Addressing
Diversity
Healthy People 2010
Launched in January 2000, Healthy People 2010 represents the
nation’s disease prevention agenda. It presents performance
outcome measures that serve as indicators of the impact of public
and private sector health programs on the lives of the American
people. The development of valid performance outcome measures
is required of all Federal agencies under the Government Performance
and Results Act (GPRA). Performance outcome measures developed
by the Department of Health and Human Services and its agencies,
including the Administration on Aging, are intended to guide the
activities and decisions of these agencies and their grantees.
They also facilitate efforts by Congress and the public to evaluate
the effectiveness of these programs.
Healthy People 2010 builds upon a national effort initiated over
twenty years ago to develop comprehensive health objectives that
can be used to effectively direct health promotion and disease
prevention efforts. Like its predecessors, Healthy People and
Healthy People 2000, Healthy People 2010 identifies the most significant
preventable threats to the health of America’s people and
establishes a singular framework for use by States, communities,
organizations and individuals. Most importantly, Healthy People
2010 reinforces the concept that improving the health of the Nation
requires the long-term commitment and participation of all.
Developed through a broad-based community process, Healthy People
identifies significant opportunities to improve health, and focuses
long overdue attention upon special populations, including minority
and older Americans. For the first time, specific objectives are
accompanied by corresponding baseline data that provide evidence
of health disparities that place specific populations at higher
risk than the general population.
The two major goals of Healthy People 2010 are to:
- Increase Quality and Years of Healthy Life, and
- Eliminate Health Disparities
These goals are operationally defined by 467 objectives in 28
focal areas. Ten leading health indicators measure progress in
the areas of physical activity, overweight and obesity, tobacco
use, substance abuse, responsible sexual behavior, mental health,
injury and violence, environmental quality, immunization, and
access to health care. The National Center for Health Statistics,
Centers for Disease Control and Prevention, has established a
data system to track progress on efforts to meet the 467 objectives.
In order to promote health and eliminate health disparities
among older persons and in particular minority elders, AoA has
encouraged the national Aging Network to participate in the Healthy
People 2010 initiative by using it as both a planning and evaluation
tool for programs and services. The AoA is targeting its efforts
to address health disparities in three areas: diabetes (Focus
Area 5), cardiovascular disease (Focus Area 12), and adult immunization
(Focus Area 14). Recently, the AoA awarded approximately $ 1 million
for one year, for demonstration grants to four community coalitions
– one each for the African American, Asian American, American
Indian and Alaska Native, and the Hispanic American communities
-- that serve older members of racial and ethnic minority populations.
The awards are part of the DHHS initiative, “Racial and
Ethnic Approaches to Community Health 2010” (REACH 2010).
The AoA is collaborating with the Centers for Disease Control
in this effort.
We encourage you to participate in Healthy People 2010 by selecting
one or more Healthy People 2010 objectives to guide your planning
and evaluation efforts. You can partner with public and private
sector organizations to coordinate activities and maximize resources.
You can also collaborate with state and local health departments,
many of whom have developed state plans based upon the Healthy
People 2010 template.
Healthy People 2010: Understanding and Improving Health is the
first component of the Healthy People 2010 series. The second
component, Healthy People 2010: Objectives for Improving Health,
contains detailed descriptions of the 467 objectives. Tracking
Healthy People 2010, the third document in the series, provides
a comprehensive review of the statistical measures that will be
used to evaluate progress. All three parts are contained in two
volumes of more than 1,200 pages.
The full text of Healthy People is available on the Healthy People
web site at: http://www.health.gov/healthypeople.
Healthy People 2010 has a search feature, which allows you to
identify the 67 objectives that address health issues and health
disparities of older Americans.
Go to: http://www.healthypeople.gov/Search/
To order documents and obtain additional information call the
Healthy People Information Line at 1-800-367-4725.
Evidence-Based Information on Health Disparities
A number of recent studies provide evidence-based substantiation
of the health disparities which place minority populations at
special risk.
For example, facts, analysis and explanation of health policy
issues including ethnic minority health issues are offered by
the Henry J. Kaiser Family Foundation Health Policy Program. The
foundation’s site is located at: http://www.kff.org.
Three recent studies published by the Henry J. Kaiser Family Foundation
analyze health disparities that dramatically impact upon the quality
of life of racial, ethnic and immigrant groups.
1. Key Facts: Racial and Ethnic Differences in Medical
Care
A chartbook provides data on racial and ethnic disparities in
health; including health coverage; access to preventive and primary
care; and the use of medical care for specific conditions including
heart disease, cancer, asthma, and HIV/AIDS. Minority Americans
are twice as likely to be uninsured as whites and minority Medicare
beneficiaries are more likely than whites to have no supplemental
insurance. African American and Latino beneficiaries report problems
accessing specialists and health care. Disparities continue to
exist in relation to screening, diagnosis and therapeutic interventions
for African American elders.
Go to: http://www.kff.org/minorityhealth/1523-index.cfm
2. Racial and Ethnic Disparities in Access to Health
Insurance and Health Care
This study was conducted in collaboration with the UCLA Center
for Health Policy Research. It examines health insurance coverage
and access to physician services for African Americans, Latinos,
Asian Americans and Pacific Islanders, and American Indians and
Alaska Natives. Fact Sheets are included for four ethnic groups.
African Americans are much more likely than whites to have such
chronic diseases as diabetes and hypertension. Twenty-three percent
of African Americans lack access to health insurance and hence
lack access to a regular source of medical care. As a result,
African Americans die from diabetes at a rate which is three times
greater than for whites.
Nearly 40% of Latinos are uninsured, which represents a quarter
of all uninsured persons in this country. Lack of insurance impedes
access to health care.
Overall, Asian Americans and Pacific Islanders are less likely
than whites to have health insurance coverage. Sixty-four percent
have insurance. Subgroups however vary widely in the coverage.
Japanese Americans have the highest rate of job-based coverage
(77%) versus Korean Americans (48%). Asian Americans and Pacific
Islanders are less likely than whites to have a regular source
for health care, despite the fact that these groups have a higher
risk for certain easily detectable and preventable chronic diseases.
Native Americans are disadvantaged in health status in part because
of their limited access to health insurance, their lower income
levels, and poor access to health care. Only about 50% of Native
Americans have health insurance through their employers. Of those
who are uninsured, more than 35% report that they do not have
a usual source of health care.
Go to: http://www.kff.org/uninsured/1525-index.cfm
3. Immigrants’ Health Care: Coverage and Access
This report analyzes the Welfare Reform Law of 1996 and its impact
on restricting Medicaid eligibility for certain immigrant populations.
Immigrants account for 20% of the uninsured. The likelihood of
being uninsured is almost double for low-income non-citizens as
compared to low-income citizens. 58% of non-citizens lack health
insurance. Included with the report are a chart pack highlighting
statistics and a policy brief discussing the legal status of Medicaid
eligibility.
Go to: http://www.kff.org/medicaid/2241-index.cfm
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