Tracking Progress in Healthy People 2020

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21st Sep 2017 Health Reference this

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Bernard F. Richards

Scope of the health problem

Tobacco is a plant used for several recreational and cultural activities such as chewing, making teas, and also for smoking. Tobacco has been found to contain chemical carcinogens with the ability to trigger a myriad of adverse health outcomes. These include chronic respiratory diseases, cardiovascular diseases, reproductive deficits, and a host of cancers of the gastrointestinal, genitourinary, and respiratory systems. Novick, Morrow and Mays (2008, pg. 23) maintain that tobacco smoking is undoubtedly the leading cause of avoidable morbidity and mortality. Primary smoking accounts for approximately 443,000 deaths annually in the U.S and of the number of children currently living, approximately 389,000 children will prematurely succumb to smoking-related maladies. In New York, smoking serves as the fundamental cause of over 25,400 deaths with second-hand smoke accounting for about 2,600 deaths. Over 500,000 persons in New York suffer from severe smoking-related illnesses with an associated cost of over $8.17 billion annually to the health care system (NYS Dep. of Health, 2013).

Adjustment of the goals in New York

A fundamental objective of the Healthy People 2010 campaign in New York was to reduce the percentage of adolescents who smoked in the previous month to less than 10% from a baseline of 16.3% in 2006. This objective represents a modification of the initial objection of 12% by the year 2010 which was already met. This speaks to work of high effectiveness on the part of the NYS Health Department.

National and state-related progress

On a national level, the objectives for the Healthy People 2020 campaign are arranged in three categories. These include implementing regulations to cut down tobacco use among the youth and adult populations, implementing interventions to improve access, affordability, and use of smoking termination services, and instituting procedures to decrease exposure to secondhand smoke, increase the price of tobacco, limit tobacco advertising, and decrease unlawful sales to minors (U.S. Dept. of Health, 2013). There has been significant progress made in most of categories.

Objective

Baseline (%)

Target (%) – 2020

Progress (%)

Reduce cigarette smoking by adults

20.6 (2008)

12

19 (2011)

Reduce use of tobacco products by adolescents (past month)

26 (2009)

21

23.4 (2011)

Reduce the initiation of the use of tobacco products among children and adolescents aged 12 to 17 years

7.8 (2008)

5.7

6.9 (2011)

Increase recent smoking cessation success by adult smokers

6 (2008)

8

6.7 (2011)

Increase smoking cessation during pregnancy

11.3 (2005)

30

18.9 (2010)

Reduce the proportion of children aged 3 to 11 years exposed to secondhand smoke

52.2 (2005-2008)

47

42 (2009-2010)

Establish laws in States and the District of Columbia on smoke-free indoor air that prohibit smoking in substance abuse treatment facilities Additional Data Options

9 (2009)

51

11 (2012)

Table 1 Positive Progress in Realizing National Objectives of Healthy People 2020 Plan

Source: U.S. Department of Health and Human Services (2013)

Table 1 illustrates examples of areas where positive progress has been made along with the relative years of reference. Despite the aforementioned positive progress, several objective areas have regressed.

Objective

Baseline (%)

Target (%) – 2020

Progress (%)

Reduce use of smokeless tobacco products by adults

2.3 (2005)

0.3

2.7 (2010)

Reduce use of cigars by adults

2.2 (2005)

0.2

2.5 (2010)

Increase tobacco cessation counseling in hospital ambulatory care settings

22.6 (2007)

24.9

19.7 (2010)

Reduce the proportion of adolescents and young adults in grades 6 through 12 who are exposed to tobacco marketing on the Internet

36.8 (2009)

33.1

40.6 (2011)

Reduce the proportion of adolescents and young adults in grades 6 through 12 who are exposed to tobacco marketing in magazines and newspapers

48.6 (2009)

19.3

51.7 (2011)

       
       

Table 2 Negative Progress in Realizing National Objectives of Healthy People 2020 Plan

Source: U.S. Department of Health and Human Services (2013)

Table 2 suggests that the program has been vastly effective at achieving its goals. This speaks to the highly efficacious work done by the public health departments. Conversely, several areas of concern are demonstrated which necessitate greater attention and effort.

For the state of New York, there has not been an updated campaign for the year 2020. As such, progress will be assessed based on the revised campaign for 2010. The NYS Dep. of Health (2013) explains that objectives to be realized by 2013 for the state in question include reducing the prevalence of smoking so that the percentage of smoking adults in previous month is less than 10.0%, and the rate of chronic obstructive pulmonary disease (COPD)/chronic lower respiratory disease (CLRD) related hospitalization in New Yorkers 18+ years of age is less than 31 per 10,000. Furthermore, it is desired that by 2013, the age-adjusted incidence of lung cancer is less than 62 per 100,000 for males and 41 per 100,000 for females.

Objective

Baseline (%)

Target (%) – 2013

Progress (%)

% cigarette smoking in adolescents (past month)

16.3 (2006)

10

12.5 (2011)

COPD hospitalizations among adults 18 + years 4 (per 10,000)

41.8 per 10,000 (2004-2006)

31 per 10,000

41.3 (2010)

Lung cancer incidence (per 100,000) – Male

82.2 per 100,00 (2000-2004)

62 per 100,00

75.8 (2009)

% cigarette smoking in adults

16.3 (2006)

10

18.1 (2011)

Lung cancer incidence (per 100,000) – Female

53.9 per 100,000 (2000-2004)

41 per 100,00

53.9 (2009)

Table 3 Progress in Realizing New York State Objectives of Healthy People 2013 Plan

Source: New York State Department of Health (2013).

Table 3 indicates that positive progress has been achieved in the first three categories as represented by decreased occurrences. In opposition, the final two categories demonstrated negative progress and stagnation respectively. Hence, greater energy is required to achieve these objectives by the specified time.

Challenge in meeting targets

The above data suggests that the Healthy People campaigns against tobacco use have been very effective at reducing negative health exposures and outcomes related to this behavioral practice. However, several deficiencies have been noted. A fundamental right afforded by the Constitution is the freedom of choice, which includes choice of pastime activities. The problem is that some of these said practices have negative health effects. This is the case with tobacco use. Health authorities can put in place initiatives to combat these negative outcomes but the extent of success largely depends on individuals accepting the health message and willingly electing to change the negative behaviors. This is one limitation contributing to disparities in observed progress in the Healthy People campaigns. The key to improving the areas of deficiencies is to continue enforcing regulations that protect the general public and seek superior methods of public education which will bring about greater personal conviction to change negative health behaviors such as tobacco use.

References

Novick, L. F., Morrow, C. B. & Mays, G. P. (Eds). (2008). Public health administration: Principles for population-based management. (2nd ed.). Sudbury, Massachusetts: Jones and Bartlett Publishers.

New York State Department of Health (2013). Healthy People 2010: Tobacco use. Retrieved from http://www.health.ny.gov/prevention/prevention_agenda/tobacco_use/index.htm

U.S. Department of Health and Human Services (2013). Healthy People 2020: Tobacco use. Retrieved from http://healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicId=41

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