APIAHF Policy Brief - April 2001
Healthy People 2010
Healthy People 2010 (HP2010) is a 10-year federal initiative focused on improving the health of individuals and communities across the United States. It is the third initiative in a series of programs that started in 1979 to provide long-term goals for health promotion and disease prevention at the national level. HP2010 provides the country with specific, measurable objectives to promote health and prevent illness, disability and premature death in all communities in the United States. Using a variety of surveys and data sources for baseline measurements, Healthy People 2010 outlines areas in which we should focus our energies over the coming decade to implement positive changes in health status. States and local areas are encouraged to use the HP2010 framework to guide development of health policies and programs in their region.
Healthy People 2010 revolves around two main goals: (1) to increase years and quality of healthy life, and (2) to eliminate health disparities among different segments of the population. These include differences that occur by race or ethnicity, as well as by gender, education level, income, disability, or sexual orientation. To achieve these overarching goals, HP2010 is organized into 28 focus areas and 467 objectives that encompass disease areas, health services infrastructure, and capacity building.
Led by Surgeon General David Satcher and Department of Health and Human Services Secretary Donna Shalala, the HP2010 initiative also received guidance from the Healthy People Consortium, an alliance of over 500 state and national agencies. The Asian & Pacific Islander American Health Forum (APIAHF) has been actively participating in the Healthy People Consortium since the development of the Health People 2000 objectives in 1989. In 1997, a progress review of the Healthy People 2000 Objectives was held at the APIAHF national conference, Voices from the Community, in San Francisco. APIAHF has provided testimonies and integral recommendations for enhancing outcomes of Healthy People 2010 for AAPIs as well as other communities.
AAPI Communities
Asian Americans and Pacific Islanders (AAPIs) are the fastest growing racial and ethnic group in the United States. In 1998, there were 10.4 million AAPIs living in the US, nearly 4% of the nation’s population. The AAPI population is expected to continue growing at a tremendous rate, reaching 11% of the total population by 2050. As the AAPI population continues to grow, distinct health issues are emerging among AAPIs as a whole, and within specific ethnic groups as well. Healthy People 2010 acknowledges the special needs of AAPI communities from a national health perspective, and hopes to motivate researchers, states, local communities, and the general public to learn more about diverse ethnic groups and promote health and prevent disease throughout all communities.
Highlights of Healthy People 2010
In addition to the unprecedented goal of eliminating health disparities among different segments of the population, the HP2010 document recognizes the diversity within Asian American and Pacific Islander (AAPI) communities and makes significant progress in identifying availability of data for AAPIs.
Recognition of the Diversity and Disparities Among AAPI Populations
Immigrant and minority communities, and Asian Americans and Pacific Islanders in particular, are often underserved by the health care system. Specific AAPI communities face a variety of barriers to achieving optimum health status, and also experience rates of disease that are distinct from the mainstream community. The HP2010 document acknowledges that “women of Vietnamese origin, for example, suffer from cervical cancer at nearly five times the rate for white women. New cases of hepatitis and tuberculosis are higher in Asian and Pacific Islanders living in the United States than in whites.” However, HP2010 fails to identify specific objectives or strategies to address these disparities among racial and ethnic subgroups.
Clarification of Data Reporting and Availability
The HP2010 document includes three categories for AAPI data: “Asian or Pacific Islander,” “Asian,” and “Native Hawaiian and other Pacific Islander” on all the objectives with population data tables. This is the first time that data has been disaggregated for these groups in HP2010. However, information on AAPIs and other ethnic groups is often missing. In fact, there is no AAPI data available for over half of the objectives which require this information.
Fortunately, whenever AAPI data are not reported, the HP2010 document codes the reasons for the absence of data by whether (1) the data have not been analyzed, (2) the data are not collected, or (3) the data are statistically unreliable. These explanations are tremendously helpful in determining approaches to increase available data on AAPI populations. It clarifies the need to prioritize data that has not been analyzed or collected, and the importance of increasing the sample size of those datasets in which AAPI representation is too low to be statistically reliable.
Focus Areas and Objectives
Healthy People 2010 has been organized into 28 focus areas and 467 specific objectives. The focus areas range from broad issues such as environmental health, access to health care, and health communication, to specific disease areas such as cancer and STDs. Each focus area contains specific objectives, measured by a particular data set. Healthy People 2010 will monitor each of these objectives, and determine the nation’s progress on a regular basis. However, since data on AAPIs is missing in over half of these data sets, it will be a challenge to work with the Department of Health and Human Services to collect additional data on many objectives for AAPIs and other groups with missing information.
Leading Health Indicators
In order to quickly determine the progress of Healthy People 2010 objectives, the Healthy People collaborative selected ten leading health indicators which reflect the health status of the population. These indicators, supposedly analogous to the leading economic indicators, are meant to be representative of the overall goals and objectives, and are directly linked to specific objectives within Healthy People 2010. They will allow for quick updates on how much has been accomplished in achieving HP2010 goals. While the idea of leading health indicators is extremely valuable, the indicators selected focus on certain individual behaviors and do not represent the broad scope of the HP2010 initiative that includes objectives to change health care delivery systems and broader, community-based health promotion and disease prevention programs.
For more information about Healthy People 2010 and related documents, see the Healthy People website at http://www.health.gov/healthypeople/ or contact Meena Deo, APIAHF Policy Analyst, at mdeo@apiahf or 415-954-9954.
