Like many people, on January 1, 2005, you made resolutions to make positive changes in your life over the course of the year. Now is the time for reflection on whether or not you have been successful in meeting your goals.
We have always been strong proponents and implementers of health promotion and disease prevention training.
Consider Healthy People 2010, an initiative sponsored by the United States Department of Health and Human Services (HHS) that launched in 2000 as a series of grand resolutions. The two primary goals were to help individuals of all ages increase life expectancy and improve quality of life, and to eliminate health disparities among different segments of the population. Now, HHS must also reflect on these "resolutions."
The Midcourse Review
The Healthy People 2010 Midcourse Review (MCR) is an assessment of the nation's progress toward meeting the objectives outlined in 10 areas of major health concerns in the United States: physical activity, overweight and obesity, tobacco use, substance abuse, responsible sexual behavior, mental health, injury and violence, environmental quality, immunization, and access to healthcare (visit http://www.healthypeople.gov/data/midcourse). One purpose of the MCR was to ensure that all objectives are still current, accurate, and relevant. To be fair, there have been many progressive steps toward achieving the goals of Healthy People 2010. However, research and the media report that we are failing terribly in meeting many of the objectives. Obesity is as much a crisis with our children now as with adults; physical education classes are one of the first areas cut in shrinking education budgets. Teenage girls are beginning to smoke at alarming rates. In facilities where smoking is banned, people stand outside in subzero temperatures just to take a puff!! Abuse of illegal and prescription drugs and alcohol extends across all socioeconomic and cultural divides. In the wake of catastrophic natural disasters and increased everyday stressors, providers can scarcely keep up with the demand for mental health services. Children have access to dangerous weapons and kill, and the courts are filled with offenders and victims of domestic family violence.
Although childhood immunization rates have improved, there are still reported cases of measles and other preventable diseases. With rising costs for medical care and more than 45 million Americans without health insurance, how can access to healthcare be equitable?
Where Do We Go From Here?
One proposed revision to a Healthy People 2010 objective is germane to advanced practice nurses, and especially nurse practitioners (NPs) working in primary care practices. A change of wording strengthens the requirement to, "Increase the inclusion of sentinel core competencies in health promotion and disease prevention in health professions training." We do not need a guard watching over what we do, checking that we are providing health promotion and disease prevention training to our students. We have always been strong proponents and implementers of these interventions. Expectation of competency in this area is written into NP curricula as well as modeled during student clinical experiences. Identifying risky lifestyle behaviors open to education and counseling and recommending appropriate preventive care are hallmarks of advanced practice nursing in primary care. We can be instrumental in "training" other professionals.
This holiday season when your patients request counseling to adopt healthier lifestyles, remember the two overarching goals of Healthy People 2010. In your own practice, take a scorecard and mark your personal or group progress in meeting these global "resolutions" for the health of our nation.