Monitoring progress toward CDC's health protection goals: health outcome measures by life stage

Abstract

Objectives: From 2004 through 2005, as part of a major strategic planning process called the Futures Initiative, the Centers for Disease Control and Prevention (CDC) developed a set of Health Protection Goals to make the best use of agency resources to achieve health impact. These goals were framed in terms of people, places, preparedness, and global health. This article presents a goals framework and a set of health outcome measures with historical trends and forecasts to track progress toward the Healthy People goals by life stage (Infants and Toddlers, Children, Adolescents, Adults, and Older Adults and Seniors).

Methods: Measurable key health outcomes were chosen for each life stage to capture the multidimensional aspects of health, including mortality, morbidity, perceived health, and lifestyle factors. Analytic methods involved identifying nationally representative data sources, reviewing 20-year trends generally ranging from 1984 through 2005, and using time-series techniques to forecast measures by life stage until 2015.

Results: Improvements in measures of mortality and morbidity were noted among all life stages during the study period except Adults, who reported continued declining trends in perceived health status. Although certain behavioral indicators (e.g., prevalence of nonsmokers) revealed steady improvements among Adolescents, Adults, and Older Adults and Seniors, prevalence of the healthy weight indicator was declining steadily among Children and Adolescents and dramatically among Adults and Older Adults and Seniors.

Conclusion: The health indicators for the Healthy People goals established a baseline assessment of population health, which will be monitored on an ongoing basis to measure progress in maximizing health and achieving one component of CDC's Health Protection Goals.

Figure 1. Trends in crude death rate by life stage, United States, 1982–2015, actual^a and forecast^b

^aMortality rate from 1982 to 2004 calculated using National Center for Health Statistics annual mortality data file and U.S. Census Bureau population estimates ^b2005–2015 forecasts estimated using the Holt-Winters method for exponential smoothing

Figure 2. Proportion of the population reporting “very good” or “excellent” health, by life stage, United States, 1985–2015, actual^a and forecast^b

^aPast trends estimated from the National Health Interview Surveys, 1985–2005 ^b2006–2015 forecasts estimated using the Holt-Winters method for exponential smoothing

Figure 3. Proportion of the population reporting no limitation in activity, by life stage, United States, 1985–2005

Data source: National Health Interview Surveys, 1985–2005 ^aComparing estimates from before and after the 1997 survey redesign is considered inappropriate because it particularly affected questions on activity limitation.

Figure 4. Proportion of the population who are not current cigarette smokers, by life stage

Figure 5. Proportion of the population with healthy weight^a by life stage, actual^b and forecast^c