1.14: The Healthy People Initiative- 1990-2030

The Healthy People Initiative began in 1979 due to another landmark surgeon general report titled: “Healthy People: The Surgeon General’s Report on Health Promotion and Disease Prevention” (Office of Disease Prevention and Health Promotion, n.d.-b) Each decade, the initiative sets targets for improving different areas of public health, and measures these outcomes to see if those targets have been hit. The overarching goals have changed over the years, but most have included decreasing or eliminating health disparities, and promoting health for all across the lifespan. The latest iteration - Healthy People 2030 - emphasizes the social determinants of health, including: economic stability, education access and quality, healthcare access and quality, neighborhood and built environment, and social and community context (more on these in Chapter 8). There is also a new focus in the 2030 objectives of health literacy - the ability to find, understand and use information to make well-informed health decisions. An emphasis is also placed on the responsibility of health organizations to provide equitable access to health information and support its use in individual decision-making. The Healthy People 2030 website offers descriptions and the latest data on each health-related objective. (Office of Disease Prevention and Health Promotion, n.d.-c).

Healthy People 2030 is a blueprint for how to drastically improve health in the US, along with measurable objectives to focus our efforts. The Healthy People 2030 goals serve as a horizon to walk towards, while the objectives serve as milestones, letting us know whether we are on track. Reports and meetings that share "evidence-based practices" -- proven strategies for health improvement -- allow public health workers to learn from others' experiences and improve health faster.

Healthy People 2030

Please view this brief video from the U.S. Department of Health and Human Services for an overview of the Healthy People 2030 goals:

The Healthy People 2030 plan (sometimes abbreviated to HP2030) includes a vision, a mission statement, foundational principles, five overarching goals (see video above), a plan of action, and 355 science-based objectives spread over 62 topic areas (ODPHP, n.d.-a).

The objectives describe measurable outcomes that are attainable in a 10-year period. For example, while a goal of HP2030 is that people attain healthy, thriving lives and well-being free of preventable disease, disability, injury, and premature death, one example of a specific objective that moves us in that direction is Objective MICH-01, reduce the rate of fetal deaths at 20 or more weeks of gestation. The baseline was 5.9 fetal deaths at 20+ weeks of gestation per 1,000 live births in 2017, and the objective set in the plan was to reach a rate of 5.6 (or lower). This objective is an example of public health success -- the lower rate of 5.6 was attained in 2021 -- and now efforts are focused on lowering it further. Healthy People 2030 is not only a plan, written once a decade, but also a system for tracking progress toward the objectives set out in the plan. It is easy to see, for example, on this page about pregnancy and childbirth where health is improving, staying the same, or getting worse, in relation to the different measurable objectives.

The developers of Healthy People 2030 have created a set of Tools for Action to support state and local public health departments, as well as independent community organizations, to use the HP2030 objectives in setting their priorities and implementing proven strategies for health. For example, local health departments can

• Use the objectives to identify specific needs and the priority populations in their county
• Set their own targets, using the national data combined with local data, for specific health improvements in their county
• Find inspiration and practical tools by learning about successful programs, policies, interventions, and resources that can be adapted to their county
• Monitor national progress and data, to compare local successes or struggles and work for improvement

Take a moment to explore the Healthy People 2030 website.

• What stands out for you in the Vision and the five Overarching Goals of Healthy People 2030?
• Browse the Objectives by Topic Area -- pick one that interests you (for example, Addiction, or Chronic Pain, or Violence Prevention). What do you notice about the measurable objectives related to this topic? Are they broader or more narrow that you would have expected? Do you see progress in this area, or not so much?
• What do you imagine are the roles for both medicine and public health in attaining the goals and objectives of HP2030? Are some of the topic areas more suited to public health or to medicine, or would they require public health and medicine to work together?
• What are some similarities and differences between setting public health goals and plans, on one hand, and setting personal health goals and plans, on the other?
• What professions do you think must be involved in implementing HP2030? Thinking of your own professional goals, do you see a way your career might intersect with HP2030 efforts?

Other Plans for the Nation's Health

The Healthy People 2030 plan and project offers overarching guidance for improving health in the United States. But it is not the only national planning effort for health.

Here are a few examples of other national plans for health (CDC, 2024):

• National Prevention Strategy. Established in 2011 through the Affordable Care Act, the National Prevention Strategy helped to coordinate efforts among different agencies and organizations to reduce substance use (including tobacco), increase active living and healthy eating, improve mental and emotional well-being, reduce violence and injuries, and improve reproductive and sexual health. For a quick summary of the National Prevention Strategy, see this PDF from NACCHO, the National Association of County and City Health Officers.
• National AIDS Strategy, 2022-2025. This plan is the latest of a series of national strategies against HIV/AIDS, a disease that has claimed over 50,000 American lives and is highly preventable. Like HP2030, the National AIDS Strategy breaks down overarching goals to measurable objectives, such as reducing new infections by 75% or getting 95% of people with a new HIV diagnosis into treatment within one month.
• National Plan to Reduce Alzheimer's Disease. This plan, in existence since 2011, aims to coordinate and strengthen research into Alzheimer's disease, improve diagnosis and treatments, reduce health disparities related to Alzheimer's, and coordinate with international health bodies (like the WHO) to address Alzheimer's around the world. With an aging population, this is increasingly important.

Other national plans for different health topics and concerns can be found at the CDC page on national health initiatives. Please note, this page is being written in April 2025; some federal webpages related to health, especially those related to health equity, may be disabled or removed by the time you read this.

References

Centers for Disease Control and Prevention. (2024, May 16). National health initiatives, strategies, and action plans. https://www.cdc.gov/public-health-ga...ion-plans.html

Office of Disease Prevention and Health Promotion. (n.d.-a). Healthy People 2030. https://odphp.health.gov/healthypeople

Office of Disease Prevention and Health Promotion. (n.d.-b). History of healthy people. Health.Gov. Retrieved November 2, 2023, from https://health.gov/our-work/national...healthy-people

Office of Disease Prevention and Health Promotion. (n.d.-c). Social determinants of health - Healthy people 2030. Health.Gov. Retrieved November 2, 2023, from https://health.gov/healthypeople/pri...minants-health

Seabert, D., McKenzie, J. F., & Pinger, R. R. (2021). McKenzie’s an introduction to community & public health. Jones & Bartlett Learning.