1. Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.
Chapter 1
Healthy People 2020
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2. Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.
Objectives
Describe what Healthy People 2020 is and what it is meant to do.
List five public health issues related defined by Healthy People 2020.
Discuss how the health status of a population is measured.
State one health issue or goal for each stage of the life cycle.
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3. Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.
Objectives (cont.)
Discuss the role of the nurse or health-care worker in achieving Healthy People 2020 objectives.
Discuss the role of the health-care worker in worldwide health improvement.
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4. 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.

5. 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
Health-care accomplishments within the United States from the years 2000 to 2010
Prescription for improvements through the year 2020
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6. 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
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7. Leading Health Indicators
Selected high-priority issues for the current 10-year period
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8. 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.
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9. 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
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10. 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
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11. 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.

12. Critical Thinking Question 1
Would greater governmental control over certain aspects of health be beneficial or detrimental (e.g., adding tobacco and alcohol to the list of illicit drugs or denying health care to persons who persist in unhealthy lifestyles)?
Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

13. 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
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14. Leading Causes of Death by Age Group
Younger than 1 year
1-4 years
5-14 years
15-24 years
25-34 years
35-44 years
45-54 years
55-64 years and older
Over 65 years
See Box 1-1.
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15. 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
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16. Critical Thinking Question 2
An increasing number of parents are refusing to immunize their children because of the perceived health risks of various vaccines. How will this affect the goals of Healthy People 2020? Would you expect an increase in certain communicable diseases?
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17. 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
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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
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19. Critical Thinking Question 3
How can school nurses continue to provide quality health education and screening programs when one nurse is often responsible for several schools?
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20. 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
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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
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22. Critical Thinking Question 4
How can meeting the health needs of the older adult affect the health needs of the geriatric adult?
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23. 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
Increasing the availability of diagnostic tools that can decrease the number of undiagnosed dementia cases
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24. Critical Thinking Question 5
Remaining independent in light of increasing life expectancy is often difficult for the aged adult. How can nurses and other health care workers ensure that this population can continue to care for itself?
Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

25. 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
Promoting health through employer-sponsored programs
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26. 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
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27. Critical Thinking Question 6
What can schools of nursing do to encourage their students and graduates to become more actively involved in meeting the goals and objectives of Healthy People 2020?
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28. 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
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