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Executive
Summary
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| North Carolina’s 2010 Health
Objectives set out a comprehensive and ambitious statewide agenda
that provides a direction for improving the health and well being
of North Carolinians over the next decade. In 1999, Governor James
B. Hunt, Jr., appointed the Governor’s Task Force for Healthy
Carolinians through an Executive Order. A major assignment of the
Governor’s Task Force for Healthy Carolinians was to develop
a list of health objectives for the Year 2010. |
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Process
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This yearlong effort to develop the 2010 Health
Objectives was collaborative and inclusive. The work to develop the
objectives was accomplished in five committees: Maternal and Child
Health, Children and Adolescent Heath, Adult Health, Older Adult Health,
and Community Health. The membership of these committees reached beyond
public health, hospitals and health care providers and brought together
a diverse group of health and human service agencies, universities
and research centers, businesses, churches, and community members
to discuss and recommend health objectives to the Governor’s
Task Force. Each committee met monthly, hearing from experts representing
a variety of agencies and organizations. The recommendations of the
committees were presented to the Governor’s Task Force in May
2000. The Governor’s Task Force then took these recommendations
to North Carolinians for public comment and discussion. Forums were
held in Greenville, Pembroke, Winston-Salem, and Asheville during
July 2000. (For the complete discussion of the Forums, see Chapter,
Moving the North Carolina 2010 Health Objectives Forward.) Additionally,
for two months, the recommendations were posted on the Healthy Carolinians
website for public comment. All the comments received were reviewed
and considered. In September, the Governor’s Task Force for Healthy
Carolinians made the final decisions about the health objectives that
are contained in this document. |
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2010
Health Goals
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The Governor’s Executive Order set out
six broad, overarching goals to guide the development of the North
Carolina 2010 Health Objectives. These goals are:
- Increase the span of healthy life of the citizens of North Carolina;
- Remove health disparities among the disadvantaged;
- Promote access to preventive health services;
- Protect the public’s health;
- Foster positive and supportive living and working conditions
in our communities; and
- Support individuals.
These six goals are supported by the objectives listed in 12 focus
areas. A full explanation of these goals can be found in the Chapter,
North Carolina 2010 Health Goals.
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Eliminating
Health Disparities
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The Governor’s goal to eliminate health disparities
among the disadvantaged aligns with the Healthy People 2010 goal.
In order to achieve equity, all people in North Carolina are challenged
with the same standards for health and safety. The definition of health
disparities used in the North Carolina 2010 Health Objectives is:
"Differences in health status among distinct segments of the
population including differences that occur by gender, race or ethnicity,
education or income, disability, or living in various geographic localities."
Failure to focus on health disparities places serious limitations
on the effectiveness of preventive health care and health promotion
programs and will undermine North Carolina’s attempts to achieve
the 2010 health objectives. (See: Chapter, Eliminating
Health Disparities – North Carolina’s Challenge.) |
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2010 Health
Objectives
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The health objectives listed in the 12 focus
areas call for improving the health of all North Carolina residents
and the health of the community. Many of the objectives call for increasing
healthy behaviors and reducing or eliminating illness, disability,
and premature death. Other objectives focus on broader issues such
as access to health care and treatment services, community health,
and environmental health. For a complete discussion of each objective,
refer to the specific focus area and objectives in the Chapter, North
Carolina 2010 Health Objectives. The following is a brief overview
of each focus area: |
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Call
For Action
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1.
Access to Health Care
Access to quality health care is
a specific goal of Healthy Carolinians 2010. Access to health
care is also essential for eliminating health disparities and
achieving many of the objectives. Within this focus area there
are objectives for providing health insurance for all North Carolinians
and improving the school nurse to student ratio to 1 nurse for
every 750 students. Four developmental objectives address the
need to increase the number of primary health care physicians,
increase the number of minority and ethnic physicians, increase
the number of dentists who accept Medicaid, and increase access
to medication for Medicare and Medicaid recipients.
2.
Chronic Disease
This focus area addresses four leading causes of premature death
due to disease: cancer, diabetes, heart disease, and stroke. The
objectives listed call for reducing premature deaths and the economic
burden of these diseases through early detection, disease management,
and health promotion. Also addressed in the Chronic Disease focus
area are arthritis and osteoporosis, asthma, and overweight and
obesity. The objectives listed under these chronic diseases call
for reducing illness, disability, and lost productivity.
3.
Community Health
Healthy people need to live in healthy communities. The Community
Health focus area lists nine essential components and goals that
promote a healthy and safe community. These essential components
are: access to quality health care, economic opportunities, education,
environmental health, food security, heath promotion, housing,
safe and secure communities, and transportation. The work on this
focus area is ongoing. The Community Health committee will continue
to meet and develop specific objectives for communities. This
document will be available in 2001.
4.
Disability
This focus area addresses the disparities between people with
disabilities and those without. Most people with disabilities
have the potential to lead healthy and productive lives if given
the opportunity to attain it and fully participate in all aspects
of community life. The objectives in this focus area address the
need for expanded information and data about people with disabilities.
Objectives also call for improving support for people with disabilities.
5.
Environmental Health
A healthy environment is critical for healthy people. Protecting
the environment is important because the impact of the environment
on human health is so great. The objectives in this focus area
target food safety and lead poisoning, as well as air, soil, and
water quality. Exposure to hazardous agents in the air, soil,
water, and food supply contribute to illnesses and developmental
disabilities. The air, soil, and water objectives follow the guidelines
from the Environmental Protection Agency. Much of environmental
health is addressed through strong environmental policy.
6.
Health Promotion
This focus area calls for healthy behavior and lifestyles, supportive
health policies, and environmental changes. Inherent in the nutrition,
physical activity, and tobacco objectives is the need to start
life with health promoting habits and sustain these habits across
the life span. Substance abuse objectives address the need for
adequate treatment as well as prevention. The objectives for responsible
sexual behavior focus on adolescents, calling for increased numbers
of adolescents who abstain from intercourse to reducing teen pregnancies
and sexually transmitted diseases.
7.
Infant Mortality
One of the greatest challenges to North Carolina is decreasing
infant mortality and the number of low birth weight babies. The
overall infant mortality rate for North Carolina is higher than
the national average. More alarming is the very high infant mortality
rate for African Americans/Blacks and American Indians in North
Carolina. The objectives listed in this focus area call for reducing
infant death and low birth weight, as well as improving maternal
health behaviors during pregnancy.
8.
Infectious Diseases
Childhood vaccinations are at the highest levels ever recorded
in North Carolina. This accomplishment is due to collaborative
work of public health, health care providers, and community partnerships
across the state. The objectives addressing childhood vaccinations
call for maintaining these great strides. This focus area also
calls for increasing influenza and pneumococcal vaccinations among
older adults. The Infectious Disease focus area lists objectives
to reduce sexually transmitted diseases. Currently, North Carolina
is ranked fourth in the nation in primary and secondary syphilis
rates.
9.
Injuries
Injuries are the leading cause of death for people age 1 to 34
years. Motor vehicle injuries are the leading cause of injury
fatalities in North Carolina. The objectives in the Injury focus
area call for reducing child abuse; motor vehicle injuries; sexual
assault and intimate partner violence; and homicide, assault,
suicide and injuries caused by firearms.
10.
Mental Health
This focus area calls for improving mental health through increased
access to appropriate mental health treatment services. Mental
disorders occur throughout life, affecting persons of all racial
and ethnic groups, both genders, and all educational and socioeconomic
groups. There is a large gap between the need for mental health
services and available services in North Carolina. Adequate funding
for mental disorder treatment through health insurance payments
and other sources is needed to address this growing health issue.
11.
Older Adult Health
One of the most innovative focus areas in this document is Older
Adult Health. The underlying philosophy of the Older Adult Health
committee is that people should be healthy as they enter old age.
Healthy behaviors should be practiced over a lifetime. Many of
the health promotion and chronic disease objectives listed in
other focus areas include older adults. The objectives listed
in this focus area address quality-of-life issues for the older
adult, including independent living, affordable housing, home
and community-based care services, fiscal well being, and end-of-life
care.
12.
Oral Health
Oral health is essential throughout life. Children in North Carolina
are at risk for poor oral health due to inadequate dental health
services. Poor oral health and untreated oral conditions can have
a significant impact on quality of life and can contribute to
poor nutrition and ultimately chronic diseases. The Access to
Health Care focus area addresses the need for increased pediatric
dentists and hygienists. The objectives in this focus area call
for reduced tooth decay and tooth loss for all ages, and increased
access to dental health services.
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Emerging
Issues
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The Governor’s
Task Force recognized that many changes will occur over the coming
decade. The final chapter in this document highlights emerging issues
for the Governor’s Task Force to follow. These issues are alternative
medicine, genomics, changes in the environment, evolving technology,
and changing demographics.
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