The Healthy People 2020 Initiative

What is Healthy People 2020?

Healthy People 2020 is the third in a series health targets set every decade by the U.S. Department of Health and Human Services (HHS). Healthy People 2020 hopes that “setting objectives and providing science-based benchmarks to track and monitor progress can motivate and focus action.” Healthy People grew out of national health targets set by the Surgeon General in 1979, with Healthy People 2000 released in 1990 (Office of Disease Prevention and Health Promotion, HHS, 1995) and Healthy People 2010 introduced In 2000. The Healthy People Consortium is an alliance of more than 350 national organizations and 250 state public health, mental health, substance abuse, environmental agencies, business leaders and community groups (HHS, 2000). Healthy People 2020 updates previous versions with new features:

  • Emphasizing ideas of health equity that address social determinants of health and promote health across all stages of life
  • Replacing the traditional print publication with an interactive Web site as the main vehicle for dissemination
  • Maintaining a Web site (healthypeople.gov) that allows users to tailor information to their needs and explore evidence-based resources for implementation

What are the Goals of Healthy People 2020?

Healthy People 2020 has 4 overarching goals:

  1. Attain high quality, longer lives free of preventable disease, disability, injury, and premature death
  2. Achieve health equity, eliminate disparities, and improve the health of all groups
  3. Create social and physical environments that promote good health for all
  4. Promote quality of life, healthy development, and healthy behaviors across all life stages

The Framework of Healthy People 2020

Healthy People 2020 identified significant threats to the public’s health and organized them into 26 Leading Health Indicators (LHIs), related to 12 of 42 broad topic areas. The LHIs “address determinants of health that promote quality of life, healthy behaviors, and healthy development across all life stages.” The LHIs allow nationwide assessment, facilitate intersectoral collaboration (e.g., across education, food systems, and health), and “motivate action at the national, state, and local levels.”

Leading Health Indicators
12 Topic Areas 26 Leading Health Indicators
Access to Health Services
  • Persons with medical insurance
  • Persons with a usual primary care provider
Clinical Preventive Services
  • Adults who receive a colorectal cancer screening based on the most recent guidelines
  • Adults with hypertension whose blood pressure is under control
  • Adult diabetic population with an A1c value greater than 9 percent
  • Children aged 19 to 35 months who receive the recommended doses of diphtheria, tetanus, and pertusses (DTaP); polio; measles, mumps, and rubella (MMR); Haemophilus influenza type b (Hib); hepatitis B; varicella; and pneumococcal conjugate (PCV) vaccines
Environmental Quality
  • Air Quality Index (AQI) exceeding 100
  • Children aged 3 to 11 years exposed to secondhand smoke
Injury and Violence
  • Fatal injuries
  • Homicides
Maternal, Infant, and Child Health
  • Infant deaths
  • Preterm births
Mental Health
  • Suicides
  • Adolescents who experience major depressive episodes (MDEs)
Nutrition, Physical Activity, and Obesity
  • Adults who meet current Federal physical activity guidelines for aerobic physical activity and muscle-strengthening activity
  • Adults who are obese
  • Children and adolescents who are considered obese
  • Total vegetable intake for persons aged 2 years and older
Oral Health
  • Persons aged 2 years and older who used the oral health care system in the past 12 months
Reproductive and Sexual Health
  • Sexually active females aged 15-44 years who received reproductive health services in the past 12 months
  • Persons living with HIV who know their serostatus
Social Determinants
  • Students who graduate with a regular diploma 4 years after starting ninth grade
Substance Abuse
  • Adolescents using alcohol or any illicit drugs during the past 30 days
  • Adults engaging in binge drinking during the past 30 days
Tobacco
  • Adults who are current cigarette smokers
  • Adolescents who smoked cigarettes in the past 30 days

For example, since 2004, the New York City Department of Health and Mental Hygiene (DOHMH) has set goals every 4 years for the city (known as Take Care New York or TCNY). The TCNY/2020 report identifies health indicator disparities for specific New Yorker populations and neighborhoods. The DOHMH will promote health equity across the city through multi-level interventions to achieve target goals, such as the percentage of Black New Yorkers newly-diagnosed with HIV who are in care and virally suppressed from 75% to 95% by 2020 (a 27% increase). Progress on some of these measures is shared annually in the publicly available NYC DOH Community Health Profiles Reports.

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