HP2010 Health Indicator: Access to Care







Healthy People 2010 Health Indicator: Access to Care


            Healthy People (2010) identifies Access to quality care as one of the major health indicators, the others being immunization, injury and violence protection, and environmental quality. Health indicator is paramount for eliminating health disparities among populations as well as raising and extending the quality of healthy life. Four components (primary care, clinical preventive care, emergency services, and long-term and rehabilitative care) of the scope of health care are discussed in details in Healthy People 2010 (HP2010) whose goal with regard to access to health care is “Improve access to comprehensive, high-quality health care services.”(U.S DHHS, 2010).      

For instance, progress in cutting down the burden of heart disease as well as narrowing the gap in outcomes of heart diseases between  different racial groups depend on several factors,  which include ensuring access to clinical preventive services, such as screening of cholesterol levels and blood pressure; effective primary care to educate the public about adjustable risk elements, such as fat consumption, and to manage chronic conditions such as hypertension, effectively; high-quality emergency services to advance results of acute cardiac events; as well as access to long-term and rehabilitative care for patients with heart diseases.                                                         Heart Diseases;                                                                                                                                         The populations at the highest risk of suffering heart diseases are the elderly, people with obesity, as well as those with poor lifestyle like excess consumption of alcohol and smoking.            According to U.S Department of Health and Human Services (2010) data from NHANES 2006 estimates for the year 2006 were that eighty-one million people in the US had one or more forms of cardiovascular disease, 73.6 million had high blood pressure, 17.6 million had Coronary heart disease, stroke (6.4m), and 5.8 million had heart failure.                                                The major risk factor for heart diseases are; hypertension/high blood pressure, overweight and obesity, high blood cholesterol, heredity, physical inactivity, gender, age, smoking, and diabetes. Some other factors have been found to contribute to development of heart diseases and include alcohol, stress, birth control pills, as well as sex hormones.                                                          Heredity; Heart disease or condition tends to run in families. For example, if ones parents or siblings had a circulatory or heart problem before the age 55, then there is greater risk for that individual to develop heart disease than someone who does not have such family history. Risk factors such as obesity and diabetes may also be hereditary.                                      Physical Inactivity; Individuals who are physically inactive have a greater risk of heart attack than those who are physically active and exercise regularly. Exercise may lower blood pressure, burns out calories, and helps in controlling cholesterol levels and diabetes. It also strengthens the muscles of the heart and thus increasing flexibility of arteries.                                Stress; The effects of emotional stress and socioeconomic status on the risk of heart disease and heart attack have not been clearly determined and for this reason stress is considered a contributing factor to heart problems. However research has linked stress to heart problems as follows; stressful situations raise an individual’s heart rate and blood pressure, thus raising the heart’s need for oxygen. This need for oxygen can bring on chest pain (angina pectoris), in people who already have heart disease. Further, stress raises the amount of blood clotting factors in the blood, making it more likely that a clot will form. Clots might block arteries that have been narrowed by plaque and cause a heart attack (AHA, 2010).                                                Environmental risk factors for heart diseases;                                                                                   Until recently air pollution was not considered serious risk factors. Second hand tobacco smoke (which is the largest cause in this category), carbon monoxide, sulfur dioxide, nitrates, ozone, lead, and particulate matter (particle solution) have all been linked to heart problems in recent research.
The objectives of health promotion as stipulated in Healthy People 2010 that concerns heart diseases prevention as well as management are;

Objective code Objective Description


1995   /    2010


Physical activity or exercise (adults aged 18 years and older)






Diet and nutrition (adults aged 18 years and older)






Smoking cessation (adult smokers aged 18 years and older)






Reduced alcohol consumption (adults aged 18 years and older with excessive alcohol consumption)



                                                                                                                                                                            Source: HP2010.               In the U.S. an estimated 15 percent of adults don’t have access to a usual source of care. This translates to upward of forty million persons having no specific doctor’s clinic, office, health center, or other place where they can go for health care counsel. Emergency departments are not included in this category by the National Health Interview Survey (www.rwjf.com).                   On the contrary, approximately 93 percent of children of 17 years and below have a specific source of ongoing care. This is attributed to the implementation of the Children’s Health Insurance Program in 1999 which provides a means for raising the percentage of children with a continuing source of care (U.S Department of Health and Human Services, 2010).                        The usual source of care varies widely among groups depending on such factors as health insurance coverage, ethnicity and race as well as age. Elderly adults aged 65 years and older as well as young children are most likely to have a usual source of care. Adults aged eighteen to sixty-four years are least likely with young adults aged 18 to 24 years being the least likely to have a usual source of care. Further, Hispanic individuals are the least likely to have a usual source of care in ethnic and racial groups. As a matter of fact some twenty-four percent of the adult Hispanic population) lack a usual source of care, as does 28 percent of the Mexican American population, compared to fifteen  percent of African Americans and an equal percentage of the total adult population (www.rwjf.org).                                                                         Objective selection criteria for HP2010;                                                                                           The Department of Health and Human Services (2010) outlines the selection criteria in Healthy People 2020 – objective selection criteria as;

  • Objectives should be constructive and should mirror issues of national importance. Federal agencies, non-governmental organizations, states, localities, as well as the private and private sectors should be in a position to use the objectives to target efforts in communities, work sites, schools, health practices, as well as other environments.
  • The objectives should also be measurable and should attend to a variety of health issues as well, including; health and behavior result; socio-environmental conditions; availability of, access to, and substance of health and behavioral interventions; and community capacity – intended for to improving health outcomes as well as quality of life across the life span of individuals as stated by DHHS (2010).

The American Heart Association;

            The American Heart Association (AHA) is a national, non-governmental voluntary health agency whose mission is: “Building healthier lives, free of cardiovascular diseases and stroke.” (www.americanheart.org). The organization aims to have an extraordinary impact on the lives of Americans by empowering them to save lives, live healthier and enjoy more peace of mind concerning cardiovascular health. AHA’s impact goal is, by 2020, to improve the cardiovascular health of all Americans by twenty percent and at the same time reduce deaths from cardiovascular diseases and stroke by an equal percent.(www.americanheart.org).


AHA. (2010).Heart Diseases and Stroke Statistics: our guide to current statistics and the supplement to our heart disease and stroke facts; 2010 update at-a-glance. American Health Association. Retrieved August 23, 2010, from http://www.amhrt.org/downloadable/heart/1265665152970DS-3241HeartStrokeUpdate_2010.pdf

U.S Department of Health and Human Services. (2010).Healthy people 2010A: Access to Qquality Health Services. . Retrieved August 23, 2010, from http://www.healthypeople.gov/Document/HTML/Volume1/01Access.htm#_Toc489432807

U.S Department of Health and Human Services. (2010). Healthy People 2020 – objective selection criteria. Retrieved August 23, 2010, from http://www.healthypeople.gov/hp2020/objectives/selectionCriteria.aspx

Robert Wood Johnson Foundation (n.d.) Health Angels. Retrieved May 1, 2010, from http://www.rwjf.org/pr/product.jsp?id=20976