1. Achieving National Health Objectives: The impact on Life Expectancy and Healthy Life Expectancy Elsie Pamuk, PhD Diane Wagener, PhD Michael Molla, PhD National Center for Health Statistics Centers for Disease Control and Prevention

2. What is Healthy People 2010 ? A comprehensive set of national health objectives for the decade A comprehensive set of national health objectives for the decade Developed by a collaborative process Developed by a collaborative process Designed to measure progress over time Designed to measure progress over time A public health document that is part strategic plan, part textbook on public health priorities A public health document that is part strategic plan, part textbook on public health priorities

3. History of Healthy People 1979 - 1979 -Healthy People : The Surgeon General’s Report on Health Promotion and Disease Prevention 1980 - 1980 -Promoting Health/Preventing Disease: Objectives for the Nation 1990 -Healthy People 2000: National Health Promotion and Disease Prevention Objectives 1990 -Healthy People 2000: National Health Promotion and Disease Prevention Objectives 2000 -Healthy People 2010 2000 -Healthy People 2010

4. Components of Healthy People 2010 28 focus areas 28 focus areas 467 specific objectives 467 specific objectivessupporting 2 overarching objectives 2 overarching objectives

5. Overarching goals of Healthy People 2010 Goal 1: Increase Quality and Years of Healthy Life Goal 1: Increase Quality and Years of Healthy Life

6. Overarching goals of Healthy People 2010 Goal 1: Increase Quality and Years of Healthy Life Goal 1: Increase Quality and Years of Healthy Life Goal 2: Eliminate Health Disparities Goal 2: Eliminate Health Disparities

7. Purpose: to quantify the impact of achieving specific Healthy People 2010 objectives and of and of eliminating racial/ethnic health disparities on summary measures of health

8. Methods Life table methods Life table methods Life expectancyLife expectancy Age-specific death rates applied to a hypothetical cohort of 1000 Age-specific death rates applied to a hypothetical cohort of 1000 Healthy life expectancyHealthy life expectancy Sullivan’s method: adds in age-specific prevalence of morbidity Sullivan’s method: adds in age-specific prevalence of morbidity

9. Impact on life expectancy of achieving specific HP2010 targets: Baseline = age-specific death rates for 1998 applied mortality reductions specified in 38 objectives

10. Impact on life expectancy of eliminating racial/ethnic differences: Adjusted the age-specific death rates for Asian or Pacific Islanders for 1997-1999 for race misreporting Applied to the U.S. population

11. Age-specific mortality reductions implied by achieving alternative objectives

13. Impact on healthy life expectancy of achieving HP2010 morbidity targets: Baseline = age-specific rates of chronic conditions causing activity limitation for 1998 Implied morbidity reductions of: 25% at ages <50 33% at ages 50+

14. Impact on healthy life expectancy of eliminating racial/ethnic differences: Age-specific activity limitation rates for Asian or Pacific Islanders for 1997-1999 Applied to the U.S. population

15. Age-specific morbidity reductions implied by achieving alternative objectives

17. Summary Achieving HP2010 targets: Achieving HP2010 targets: Increases life expectancy by 2.8 yrsIncreases life expectancy by 2.8 yrs Increases healthy life expectancy by 5.8 yrsIncreases healthy life expectancy by 5.8 yrs Elimination of racial and ethnic disparity Elimination of racial and ethnic disparity Increases life expectancy by 4.1 yrsIncreases life expectancy by 4.1 yrs Increases health life expectancy by 8.1 yrsIncreases health life expectancy by 8.1 yrs

18. Usefulness of the exercise Summarizes the impact of many diverse objectives and allows tracking of overall progress Summarizes the impact of many diverse objectives and allows tracking of overall progress Identifies areas that need attention Identifies areas that need attention

19. For more information…. Pamuk ER, Wagener DK, Molla MT. Achieving national health objectives: the impact on life expectancy and on healthy life expectancy. American Journal of Public Health, 2004; 94(3):378-83. Pamuk ER, Wagener DK, Molla MT. Achieving national health objectives: the impact on life expectancy and on healthy life expectancy. American Journal of Public Health, 2004; 94(3):378-83.