What is “Healthy People 2020”?

Michael Greger, M.D. FACLM

What is
Healthy
People
2020?
What are 2-3
additional
resources to
learn more
about this
topic? .
 Healthy People 2020
Leading Health Indicators
1. Access to Health Services
2. Clinical Preventive Services
3. Environmental Quality
4. Injury and Violence
5. Maternal, Infant, and Child Health
6. Mental Health
7. Nutrition, Physical Activity, and Obesity
8. Oral Health
9. Reproductive and Sexual Health
10. Social Determinants of Health
11. Tobacco Use
12. Substance Abuse
Access to
Health
Services
“school quality may be an important, but
complex, social determinant of health.”
 Healthy People 2020
Leading Health Indicators
1. Access to Health Services
2. Clinical Preventive Services
3. Environmental Quality
4. Injury and Violence
5. Maternal, Infant, and Child Health
6. Mental Health
7. Nutrition, Physical Activity, and Obesity
8. Oral Health
9. Reproductive and Sexual Health
10. Social Determinants of Health
11. Tobacco Use
12. Substance Abuse
 Clinical
Preventive
Services

“...childhood immunizations… are

widely regarded as cost-saving”
 Clinical
Preventive
Services
 Healthy People 2020
Leading Health Indicators
1. Access to Health Services
2. Clinical Preventive Services
3. Environmental Quality
4. Injury and Violence
5. Maternal, Infant, and Child Health
6. Mental Health
7. Nutrition, Physical Activity, and Obesity
8. Oral Health
9. Reproductive and Sexual Health
10. Social Determinants of Health
11. Tobacco Use
12. Substance Abuse
Environmental
Quality
“One of the most widespread air pollutants
in the United States is ozone at the
ground level.”
Environmental
Quality
 livestock’s long shadow
environmental issues and options

Environmental
Quality
Environmental
Quality
Environmental
Quality
 HABIT #1
Challenge your clients to learn more
about the products they choose in their
LEARN home.

A starting point might be The Environmental

Working Group (EWG.org), a non-profit,
Healthy evidence-based resource.
People
2020
 Healthy People 2020
Leading Health Indicators
1. Access to Health Services
2. Clinical Preventive Services
3. Environmental Quality
4. Injury and Violence
5. Maternal, Infant, and Child Health
6. Mental Health
7. Nutrition, Physical Activity, and Obesity
8. Oral Health
9. Reproductive and Sexual Health
10. Social Determinants of Health
11. Tobacco Use
12. Substance Abuse
Injury and
Violence

“...much progress has been made in identifying

effective prevention strategies that reduce
injury or mitigate risk behaviors.”
Injury and
Violence
"Ninety percent of women, 91% of children
aged 0 to 14 years, 92% of youth aged 15 to
24 years, and 82% of all people killed by
firearms were from the United States."
 Healthy People 2020
Leading Health Indicators
1. Access to Health Services
2. Clinical Preventive Services
3. Environmental Quality
4. Injury and Violence
5. Maternal, Infant, and Child Health
6. Mental Health
7. Nutrition, Physical Activity, and Obesity
8. Oral Health
9. Reproductive and Sexual Health
10. Social Determinants of Health
11. Tobacco Use
12. Substance Abuse
Maternal,
Infant, &
Child
Health
“A higher-than-normal BMI was associated with significantly more
prenatal fetal tests, obstetrical ultrasonographic examinations,
medications dispensed from the outpatient pharmacy, telephone
calls to the department of obstetrics and gynecology, and prenatal
visits with physicians."
 Healthy People 2020
Leading Health Indicators
1. Access to Health Services
2. Clinical Preventive Services
3. Environmental Quality
4. Injury and Violence
5. Maternal, Infant, and Child Health
6. Mental Health
7. Nutrition, Physical Activity, and Obesity
8. Oral Health
9. Reproductive and Sexual Health
10. Social Determinants of Health
11. Tobacco Use
12. Substance Abuse
 Mental
Health
National Suicide Prevention
Lifeline: 1-800-273-TALK
"Serious psychological distress includes
mental health problems severe enough to
cause moderate-to-serious impairment in
social, occupational, or school functioning
and to require treatment."
 HABIT #2

LEARN In the interest of injury prevention,

maternal/child health, and suicide
prevention, either don’t keep guns in the
home or keep them unloaded, locked, and
separate from ammunition.
Healthy
People
2020 HABIT #3
If guns are in the home, consider a family-
based gun safety class.
 Healthy People 2020
Leading Health Indicators
1. Access to Health Services
2. Clinical Preventive Services
3. Environmental Quality
4. Injury and Violence
5. Maternal, Infant, and Child Health
6. Mental Health
7. Nutrition, Physical Activity, and Obesity
8. Oral Health
9. Reproductive and Sexual Health
10. Social Determinants of Health
11. Tobacco Use
12. Substance Abuse
 Nutrition,
Physical
Activity
and Obesity
 Nutrition,
Physical
Activity
and Obesity
 HABIT #4
Exercise daily.
LEARN Per the best evidence, 90 minutes or more of
moderate intensity activity (walking,
gardening, cycling, stair climbing) provides
the best benefit against obesity and other
Healthy chronic diseases.
People
2020
 Healthy People 2020
Leading Health Indicators
1. Access to Health Services
2. Clinical Preventive Services
3. Environmental Quality
4. Injury and Violence
5. Maternal, Infant, and Child Health
6. Mental Health
7. Nutrition, Physical Activity, and Obesity
8. Oral Health
9. Reproductive and Sexual Health
10. Social Determinants of Health
11. Tobacco Use
12. Substance Abuse
 Oral
Health
"The annual per-person cost savings for
those aged 6–65 years ranged from $35.90
to $28.70 for larger and smaller
communities, respectively."
 Healthy People 2020
Leading Health Indicators
1. Access to Health Services
2. Clinical Preventive Services
3. Environmental Quality
4. Injury and Violence
5. Maternal, Infant, and Child Health
6. Mental Health
7. Nutrition, Physical Activity, and Obesity
8. Oral Health
9. Reproductive and Sexual Health
10. Social Determinants of Health
11. Tobacco Use
12. Substance Abuse
Reproductive
and
Sexual
Health
LEARN HABIT #5
STD prevention and treatment is important
for all Americans, but especially for our
youth.
Reproductive For practical information on preventing
and STDs, add an evidence-based, user-friendly
Sexual site like CDC to your Resource List.
Health
 Healthy People 2020
Leading Health Indicators
1. Access to Health Services
2. Clinical Preventive Services
3. Environmental Quality
4. Injury and Violence
5. Maternal, Infant, and Child Health
6. Mental Health
7. Nutrition, Physical Activity, and Obesity
8. Oral Health
9. Reproductive and Sexual Health
10. Social Determinants of Health
11. Tobacco Use
12. Substance Abuse
 Social
Determinants
of
Health "Chronic stressors in early childhood, such
as poverty, can have cumulative lifetime
effects on learning, earnings, and health."
 Healthy People 2020
Leading Health Indicators
1. Access to Health Services
2. Clinical Preventive Services
3. Environmental Quality
4. Injury and Violence
5. Maternal, Infant, and Child Health
6. Mental Health
7. Nutrition, Physical Activity, and Obesity
8. Oral Health
9. Reproductive and Sexual Health
10. Social Determinants of Health
11. Tobacco Use
12. Substance Abuse
Tobacco
Use
"In 2014, e-cigarettes became the most
commonly used tobacco product among U.S.
middle and high school students,
surpassing cigarettes."
 Healthy People 2020
Leading Health Indicators
1. Access to Health Services
2. Clinical Preventive Services
3. Environmental Quality
4. Injury and Violence
5. Maternal, Infant, and Child Health
6. Mental Health
7. Nutrition, Physical Activity, and Obesity
8. Oral Health
9. Reproductive and Sexual Health
10. Social Determinants of Health
11. Tobacco Use
12. Substance Abuse
Substance
Abuse
 HABIT #6
Substance abuse concerns need to be
LEARN referred to an appropriate professional.

There are tips on how to start this

conversation with a client at
Healthfinder.gov
Substance
One powerful way to start is just to say:
Abuse “I care about you and want to help.”
mhg1@cornell.edu
 References
Dudovitz, R., Nelson, B., Coker, T., Biely, C., Li, N., Wu, L. and Chung, P. (2016). Long-term health implications of school
quality. Social Science & Medicine, 158, pp.1-7.

Neumann, P. and Cohen, J. (2009). Cost savings and cost-effectiveness of clinical preventive care. The Synthesis Project,
(Sept), p.18.

Berezin, M., & Eads, A. (2016). Risk is for the rich? Childhood vaccination resistance and a Culture of Health. Soc Sci
Med,Sept(165), 233-245.

Li C, Balluz LS, Vaidyanathan A, Wen X-J, Hao Y, Qualters JR. Long-Term Exposure to Ozone and Life Expectancy in the
United States, 2002 to 2008. Lin. Y-S, ed. Medicine. 2016;95(7):e2474.

Steinfeld, H. (2006). Livestock's Long Shadow (Italy, The United Nations, Food and Agriculture Organization).

Choi H, Schmidbauer N, Sundell J, Hasselgren M, Spengler J, Bornehag C-G. Common Household Chemicals and the
Allergy Risks in Pre-School Age Children. Hartl D, ed. PLoS ONE. 2010;5(10):e13423.

Potera C. INDOOR AIR QUALITY: Scented Products Emit a Bouquet of VOCs. Environmental Health Perspectives.
2011;119(1):A16.

Gielen, A. (2015). Unintentional Home Injuries Across the Lifespan: Problems and Solutions. Annual Review of Public
Health. 36:1, 231-253.
 References
Grinshteyn, E. et al. (2010). Violent Death Rates: The US Compared with Other High-income OECD Countries. The
American Journal of Medicine, Vol 129, Issue 3, 266 - 273.

Chu, S. (2004). Association between obesity during pregnancy and increased use of health care. New England Journal of
Medicine, 358, 1444-1453

Weissman, J. et al. (2015). Serious psychological distress among adults: United States, 2009–2013. NCHS data brief, no
203. Hyattsville, MD: National Center for Health Statistics.

Pate, R. et al. (1995). Physical activity and public health. A recommendation from the Centers for Disease Control and
Prevention and the American College of Sports Medicine. JAMA. 1995 Feb 1;273(5):402-7.

Laskowski, E. (2012). The role of exercise in the treatment of obesity. P M &R Journal. Nov;4(11):840-4.

Briss, P. et al. (2015) U.S. Public Health Service Recommendation for Fluoride Concentration in Drinking Water for the
Prevention of Dental Caries, Public Health Rep. 2015 Jul-Aug;130(4):318-31.

Robinson, L. et al. CDC Grand Rounds: Addressing Health Disparities in Early Childhood. MMWR Morb Mortal Wkly
Rep 2017;66:769–772
 References
The Health Consequences of Smoking—50 Years of Progress. A Report of the Surgeon General. Atlanta, Georgia: U.S.
Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic
Disease Prevention and Health Promotion, Office on Smoking and Health, 2014.

US Department of Health and Human Services (HHS), Office of Disease Prevention and Health Promotion. Healthy People
2010 midcourse review: Focus area 26, Substance Abuse. Washington: HHS; 2006.