The Healthy People 2020 Initiative - Essay Example

? The Healthy People 2020 Initiative The Healthy People 2020 Initiative Introduction ‘Healthy People’ is a series of projects through which aims and objectives referring to health issues in USA are set (Centers for Disease Control and Prevention 2011). The duration of each of these projects is a decade. In the last project of this type, which started in the beginning of 2010, particular objectives were set for the improvement of health across USA up to 2020. The Healthy People 2020 project incorporates about 1,200 objectives, which focus on 42 health-related sectors in USA (Centers for Disease Control and Prevention 2011). The use of these projects for promoting health in USA has been proved particularly effective; the access of people to health services has been improved while the performance of health institutions across the country has been increased. However, in certain cases, delays are monitored in the completion of the project’s phases. It seems that additional measures are required in order for the project’s parts to be fully developed. The historical development of Healthy People projects is presented in this paper; reference is given specifically to the Healthy People 2020 project. The terms of the project’s successful implementation are analytically presented. In order for the needs and the value of the project to be clear, the example of its performance in a specific sector is used. The food safety in USA as promoted through the Health People 2020 project is presented and evaluated, referring to the measures taken by the New York City Department of Health and Mental Hygiene or supporting the relevant initiative. The level of success of Healthy People 2020 project and its potentials for the future are evaluated using relevant commentary. The responses of the public to the specific project seem to be encouraging; however, the need for improvements in the development of the project’s plans is clear. 2. The Healthy People Initiative 2.1 Healthy People Initiative history and lessons learned The history of Healthy People project proves that the specific initiative has significantly contributed in the improvement of health across USA, even if the relevant targets have been achieved gradually. In 2010, a Workshop was developed for the evaluation of the performance of Healthy People project and the identification of its major requirements, both in the short and the long term. Of particular importance has been the potential of HP project to respond to the challenges of health for the period between 2010 and 2020. It was made clear that for this period, as in the past also, emphasis should be given on the implementation of the project’s plans and the monitoring of their performance. The HP project has been introduced for first time about 3 decades before (Office of Disease Prevention and Health Promotion 2010). In fact, the first initiative of this type introduced in 1979 through ‘a surgeon’s report that suggested a series of objectives which would be achieved by 1990’ (Gever 2010). HP project reflects the 4th decade of the project and aims to cover any issue, which was not addressed through the previous projects of this type. The key characteristic of HP project is that it is flexible enough so that it can be aligned with the health care needs of each particular period. For example, in 2000 the most important challenge for legislators in USA was to identify a method for improving clinical care across the country; the HP project helped towards the achievement of this target (Office of Disease Prevention and Health Promotion 2010). In a similar way, the HP 2010 project promoted the value of individual as a member of the community while the HP 2020 project ‘recognizes societal influences on health’ (Office of Disease Prevention and Health Promotion 2010, p.3). Moreover, the use of the HP projects for addressing health needs in USA proved that the specific sector suffers from disparity, delays in the limitation of costs, redundancies and failures in the control of performance. In certain cases, these problems made clear after the implementation of the HP project; for instance the disparity problem first appeared in 2000 (Office of Disease Prevention and Health Promotion 2010). On the other hand, the need for improvement of clinical care in specific areas was another issue appeared as a result of the promotion of the HP projects; for instance the need for focusing on heart problems became emergent in 2010, a fact that led to the appropriate adjustment of the HP project of that period (Office of Disease Prevention and Health Promotion 2010). One of the most important challenges that the HP 2020 has to face is accountability; the affordability of health care is another problem addressed through the HP 2020. Indeed, the radical increase of medical costs has made health care in USA less affordable, for a high percentage of people. The Affordable Care Act is expected to support the development of HP 2020 so that costs are appropriately dispersed among the population setting realistic criteria for allowing the access to health services of people of different financial status. In accordance with the above, the key lessons learned from the development of HP projects up to now are the following ones: health – related projects need to be continuously monitored as of their alignment with the actual health needs of local population. Also, health programs do not have any value unless they are accessible to all people, or at least to the most of them. Finally, accountability is an important factor for the success of any health project, as in all projects the cost of which is quite high. All these issues need to be taken into consideration by the initiators of the HP projects, both for ensuring the success of the HP 2020, which is in progress, and for further improving the relevant scheme by incorporating appropriate rules in the HP project that follows, i.e. the HP 2030. 2.2 Presentation and analysis of the elements of Health People 2020 Initiative The success of the Healthy People initiatives up to now is based on the following fact: when a new initiative is to be planned, the findings related to the performance of the previous initiative are reviewed and evaluated (Healthy People 2020, 2008). At the same time, current data (figures, reports) are examined in order to understand the potential risks of the new initiative, i.e. the initiative which is going to be implemented for the next decade (Healthy People 2020, 2008). The key targets of each initiative are: a) the promotion of transparency, b) the attract of the interest of the public, the support of which is critical for the success of the initiative and c) the continuous development of the dialogue with all stakeholders ensuring that the initiative will be adequately supported through the decade involved (Healthy People 2020, 2008). Since an initiative is launched it has the support of thousands of people, which means that the chances for failures are minimized. The Healthy People 2020 initiative includes a series of objectives related to health care in USA; these objectives need to be achieved within the 10-years that the initiative lasts (Health Sciences Library System 2011). The initiative is a group-work, meaning that it is not developed solely by the state but it is the result of a long-term collaboration between ‘a series of federal agencies (including the U.S. Department of Health and Human Services) and thousands of citizens across the country’ Department of Health and Human Services (Health Sciences Library System 2011). This means that the objectives of the initiative have been thoroughly examined in advance as of their necessity and feasibility but also of their outcomes. The above initiative was introduced in December 2, 2010 and incorporates a wide range of topics, which are categorized in 39 sections (Health Sciences Library System 2011). Each of these sections is further divided into three parts, entitled as ‘“Overview,” “Objectives,” and “Interventions & Resources.”’ (Health Sciences Library System 2011). Through this initiative, a series of issues are addressed for the first time, such as: a) it makes clear that social factors are likely to affect the quality of health and the access to health, b) dissemination is developed, since the introduction of the initiative, through an appropriately customized web-site, c) the system’s customers (i.e. the public) can be informed on their cases online; moreover, they can be informed on the options available as supported by appropriate evidence (Health Sciences Library System 2011). Apart from the initiative’s web site, other web tools and applications, such as popular social networking sites (such as the LinkedIn) and e-mail option are available to the system’s visitors ensuring that their needs will be appropriately addressed. 2.3 Implementation of the Healthy People 2020 The criteria and the methods used for the implementation of the Healthy People 2020 promote the effectiveness of the initiative; indeed, through a process called MAP-IT, individuals can develop plans of action, which can address their needs in the workplace. As explained in the Healthy People 2020 website, the response of employees to a particular organizational problem, related to them, can be organized as follows: employees can first develop an employee committee, which will discuss the issue. Then, the employer will be informed on the measures decided; at this phase of the process, negotiations can be held between the employees and the employer. After applying their own plan, employees evaluate the results. In case they consider that additional measures are required, then they can develop a report using the appropriate objectives (among the sectors/ topics of the initiative) from the Healthy People 2020 initiative; the objectives are incorporated in the employees’ report and they are submitted to the employer who is obliged to follow the suggestions of employees as aligned with the Healthy People 2020 objectives (Healthy People 2020, implementation). At the next level, employees can seek for assistance in the federal and local authorities. Commonly, the promotion of the objectives of the Healthy People initiatives, as of other similar legislative texts, is supervised by the United States Departments of Labor. The above authority defines the plans of implementation for the initiatives’ objectives. An example of such case is the New York State Plan, a scheme aiming to ensure the application of certain standards in regard to job safety and health across the state (United States Department of Labor 2011, New York Plan). The plan includes both voluntary and enforcement programs ensuring that employers across the state are conformed with the Federal OSHA standards. The employers are given the chance ‘to seek for administrative review of their case’ (United States Department of Labor 2011, New York Plan) if they consider that the measures taken by the relevant authority were unfair or not fully justified. 2.4 Food Safety in the context of the Healthy People 2020 Initiative The phases of the implementation and the common requirements of the Healthy People 2020 initiative are explored by referring to one of its objectives: Food Safety is among the objectives of the particular initiative. This objective includes certain sub-categories; for the needs of this paper reference is made to one of these categories, the consumer food safety practices (Healthy People 2020 objectives). In accordance with the relevant guidelines, authorities would ensure the safety of consumer food by ‘increasing the number of consumers who follow food safety practices’ (Healthy People 2020 objectives). The objective set is the increase of the above percentage at least by 10% practices’ (Healthy People 2020 objectives, p.123). The results of certain of such practices in the past are revealed: when consumers tried to separate food for keeping it safety, this led to an increase of food safety by 3.4% (in 2006) (Healthy People 2020 objectives, p.124); similar percentages of increase of food safety were reported when using other practices, such as increasing refrigerating temperatures or cooking better the meals (Healthy People 2020 objectives, p.124). 2.4.1 Efforts of the New York City Department of Health and Mental Hygiene for promoting food safety The efforts of the New York City Department of Health and Mental Hygiene in regard to the increase of food safety can be identified in the relevant site; a food protection course is offered to people who are going to work in the food industry (New York City Department of Health and Mental Hygiene. ‘Services’ 2011); after being appropriately trained these individuals can promote the objectives of the Healthy People 2020 initiative in regard to food safety. It should be noted that this course addresses the food supervisors, the mobile vendors of food and the food operators in general (New York City Department of Health and Mental Hygiene, ‘Services’ 2011). The course last five sessions and provides to the participants the necessary information on food safety. Moreover, the Bureau of Food Safety and Community Sanitation ensures that food safety rules are applied in any place where food is stored, processed or sold (New York City Department of Health and Mental Hygiene, ‘Services’ 2011), within the context of the Community, so that the health of local people is not threatened. Furthermore, publications on food safety (reports, rules, legislative texts) are available through the website of the New York City Department of Health and Mental Hygiene, so that visitors can be informed on all critical issues on food safety as related to their activities. 2.5 Commentary on the Healthy People 2020 Initiative The performance of the Healthy People 2020 would be better evaluated after the end of the specific process, i.e. in 2020. However, in the meantime, the value of these initiatives up today can be criticized by using relevant data and figures, as published by federal and non-federal agencies. The reports and the commentaries referring to the specific subject would be also valuable sources for understanding the level of success of Healthy People initiatives up today. In accordance with a report published in 2011 by the Policy and Medicine Department, the success of the Health People initiative ‘in last decade reached the 71%, an important level taking into consideration the challenges that the American economy had to face this period (Policy and Medicine Department 2011). In accordance with Elliott (2008) the key challenge for the initiators of the Healthy People 2020 project is to increase the sources employed in the project, since only this way its effectiveness can be guaranteed. It seems that the key challenge that the specific initiative has to face is not the availability of funds required for its implementation but the lack of other sources, for instance, appropriately trained staff. Indeed, in May 2011, ‘a $26,361 grant award from the U.S. Department of Health and Human Services to the Connecticut Department of Public Health’ (Department of Public Health 2011). The state of Connecticut recognized the value of this form of help; however, the local authorities noted the need for developing training programs in order to support the implementation of the Healthy People 2020 objectives related to ‘hereditary cancers’ (Department of Public Health 2011), an objective delegated to the specific state. Moreover, Quick (2010) emphasizes on the importance of the Healthy People 2020 for addressing a series of chronic diseases, which could not be addressed by scientific research through a different plan of action. On the other hand, in accordance to Becker (2011) the introduction of the Health People 2020 initiative has not eliminated disparities, a problem that would be resolved by the relevant federal and local authorities. This problem is further verified through the following fact: the smoking among teenagers in New York has been increased in 2009 despite the promotion of the Health People 2020 initiative (Niagara Gazette 2011). 3. Conclusion The development of the Healthy People initiatives has helped the Healthcare System in USA to become more effective. The major advantage of these initiatives seems to be their potential to offer detailed plans of action in case of health problems. The Healthy People 2020 initiative is developed within the same framework. The specific initiative is supported by thousands of citizens and many federal agencies, a fact that guarantees its effectiveness, at least up to a level. More specifically, even if the phases of the initiative’s implementation, as explained above, are well planned and carefully monitored, still there are cases that the objectives of Healthy People 2020 cannot be achieved. Reference is made specifically to the case that the implementation of the phases of the initiative faces delays, which cannot be avoided; the limitation of bureaucracy and the increase of independence of non-federal agencies can help individuals to access quicker the objectives of the initiative. In this way, the implementation of the initiative can be attempted early, before the health or safety issue becomes severe. The improvement of communication and collaboration between the federal and non-federal agencies would help to the increase of effectiveness of the particular initiative, which cannot reach its targets unless its requirements are fully met. References Becker, A. (2011, June) ‘Healthy People: Nation's health improved, but disparities persist’ The CT Mirror. Retrieved 2011, November 13 from http://www.ctmirror.org/node/14140 Centers for Disease Control and Prevention (2011, May) ‘Healthy People’ Retrieved 2011, November 13 from http://www.cdc.gov/nchs/healthy_people.htm Department of Public Health (2011, May) ‘Connecticut's Healthy People 2020 Action Project’ Retrieved 2011, November 13 from http://www.ct.gov/dph/cwp/view.asp?a=3130&Q=478922&PM=1 Elliott, V. (2008, June) ‘Healthy People 2020: National agenda shifts to risks, roots of disease’ American Medical News. Retrieved 2011, November 13 from http://www.ama-assn.org/amednews/2008/06/02/hll20602.htm Florida BrownFields Association (2011, January) ‘Healthy People 2020 Community Innovation Awards’ Retrieved 2011, November 13 from http://flba.affiniscape.com/displaycommon.cfm?an=1&subarticlenbr=30 Gever, J. (2010). ‘HHS Launches Healthy People 2020’ Retrieved 2011, November 13 from http://www.medpagetoday.com/PublicHealthPolicy/HealthPolicy/23706 Health Sciences Library System (2011, February) ‘Healthy People 2020 Initiative Launched’ Retrieved 2011, November 13 from http://info.hsls.pitt.edu/updatereport/?p=4405 Healthy People 2020 ‘Objectives’ Retrieved 2011, November 13 from http://www.healthypeople.gov/2020/topicsobjectives2020/pdfs/HP2020objectives.pdf Healthy People 2020 ‘Implementation - MAP-IT in Action – In the Workplace: Employees Organize To Improve Workplace Wellness’ Retrieved 2011, November 13 from http://healthypeople.gov/2020/implementing/workplaceWellness.aspx Healthy People 2020 (2008, August) ‘Welcome to Healthy People 2020!’ Retrieved 2011, November 13 from http://healthypeople2020.pbworks.com/w/page/17373651/FrontPage National Network of Libraries of Medicine (2011, August) ‘Get Involved with the Healthy People 2020 Initiative!’ Retrieved 2011, November 13 from http://nnlm.gov/psr/newsbits/2011/01/12/get-involved-with-the-healthy-people-2020-initiative/ New York City Department of Health and Mental Hygiene. ‘Services’ Retrieved 2011, November 13 from http://www.nyc.gov/html/doh/html/home/home.shtml Niagara Gazette (2011, March) ‘Report says teen smoking on the rise’ Retrieved 2011, November 13 from http://niagara-gazette.com/local/x415202631/Report-says-teen-smoking-on-the-rise Office of Disease Prevention and Health Promotion. Department of Health and Human Services Washington, DC. September 28, 2010 ‘2010 Healthy People State Coordinators Workshop’ Retrieved 2011, November 13 from http://www.atpm.org/prof_dev/pdfs/2010StateCoordinatorsWorkshopSummary.pdf Policy and Medicine (2011, March) ‘IOM Report: Leading Health Indicators for Healthy People 2020’ Retrieved 2011, November 13 from http://www.policymed.com/2011/03/iom-report-leading-health-indicators-for-healthy-people-2020.html Quick, D. (2010, December) ‘Initiative targets a healthier 2020’ The Post and Courier. Retrieved 2011, November 13 from http://www.postandcourier.com/news/2010/dec/14/initiative-targets-a-healthier-2020/ United States Department of Labor (2011) New York Plan. Retrieved 2011, November 13 from http://www.osha.gov/dcsp/osp/stateprogs/new_york.html Read More