The "Healthy People 2010" initiative was formally launched on January 25, 2000 at the Partnership for Health in the New Millennium conference held at the Omni Shoreham Hotel in Washington DC. Healthy People 2010 outlines a nationwide health promotion and disease prevention agenda designed to guide the efforts of programs in workplaces, medical care organizations, schools and communities for improving the health of all people in the United States. Its two basic goals are to increase the years and quality of life of Americans, and end the health inequalities that exist between different population groups.

By most measures, the launch was a BIG success. The conference itself, convened by the Office of Disease Prevention and Health Promotion, was sold out, with advance registration exceeding 2,000. Health leaders in attendance included Dr. Donna Shalala, Secretary of Health and Human Services (HHS), Dr. David Satcher, Surgeon General, Dr. Louis Sullivan former HHS Secretary, and Julius Richmond, former Surgeon General. Popular figures included members of the US Women's World Cup Soccer Team, and Nicole Johnson, Miss America for 1999. They were joined by hundreds of professors, state and local health agency officials and over one thousand health practitioners.

The actual planning document, titled Healthy People 2010 : Objectives for Improving Health is inspirational from an organizational and inclusion perspective. It lists 467 objectives, grouped into 28 focus areas by health behavior, disease or setting. It was developed by a public/private alliance of over 350 national organizations and 270 state agencies. Over 2,000 people participated in 3 national and 5 regional planning meetings. Over 11,000 comments were received by mail or internet. The full planning document and people's comments on the document could be viewed at the interactive Healthy People Website: <http://www.health.gov/healthypeople>

The content of the document is also quite impressive. It specifies the health targets we should be directing our efforts toward in the next decade, and provides good documentation for each of these areas. My primary disappointments with the objectives is that many of them fall beyond the scope of health promotion and disease prevention and they are not organized into logical groupings such as health promotion, disease prevention and health protection. Nevertheless, the document remains quite impressive.

The Healthy People 2010 initiative, like the Healthy People 2000 initiative before it, is a wonderful rallying point, but that is all it is. If we are to progress in creating a nation of healthy people, we must realize that this initiative represents only the first step. Indeed, we are still preaching this message of health promotion and disease prevention to ourselves. President Clinton's State of the Union address only a few days after the conference made absolutely no mention of health promotion and mentioned disease prevention only from the perspective of vaccines and immunization.

The second step, beyond Healthy People 2010, is to start to redirect the more than one trillion dollars we spend on medical care each year in the United States so that we begin to spend this money in closer proportion to the burden of disease. Currently, an estimated 50% of deaths are caused by lifestyle related problems. Just imagine the impact we could have on health if 50% of all health care spending were devoted to health promotion! Some of the change to redirect our resources can be mandated through legislation, and this may be a good place to start. Perhaps we can create legislation to redirect a larger portion of the $17 billion NIH research budget to health promotion. Perhaps we can redirect part of the $216 million Medicare budget or the $179 million Medicaid budget to health promotion. Perhaps we can redirect part of the $249 billion tobacco settlement to health promotion. Is this shooting too high? In the short term, maybe yes. Then again, maybe not.

To contribute to this effort, the American Journal of Health Promotion is kicking off an effort called "Building Health Promotion into the National Agenda." We are just beginning to contact other national leaders to join us in this effort, and I want to extend the same invitation to each of our readers. After pulling together a planning group, our second step will be to select an issue we can successfully advocate for in the first year and thereby build momentum. This first year effort will culminate at our annual Art and Science of Health Promotion Conference which will be held at the Omni Shoreham Hotel in Washington, DC February 12-17, 2001 with the theme of "Building Health Promotion into the National Agenda." Our next effort will be to identify the issues we want to advocate long term. One possible goal might be secure sufficient funding to achieve the health promotion and disease prevention goals articulated in Healthy People 2010.

As one person, I cannot affect this change, but together we can. To quote Margaret Mead...."A small group of thoughtful people can change the world. Indeed, it's the only thing that ever has."

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Michael P. O'Donnell, PhD, MBA, MPH
Editor in Chief, American Journal of Health Promotion