"The Heart of the Matter"

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Transcripts: 553-4 & 553-5

Week: 553.4 Guest: Debbie Maiese, spokeswoman, Nat'l Health Information Center Topic: Healthy People 2000 update, Part One of Two Producer/Host: Steve Girard

NEMA: Imagine the work involved in assessing the health status of our country...first finding out what the health problems are, and determining a course of action to solve them. Also, attempting to discern what we're doing right, and integrating those practices, habits and tendencies into an overall design for health. Well, it's been going on for some time now...called Healthy People 2000, and spokesman Debbie Maiese is here to update us....

MAIESE: The first Healthy People was published as a Surgeon General's report in 1979, and established five life stage targets. Four of those are mortality reductions, such as infant mortality reductions, child death reductions, and adolescent death reductions. And those set targets for 1990. We subsequently continued those life stage targets, and, into Healthy People 2000. So, we have been in the business of tracking Healthy People life stage targets for some 17 years.

NEMA: I suppose it would be only natural that as our health consciousness has grown, the assessments and aims of Health People 2000 have grown somewhat over those years...What are the areas focused on today...?

MAIESE: There are actually 22 priority areas in Healthy People 2000. They begin first with physical activity and fitness, followed by nutrition, tobacco, substance abuse, family planning, mental health....and the list goes on to encompass the major killers of heart disease and stroke, cancer, diabetes and HIV infection. There are also the protective factors of clinical preventive services, and immunizations covered in these priority areas.

NEMA: That's a huge task...coordinating all the gathering of stats from what must be many different agencies....

MAIESE: There are some 200 data systems used to track the Healthy People objectives. The primary sources of information are the vital statistics systems that give us birth records and the characteristics of maternal and infant health status at birth. There are the vital records associated with death that gives us the cause of death and the underlying causes of death...followed by such surveys as the national health interview survey, and other household survey instruments that give us the risks to health primarily. In addition to those data systems supported by the department of health and human services, we turn to our colleagues in environmental health, at the agriculture department, in housing and other agencies to give us information and tracking sources for other objectives, such as environmental health, food and drug safety, occupational safety and health.

NEMA: What have the results for this decade been so far....?

MAIESE: The mid-decade report for Healthy People showed some great successes in smoking prevalence reduction, in keeping youths from starting to smoke. In terms of mammography screenings, women are increasingly getting the message to do that protective screening. In addition, we've seen progress in areas such as breast feeding...more women are giving their babies a healthy start.

NEMA: Next time, we'll look into the new millennium as Healthy People 2000 plans for improvements in our health for 2010. Thanks to Debbie Maiese... I'm Steve Girard.


Week: 553.5 Guest: Debbie Maiese, spokeswoman, Nat'l Health Info. Cntr. Topic: Coordinating public/private efforts toward better health practices and results, Part Two of Two Producer/Host: Steve Girard

NEMA: Debbie Maiese of Healthy People 2000 is with us...it's an active consortium of more than 600 government agencies and private groups assessing America's health problems, and good health habits, and integrating them into a group of proactive, preventive programs...aimed at certain goals. The Healthy People 2000 mid course review showed that there were many gains...in life expectancy, immunization, mammography, and reductions in tobacco use and infant mortality. But there are still many areas needing improvement. What about obesity ... are the things we've heard about a continuing increase being shown in your work?

MAIESE: Absolutely, in fact, the overweight objective is found in three different priority areas of Healthy People...because it is a risk factor in heart disease, it is a risk factor in diabetes, and of course, one of the prominent objectives is in the nutrition section....and we've seen the overweight prevalence in adults go from quarter of the population to a third of the population among adults, and we've also seen increases in child obesity as well. A major risk factor to health. And, of course, the way to create an energy balance and reduce that overweight prevalence in the United States is to get people physically active...off the couch and out for a walk, or out for a run, or whatever makes them more active people.

NEMA: What about the plan for the first decade in the new millennium?

MAIESE: We have begun to have focus groups of our consortium members to talk about the structure of Healthy People 2010...the extent to which these priority areas need to be rearranged or reinforced in some new ways. In fact, we're thinking of 2010 as perhaps a virtual document, that people could go on the Internet, onto our Healthy People home page and download the objectives, sorting them in ways that are relevant for community health promotion, school health promotion, work site health promotion, or focused on particular gender, race or age groups. So, we're really beginning to put together a plan to make Healthy People 2010 a more vital and vibrant document...and we hope that people use it for health improvement efforts, because there's a lot of work to be done in terms of improving the quality of life, and ensuring years of healthy life for all age groups. There's also a lot of work to be done in closing the gaps and decreasing those disparities between groups of populations, be it rich or poor, black or white, or by geographic region of this country. We all need to look at every opportunity we have to prevent disease and promote health.

NEMA: And aside from all the statistics and information provided by your agency and this type of program, there's still that basic health care relationship...

MAIESE: Be proactive with your health providers... because often times we talk about here, that it's really getting your doctor, your nurse, your nutritionist, your dentist, your dental hygienist...to give you information, or give you those clinical preventive services that can make a difference in your health. And we're doing a lot more to promote cost effective interventions that can have long term savings and long terms benefits to health.

NEMA: You're cordially invited to check out the work of Healthy People 2000 on the Internet...just ask your search engine to find it by name, or under the National Health Information Center. I'm Steve Girard.


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