Contents
Introduction...... 1
Part A: General Data Issues...... A-1
1.Target-Setting and Assessing Progress for Measurable Objectives ...... A-3
Target-Setting Methods...... A-3
Assessing Progress...... A-4
2.Developmental Objectives...... A-5
3.Population Estimates...... A-6
Postcensal Population Estimates...... A-6
Intercensal Estimates...... A-7
Population Undercounts...... A-8
Target Populations...... A-8
Resident Population...... A-8
Civilian Population...... A-8
Civilian, Noninstitutionalized Population...... A-8
4.Population Template...... A-10
Minimum Template...... A-10
Race and Hispanic Origin...... A-11
OMB Classification...... A-11
Misreporting Racial and Ethnic Data...... A-15
National Vital Statistics System (Mortality)...... A-15
Patient Care Data...... A-15
Missing Data...... A-16
National Hospital Discharge Survey...... A-16
National Ambulatory Medical Care Surveys...... A-16
National Notifiable Disease Surveillance System...... A-16
Socioeconomic Status...... A-16
Income...... A-17
Family Income Level...... A-18
Education...... A-20
Other Population Groups...... A-22
Urbanization...... A-22
Urban...... A-22
Metropolitan Statistical Areas (MSA’s)...... A-23
Health Insurance Status...... A-23
Disability...... A-24
Age...... A-26
5.Age Adjustment...... A-28
Mortality...... A-29
Health Surveys...... A-32
6.Mortality and Morbidity Classification...... A-36
Mortality Data...... A-36
Morbidity Data...... A-38
7.National Data...... A-40
8.State and Local Data...... A-41
Objective Wording/Operational Definition...... A-41
Population Data/Race and Ethnicity Reporting...... A-41
“Rare” Events/Confidentially...... A-42
Age Adjustment...... A-42
Data Sources...... A-42
9.Variability of Estimates...... A-45
10.Healthy People 2010 Database...... A-48
Database Description...... A-48
Future Plans...... A-49
Part B: Operational Definitions...... B-1
1.Access to Quality Health Services...... B1-1
Clinical Preventive Care...... B1-3
Primary Care...... B1-11
Emergency Services...... B1-38
Long-Term Care and Rehabilitative Services...... B1-44
2.Arthritis, Osteoporosis, and Chronic Back Conditions...... B2-1
Arthritis and Other Rheumatic Conditions...... B2-3
Osteoporosis...... B2-9
Chronic Back Conditions...... B2-12
3.Cancer...... B3-1
4.Chronic Kidney Disease...... B4-1
5.Diabetes...... B5-1
6.Disability and Secondary Conditions...... B6-1
7.Educational and Community-Based Programs...... B7-1
School Setting...... B7-5
Worksite Setting...... B7-19
Health Care Setting...... B7-29
Community Setting and Select Populations...... B7-32
8.Environmental Health...... B8-1
Outdoor Air Quality...... B8-5
Water Quality...... B8-17
Toxics and Waste...... B8-21
Healthy Homes and Healthy Communities...... B8-28
Infrastructure and Surveillance...... B8-38
Global Environmental Health...... B8-55
9.Family Planning...... B9-1
10.Food Safety...... B10-1
11.Health Communication...... B11-1
12.Heart Disease and Stroke...... B12-1
Heart Disease...... B12-3
Stroke...... B12-7
Blood Pressure...... B12-9
Cholesterol...... B12-14
13.HIV...... B13-1
14.Immunization and Infectious Diseases...... B14-1
Diseases Preventable Through Universal Vaccination...... B14-5
Diseases Preventable Through Targeted Vaccination...... B14-28
Infectious Diseases and Emerging Antimicrobial Resistance...... B14-31
Vaccination Coverage and Strategies...... B14-49
Vaccine Safety...... B14-81
15.Injury and Violence Prevention...... B15-1
Injury Prevention...... B15-3
Unintentional Injury Prevention...... B15-13
Violence and Abuse Prevention...... B15-32
16.Maternal, Infant, and Child Health...... B16-1
Fetal, Infant, Child, and Adolescent Deaths...... B16-5
Maternal Deaths and Illnesses...... B16-15
Prenatal Care...... B16-17
Obstetrical Care...... B16-19
Risk Factors...... B16-23
Developmental Disabilities and Neural Tube Defects...... B16-28
Prenatal Substance Exposure...... B16-33
Breastfeeding, Newborn Screening, and Service Systems...... B16-40
17.Medical Product Safety...... B17-1
18.Mental Health and Mental Disorders...... B18-1
Mental Health Status Improvement...... B18-3
Treatment Expansion...... B18-8
State Activities...... B18-15
19.Nutrition and Overweight...... B19-1
Weight Status and Growth...... B19-3
Food and Nutrient Consumption...... B19-12
Iron Deficiency and Anemia...... B19-27
Schools, Worksites, and Nutrition Counseling...... B19-33
Food Security...... B19-37
20.Occupational Safety and Health...... B20-1
21.Oral Health...... B21-1
22.Physical Activity and Fitness...... B22-1
Physical Activity in Adults...... B22-3
Muscular Strength/Endurance and Flexibility...... B22-8
Physical Activity in Children and Adolescents...... B22-10
Access...... B22-18
23.Public Health Infrastructure...... B23-1
Data and Information Systems...... B23-3
Workforce...... B23-8
Public Health Organizations...... B23-10
Resources...... B23-13
Prevention Research...... B23-14
24.Respiratory Diseases...... B24-1
Asthma...... B24-3
Chronic Obstructive Pulmonary Disease (COPD)...... B24-14
Obstructive Sleep Apnea (OSA)...... B24-17
25.Sexually Transmitted Diseases...... B25-1
Bacterial STD Illness and Disability...... B25-3
Viral STD Illness and Disability...... B25-9
STD Complications Affecting Females...... B25-10
STD Complications Affecting the Fetus and Newborn...... B25-14
Personal Behaviors...... B25-15
Community Protection Infrastructure...... B25-17
Personal Health Services...... B25-19
26.Substance Abuse...... B26-1
Adverse Consequences of Substance Use and Abuse...... B26-3
Substance Use and Abuse...... B26-11
Risk of Substance Use and Abuse...... B26-34
Treatment for Substance Abuse...... B26-41
State and Local Efforts...... B26-44
27.Tobacco Use...... B27-1
Tobacco Use in Population Groups...... B27-3
Cessation and Treatment...... B27-13
Exposure to Secondhand Smoke...... B27-19
Social and Environmental Changes...... B27-30
28.Vision and Hearing...... B28-1
Vision...... B28-3
Hearing...... B28-7
Part C: Major Data Sources for Healthy People 2010...... C-1
Behavioral Risk Factor Surveillance System (BRFSS)...... C-4
Continuing Survey of Food Intake by Individuals (CSFII), 1994–96...... C-6
HIV-AIDS Case Surveillance System...... C-8
Medical Expenditure Panel Survey (MEPS)...... C-10
Monitoring the Future Study (MTF)...... C-13
National Ambulatory Medical Care Survey (NAMCS)...... C-15
National Crime Victimization Survey (NCVS)...... C-17
National Health and Nutrition Examination Survey (NHANES)...... C-19
National Health Interview Survey (NHIS)...... C-21
National Hospital Ambulatory Medical Care Survey (NHAMCS)...... C-23
National Hospital Discharge Survey (NHDS)...... C-25
National Household Survey on Drug Abuse (NHSDA)...... C-27
National Notifiable Disease Surveillance System (NNDSS) and National Electronic Telecommunications System for Surveillance (NETSS) C-29
National Profile of Local Health Departments (NPLHD)...... C-31
National Survey of Family Growth (NSFG)...... C-32
National Vital Statistics System, Mortality (NVSS-M)...... C-34
National Vital Statistics System, Natality (NVSS-N)...... C-36
1999 National Worksite Health Promotion Survey (NWHPS)...... C-38
School Health Policies and Programs Study (SHPPS)...... C-39
State Tobacco Activities Tracking and Evaluation System (STATE)...... C-41
STD Surveillance System (STDSS)...... C-43
United States Renal Data System (USRDS)...... C-45
Youth Risk Behavior Surveillance System (YRBSS)...... C-47
Appendices
A. Healthy People 2010 Work Group Coordinators
B. List of Abbreviations and Acronyms Used in Healthy People 2010
C. Baselines for Age-Adjusted Mortality Objectives Using Rates Age Adjusted to 1940 and to 2000 Standards: United States, 1999
D. ICD-9 Codes for Cause-Specific Healthy People 2010 Mortality Objectives
E. ICD-9-CM Codes for Cause-Specific Healthy People 2010 Morbidity Objectives
F. Crosswalk From Healthy People 2010 Objectives to Healthy People 2000 Objectives
G. Crosswalk From Healthy People 2000 Objectives to Healthy People 2010 Objectives
H. Healthy People 2010 Objectives That Are Leading Health Indicators
List of Tables and Figures
Figure 1. Resident population by age and gender, United States, 1998...... A-7
Figure 2. Resident population by race, United States, 1998...... A-12
Figure 3. Resident population by Hispanic origin, United States, 1998...... A-12
Figure 4. Poverty status for the civilian, noninstitutionalized population,
United States, 1998...... A-18
Figure 5. Educational attainment for the civilian, noninstitutionalized
population aged 25 years and older, United States, 1998...... A-21
Figure 6. Resident population living in metropolitan and nonmetropolitan
areas, United States, 1998...... A-23
Figure 7. Crude and age-adjusted death rates based on the 1940 and
2000 standard populations, United States, 1979–95...... A-30
Figure 8. Mortality race ratio based on the 1940 and 2000 standard
populations, United States, 1979–95...... A-31
Table 1. Poverty thresholds in 1998, by size of family and number
of related children under 18 years...... A-19
Table 2. Healthy People 2010 data systems and ages used to report
educational attainment...... A-22
Table 3. 2000 standard million age distribution...... A-32
Table 4. Age groups used to age adjust from selected major
Healthy People 2010 data systems...... A-33
Table 5. 2000 population projections by age (in thousands)...... A-34
Table 6. Variables in major data systems for which data are not available
from all States...... A-41
Table 7. Number of Objectives Tracked by Healthy People 2010 Major Data
Sources...... C-3
1