Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Chapter 1 Healthy People 2020 Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Key Terms behaviors biology determinants of health health status Healthy People 2020 infant mortality rate Leading Health Indicators life expectancy physical environment social environment Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. What Healthy People 2020 Is Published by the U.S. Department of Health and Human Services An evidence-based 10-year report card Healthcare accomplishments within the United States from 2000 to 2010 Health-care accomplishments within the United States from the years 2010 to 2020 Prescription for improvements through the year 2020 Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

What Healthy People 2020 Does Focus on the larger social picture surrounding health-care outcomes Social issues, preparedness, and global health have been included for the first time Eight new topic areas Adolescent health Early and middle childhood, genomics Global health-health care associated infections Health related to quality of life Older adults, including ones with dementia Preparedness Sleep health Social determinants of health Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Leading Health Indicators Selected high-priority issues for the current 10-year period Access to health services Clinical preventive services Environmental quality Injury and violence Maternal, infant, and child health Mental health Oral care Reproductive and sexual health Nutrition, physical activity, and obesity Social determinants-including students graduating from schools Substance abuse Tobacco Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Determinants of Health Range of social, economic, and environmental factors that influence health status Can include individual behavior and biological and genetic factors See Figure 1-3. Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Biology and Behavior Biology refers to an individual's genetic makeup, family history, and physical and mental health problems acquired during his or her lifetime Behaviors are individual responses or reactions to internal stimuli and external conditions Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Biology and Behavior (cont.) Behavior and biology are interrelated A disease affects biology, but behaviors can make a person susceptible or resistant to a disease Social and physical environments impact behavior Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Environments The social environment includes interactions with family, friends, coworkers, and others in the community The physical environment can be viewed as that which can be seen, touched, heard, smelled, and tasted; also contains less tangible elements, such as radiation exposure and ozone depletion Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Health Status Among other factors, health status can be measured by: Birth and death rates Life expectancy Morbidity from specific disease Access to health care Health insurance coverage Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Leading Causes of Death by Age Group Younger than 1 year 1-4 years-Congenital anomalies; premature birth; SIDS 5-14 years-Unintentional injuries; birth defects; homicide; cancer 15-24 years-Unintentional injuries; cancer; homicide; suicide; heart/respiratory diseases 25-34 years-Unintentional injuries; homicide; suicide; cancer; heart diseases 35-44 years-Unintentional injuries; cancer; heart disease; suicide 45-54 years-Cancer; heart disease; unintentional injury; suicide 55-64 years and older-Cancer; heart disease; respiratory disease; unintentional injury; diabetes mellitus Over 65 years-Heart disease; cancer; respiratory disease; stroke; dementia See Box 1-1. Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Progress and Goals yet to be Achieved Communities and health care professionals are expected to develop action plans to help achieve and maintain healthy behaviors and lifestyles and morbidity and mortality statistics can help identify risks for a certain age group Another important indicator of improvement is to research the number of deaths that occur before the age of 1, this is known as the infant mortality rate, per 1,000 live births Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Prenatal and Infant Health Maternal and infant health is the core of the health status of the next generation The leading areas of progress: Reducing sudden infant death syndrome (SIDS) with the “back-to-sleep” educational program Promoting the use of folic acid supplements early in pregnancy to reduce congenital malformations such as spina bifida Guidelines for “baby friendly” hospitals have been established and have help increase breastfeeding during first year of life Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Childhood Health Overall goals Increase health literacy Improve the quality, availability, and effectiveness of community-based programs designed to prevent disease and improve health. Health issues should be added to school curricula; teachers should be well informed; and school nurses should be available in all schools Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Adolescent and Young-Adult Health Goal is to reduce the death rate and increase health education to prevent: Health problems related to injuries Violence Suicides Tobacco and drug use Unintentional pregnancy STDs Unhealthy diets and activity lifestyles Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Older Adult Health Problems related to maintaining an independent lifestyle remain a challenge Goals include improving health, function, and quality of life; and increasing physical activity, self-management of chronic diseases, use of health services, and training of caregivers Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Geriatric Adult Health Goals for the geriatric phase of life Reducing the number of illnesses and deaths related to vaccine-preventable diseases Reducing the number of hip fractures, most often cause is falls Increasing the availability of diagnostic tools that can decrease the number of undiagnosed dementia cases Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Role of the Health-Care Worker in Achieving Healthy People 2020 Goals Increasing the use of prenatal services Promoting breastfeeding Educating the school-age child about nutrition, diet and exercise, smoking and drug use, and healthy lifestyles, so person is able to make better health choices Promoting health through employer-sponsored programs Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Role of the Health-Care Worker in Achieving Healthy People 2020 Goals (cont.) Providing health education services to patients in managed care organizations Identifying health risks through screening programs Encouraging older adults to participate in at least one organized health promotion activity Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. World Health World Health Organization (WHO) Objectives were developed for improving the environment, eliminating poverty, and providing reproductive health services, adolescent health, women's empowerment, human rights, and tobacco control Nurses are encouraged to become involved in helping form legislation to help come up with policy that will beneficial to meet goals established by Healthy People 2020 Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.