Several of the health-related listservs to which I subscribe recently have remarked on how well the United States has achieved many of its health-improvement targets during the past 2 decades of the "Healthy People" campaign. For example, regarding Healthy People 2000: National Health Promotion and Disease Prevention Objectives (United States Department of Health and Human Services Public Health Service, 1991), 13% of the 319 objectives have reached or exceeded their targets, and significant progress has been made toward achieving another 43%. That leaves an additional 44% of the goals toward which satisfactory progress was not made. More important, only 2% of the objectives were unchanged from their 1990 (baseline) values.
Lest we get too flush with these national accomplishments, I also would point out that many older adults are not taking advantage of preventive services, although research supports their efficacy and Medicare pays for them. A recent report, The Quality of Medical Care in the United States: A Report on the Medicare Program (part of the Dartmouth Atlas of Health Care published by the American Hospital Association's subsidiary Health Forum), noted that only 28.3% of women age 65 to 69 received at least one mammogram during 1995 to 1996. Further, only 12% of Americans enrolled in Medicare during that same time period received a preventive test for colorectal cancer. It seems we are doing a bit better when it comes to immunizations for pneumonia, with rates for those receiving the vaccine ranging from 9% to 38%. But this figure still is too low considering recent reports on outbreaks of antibiotic-resistant pneumococcal disease, especially in nursing homes, and the fact that the pneumococcal vaccine is 100% reimbursable through Medicare Part B. The Journal of Gerontological Nursing will continue to support health promotion among older adults by informing readers of the latest advances in research, education, and practice through relevant articles and sections, such as Healthy People 2000 (Virginia Burggraf, RN, C, DNS, and Richard J. Barry, MDiv, MLS, Editors). Readers who are interested in obtaining a copy of the Dartmouth Atlas of Health Care may do so by contacting the American Hospital Association at (800) 242-2626 and asking for catalog #044401. The cost is $350.
Kathleen C. Buckwalter
- United States Department of Health and Human Services Public Health Service. (1991). Healthy people 2000: National health promotion and disease prevention objectives (DHHS Publication No. PHS 91-50212). Washington, DC: U.S. Government Printing Office.