Healthy People 2010 Met Goal of Lower CVD Deaths in CKD

Daniel M. Keller, PhD

November 29, 2011

November 28, 2011 (Philadelphia, Pennsylvania) — The Healthy People project is embarking on its fourth decade with Healthy People 2020, having achieved or made significant progress toward 71% of its past goals.

Speaking at a news conference here at Kidney Week 2011, Lawrence Agodoa, MD, director of the Office of Minority Health Research Coordination at the National Institute of Diabetes and Digestive and Kidney Diseases and director of the Chronic Kidney Disease and End Stage Renal Disease Programs at the National Institutes of Health (NIH) in Bethesda, Maryland, said the latest iteration of the program strives to identify nationwide health improvement priorities and increase public awareness and understanding of the determinants of health, disease, and disability and opportunities for progress.

In addition, he said the program will "provide measurable objectives and goals that are applicable at the national, state, and local level," while calling on multiple sectors to strengthen policies and improve practices using the best available evidence and knowledge.

"The principle of it is that if the nation develops objectives and tracks these objectives over time, it will help motivate action in various parts of the country...[and improve] the health of the nation and ultimately reduce the health disparities, which are very prevalent, particularly in major diseases," Dr. Agodoa said.

The program originated as the Promoting Health/Preventing Disease: Objectives for the Nation in 1980 and subsequently became the Healthy People 2000 program in 1990, with 10-year goals set every decade and midcourse corrections along the way. The Centers for Disease Control and Prevention (CDC) and the NIH have taken the lead, but all US government health agencies are involved in the program.

Chronic Kidney Disease Added in 2000

With 25 million people in the United States with chronic kidney disease (CKD) and a half million with end-stage renal disease (ESRD), costing annually more than $35 billion in private and public funds for ESRD alone, CKD was added to the list in 2000 with 9 objectives as part of the Healthy People 2010 goals.

By 2010, 3 objectives exceeded the goal for the decade: reduction of cardiovascular disease (CVD) deaths in people with CKD and medical evaluation and medical treatment of patients with type 1 or type 2 diabetes and CKD. However, 3 objectives failed to meet their goals: reduction in the number of new cases of ESRD, reduction in new cases of ESRD from diabetes, and increase in the proportion of ESRD patients undergoing transplantation within 3 years of the start of dialysis.

One particular area of success was CVD. "The target was supposed to be 66.1 [CVD deaths] per 1000 patient-years at risk, and every one of the segments of the United States actually met this objective," Dr. Agodoa reported. "So we were quite successful in diminishing cardiovascular death with chronic kidney disease."

Going Forward: Healthy People 2020

Across all areas of health, Healthy People 2020 has integrated input from public health and prevention experts; local, state, and federal government officials; more than 2000 organizations; and the public. The comprehensive set of new objectives is based on consideration of more than 8000 comments.

Specifically in terms of CKD, based on previous goals and experience up to now, the latest program consists of 24 objectives. One objective from Healthy People 2010 has been retained, 8 have been modified, and 15 have been added. (For the list, see www.healthypeople.gov/2020/topicsobjectives2020.)

Healthy People 2020 was launched in December 2010. The final review of the goals and progress of Healthy People 2010 was completed in October 2011 and is also available on the Web site.

Technological innovation is a part of Healthy People 2020. Web application developers are being encouraged to create easy-to-use applications for professionals working with the new health objectives and so that communities can track their progress. The Department of Health and Human Services has launched a new Web site that allows users to tailor information to their needs and to find evidence-based resources and solutions.

Dr. Agodoa has disclosed no relevant financial relationships. He is an employee of the National Institutes of Health.

Kidney Week 2011; Abstract # TH-PO297. Presented November 10, 2011.

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