Healthy People 2020: Midcourse Review Sees Progress, Challenges

Megan Brooks

January 12, 2017

The United States has met or exceeded 40% of its measurable national health objectives set for 2020 but has shown no improvement on about a third of the health objectives and lost ground in some areas, including mental health, according to a report released on Wednesday.

The findings are part of a mid-decade review of national health objectives established by the US Department of Health and Human Services and released by the Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS).

"It is my hope that the findings presented in the Healthy People 2020 Midcourse Review, both successes and challenges, serve to help guide officials, the public, and individuals in developing policies and programs that improve the health of Americans," NCHS Director Charles J. Rothwell said in a statement.

The "Healthy People" initiative provides a comprehensive set of national goals and objectives for improving the health of all Americans. Healthy People 2020, the most recent iteration, tracks the country's health through more than 1200 objectives that span 42 topic areas, the report explains.

The Leading Health Indicators are a select subset of 26 Healthy People 2020 objectives organized in 12 topic areas that represent "high-priority" health issues and challenges, the NCHS says.

According to the report, 8 of the 26 objectives had met or exceeded their 2020 targets, 8 were improving, 7 demonstrated little or no detectable change, and 3 were getting worse.

Here is a snapshot of "selected findings" by topic area highlighted in the 820-page report.

Access to Health Services

  • The proportion of persons under age 65 years with medical insurance increased from 83.2% in 2008 to 86.7% in 2014, moving toward the 2020 target.

Clinical Preventive Services

  • The age-adjusted proportion of adults aged 50 to 75 years who underwent guideline-based colorectal cancer screening increased from 52.1% in 2008 to 58.2% in 2013, moving toward the 2020 target.

  • The age-adjusted proportion of adults aged 18 years and older with hypertension whose blood pressure was under control increased from 43.7% in 2005–2008 to 48.9% in 2009–2012, moving toward the 2020 target.

  • The percentage of children aged 19 to 35 months who received the recommended doses of diphtheria-tetanus-acellular pertussis (DTaP); polio, measles, mumps, rubella (MMR); Haemophilus influenza B (Hib); and hepatitis B, varicella, and pneumococcal conjugate vaccines increased from 68.4% in 2012 to 71.6% in 2014, moving toward the 2020 target.

Environmental Quality

  • The number of days the Air Quality Index (AQI) exceeded 100 decreased from 2,200,000,000 (weighted by population and AQI) in 2006–2008 to 982,186,972 in 2012–2014, exceeding the 2020 target.

  • The proportion of children aged 3 to 11 years who were exposed to second-hand smoke decreased from 52.2% in 2005–2008 to 41.3% in 2009–2012, exceeding the 2020 target.

Injury and Violence

  • The age-adjusted rate of injury deaths per 100,000 decreased from 59.7 in 2007 to 58.8 in 2013, moving toward the 2020 target.

  • The age-adjusted rate of homicides per 100,000 fell from 6.1 in 2007 to 5.2 in 2013, exceeding the 2020 target.

Maternal, Infant, and Child Health

  • All infants deaths under age 1 year per 1000 live births decreased from 6.7 in 2006 to 6.0 in 2013, meeting the 2020 target.

  • Total preterm live births born before 37 completed weeks of gestation decreased from 12.7% in 2007 to 11.4% in 2013, meeting the 2020 target.

Mental Health

  • The age-adjusted rate of suicide per 100,000 increased from 11.3 in 2007 to 12.6 in 2013, moving away from the baseline and 2020 target.

  • The proportion of adolescents aged 12 to 17 years with a major depressive episode in the past 12 months increased from 8.3% in 2008 to 10.7% in 2013, moving away from the baseline and 2020 target.

Nutrition, Physical Activity, and Obesity

  • The age-adjusted proportion of adults aged 18 years and older who met the physical activity guidelines for both aerobic and muscle-strengthening physical activity increased from 18.2% in 2008 to 21.3% in 2014, exceeding the 2020 target.

  • There was little or no detectable change (33.9% in 2005–2008 and 35.3% in 2009–2012) in the age-adjusted proportion of adults aged 20 years and older with obesity. The same was true for children and adolescents aged 2 to 19 years (16.1% in 2005–2008 and 16.9% in 2009–2012).

Reproductive and Sexual Health

  • There was little or no detectable change (78.6% in 2006–2010 and 77.3% in 2011–2013) in the proportion of sexually active females aged 15 to 44 years who had received reproductive health services in the past year.

  • The proportion of HIV-positive persons aged 13 years and older who were aware of their HIV infection status increased from 80.9% in 2006 to 87.2% in 2012, moving toward the 2020 target.

Social Determinants

  • The proportion of students who graduated from high school 4 years after starting ninth grade increased from 79% in 2010–2011 to 81% in 2012– 2013, moving toward the 2020 target.

Substance Abuse

  • The proportion of adolescents aged 12 to 17 years who had used alcohol or illicit drugs in the past 30 days decreased from 18.4% in 2008 to 15.9% in 2013, exceeding the 2020 target.

  • There was little or no detectable change (27.1% in 2008 and 26.9% in 2013) in the proportion of adults aged 18 years and over who engaged in binge drinking in the past 30 days.

Tobacco

  • The age-adjusted proportion of adults aged 18 and older who were current cigarette smokers decreased from 20.6% in 2008 to 17.0% in 2014, moving toward the 2020 target.

  • The proportion of students in grades 9 to 12 who smoked cigarettes in the past 30 days decreased from 19.5% in 2009 to 15.7% in 2013, exceeding the 2020 target.

Oral Health

  • The age-adjusted proportion of people aged 2 years and older who visited a dentist in the past year decreased from 44.5% to 42.1% in 2002, moving away from the 2020 goal.

Healthy People 2020 Midcourse Review. Published online January 11, 2017.

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