'Healthy People 2000'
Improving the health of Americans takes cooperation among federal, state and local health care professionals, educators and researchers. To increase that cooperation, the National Heart, Lung, and Blood Institute, the U.S. surgeon general and the Centers for Disease Control and Prevention used the latest communications technology to bring together health care professionals from across the country to discuss progress in Americans' battle against heart disease and stroke.
The event, which transformed the third floor of Bldg. 1's Wilson Hall into a high-tech command center, was a review of "Healthy People 2000 in Heart Disease and Stroke." The document consists of 318 objectives in 22 key areas. It serves as a blueprint for improving the nation's health.
The review was broadcast by satellite to 200 sites across the United States mainland, and Puerto Rico and the U.S. Virgin Islands. In addition to participating in the national review, many of the sites also hosted their own community health conferences, which were attended by a variety of health care professionals. The event was also available via the Internet. At NIH, the session was shown on NIH videocasting.
The high-tech approach allowed the far-flung audience to pose many questions, both live by phone and in writing by fax, to assistant secretary for health and U.S. surgeon general Dr. David Satcher, NHLBI director Dr. Claude Lenfant, Dr. Edward Sondik, director of CDC's National Center for Health Statistics, and others on the 24-member panel of top policymakers and experts. The panel included representatives from the American Heart Association and other national organizations, minority health groups, community health agencies, universities and medical facilities.
The session was opened by journalist Doris McMillon, who served as moderator. Next came a welcome from Satcher, followed by highlights of progress made and challenges remaining from Lenfant and Sondik. After that, discussion turned to three key issues affecting Americans' health how knowledge gained can be more fully applied to improving health care; how disparities in the burden of cardiovascular disease can be ended; and how the increasing prevalence of overweight and obesity can be reversed.
Among the achievements and challenges noted were: The Healthy People 2000 target for reducing coronary heart disease deaths was almost reached; Healthy People 2000 goals have been met for reducing the prevalence of both high blood cholesterol and high blood pressure; Healthy People 2000 goals were met for reducing Americans' total and saturated fat consumption; smoking decreases among American adults has stalled and, after decades of decline, begun to increase among American teenagers; coronary heart disease and stroke deaths for African Americans are double those for any other population group; the incidence of end stage renal disease has doubled in the past decade.
Lenfant noted that progress against heart disease and stroke had accelerated in the past 2 to 3 decades, resulting in a 59 percent drop in cardiovascular disease deaths between 1950 and 1996. But, he added that dangerous trends now overshadow that progress, including increasing rates among Americans of heart failure, physical inactivity and overweight and obesity.
Sondik used a statistic to illustrate the huge impact heart disease has on Americans' lives: U.S. life expectancy at birth would increase by almost 5 years if heart disease were eliminated. He also described heart disease's burden on the health care system. It accounts for 23 percent of hospice care, 28 percent of home health care, 29 percent of all hospitalizations, and over a third of nursing home care.
Session participants then discussed the three key issues of application of knowledge, health disparity, and increasing overweight and obesity. Solutions suggested included: For the first issue, creating more community alliances, increasing the number of continuing medical education activities, and giving physicians clearer health messages; for the second issue, forging more community alliances, increasing the delivery of health information and programs through schools, and improving cultural knowledge among health care providers and educators; and for the third issue, changing how food is marketed and increasing environmental supports for physical activity, especially at the workplace.
The Healthy People 2000 discussion can be watched through NIH videocasting, available at http://videocast.nih.gov/. Background material is available through NHLBI at http://www.nhlbi.nih.gov/nhlbi/special/hp/welcome.htm.
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