Halfway through a national campaign to make people more healthy, federal officials say Americans are smoking less, driving more safely and avoiding fatty foods, but there are still too many couch potatoes, pregnant teenagers and homicides.
A U.S. Public Health Service program called Healthy People 2000 was begun five years ago to promote, through education of the public and physicians, programs that work toward some 300 specific health goals. It set 10-year healthy lifestyle goals for all Americans. After five years, federal officials say some trends are on target while other categories are getting worse."The variable results, especially among certain populations, for Healthy People 2000 goals and objectives at mid-decade suggest the need for a number of course corrections," Drs. J. Michael Mc-Gin-nis and Philip R. Lee of the health service report in this week's Journal of the American Medical Association.
A review of program progress was being reviewed at a news conference Tuesday.
The program was created to achieve three primary goals: Increase the span of healthy life for Americans; reduce the differences in health trends among various American populations; and provide access to disease prevention services to all Americans.
Based upon surveys, the health service said it found that most programs were moving toward the objectives. But some programs had shown no gains, and still others were trending in the wrong direction, or getting worse.
Among the improvements:
- Life expectancy for Americansat a record 75.8 years.
- Fewer heart attack and stroke deaths, better control of high blood pressure and a lowering of blood cholesterol levels.
- Decreases in cancer deaths and increases in screening for breast and cervical cancer. The percentage of women over 50 getting mammograms has increased from 25 percent in 1987 to 55 percent.
- Among black Americans, improvements in prenatal care, infant deaths and deaths from ac-ci-dental injuries, heart disease, stroke and liver disease.
- Among Hispanics, more women being screened for breast and cervical cancers. Also, there are fewer infant deaths and teen pregnancies and less cigarette smoking.
- More children getting shots against childhood diseases, and the number of cases has generally declined, with the exception of whooping cough, which has increased.
- Fewer sexually transmitted diseases.
- Fewer people smoking, and young people are less likely to start the habit.
- Less use of alcohol and marijuana among the young.
- Fewer deaths in auto accidents. This is attributed to less drunken driving, 55-mile-per-hour speed limits, wider use of seat belts and child safety seats, and air bags.
- In mental-health measures, fewer suicides and fewer stress-related disorders.
- Injuries at work claiming fewer lives, although the number of injuries has gone up.
- In environmental health, fewer children with high blood lead levels and more people living in clean air.
- Fewer older people losing all their teeth.
- Fewer cases of salmonella, a type of food poisoning.
- More people following lower-fat diets and more people exercising regularly.
There has been no proportional change in the total number of people who never exercise, nor in diabetes-related deaths. Also, the average expected length of life free of health problems for Americans remains at 64.
Among the national trends getting worse:
- More people are overweight.
- Among blacks, more hospitalizations for asthma, more cases of AIDS and more homicides.
- Among Hispanics, less access to primary health care due to a lack of health insurance coverage and an increase in AIDS cases, homicides, tuberculosis and excess weight among women.
- More teenage pregnancies, particularly among blacks.
- More homicides and assault injuries.
- More babies born at low weight.
- More people disabled by chronic conditions.
- More people dying of pneumonia and influenza.
- And more people not receiving clinical disease prevention services because of financial barriers.