1. 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.

2. 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.

3. 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.

4. 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.

5. 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
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6. 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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7. 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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8. 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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9. 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.

10. 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.

11. 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.
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12. 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.

13. 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
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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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15. 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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17. 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
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18. 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
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19. 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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20. 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
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