This report has two purposes:

First, it provides important information for those drafting objectives at all levels. The report does not relate every statement made in the testimony, but instead highlights major themes, puts the testimony in context, and spells out the implications of this testimony for setting objectives. All of the testimony has been distributed to the groups writing the national objectives, and this report serves as a guide to that material. Groups drafting objectives for states or local areas, or for other organizations, should also find the structure created by this report and the material summarized here useful.

Second, it serves as the record of a unique process in which over 1,000 concerned health professionals and laymen from all regions of the country contributed their knowledge and experience to the building of national objectives for health promotion and disease prevention. Those present at the regional hearings were uniformly impressed with the level of commitment that the participants exhibited to the objectives-setting process and to the activities that the objectives address. To build broader commitment to the Year 2000 Health Objectives, this report recognizes the contributions these individuals made and documents their efforts.

Contents

• COMMITTEE ON HEALTH OBJECTIVES FOR THE YEAR 2000
• Preface
• Acknowledgments
• 1. Introduction
  • History and Purpose of the Objectives
  • Hearings and Testimony
  • Purpose and Structure of This Report
  • References
  • Testifiers Cited in Chapter 1
• 2. Objectives Process And Structure
  • Nature of the Objectives
  • Format and Focus of the Objectives
  • Priority Setting
  • References
  • Testifiers Cited in Chapter 2
• 3. Implementing the Objectives at State and Local Levels
  • State and Local Public Health Initiatives
  • Intersectoral Cooperation: Role of the Private Sector
  • Surveillance and Information Resources
  • References
  • Testifiers Cited in Chapter 3
• 4. Children and Adolescents
  • Crosscutting Topics
  • Health Promotion
  • Physical Fitness
  • Health Protection
  • Data Needs
  • References
  • Testifiers Cited in Chapter 4
• 5. Older Adults
  • Crosscutting Issues and Quality of Life
  • Health Promotion and Health Protection for Older Adults
  • Preventive Services for Older Adults
  • Long-Term Health Care Needs of the Aging
  • Implementation
  • References
  • Testifiers Cited in Chapter 5
• 6. Racial and Ethnic Minorities
  • Social, Behavioral, and Cultural Factors
  • Access to Health Care
  • Specific Health Problems of Minority Groups
  • References
  • Testifiers Cited in Chapter 6
• 7. People with Disabilities
  • Health Promotion for People with Disabilities
  • Access to Health Services
  • Implementation
  • References
  • Testifiers Cited in Chapter 7
• 8. Health Promotion and Disease Prevention in the Health Care System
  • Problems with Access to Health Care
  • Health Promotion and Disease Prevention in the Health Care System
  • Financing Health Promotion and Disease Prevention Programs in the Health Care System
  • Implementation within the Health Care System
  • References
  • Testifiers Cited in Chapter 8
• 9. Health Promotion and Disease Prevention in Community Settings
  • Health Promotion and Education in Schools
  • Health Promotion in the Workplace
  • Community-Level Interventions
  • Crosscutting Implementation Issues
  • References
  • Testifiers Cited In Chapter 9
• 10. Tobacco
  • Adolescent Smoking
  • Smoking and Pregnancy
  • Worksite Smoking
  • Smokeless Tobacco
  • Implementation Issues
  • References
  • Testifiers Cited in Chapter 10
• 11. Alcohol and Drug Abuse
  • Alcohol Problems
  • Adolescent Substance Abuse
  • Substance Abuse by Minority Groups
  • Implementation
  • References
  • Testifiers Cited in Chapter 11
• 12. Nutrition
  • Hunger
  • Specific Nutritional Risk Factors
  • Special Target Groups
  • Education and other Preventive Strategies
  • Implementation
  • References
  • Testifiers Cited in Chapter 12
• 13. Physical Fitness and Exercise
  • New Emphases Needed
  • Special Populations
  • Revising Goals for Children and Youth
  • Implementation
  • References
  • Testifiers Cited in Chapter 13
• 14. Mental Health
  • Particular Problems
  • Interventions
  • Implementation
  • References
  • Testifiers Cited in Chapter 14
• 15. Unintentional Injuries
  • Motor Vehicle Injuries
  • Other Causes of Injury
  • Disabling Injuries
  • Implementation
  • References
  • Testifiers Cited in Chapter 15
• 16. Violent and Abusive Behavior
  • Homicide and Interpersonal Violence
  • Suicide
  • Family Violence
  • Implementation
  • References
  • Testifiers Cited in Chapter 16
• 17. Occupational Safety and Health
  • Groups With Particular Needs
  • Workplace Protection Issues
  • The Workplace as a Site for Health Promotion and Disease Prevention Activities
  • Implementation
  • References
  • Testifiers Cited in Chapter 17
• 18. Environmental Public Health
  • Toxic Agents
  • Air Pollution
  • Food-Borne Disease
  • Implementation
  • References
  • Testifiers Cited in Chapter 18
• 19. HIV Infection and AIDS
  • Education, Testing, and Counseling
  • Mandatory Testing, Reporting, and Contact Notification
  • Special Populations
  • Implementation
  • References
  • Testifiers Cited in Chapter 19
• 20. Sexually Transmitted Diseases
  • Targeting Youth
  • Reducing Congenital Sexually Transmitted Diseases
  • Implementation
  • References
  • Testifiers Cited in Chapter 20
• 21. Infectious Disease
  • Immunizable Diseases
  • Nosocomial Inefections
  • Tuberculosis
  • Other Infectious Diseases
  • Implementation
  • References
  • Testifiers Cited in Chapter 21
• 22. Maternal And Infant Health
  • Prenatal Care
  • Maternal Mortality and Complications
  • Newborn Care
  • Implementation
  • References
  • Testifiers Cited in Chapter 22
• 23. Adolescent Pregnancy
  • Contributing Causes
  • Prevention Strategies
  • References
  • Testifiers Cited in Chapter 23
• 24. Cardiovascular Disease
  • Hypertension
  • High Blood Cholesterol
  • Target Populations
  • Implementation
  • References
  • Testifiers Cited in Chapter 24
• 25. Cancer
  • Specific Cancers
  • References
  • Testifiers Cited in Chapter 25
• 26. Oral Health
  • Fluoridation
  • Infants and Children
  • Adults
  • Older Adults
  • Underserved Populations: Problems and Strategies
  • Implementation
  • References
  • Testifiers Cited in Chapter 26
• 27. Other Chronic Diseases and Disabling Conditions
  • Diabetes
  • Musculoskeletal Conditions
  • Hearing Disorders
  • Vision Disorders
  • Developmental and Chronic Disabilities
  • Mental Retardation
  • References
  • Testifiers Cited in Chapter 27
• Appendix A: Testifiers for the Year 2000 Health Objectives
• Appendix B: Year 2000 Health Objectives Consortium
• Appendix C: Local Cosponsors for Year 2000 Regional Hearings

The project was supported by the Office of Disease Prevention and Health Promotion, Office of the Assistant Secretary of Health, Department of Health and Human Services under corporate agreement no. HPV-87-002-03-0.

NOTICE: This volume was prepared as a record of the public hearings and other activities designed to gather and organize information for the United States Public Health Service in formulating national health objectives for the year 2000. The opinions expressed in this report are those of the testifiers, not the Institute of Medicine or its parent organization, the National Academy of Sciences.

The Institute of Medicine was chartered in 1970 by the National Academy of Sciences to enlist distinguished members of the appropriate professions in the examination of policy matters pertaining to the health of the public. In this, the Institute acts under both the Academy's 1863 congressional charter responsibility to be an adviser to the federal government and its own initiative in identifying issues of medical care, research, and education.