Healthy People: Nation’s health improved, but disparities persist

Smoking rates decreased, cancer deaths fell and fatal cases of coronary heart disease dropped in the U.S. during the first decade of the 21st century. But racial and ethnic disparities in health persisted, and across the board, obesity grew dramatically, federal and state officials said Thursday during a webinar to review Healthy People 2010, a set of public health objectives for the country.

Through the Healthy People initiative, health officials have released a set of national public health objectives every 10 years since 1980. The most recent, Healthy People 2020, was launched in December.

Assistant Secretary for Health Dr. Howard Koh described Healthy People as a way to align public health efforts. It has two overarching goals–increasing the quality and years of healthy life, and eliminating health disparities across race and ethnicity, sex, education, income, geographic location, disability status and sexual orientation. “We call Healthy People a roadmap and a compass for the country,” Koh said.

Nationally, life expectancy at birth, a key indicator, rose during the first decade of this century, but disparities persisted. A black child born today will die on average five years sooner than a white child, said Edward J. Sodnik, director of the National Center for Health Statistics. The gap narrowed somewhat, from 5.5 years in 2000 to 4.9 years in 2007.

Racial and ethnic health disparities did not change significantly from 2000 to 2010 in 117 of 169 Healthy People objectives.

Overall, the nation moved toward targets in youth immunization rates, physical activity among high school students, cigarette use, cancer mortality and coronary heart disease deaths. On obesity measures, the nation got worse.

Connecticut Public Health Commissioner Dr. Jewel Mullen spoke of Connecticut’s efforts to adapt the national objectives to state goals.

She also described Connecticut’s contradictions. The state has a higher median age, proportion of white residents and degree of educational attainment than the country as a whole, she said. It also has the highest per capita debt, income inequality and the widest achievement gap among high school students. And its three largest cities, Bridgeport, New Haven and Hartford, have much larger black and Hispanic populations, lower per capita income, higher proportions of residents who speak a foreign language at home, and higher rates of people without health insurance than the state as a whole.

“Connecticut’s statewide demographic profile really doesn’t accurately portray the characteristics of its largest towns,” she said.

Mullen also noted that while many disparities exist between Connecticut cities and the state as a whole, Windham County, which is 90 percent white and includes rural areas, ranks at the bottom of the state’s eight counties in health rankings and seventh in health outcomes.

She cited some improvements. From 2000 to 2010, smoking in Connecticut fell by 32 percent among adults, while flu vaccination rates for seniors rose by 14 percent, and the rate of pneumococcal vaccination among seniors increased by 40 percent.

Mullen also identified challenges for the next decade, including the increased rate of obesity and increases in deaths from motor vehicle accidents, falls and poisoning–which includes drug overdoses–over the past decade. The state also has failed to make progress in addressing the disproportionate rate of low birth weight babies and premature deliveries among black women. “We’re very concerned about this link to equally disproportionate rates of infant mortality,” she said.