Are Americans Any Healthier Since 2000?

ATLANTA (AP) — About 10 years ago the government set some lofty health goals for the nation to reach by 2010.

So how did we do? By many measures, not so hot.

There are more obese Americans than a decade ago, not fewer. We eat more salt and fat, not less. More of us have high blood pressure. More of our children have untreated tooth decay.

But the nation has made at least some progress on many other goals. Vaccination rates improved. Most workplace injuries are down. And deaths rates from stroke, cancer, and heart disease are all dropping.

As Americans move into a new decade, the government is analyzing how well the nation met decade-old Healthy People objectives created in 2000. And health advisors are drawing up a new set of goals for 2020 expected to be more numerous and — perhaps — less ambitious.

“We need to strike a balance of setting targets that are achievable and also ask the country to reach,” said Dr Howard Koh, the federal health official who oversees the Healthy People project. “That’s a balance that’s sometimes a challenge to strike.”

The Healthy People objectives were first created in the late 1970s to set an agenda for getting Americans to live longer, healthier lives. It was also an attempt to involve the public and emphasize that many health problems are preventable.

Every 10 years, the US Department of Health and Human Services reassesses the goals, and reports on progress made in the previous decade.

Many call the effort a success. The report has been imitated by states and other nations. Because of its importance within public health circles, interest groups jockey to add their goals to the document, which is expanding to more than 1,000 targets. And health agency workers have Healthy People goals memorized.

“It is something that we think about all the time,” said Dr Lance Rodewald, a vaccination expert at the US Centers for Disease Control and Prevention.

But after more than 30 years, the goals aren’t well known to the public and only a modest number have been met.

About 41 percent of the 1990 measurable goals were achieved. For the 2000 goals, it was just 24 percent.

As for the 2010 goals, data is still being collected, and a final report is not due out until 2011. But it looks like the results will be in the neighborhood of 20 percent, according to a preliminary analysis by the CDC’s National Center for Health Statistics.

The CDC analysis done this fall found that just 18 percent of those goals have been met so far. Worse, the nation actually retreated from about 23 percent of the goals.

One example: Healthy People 2010 called for the percentage of adults who are obese to drop to 15 percent. That goal was set at a time when nearly a quarter of all adults were obese. Now, about 34 percent of adults are obese, according to the latest federal statistics.

Some other backslides:

*An estimated 28 percent of adults had high blood pressure in 2000. The goal was to reduce that to 16 percent. But the most recent government data say the proportion has risen to 29 percent.

*About 16 percent of young children had untreated tooth decay in 2000. The target was 9 percent. The latest statistic is about 20 percent.

*The proportion of births by cesarean section increased despite a 2010 goal of lowering them, and the percentage of infants born very small and fragile also increased.

The nation has had better luck raising childhood vaccination rates, lowering cancer death rates, increasing smoking laws, and reducing most types of work injuries.

To many health officials, simply making progress is a victory. An analysis of 635 of the nearly 1,000 targets for the past decade shows only 117 goals have been met. But progress was made toward another 332. In other words, there was improvement in 70 percent of the measures.

“That’s evidence of a healthier nation,” Dr Koh said.

The Healthy People effort could be better if it included more information about how to reach the goals, and how much it would cost, said David Holtgrave, a health policy expert at Johns Hopkins University.

The program lays out the goals, but looks to others — and the public — to find ways to achieve them. Healthy People does not provide funding to meet the goals, either.

“It’s all carrot and no stick,” said Dr Richard Riegelman, founding dean of the George Washington University School of Public Health, who has been part of the Healthy People planning.

Right now, health officials are developing goals for 2020. The details are far from settled, but an advisory panel of experts has recommended that the new goals be more realistic. They also hope to make it more inviting to the public.

In the past, Healthy People reports have been released as a book the size of a James Michener epic.

“They have a lot of good information. They can also give you a backache,” said Dr Jonathan Fielding, director of the Los Angeles County Department of Public Health who heads a committee working on the new goals.

He and others are pushing for Healthy People 2020 to be an online document that links to websites and sources for nutrition and exercise advice and other ways people can improve their own health.

“We want to make 2020 a blueprint everyone can rally behind,” Dr Fielding said.

SIDEBAR / PULLOUT

TOPS Says Focus Makes New Year’s Resolutions Stick

When the calendar turned to January 1, many chose weight loss goals for the new year. Patricia Amborn, MSM, educator, wellness author, and expert for TOPS Club, Inc (Take Off Pounds Sensibly), says New Year’s resolutions offer a fresh start for those with self-improvement intentions.

TOPS maintains an active chapter in Newtown.

“With a resolution, it’s a commitment to take care of what you value,” Ms Amborn said in a recent release. “Start with self-love. If you value yourself, you will make a concerted effort to take care of yourself.”

Visualize Changes

When forming individual New Year’s resolutions, start by dreaming a little. Ms Amborn cites research that shows people are most productive and creative when relaxed, and suggests taking advantage of a daydream state to visualize weight-loss success.

To be most effective, she recommends, write resolutions down.

“Scientists have proven that when you write something down in the present tense, your brain thinks you’ve already done it, and believes it. For example, ‘I am eating better. I am exercising more. I am getting appropriate rest,’ ” Ms Amborn explained.

Change, even positive, can be overwhelming, so start small, she advises. One way to kick off a new resolution might be to assertively state it to your household. Your announcement could be as simple as, “I want to make 2010 a healthy year.”

List expectations of how family members can support this goal. Ms Amborn added, “A week or two later, repeat the statement. Those words sound assertive and represent boundaries and expectations being established.”

Make An Action Plan

Define core values as you work to set and attain goals. Ms Amborn said, “One way to define your values is to visualize yourself at the end of your life, thinking of the legacy you want to leave behind. 2010 is a fresh start. Ask yourself: How do I direct myself to build a foundation for my legacy? The action plan has to become specific.”

To develop a plan of action, set a weight-loss goal and establish it as a priority. Recognize obstacles and double resistance to them. Build determination. For example, if pressured to eat tempting, high-calorie treats, say, “Thanks, but I’m not hungry right now.”

Visualize saying this in present tense, and rehearse turning down tempting holiday food.

Take Concrete Steps

Practice new “small picture” habits while keeping a focus on the “big picture” to fuel motivation. Make the following changes that can add up to big improvements by the end of the year.

*Place workout gear by the front door to minimize excuses about exercising.

*Find a supportive workout buddy who has also resolved to live a healthier lifestyle. Make regular appointments with each other to exercise.

*Maintain a food log and keep track of everything eaten during the day to reflect on your eating habits and assess your diet.

*Toss out or give away treats from the holidays that are lingering in the house.

*Post a “healthy living” tally on the refrigerator door. List pounds lost, miles walked, inches lost, and other measurable progress. It is a powerful reminder of what has been accomplished and a deterrent to raiding the refrigerator.

In addition, follow these recommendations from Ms Amborn to make your resolutions stick and promote motivation.

Do not mourn the past, when weight was gained. It wastes time to be mired in regrets. Simply start your 2010 action plan.

As weight comes off, look for hidden rewards. Every few pounds will yield additional health benefits.

Confront negative beliefs held by both you and others. Each of us has “a rebel inside us” who urges us to give in to temptations. Even if we failed in the past, that does not necessarily mean we will fail again.

Take responsibility for each day. Reflect on how the day went. If you ate too much food, recognize it, move on, and plan for tomorrow.

Believe in yourself. Do not be afraid to ask for help. TOPS chapter meetings each week are a treasure trove of support.

“Remember this is for your benefit. You have to love yourself enough to do it,” says Ms Amborn. “It’s about the kind of life you want to live in the new year and in the years ahead.”

Visitors are welcome to attend their first TOPS meeting free of charge. Learn more at www.tops.org.

TOPS meets locally at the Newtown Meeting House, 31 Main Street, Mondays at 5:45 pm. For more information, contact Betty L. Presnell at 203-426-6224.