文章基本信息

标题：Achieving National Health Objectives: The Impact on Life Expectancy and on Healthy Life Expectancy
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作者：Elsie R. Pamuk ; Diane K. Wagener ; Michael T. Molla 等
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2004
卷号：94
期号：3
页码：378-383
语种：English
出版社：American Public Health Association
摘要：Our study quantifies the impact of achieving specific Healthy People 2010 targets and of eliminating racial/ethnic health disparities on summary measures of health. We used life table methods to calculate gains in life expectancy and healthy life expectancy that would result from achievement of Healthy People 2010 objectives or of current mortality rates in the Asian/Pacific Islander (API) population. Attainment of Healthy People 2010 mortality targets would increase life expectancy by 2.8 years, and reduction of populationwide mortality rates to current API rates would add 4.1 years. Healthy life expectancy would increase by 5.8 years if Healthy People 2010 mortality and assumed morbidity targets were attained and by 8.1 years if API mortality and activity limitation rates were attained. Achievement of specific Healthy People 2010 targets would produce significant increases in longevity and health, and elimination of racial/ethnic health disparities could result in even larger gains. THE PRACTICE OF ESTABLISHING national health objectives has been in effect for more than 2 decades. Beginning in 1979 with Healthy People: The Surgeon General’s Report on Health Promotion and Disease Prevention , 1 each succeeding decade has brought an increasing number of quantifiable objectives for preventing disease and for promoting health. The current objectives, Healthy People 2010, were developed by coordinating input from more than 350 national organizations, 250 state public health–related agencies, and the general public. 2 Experts from various federal agencies were responsible for developing the final 467 objectives, with different agencies taking the lead for each of the 28 focus areas. The large number and the many types of objectives are designed to provide a road map for achieving 2 overarching goals: (1) increase life expectancy and improve quality of life, and (2) eliminate health disparities. 2 Aiming for the elimination of health disparities is arguably the most ambitious goal of Healthy People 2010 . When the US population is divided by any of a number of demographic criteria—gender, race/ethnicity, education or income level, geographic location, disability, or sexual orientation—we find substantial differences in health status and longevity. Differences in health status reflect disparities in many types of health determinants: social and environmental factors, health-related behaviors, access to and use of health services, and quality of health care received. 3– 6 For the specific population-based objectives in Healthy People 2010 , the goal of eliminating health disparities was acknowledged by setting a single national target that applies to all population subgroups. However, 2 different principles were used to establish these targets. 7 For objectives related to access to and use of health services, and for objectives in areas that can be influenced in the short term by changes in health behaviors or health policy, targets were set at a level “better than the best” racial/ethnic group. For other objectives, achievement of a “better than the best” target for all racial/ethnic groups within 10 years was considered unrealistic regardless of the level of resources invested. For these objectives, the target was set at a level that represented improvement for a substantial proportion of the population but did not imply the elimination of racial/ethnic health disparities. In contrast to the specific Healthy People 2010 objectives, the overarching goal of increasing life expectancy and improving quality of life does not specify a numerical target. Although it is certain that achieving the specific targets will increase both longevity and health for the average American, as will eliminating racial/ethnic health disparities in a manner consistent with these goals, the expected increase in life expectancy and healthy life expectancy has not been estimated. Making these estimates will provide public health policymakers and planners with benchmarks against which the variable progress toward the many specific Healthy People 2010 objectives can be evaluated.