The CDC And Healthy People 2020 Essay
The CDC and Healthy People 2020 continue to educate on the importance, the improved ease of access and insurance coverage for screenings and vaccinations. It is the responsibility of nurses to engage our aging adults in self-advocating for services that benefit the individual and community health. How can you, as a registered nurse, impact older adults to encourage routine vaccination? What impact does this have on the community as a whole?The CDC And Healthy People 2020 Essay
Your initial posting should be at least 400 words in length and utilize at least one scholarly source other than the textbook
Choose one older adult community population and create an infographic on a topic of preventative screenings or vaccines for this population. You may choose to focus on one specific preventative screening (like colonoscopy) or one specific vaccine (like pneumovax). You will create a one page infographic and then write an essay on the topic you chose.
View websites on How to create Infographics:
Submit an 8 X 11.5 color (one page Word or pdf. document) infographic on the importance of one of the concepts found in one of the assigned websites.
Include a detailed description of the infographic and the APA references in an APA-formatted essay.
The description part of the essay assignment should be written in an APA-formatted essay. The essay should be at least 750 words in length and include at least two scholarly sources other than provided materials.The CDC And Healthy People 2020 Essay
Length: One-page infographic PLUS essay of 750 to 1000 words in length
Structure: Infographic: One-page. Essay: Include a title page and reference page in APA format. These do not count towards the minimum word count for this assignment. Your essay must include an introduction and a conclusion.
References: Use appropriate APA style in-text citations and references for all resources utilized to answer the questions. A minimum of two (2) scholarly sources are required for this assignment.
Health Promotion and Protection.The CDC And Healthy People 2020 Essay
Under the general rubric of promoting and protecting the public’s health, the health director
and staff face a daunting array of programs designed to preserve and promote public health,
from licensing septic tanks, monitoring the quality of air and water and minimizing accidents
to conducting campaigns aimed at reducing blood pressure, intake of alcohol and tobacco and
improving physical fitness. Wherever a law, regulation or ordinance has some impact on
human health, it is the health department’s job to promote, administer, or enforce it.
While their sheer variety may make these programs appear overwhelming, in practice they
tend to sort themselves out rather tidily. The programs that protect health, as opposed to
programs to promote it, have the virtue of being specific and concrete: licensing food
handlers, for instance, involves testing for (or seeing the documentation of testing for) a finite
set of conditions, and it becomes a simple pass/fail situation. Many of these programs also
generate revenue for the local health department or reduce expenses for the local
government. Most mandated licenses have a fee structure to cover their administration, and
where the health department effort does not result in direct income it may perform services
for other departments, saving money overall. Chronic disease control programs for the general
public can, for instance, be woven into a city employee’s wellness programs. The personal
health services provided to city employees in an occupational health program and the savings
to the city due to reduced sick leave and early return to work, thus improving overall
productivity promote the health department’s reputation and promote the case for additional
resources at budget time.
The word “health” refers to the health and well being of the entire community from its
broadest aspects, their general physical fitness, mental health and nutrition, with an emphasis
on early intervention to prevent onset of chronic conditions like hypertension and dental
problems, to quite narrow attempts to modify deleterious behaviors, like smoking and drinking
alcohol. Surprisingly, there were no objectives or goals for physical fitness in the first iteration
of the Model Standards for Community Health Programs (Model Standards.) The 1990 Health
Objectives for the Nation (1990 Objectives), however, provided several outcome objectives
designed to get people involved in enjoyable activities that stimulate cardio-respiratory
function and are appropriate to their ages. These were further modified in the Healthy People
2000, 2010, 2020 publications, which should be reviewed while reading this essay to compare
the latest goals and objectives for each topic. They have since been modified further as seen
in this PowerPoint slide set on Performance Standards by CDC’s Office of Public Health
Practice. Currently the prior “Model Standards” have been changed to the 10 essential
services, in the National Public Health Performance Standards Program. The national program
provides standards for
State Public Health System Model Standards
Local Public Health System Model Standards
Local Public Health Governance Model Standards
At the state level, the goal is often one of making a compelling case for fitness benefits to
the public. Texas collects a variety of data to measure effects of exercise on health costs, and
school and job performance. The Virginia plan recognizes the responsibility of public health
departments to work with other community agencies, profit and nonprofit, government and
private to promote exercise and physical fitness. In the “Future of Public Health” this is the
“assurance” function of the health department where the emphasis is on assisting other
agencies to help the community, rather than expecting the health department to implement
the services itself. The IOM’s 2003 publication on the future of Public Health in Chapter 2
focuses on “Understanding Population Health and Its Determinants”. Few local departments
have specific objectives for exercise and fitness, though most can provide technical and
research information on the value of these activities. The local health department is expected
is to support groups interested in exercise while providing a balance between those who would
emulate Mainland China by requiring everyone to perform public exercise, and the “couch
potato”. The data on the protective effects of exercise against heart disease are fairly good
(Look at Framingham Data). Data on many other health benefits of exercise are not so well
documented, often being little more than anecdotal accounts supplied by health activists.
While promoting exercise is clearly a role for the public health department, a problem goal The CDC And Healthy People 2020 Essay
setters face is that the resources for exercise belong to private clubs, professional sports
groups, recreation departments and sometimes employers. By working with YMCAs, recreation
departments, athletic clubs, schools, colleges and sports minded groups to promote options
for exercise and physical fitness, the heath department can lead its community, with small
cost, toward better health. Physical fitness and its accompanying benefits provide a wonderful
opportunity for role modeling by all public health staff. Unsuccessful health programs tend to
lack a key ingredient; direct participation of their promoters. There is too much data on
models and standards for any single agency to manage. It is the health director’s and program
manager’s job to select the recommended standard appropriate for the community’s current
health status and resources available to enhance this health status.
The 2020 Recommended Objectives follow
Objectives Retained As Is From Healthy People 2010
NWS HP2020–1: Increase the proportion of adults who are at a healthy weight.
NWS HP2020–2: Reduce the proportion of adults who are obese.
NWS HP2020–3: Reduce iron deficiency among young children and females of
NWS HP2020–4: Reduce iron deficiency among pregnant females.
Objectives Retained But Modified From Healthy People 2010
NWS HP2020–5: Reduce the proportion of children and adolescents who are
overweight or obese.
NWS HP2020–6: Increase the contribution of fruits to the diets of the population
aged 2 years and older.
NWS HP2020–7: Increase the variety and contribution of vegetables to the diets
of the population aged 2 years and older.
NWS HP2020–8: Increase the contribution of whole grains to the diets of the
population aged 2 years and older.
NWS HP2020–9: Reduce consumption of saturated fat in the population aged 2
years and older.
NWS HP2020–10: Reduce consumption of sodium in the population aged 2 years
NWS HP2020–11: Increase consumption of calcium in the population aged 2 years
NWS HP2020–12: (Developmental) Increase the proportion of worksites that offer
nutrition or weight management classes or counseling.
NWS HP2020–13: Increase the proportion of physician offices visits that include
counseling or education related to nutrition or weight.
NWS HP2020–14: Eliminate very low food security among children in U.S.
Objectives New to Healthy People 2020
NWS HP2020–15: (Developmental): Prevent inappropriate weight gain in youth
NWS HP2020–16: Increase the proportion of primary care physicians who
regularly measure the body mass index of their patients.
NWS HP2020–17: Reduce consumption of calories from solid fats and added The CDC And Healthy People 2020 Essay
sugars in the population aged 2 years and older.
NWS HP2020–18: Increase the number of States that have State-level policies
that incentivize food retail outlets to provide foods that are
encouraged by the Dietary Guidelines.
NWS HP2020–19: Increase the number of States with nutrition standards for foods
and beverages provided to preschool-aged children in childcare.
NWS HP2020–20: Increase the percentage of schools that offer nutritious foods
and beverages outside of school meals.
Even at the state level trying to meet all these goals with limited resources is problematical, at
the local level it is necessary to take a more focused view. Besides setting general goals and
promoting nutrition information, state and local programs usually aim to provide information
on basic foods to segments of the population in need and, in the U.S., to actually provide
special foods and food supplements to pregnant women, infants and young children. These
programs are known as WIC programs. A detriment to focusing education on good nutrition to
poor people is that these programs are managed by at least three different agencies. Pregnant
women and infants found to have medical problems receive targeted food supplements from
the WIC program, discussed later. Many of these same women are also eligible for food
stamps, which they receive from social service departments. Poor school age children take
part in school breakfast and lunch programs are managed by the Department of Agriculture.
Some are also eligible for additional food through Community Action Programs. Lack of central
coordination for these programs often makes them inefficient and vulnerable to abuse. Such
abuse has been a major problem in many communities where the money vouchers intended
for purchase of specific foods to combat medical problems, such as iron rich foods to combat
iron deficiency anemia, are exchanged for cigarettes or alcohol, or even given to drug dealers
to buy heroin!
Centralizing all food programs under the local health department or the local social services
department may benefit the entire community. People suffering from poor nutrition can then
receive medical intervention and nutritional counseling as well as food. Schools and public
health departments, which often provide school nurses, can work together to focus on total
nutritional education. Formal links can be developed between food purchasing, nutritional
advice, health maintenance and treatment, and education using school children as change
agents. There is an unexplored potential to change health status by linking the core curriculum The CDC And Healthy People 2020 Essay
for food and nutrition in kindergarten through 12th grade with food purchases in the various
nutrition programs and the food provided at school meals.
A major issue in the first decade of the 21st Century is that of childhood and adult obesity,
although the definition seems to change almost daily it is clear that morbid obesity is
associated with early mortality and much prior disability. Now look at the HP2010 and the
HP2020 goals and objectives for nutrition to see how they have developed. Consider whether
the objectives are clear, and whether they are likely to be met.
Goal: Prevent and control oral and craniofacial diseases, conditions, and
injuries and improve access to related services.
The above goal was the HP2000 goal. In the HP2020 there are 17 objectives for Oral Health.
Oral health is an essential and integral component of health throughout life. No one can be
truly healthy unless he or she is free from the burden of oral and craniofacial diseases and
conditions. Millions of people in the United States experience dental caries, periodontal
diseases, and cleft lip and cleft palate, resulting in needless pain and suffering; difficulty in
speaking, chewing, and swallowing; increased costs of care; loss of self-esteem; decreased
economic productivity through lost work and school days; and, in extreme cases, death.
Further, oral and pharyngeal cancers, which primarily affect adults over age 55 years, result in
significant illnesses and disfigurement associated with treatment, substantial cost, and more
than 8,000 deaths annually. Poor oral health and untreated oral diseases and conditions can
have a significant impact on quality of life. Millions of people in the United States are at high
risk for oral health problems because of underlying medical or handicapping conditions,
ranging from very rare genetic diseases to more common chronic diseases such as arthritis
and diabetes. Oral and facial pain affects a substantial proportion of the general population.
Fluoridation has been so successful that the Georgetown University School of Dentistry shut its
doors in the early 1990s. Because of fluoride compounds in water, toothpastes and topical
applications, along with the use of sealants for the dental enamel few children have serious
dental problems any more. The major dental problem seen in many communities today is
periodontal disease in older citizens.
Ideally, a single site dental program has one dentist, one dental hygienist, one dental
assistant, and three operatories. The dentist provides acute dental care (with additional care
for the elderly), while the hygienist applies topical fluoride and sealants. The hygienist may
also give dental instruction in the school systems.
High blood pressure.
The HP 2000 Objectives proposed: “at least 60 percent of the estimated population having
definite high blood pressure (160/95 or greater) should have attained successful long term
blood pressure control, i.e., a blood pressure at or below 140/90 for two or more years.” This
goal does not appear to consider the difficulty associated with changing the behavior of large
numbers of people, particularly that of older people. Younger people, more likely to respond to
education about lifestyle, will not experience health benefits from changes for 2030 years; this
reduces the perception about the urgency of the message. The 2010 Objectives also link
adverse behaviors (smoking, salt ingestion, overeating) with development of a community
infrastructure to control them.
The 2020 Objectives for hypertension control are:”
Increase the proportion of adults aged 20 years and older who are
aware of, and respond to, early warning symptoms and signs of a
heart attack.The CDC And Healthy People 2020 Essay
HDS HP2020–13: Reduce the proportion of persons in the population with
Increase the proportion of adults with prehypertension who meet
the recommended guidelines for:
Increase the proportion of adults with hypertension who meet the
recommended guidelines for:
Change is best made gradually, at the local level, by helping communities adapt gradually to
necessary changes that support their standards and beliefs. Attempts to impose changes in
behavior by authoritarian approaches rarely work
In Virginia, with the new emphasis by the State Board of Health on Chronic Disease, high
blood pressure objectives are part of a chronic disease control program that ties health
education and nutrition together. It focuses on risk factors related to lifestyle, all of which
contribute significantly to the leading causes of death, such as:
high blood pressure
seat belt use
use of weapons.
The current state budget restrictions for 2011 – 2012 this program has
been cut back significantly. It is very hard to explain the value of
future health status based on public policy, were the policies are
attached to fiscal statements
Dealing with chronic disease locally
Chronic disease programs must have public credibility for a local health department to carry
them out successfully. In the 1980s Corpus Christi included chronic disease within its General
Nursing program. All nurses were assigned to census tracts as well as clinics. Health educators
worked closely with the nurses and clinicians to identify risk factors which they shared with
organizations such as the United Way; cancer, diabetes, lung, and heart associations; the
hospitals, doctors, nurses, dentists, pharmacists, and health clubs to show how people could
change their behaviors, and improve their health. Each organization’s board and volunteers The CDC And Healthy People 2020 Essay
examined the behavioral changes that fit into their long range plans. All agreed on the value
of changes in nutrition, knowledge about blood pressure, reduced smoking, increased exercise
and reduced stress. The local health department staff, without much fanfare, did what public
health agencies do well: they developed consensus for health standards within the community.
After 5 years, using formal reports that linked the major causes of death and disability with
community changes needed to combat them, the media started paying attention to the annual
reports and maps that showed who died where, and from what major causes. Also, maps that
showed locations of deaths from traffic accidents, identifying those associated with alcohol.
These actions raised the community’s awareness about personal behaviors leading to illness,
injury and death. Ongoing surveys, using population samples by income and geography, found
that people felt they could change their behaviors to improve their health. The community’s
news media started to emphasize individual responsibility to avoid illness in news stories
about new support groups for people with specific health problems, such as diabetes,
Alzheimer’s disease or cystic fibrosis. The media also gave publicity to statements by elected
officials, which fostered community spirit among citizens to help one another avoid disease,
disability and death. Look at the Virginia Department of Health Goals and Objectives to reduce
Chronic disease in the early 21st century and consider the likelihood of meeting the goals.
Despite the five years of effort needed to develop a community infrastructure devoted to
health you should know that the it takes less in financial resources, than in leadership.
The role of the health department:
Smoking and health
The overwhelming majority of Americans believe that smoking affects health adversely.
Besides proposing specific goals for the reduction of smoking the 2010 Overall Goal stated
Reduce illness, disability, and death related to tobacco use and exposure to secondhand
The objectives for adult tobacco use was:
Target and baseline:
Objective Reduction in Tobacco Use by Adults
Aged 18 Years and Older The CDC And Healthy People 2020 Essay
27-1a. Cigarette smoking 24 12
27-1b. Spit tobacco 2.6 0.4
27-1c. Cigars 2.5 1.2
27-1d. Other products Developmental
Note that the 2000 Goal was utopian:
“by 2000 morbidity & mortality associated with tobacco use will be eliminated.”
Not surprisingly, some southern states that are major tobacco producing states came to the
table late with goals to eliminate tobacco use. While the existence of tobacco addiction and its
relation to disease and death are supported by crystal clear data, public policy at the federal
and state levels tended to be somewhat less clear until the late 1990s. The limited federal and
state actions still leave room for an aggressive local health director to prevent additional
disease, disability and death from a preventable cause. Local health departments exercised
their unique working relationships with the cancer, lung and heart associations, and with the
local restaurant associations, to develop strong clean air ordinances. They worked with
coalitions to develop state and local ordina okay nces to prohibit smoking in public places.
Local ordinances have been developed even in North Carolina and Virginia. In the 1990
session of the Virginia (the heartland of tobacco farming) legislature a statewide law against
smoking in public places was passed with a specific prohibition against smoking in local health
departments. Local departments kept the public informed about new research identifying and
strengthening additional diseases caused by use of tobacco. They tried to influence insurance
groups to offer lower rates to nonsmokers. In addition to the rising price of tobacco products
themselves, the financial impact of related health problems can be a potent argument against
smoking. Some local health departments tracked all smoking related deaths and morbidity The CDC And Healthy People 2020 Essay
reported by hospitals, nursing homes, funeral homes, and physicians; then analyzed the
reports by age, sex and race to provide the news media with information useful to influence
current smokers to stop smoking and children to avoid starting. What can you find out about
the VDH role in tobacco use reduction and disease prevention?
The 2020 objectives show how far we have come toward facing reality: Specially as local
health departments have lost `12,000 employees over the last year and are facing further
cuts in the current fiscally impoverished state systems. ( see the NACHHO Report.)
Tobacco related Objectives for 2020 have been significantly amended:
Why Is Preventing Tobacco Use Important?
Tobacco use is the single most preventable cause of death and disease in the United States.
Each year, approximately 443,000 Americans die from tobacco-related illnesses. For every
person who dies from tobacco use, 20 more people suffer with at least 1 serious tobaccorelated illness. 5, 6 In addition, tobacco use costs the U.S. $193 billion annually in direct
medical expenses and lost productivity.
Healthy People 2020: A Framework for Ending the Tobacco Use Epidemic
Healthy People 2020 provides a framework for action to reduce tobacco use to the point that
it is no longer a public health problem for the Nation. Research has identified a number of
effective strategies that will contribute to ending the tobacco use epidemic. 7, 8, 9, 10, 11, 12
Based on more than 45 years of evidence, it is clear that the toll tobacco use takes on
families and communities can be significantly reduced by:
Fully funding tobacco control programs.
Increasing the price of tobacco products.
Enacting comprehensive smoke-free policies.
Controlling access to tobacco products.
Reducing tobacco advertising and promotion.
Implementing anti-tobacco media campaigns.
Encouraging and assisting tobacco users to quit.
The Healthy People 2020 Tobacco Use objectives are organized into 3 key areas:
1. Tobacco Use Prevalence: Implementing policies to reduce tobacco use and initiation
among youth and adults.
2. Health System Changes: Adopting policies and strategies to increase access,
affordability, and use of smoking cessation services and treatments.The CDC And Healthy People 2020 Essay
3. Social and Environmental Changes: Establishing policies to reduce exposure to
secondhand smoke, increase the cost of tobacco, restrict tobacco advertising, and reduce
illegal sales to minors.
The Abuse of alcohol and other drugs
A distinction is typically made between alcohol and other abused substances rather than using
the “abuse of alcohol and other drugs”. Clearly, nicotine addiction, alcohol addiction,
prescription drug addiction and illegal drug addiction share much common ground and
physiologically and behaviorally. From the behavioral point of view the only difference is the
judicial danger associated with use of illegal drugs and the profit made from supplying them.
When Many local health departments do not have addiction programs since these have
become the responsibility of the mental health, social services, corrections, and police and
disabilities departments. The health department staff can find many examples of addiction on
home visits and in occupational health programs. Employees who abuse alcohol and other
drugs are generally referred to employee assistance programs. In such situations, the local
health department’s role becomes one of evaluating demographic, disease, disability and
mortality data. Then it gives safety, police and social agencies outcome data to measure the
effectiveness of their efforts. While the Virginia Department of Behavioral Health has specific
substance abuse policies can you find a role within the VDH for such policies or for cooperation
with the VDBH programs?
Control of stress and violent behavior
The HP 2000 and 2010 Objectives set target levels for
Death by homicide among young black males
For parental abuse among children
For suicide among persons aged 15 to 24.
While the healthy people 2020 goal and objectives are:
Prevent unintentional injuries and violence, and reduce their consequences.
Injuries and violence are widespread in society. Both unintentional injuries and those caused
by acts of violence are among the top 15 killers for Americans of all ages. 1 Many people The CDC And Healthy People 2020 Essay
accept them as “accidents,” “acts of fate,” or as “part of life.” However, most events resulting
in injury, disability, or death are predictable and preventable. The Injury and Violence
Prevention objectives for 2020 represent a broad range of issues which, if adequately
addressed, will improve the health of the Nation.
Healthy People 2020 was launched on December 2, 2010 by the government of the United States with a set of ambitious, yet achievable, 10-year agenda for improving the Nation’s health. Healthy People 2020 is the result of a multiyear process that reflects input from a diverse group of individuals and organizations. It is a science-based, 10-year national objective for improving the health of all Americans. For 3 decades, Healthy People has established benchmarks and monitored progress over time in order to encourage collaborations across communities and sectors , empower individuals toward making informed health decisions and to measure the impact of prevention activities. The vision of healthy people 2020 is to have…show more content…
Working with the elderly is viewed as routine, boring and depressing. These negative attitudes that are held by health care providers will ender this challenging and potentially rewarding area of service and our elderly will suffer. (pg. 5)
According to the article Attitudes towards caring for older people in Scotland,Sweden and the United States by Angela Kydd etal which states that the findings based on survey conducted in these three countries suggest that practice environments, coupled with the attitudes of other professionals towards those who work with older people, have an influence on attitudes. In general, working conditions in care of older people are not conducive to recruiting and retaining staff. On the whole, there is a lack of career advancement in care of the older person. Other healthcare professionals do not seem to appreciate that care of the older person is a highly skilled specialty. Poor environments with substandard care have a negative effect on patients and staff. The CDC And Healthy People 2020 Essay