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Healthy People Home > Healthy People 2020 > Public Comment > Vision, Mission,
Overarching Goals

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Each iteration of Healthy People has included a set of overarching goals. Should the overarching goals be realistic and achievable or should they be aspirational in nature? For example, Healthy People 2010’s two overarching goals are aspirational:
  • Increase quality and years of healthy life.
  • Eliminate health disparities.

This section is closed for comments.

jonesbw on 3/2/2009 11:24:44 AM
I think that physical education in schools has got to stay. The effects of physical activitiy has been know for years and getting children to develop good habits will be steps towards increasing quality years of healthy life. If people are healthier and more fit, then some health disparities will be eliminated as well.
Anonymous on 2/25/2009 8:17:38 AM
more walking paths and biking paths plus enforcing that vechicles must give way not matter would help look at the netherlands everyone rides bikes you see parents dropping kids off at daycar from bikes you see grannies biking to the store I know many people wont because roads arent safe for walking or biking we need more bike lanes and strolling paths to get places
Anonymous on 2/25/2009 8:17:28 AM
more walking paths and biking paths plus enforcing that vechicles must give way not matter would help look at the netherlands everyone rides bikes you see parents dropping kids off at daycar from bikes you see grannies biking to the store I know many people wont because roads arent safe for walking or biking we need more bike lanes and strolling paths to get places
Anonymous on 2/19/2009 1:46:19 AM
I believe the goals should be realistic, and should be able to be achieved by any individual. It is nearly impossible to get motivated to work towards unbelievable goals.
Anonymous on 2/19/2009 12:30:18 AM
I feel the goals she be realistic and achievable, because people really will not work for somthing they know they can not achieve. They should be able to work hard to get to the goals.
killinge on 2/19/2009 12:10:19 AM
I believe the goals should be realistic and achievable. Nobody wants to strive for a goal that is impossible to acheive. However, the goals should not be easily attainable. There needs to be some work involved and there definitely needs to be some changes made.
Anonymous on 12/9/2008 7:49:11 PM
I believe the overarching goals should be realistic and achievable. If you set a goal that is aspirational, its harder to find ways to be strong and proactive in working toward the goal. But if the goal is realistic and achievable, people will feel that the goal can be reached. They will worker harder to achieve the goal and make it a priority. An aspirational goal would be ideal for setting a 20 year goal.
Anonymous on 12/8/2008 10:27:04 AM
I believe that the over-reaching goals should be realistic and achievable. If a person does not believe that they can do something then the chances of that person achieving a goal will not be met. I am a strong believer in that if you can actually see results in people the chances are increased for someone else to do as they did. It also shows how goals are achievable and that anybody can do it.
Anonymous on 12/8/2008 10:21:52 AM
I think having overarching goals are beneficial as something to strive for but it can be very vague as to if it has been accomplished or not. If we differentiate between a realistic and measurable 10 year goal and then in conjunction have an overall goal that we strive for it can motivate organizations and people to achieve something that is realistically within reach in a 10 year period. So overall I think we should set realistic, specific, and measurable goals so we will know when we have achieved them but as a set of overching goals that is continuallly being improved. I would also like to emphasize the importance of have realistic goals as it can be discouraging every decade to fall short of our stated goals. Having reachable goals I think is essential to motivate the nation to strive for better health.
Anonymous on 12/8/2008 7:09:03 AM
While the first objective is a very well stated and possible goal, the second isn't as achievable. Some health disparities aren't effected completely by lifestyle alone. Many are inherited. So to claim to want to eliminate health disparities makes me think all health disparities which isn't possible. This makes a very large claim with little realistic probability of achieving. They should reword this so it isn't as vague and so far over-reaching.
Anonymous on 12/8/2008 12:29:45 AM
I believe the overarching goals can be aspirational but I think it is important to make them a little more realistic. Broad aspirational goals such as "eliminate health disparities" seems pretty unrealistic to those reading the document. If you include an achievable number in the goal such as eliminate health disparities by a certain percentage, it makes it sound a little more realistic. Giving people realistic goals to work toward provides more motivation to try to reach them.
Anonymous on 12/7/2008 9:51:36 PM
I think that Healthy People's goals should be realisting and achievable. This is a very simple question because everyone gets satisfaction from being able to achieve something. There is really not a good way to measure aspirational goals, but there is definitely a way to measure goals that are realistic and acheivable. This will make it more satisfying for everyone involved, whether they are the ones doing the research or the ones that read the reports.
Anonymous on 12/7/2008 5:38:32 PM
I believe that Healthy people should set overarching goals that are aspirational. However, I believe that they can be more realistic. It is good to have a final goal but every 10 years the goal should make progress towards that final goal. For example, instead of just having "eliminate health disparities," every ten years there should be a different percentage to reach. So for 2020 it could say eliminate health disparities in minority groups by "_" percent. This would make the goal more realistic but still aspirational.
Anonymous on 12/7/2008 2:03:13 PM
I believe we should set overarching goals that are achievable and aspirational. Achievable goals help the everday person get on a healthy start. If you are trying to help someone achieve a certain weight or get a certain amount of excercise a day you are going to want to set small goals for them and make them grow as they are achieved. If you set goals that are not achievable the subject will get discouraged and not continue on with his/her plan. Then again setting aspirational goals is also something that should be used but in a certain context with certain people. Our national government and big health agencies should set goals like these to keep their minds rolling and more ideas coming out. If you set goals that are achievable then they will reach them and stop. They won't keep pushing forward for better qualities of health.
Anonymous on 12/6/2008 5:30:16 PM
I think the overarching goals should be realistic and achievable. It is intimidating and discouraging to begin the first steps to achieving a goal if you know you have a long ways to go or that you may not ever reach it. Especially when it comes to personal issues such as healty eating and exercising and other health realted behaviors that will contribute to increasing quality and years of life, people need the reasurance that what they are doing is beneficial and obtainable. How is the goal of increasing quality of life going to be measured? How when we know when/if the goal is reached? However, I do like that the goal is to increase quality of life and not just length. The goal of eliminating healthy disparities is obtainable, as long as people realize it is going to take a long time achieve as well as many aspects must be considered. This is also a goal that can be measured with statistics.
Anonymous on 12/5/2008 8:49:29 PM
Healthy People 2020 should be realistic and achievable. It's nice to have aspirational goals, but people look at those goals and think they will never reach that, or they lose motivation because reaching them seem so far away. Aspirational goals, such as the two overarching goals will never be fully reached. How do you know specifically when the quality and years of healthy lives have increased? I think the goals should be realistic and achievable.
Anonymous on 12/2/2008 9:04:11 PM
Healthy People 2010's goals should be both realistic and aspirational in nature. It could be beneficial to have a list of short-term, more achievable goals beneath each aspirational goal to demonstrate how that goal will be attained. By merely listing the two aspirational goals with no further explanation, the public is left wondering what will/should be done to achieve it. Specific ideas, like how the attainment of this goal will be measured and what we, as individual citizens, can do to help achieve these goals, are needed.
Anonymous on 11/26/2008 12:43:34 PM
As a country, we need to decide what the realistic minimal (not maximal) philosophically and financially acceptable level of healthcare should be. Is it in our best interest to start programs that will leave a financial burden for our children to carry in the future? Is this healthcare to be provided to citizens or all comers? For example, should all people have access to prenatal care, childhood immunizations, free meals, etc. or should this just be limited to legal Americans? (What defines "legal"?) With the increase in TB from countries outside the US, should we provide free testing/treatment to all in order to protect the existing citizens? Due to the emotional volatility of these questions and the unwillingness of politicians to "pick a side" that might be politically fatal, we need Ethicists, Economists and Physicians in private practice & Federal programs on the Board to encourage dialogue and establish these criteria before a plan is instituted and blank check written. Additionally, we are already in a healthcare crisis: physicians are leaving their practice due to high costs of litigation (and insurance) as well as the mountainous burden of paperwork required for existing Federal programs like Medicare. Nursing programs do not currently have enough qualified faculty (Masters level or higher) to prepare existing applicants, much less to increase the number of qualified practitioners by 2010 as the population (and faculty) age. Until these basic problems are considered, all the "plans" for the future will be moot.
clsports on 10/17/2008 5:12:19 AM
In order to better rehabilitate citizens, especially those of a economically-disadvantaged status, as well as provide health and wellness services for those citizens, the Medicare therapy cap should be permanently repealled by 2015. By 2020, health and wellness services will be primarily covered by Medicare when provided in a group session of multiple clients/patients.
PolicyLink on 9/18/2008 7:15:44 PM
While it can be helpful for long-term goals to be aspirational, goals for these next 10 years should be entirely realistic and achievable. The immediate goals should also lend themselves to benchmarks that allow progress and eventual attainment to be measured. Selecting goals that meet criteria set forth by the SMART Goals model (specific, measurable, attainable, realistic and timely) could increase the chances that Healthy People 2020 goals are indeed met during the specified timeframe.
PolicyLink on 9/18/2008 7:12:14 PM
Expand this goal by proposing a means of achievement. For example: Eliminate health disparities by improving the health of lower income communities and communities of color.
Anonymous on 8/11/2008 11:23:24 AM
To develop healthy people, we need a healthy environment including less polluting transportation, universal preventative/health care, and to avoid wars if at all possible--especially unnecessary wars such as the one in Iraq.
Anthony Salafia PT on 7/24/2008 4:19:11 PM
Eliminating Health disparities among the elderly poor is an area that government agencies need to link arms with existing organizations (civic and faith based organizations) such as the community senior centers and the Salvation Army senior living and community centers. Creating new layers of bureaucracy is not necessary to bridge the disparity. The line is very fine between those elderly living completely on public assistance and those who live in upscale senior living facilities. County health agencies also need to join forces with corporate organizations (Big box stores like Target, Wal Mart, Lowes, Home Depot, Costco and even Starbucks) to give back to the community by sponsoring health screenings for the elderly ... not just offering flu shots. It will take an intentional effort on the part of government and private organizations to work in a mutualistic relationship.
Ramon P. Llamas on 6/27/2008 10:48:38 AM
Health disparities of all types are entrenched in our healthcare system. HP 2020 should continue and build upon its efforts in reducing these disparities from HP 2010, but instead of addressing health disparities resulting from distinct characteristics, such as socioeconomic status, race and age, its priorities should lie in addressing an upstream determinant encompassing all of the above: gender. Men fall behind women in most health outcomes, accumulating to at least a five year difference in life expectancy across all races. The top causes of death, heart disease and cancer, have significantly higher mortality rates in men compared to women. Additionally, men have lower access to health care services and are half as likely than women to visit the doctor. Therefore, I respectfully request that HP 2020 continue its efforts in eliminating health disparities by initiating a focus on eliminating gender disparities.
Anonymous on 6/27/2008 10:46:50 AM
Health disparities of all types are entrenched in our healthcare system. HP2020 should continue and build upon its efforts in reducing these disparities from HP2010, but instead of addressing health disparities resulting from distinct characteristics, such as socioeconomic status, race and age, its priorities should lie in addressing an upstream determinant encompassing all of the above: gender. Men fall behind women in most health outcomes, accumulating to at least a five year difference in life expectancy across all races. The top causes of death, heart disease and cancer, have significantly higher mortality rates in men compared to women. Additionally, men have lower access to health care services and are half as likely than women to visit the doctor. Therefore, I respectfully request that HP2020 continue its efforts in eliminating health disparities by initiating a focus on eliminating gender disparities.
TMorrow on 6/24/2008 10:45:43 AM
Today we face a major gender disparity in health in our country. Men continue to experience a life expectancy that is 6 years less than that of their female counterparts. Men also die at higher rates of the top causes of death . Cancer is the number 2 killer of men with prostate cancer being the most common type, after skin cancer, with 1 in 6 men getting the disease during their lifetime. Women Against Prostate Cancer is requesting that HP 2020 continue the unfulfilled mission of HP 2010 to address gender disparities in health among our population, including the continued education and promotion of screenings for prostate cancer. Prostate cancer has a huge impact on our society: 1. In 2008, an estimated 186,320 men will be diagnosed with prostate cancer and the disease will cause 28,660 deaths. 2. The sheer numbers and burden of this disease are overwhelming. Prostate cancer has a significant economic, physical, and emotional impact on payers, physicians, and patients. 3. Men who do survive prostate cancer experience a significantly lower quality of life, especially when the disease is caught at later stages. We can ease some of this burden through early detection, education, and promotion and increased availability of prostate screenings. We know that when detected early prostate cancer is a highly treatable disease. We hope that the HP2020 goals will show support for the education of this disease and help lessen the burden to society of prostate cancer. As a woman and representative of Women Against Prostate Cancer, I know that gender disparities in health do not affect men in isolation, but can lead to devastating consequences for entire families. Children missing out on spending time with their fathers and grandfathers, wives becoming widows when they should be growing old with their husbands, and families left in poverty with the death of their fathers and husbands. Gender disparities are clearly illustrated by funding levels among federal government programs. • Funding for gender research at NIH includes: i. $ 4,376,000,000 for women’s health (breast cancer, cervical cancer, ovarian cancer, and “women’s health”) ii. And $345,000,000 for men’s health (prostate cancer) • Funding for programs at the Centers for Disease Control and Prevention include: i. $ 309,486,000 for breast and cervical cancer ii. $ 13,243,000 for prostate cancer In Conclusion, I would like to thank the committee for the opportunity to share our recommendations and we hope that HP 2020 will continue the mission of HP 2010 to examine and address gender disparities in health and wellness with specific goals to seek gender equity in education, outreach, and research among federal and state agencies.
Susan B. Shurin MD on 6/6/2008 8:46:46 PM
Provision of access to health care, especially to preventive health care maintenance, is essential to elimination of health disparities. The goal is achievable, but will require ensuring that all persons have access to care. A particularly achievable goal is provision of health care maintenance and a medical home to all persons with chronic diseases. Among the most important relevant to health disparities is sickle cell disease. While children often have access to care, adult patients often receive episodic, fragmented, crisis-based acute care, and do not have access to consistent preventative care. Interventions known to be effective are often not employed. A major impact could be made by addressing some of these very targeted issues intensively. The impact would be great, with great improvement in the quality of life of persons heavily burdened with disease.
Dr. Melody Madlem on 6/3/2008 12:49:36 PM
While I appreciate the intent of aspirational goals, unless they are based or grounded by potential realization, they become too out of touch. How long have we all known about disparities in health? Most people in Public Health circles understand, explore, and impact many social determinants of health. It is time to lean away from "lifestyle" (exercise and nutrition) alone, and lean more into policy, programming, and providing dollars for the infrastructure needed to affect meaningful and realistic change.
Michele H. Goldschmidt EdD MS RN CNL on 6/2/2008 9:52:21 PM
Re: Increase quality and years of healthy life. Like the specifics discussed in the comments on eliminating health disparities, people are unsure they are included unless they are named. How, and by what mechanisms do we plan to increase the quality and years of healthy life? Health promotion and disease prevention are at the forefront of improving healthy life. Specifying how we will improve environmental factors that affect individuals' choices and ability to improve personal health; and universal access to primary care and prevention, should form the basis of how we will achieve these goals. It's time we moved forward with efforts that really can make a difference.
Anonymous on 6/2/2008 5:23:56 PM
Re: Inclusion of the Voices and Perspectives of Children with Lesbian, Gay, Bisexual, and/or Transgender (LGBT) Parents Who are We? COLAGE is a national movement of children, youth, and adults with one or more lesbian, gay, bisexual, transgender and/or queer (LGBTQ) parents. As its mission, this public benefit organization builds community and work toward social justice through youth empowerment, leadership development, education, and advocacy. In the United States alone, there are millions of people with one or more lesbian, gay, bisexual, and/or transgender (LGBT) parent(s). While research shows that there are no significant developmental differences or negative affects on children of LGBT parents, these youth report facing significantly more prejudice and discrimination because of societal homophobia and transphobia. How is COLAGE a stakeholder in Healthy People 2020? LGBT families, particularly families that include one or more non-biological parents, face a range of systemic impediments to care and custody of children, including hostility in health care settings and exclusion from a parent’s health insurance coverage. In making this presentation, we hope that Healthy People 2020 will incorporate our recommendations into its planning, data collection, and final stated objectives, which will shape the nation’s health priorities in the coming decade. We have identified three key areas to touch upon at today’s forum: (1) health disparities; (2) cultural competency; and (3) data collection. (1) Eliminate Health Disparities – Advocate for Greater Inclusion in Health Access and Health Insurance Coverage: Health disparities are often perpetuated by, if not created by, legal impediments to access quality care. Many states deny equal rights to our LGBT families. Hospital visitation rules are probably the most mentioned form of discrimination among children of LGBT parents. Unfortunately, it is not unusual to have an LGBT parent blocked from seeing his/her child because the law fails to recognize the relationship. Redefining “family” to stretch beyond bloodlines can only aid in patient care. Additionally, COLAGE supports health care reform that assures access to and coverage of comprehensive health care services for all US residents and families. The Williams Institute published research in October 2006 that shows 20 percent of same sex couples are uninsured, compared with only 10 percent of married people and 15 percent of the overall population. This means that a higher number of LGBT couples as well as their children do not have health coverage. LGBT people who are unable to access adequate health care are less able to care for children. Some LGBT parents are able to access health coverage through domestic partner benefits. Still, the majority of employers do not offer domestic-partner benefits, and even among those that do, some people may not feel comfortable taking advantage of them, especially if they are not able to be “out” at work due to legal employment discrimination. We join many other stakeholders in recommending that Healthy People 2020 support health coverage for poor and low-income families. In particular the SCHIP program, which broadens coverage for low-income children, provides state-based health insurance to children in working families who do not have employer provided coverage, or who earn too much to qualify for Medicaid. This also covers children whose LGBT parents’ insurance can not cover the child because of lack of family recognition by the provider or the state. (2) Promote Cultural Competency Among Health Care Providers: Medical professionals are the first responders when it comes to making sure people are treated equally, regardless of their differences – like sexual orientation, gender identity or family status. Patients should feel safe and confident when they are in hospitals, clinics, or even on the operating table. Based on a Kaiser Permanente national survey of nursing students, 8-12 percent “despised” lesbian, gay and bisexual people, 5-12 percent found lesbian, gay and bisexual people “disgusting” and 40-43 percent thought lesbian, gay and bisexual people should keep their sexuality private. Homophobia and transphobia in health care fields impacts the ability of youth with LGBT parents and their families to access care. While medicine is about rendering judgment and finding a solution, it is best to enter conversations with children of LGBT families judgment-free. Language can be very stigmatizing. In addition, providers should not make assumptions about the risk of violence within different families, but rather inquire about concerns of domestic violence regardless of family structure. Healthy People 2010 set as a primary goal the elimination of health disparities, with a major mechanism being enhanced cultural competency among health care providers. There are simple ways to make the practice environment safer and more welcoming for children of LGBT parent(s) and their families. In addition to education and training, simple changes in everything from patient forms to office décor can have a significant impact on the comfort level and interactivity of a child of LGBT parent(s) of any age. Open communications between medical professional and patient not only make the relationship easier, but it can also save lives. (3) Account for Family Diversity in Data Collection: In collecting data for Healthy People 2020, the phrasing of the questions often guides the answers. We ask that when supporting research relies on medical history sheets, the researchers reject the assumption that all children have a known mother and father and change forms to be more general and open to multiple parents. Because of stigma and prejudice, and because people with LGBT parents and their families represent a minority of the U.S. population (a population that is still not a recognized category in the U.S. census), clinical and public health studies and program evaluation have been scarce in all sectors of health delivery and research. Please help us to achieve inroads in this arena of unbiased and inclusive data collection. In Conclusion: We request that Healthy People enhance its mission of addressing and eliminating health disparities by being as inclusive as possible and incorporating the suggestions made by COLAGE in this testimony. We furthermore offer ourselves as experts and authorities on this broad and diverse constituency, should you desire or require additional information or recommendations. Thank you for your time.
National Latina Institute for Reproductive Health on 4/30/2008 9:46:48 AM
The Healthy People overarching goals should be realistic and achievable. In theory, aspirational goals appear to provide guidance in eliminating health disparities, but expanding healthcare access, for example, is a practical endeavor. Therefore, healthcare access is only one of the many determinants of health and thus should not be the only target of Healthy People 2020. Therefore, in attempting to address systematic prejudices and stereotypes and discriminatory barriers within our health system and other institutions, those of us providing care and advocating for improved health, require realistic and achievable goals, with a range of benchmarks so that all of us served by Healthy People 2020 can match our organization’s resources and programs to measurable achievements that contribute to Healthy People 2020 goals. Benchmarks would allow all organizations and governments to strive to not only achieve those benchmarks but to also plan for resources and strategies to achieve the next ones. Lastly, benchmarks would also serve as a tool of accountability, which is drastically needed if we as a Nation truly want to eliminate health inequities and achieve healthy people in healthy communities.
Pam Baker on 4/18/2008 11:03:17 PM
Goals should always be aspirational but that doesn't mean that realistic/achievable goals and aspirational goals are mutually exclusive. Most importantly, goals should be measureable. How much are you going to reduce illness? What markers will you use to determine if you've met the goal "Increase quality and years of healthy life"? As always, a balance between aspirational and measureable/realistic/achievable is best.
Jeff Levi on 4/16/2008 10:24:40 AM
The goals should provide a common charge to audiences at the federal, state and local level, as well as the private sector. They should be realistic and achievable when possible but aspirational when data is lacking. We must assign responsibility for achieving these goals.
HPKAY on 4/7/2008 3:14:01 PM
Emphasis needs to be focused on the beginning, starting with infant feeding practices, making breastfeeding a cultural standard by creating a climate to make this happen. It starts in hospitals, pediatric offices and then through support in the work place for breastfeeding women. If our infants become healthier adults (as evidence shows), the world benefits intellectually, economically and ecologically. Please add this as a primary goal of Healthy People 2020!

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