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Editorials

Healthy People 2030: A Compass in the Storm

McGinnis, J. Michael MD, MPP

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Journal of Public Health Management and Practice: November/December 2021 - Volume 27 - Issue - p S213-S214
doi: 10.1097/PHH.0000000000001328
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Events of the year 2020 offer poignant testament to the central importance of Healthy People 2030 and the need to be guided in challenging times by what the evidence tells us is compellingly essential and entirely possible for better health for Americans. The nation is currently in the throes of what amounts to a perfect storm—the COVD-19 pandemic, a fragmented health system with errant incentives, and the impact of structural racism as a source of staggering health consequences for large segments of our population. At no time has it been more important to have the combination of integrative vision, strategic guidance, and accountability metrics embedded in Healthy People 2030 to both help chart our course in this storm and contribute a template for the partnerships and actions necessary.

The Healthy People process began in 1979, with the release of Healthy People: The Surgeon General's Report on Health Promotion and Disease Prevention.1 The primary aim of Healthy People was to draw attention to the power of prevention as the most direct line to a healthier nation, in contrast, though not in opposition, to the relatively limited impact on the nation's health profile that might be anticipated from treatment of illness and injury-then and now commanding more than 90% of national health expenditures.

To underscore the realistic opportunities at hand, Healthy People presented quantified predictions of the considerable mortality burden for people at each life stage—infants, children, teens and young adults, adults, and older adults—could be eliminated by 1990, within existing resources. Interesting in light of the current pandemic, this anchor feature of Healthy People drew its inspiration from the successful application of quantified target-setting, tracking, and resource shifting in the final stages of the eradication of smallpox, historically the world's leading killer.

As the Healthy People report was being developed, work was initiated to expand the scope and specificity of the vision it presented. To emphasize that the initiative was truly national, as distinct from federal, a broad national consultative effort was undertaken to develop a practical set of measurable targets for each of the 15 health promotion, health protection, and preventive services priority areas. The product was the 226 national health objectives released in 1980 in Promoting Health/Preventing Disease: Objectives for the Nation.2 The intent was to provide a tool to shape and track health improvement efforts in national programs as well as at the state, local, and organizational levels. Building on accumulated knowledge and experience, enhanced versions have been developed for each decade and issued as Healthy People 2000,3 Healthy People 2010,4 Healthy People 2020,5 and now Healthy People 2030.

From a conceptual perspective, the development and release of Healthy People 2030 present a critical advance and a core resource to the nation, offering, in the spirit of the process, foundational improvements on its stage-setting predecessors. Beginning with its vision of “a society in which all people can achieve their full potential for health and well-being across the lifespan,” coursing throughout its framework are foundational priorities on what science is revealing about the essential roles that social determinants play on the health profile of many populations, as well about the nature and impact of well-being in each of our lives.

From a technical perspective, Healthy People 2030 has reduced the number of objectives to sharpen the focus on the most important controllable issues, and it has ratcheted up the focus on currency, rigor, and trackability as part of the scientific criteria used in their establishment. It has also given close consideration to increasing the harmonization among the objectives in the full set and to transparency in target-setting.

From a solidarity perspective, Healthy People 2030 deepens the national commitment to place first priority on the elimination of health inequities and disparities, by both identifying areas of particular concern and selecting relevant core objectives as essential to progress across the set.

And from an implementation perspective, Healthy People 2030 is accompanied with an unprecedented set of resources and tools designed not only to help in tracking and communication on progress at multiple levels but also to facilitate use in diverse organizations, settings, and technical capacity. Even a casual look at HealthyPeople.gov indicates that the increasing democratization of the process will be of immense importance to its utility and applicability.

The Healthy People process that began over 4 decades ago as an initiative aimed to inform and inspire, to recruit new users to health leadership, and to serve as a conscience alerting all to avoidable shortfalls has therefore evolved into an essential resource for a more complex nation with more complex problems—one sorely in need of orientation as to common possibilities, shared values, feasible strategies, and individual engagement. In effect, Healthy People 2030 offers each of us a compass, functional from any vantage point, on the path to our true North: a nation in which every individual can achieve the full measure of his or her potential for health and well-being.

Each of us is indebted to the many stewards of Healthy People 2030, including the members of the Health and Human Services Secretary's Advisory Committee on National Health Promotion and Disease Prevention Objectives for 2030, the members of the Federal Interagency Workgroup, and especially the staff and leadership of the US Office of Disease Prevention and Health Promotion, who have for more than 40 years skillfully facilitated the broad involvement of national, state, and local health agencies and organizations as key users with shared interests.

Our challenge is now to marshal and commit the collective will to engage, nurture, achieve, record, and celebrate the potential embodied in Healthy People 2030. Then we will be able to look forward to the reward of healthier neighbors, friends, and family members—a healthier nation—not to mention the resulting lessons and inspiration of an even better Healthy People 2040.

References

1. US Department of Health, Education, and Welfare. Healthy People: The Surgeon General's Report on Health Promotion and Disease Prevention. Washington, DC: US Government Printing Office; 1979.
2. US Department of Health and Human Services, Public Health Service, Office of the Assistant Secretary for Health. Promoting Health/Preventing Disease: Objectives for the Nation. Washington, DC: US Government Printing Office; 1980.
3. US Department of Health and Human Services. Healthy People 2000. https://www.cdc.gov/nchs/healthy_people/hp2000.htm. Accessed December 18, 2020.
4. US Department of Health and Human Services. Healthy People 2010. https://www.cdc.gov/nchs/healthy_people/hp2010.htm. Accessed December 18, 2020.
5. US Department of Health and Human Services. Healthy People 2020. https://www.healthypeople.gov/2020. Accessed December 18, 2020.
© 2021 The Author. Published by Wolters Kluwer Health, Inc.