug abuse was 276 billion This represents more than 1,000 for
every man, woman, and child in the United States to cover the costs of
health care, motor vehicle crashes, crime, lost productivity, and other
adverse outcomes of alcohol and drug abuse
Objectives
26-10a Increase the proportion of adolescents not using alcohol or
any illicit
drugs during the past 30 days
26-10c Reduce the proportion of adults using any illicit drug during
the past 30 days
26-11c Reduce the proportion of adults engaging in binge drinking of
alcohol beverages during the past month
Tobacco Use
Goal: Reduce illness, disability, and death related to tobacco use and
exposure to secondhand smoke
Overview: Scientific knowledge about the health effects of tobacco use has
increased greatly since the first Surgeon Generals report on tobacco was
released in 1964 Cigarette smoking causes heart disease, several kinds of
cancer lung, larynx, esophagus, pharynx, mouth, and bladder, and chronic
lung disease Cigarette smoking also contributes to cancer of the pancreas,
kidney, and cervix Smoking during pregnancy causes spontaneous abortions,
low birth weight, and sudden infant death syndrome
Other forms of tobacco are not safe alternatives to smoking cigarettes
Use of spit tobacco causes a number of serious oral health problems,
including cancer of the mouth and gum, periodontitis, and tooth loss
Cigar use causes cancer of the larynx, mouth, esophagus, and lung In
recent years,
reports have shown an increase in the popularity of bidis
Bidis are small brown cigarettes, often flavored, consisting of tobacco
hand-rolled in tendu or temburni leaf and secured with a string at one end
Research shows that bidis are a significant health hazard to users,
increasing the risk of coronary heart disease and cancer of the mouth,
pharynx and larynx, lung, esophagus, stomach, and liver
Objectives
27-1a Reduce cigarette smoking by adults
27-2 Reduce tobacco use by adolescents
27-3 Reduce initiation of tobacco use among children and
adolescents
27-10 Reduce the proportion of nonsmokers exposed to environmental
tobacco smoke
