Healthy People 2020 - Key Determinants

Healthy People 2020 aims to reach four goals: Attain high-quality, longer lives free of preventable disease, disability, injury, and premature death and to improve the health of all groups. Nurses General Nursing Article


Healthy People 2020 - Key Determinants

Healthy People initiatives is a program from the US government Department of Health and Human Services. It is composed of many leading health indicators. They are chosen after extensive collaborative efforts from a workgroup composed of 50 members from across the US.

Many governmental agencies inputted into the leading health indicators:

Reports by the Institute of Medicine

National Health Promotion and Disease Prevention

The National Prevention Strategy

In addition to these resources, there are other resources for Healthy People 2020 initiatives:

Dietary guidelines for the US - provides info for professionals about teaching nutrition to people. This includes dietary advice on improving your overall eating habits also.

Another evidence-based summary gives info on Caring for GBLT Individuals with Substance Abuse Issues. There are suggested interventions. Designed for both clinicians this guide outlines treatment guidelines and approaches as well as organizational policies and procedures. This document is meant to be used as a reference tool for clinicians.

Fall prevention in the elderly is a hot topic as we all strive to reduce falls and injuries, especially in congregate living situations. Here is a compedium of scientifically proven ways to implement a no-fall program as well as home modifications. Exercises to improve balance and strength are also provided.

As health insurance rates soar, reducing premium expenditures is also on the forefront of most Americans. Healthy People 2020 has an initiative for this also. One of the most important facets of this guideline is weight reduction as obesity is a major issue for the American people as a whole. Weight reduction helps to reduce cardiovascular risk and reduces hypertension and diabetes risks also.

In addition to addressing current health issues, prevention is another key component of Healthy People 2020:

Access to Health Care services remains problematic for some in the US. There is often great disparity from one area to the next and from rural to urban regions. Some areas of general health can be addressed by being able to be seen by a medical provider...

  • Overall physical, social, and mental health status
  • Prevention of disease and disability
  • Detection and treatment of health conditions
  • Improved quality of life
  • Preventable death
  • Extended life expectancy

Chronic kidney disease (CKD) continues to affect more and more Americans, mostly due to the increasing numbers of patients diagnosed with hypertension and diabetes. One of the initiatives by several organizations is earlier referral to nephrologists who can provide the best care for CKD patients. This includes diet management, medication, overall care management. Perhaps the most important aspect of CKD care is education for both the patient and family. Staving off further deterioration of kidney function delays and possibly reduces the risk for the need for renal replacement therapy or dialysis.

We all need food to survive. However, food safety is another diverse Healthy People initiative. Foodborne illness can result in hospitalization and even death. It is often preventable and unreported.

  • Children younger than age 4 have the highest incidence of laboratory-confirmed infections from some foodborne pathogens, including Campylobacter, Cryptosporidium, Salmonella, Shiga toxin-producing Escherichia coli O157, Shigella, and Yersinia.
  • People older than age 50 and those with reduced immunity are at greater risk for hospitalizations and death from intestinal pathogens commonly transmitted through foods.

Healthcare-related infections are another area many healthcare workers are aware of. Many of us that work in hospitals are well area of many of these strategies are part of our work-day. Are you familiar with your facililty's policy to reduce?


CDC Health People

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On one hand glad to see this direction, on the other there's not much new here (I cherry picked sections to read so perhaps there are new ideas presented that I missed).

Fall reduction with OT home evaluation and modification recommendations...We already do that all day everyday. I wish I could copy and paste a statement but it essentially says the OT made f/u phone calls to see if the recommended modifications were made in the homes of vision impaired 75 yr olds. That's where a big gap lies, the follow through on making the home modifications. Medicare and Medicaid doesn't pay for it, we have very limited funding in our county resources to pay a handyman to install grab bars and purchase equipment. Our OT scours the thrift shops for used equipment for patients (which is a liability).

I don't know if the initiative has a plan for covering the recommendations that come out of these assessments, but the plan won't hold a lot of water if they don't.

Specializes in Nephrology, Cardiology, ER, ICU.

Good points. I work with elderly too and often write scripts for bath chairs, etc., Medicare does pay some portion of this and some Medicare supplements also pay for it. So, it is possible to have it at least partially paid for but the pt must get a script from a provider (which can sometimes be a hassle).

Medicare doesn't pay for shower chairs. And it's getting incredibly hard to get Medicare to pay for essential DME.

Our local DME, with a very long reputable history, gave up billing and will now only rent equipment directly. No DME, especially a local guy, wants to remove equipment from the home due to insurance denial and patients' inability to pay but it has been happening. We have literally seen the beds removed out from under the patients due to all of the physician's documentation not being good enough despite the effort to do so, patients just didn't meet the increasing steep criteria.

If you're writing prescriptions for supplies and equipment, you must be having to provide the specific required documentation, have you followed up to see if the equipment was actually delibered and reimbursed?

We spend a lot of time advocating for delivery of equipment following hospital discharge. We've had a rash of COPD patients discharged home on new neb meds but no neb because is wasn't yet approved. Patient ends back in hosptial and none of the providers or case managers had any idea of the delay in care. They thought that since they did their piece (understandably) and things would fall into place but they don't always.

Things like grab bars are not covered by insurance unless patient falls under some special category, but not your garden variety beneficiary. There are programs out there like DRAIL but there is a limit of funding for such programs and as well as who qualifies.

I could go on all day but I think I've drone on enough :-)

Specializes in Nephrology, Cardiology, ER, ICU.

You are right - I'm documenting very well, providing progress notes to include all ICD-10 codes, full details regarding why the shower chair is needed and yes I know my pts get the DME because I see my patients weekly.

Durable medical equipment (DME) coverage |