《新英格蘭醫學雜志》在2010年3月6日發表的一篇文章，為我們展現了美國人對未來健康的愿景，文中為我們介紹了過去美國民眾有關的疾病狀況和健康問題，還提供了美國未來的公共健康路線圖和指南，這不僅對美國，也對我們實施健康戰略有所啟發。我們可以從中學習，重新審視過去的工作，調整并設立未來的目標，運用更積極的策略、激勵措施，鼓勵健康促進的新方向。感興趣的朋友們可以到一下網址查看原文：http://content.nejm.org/cgi/reprint/362/18/1653.pdf
A 2020 Vision for Healthy People
以2020年的視角對健康人的展望
作者：Howard K. Koh, M.D., M.P.H.
How can we best advance the collective health of the
The initiative, launched by the Department of Health and Human Services in 1979 as a systematic approach to health improvement, encompasses the mutually reinforcing tasks of setting goals, identifying baseline data and 10-year targets, monitoring outcomes, and evaluating the collective effects of health-improvement activities nationwide. Since the first iteration, the successive plans of Healthy People 2000 (released in 1990) and Healthy People 2010 (released in 2000) have identified emerging public health priorities and helped to align health-promotion resources, strategies, and research. Each decade, the program has set objectives that were deemed important, understandable, prevention-oriented, actionable, measurable with available high-quality data, and comparable to those in previous versions. Over the years, the responsibility of developing and implementing these objectives has engaged a growing network of professional and public partners, and the priority-setting process includes sifting through thousands of public comments that are routinely submitted through open community meetings and over the Web.
Wrapping up the activities of Healthy People 2010 permits an assessment of the status of the country's health in relation to targets set a decade ago. The 2010 plan focused on two overarching goals: increasing the quality of life (including years of healthy life) for Americans and eliminating health disparities. Preliminary analyses show that life expectancy has in fact increased (during the period from 2000 to 2006) by 1.2% when measured at birth and by 5.1% when measured at age 65. However, the goal of eliminating disparities remains unmet.1
Digging deeper, one can analyze movement in 28 focus areas (see Leading Health Indicators and Focus Areas for the Healthy People 2010 Initiative), encompassing 467 measurable objectives. Although the definitive report won't be released until the spring of 2011, preliminary analyses indicate that for 71% of the objectives and subobjectives for which we have at least two data points over the course of the decade, the country has either progressed toward (52%) or met (19%) the target. These figures, similar to results from previous decades, reflect broad movement on a host of diseases, conditions, risk factors, and behaviors.
Outcomes for some objectives have already surpassed the 2010 targets. By 2007, for example, the age-adjusted death rate from coronary heart disease had already dropped well below the target of 162 deaths per 100,000 population — down from 203 per 100,000 in 1999 to 135 per 100,000 (see Figure 1). Reductions in major risk factors (e.g., total cholesterol levels, systolic blood pressure, and smoking) as well as evidence-based medical therapies (e.g., secondary preventive therapies after myocardial infarction or revascularization and treatments for acute myocardial infarction, unstable angina, and heart failure) have contributed equally to this 33% decrease.2 However, death rates among men still exceed those among women, and heart disease (of which coronary heart disease remains the largest component) is still the leading cause of death in the United States.
（編輯：劉鵬達）
