Healthy people 2010: diabetes.

853 B eginning in 1979, the then Department of Health, Education, and Welfare issued a document titled " Healthy People: The Surgeon General' s Report on Health Promotion and Disease Prevention " (1). With the release in 1990 of Healthy People (HP) 2000, the process of establishing health directions for the nation, as well as the increased variety of topics addressed, both signified expanded considerations about the future health of the U.S. (1). Within HP 2000, diabetes was included in a chapter titled " Diabetes and Other Chronic Disabling Conditions " (2). Initially, 4 diabetes objectives were addressed, including prevalence, mortality, complications , and patient education. During a " mid-course review " of HP 2000 in 1995, a fifth specific diabetes objective—screening for diabetic retinopathy—was added (3). The addition of this objective was important not only because of its clinical relevance to diabetes (4), but also because it was the first process indicator in the diabetes chapter (compared to objectives reflecting end-stage diabetes complications, such as mortality and lower-extremity amputations). For content areas within HP 2000, periodic reviews with the Department of Health and Human Services occurred that were formal, intense, and public. These reviews addressed issues such as data availability, trends in targets, program efforts to achieve objectives, and pending challenges. The proceedings of these reviews were published as a statement of the extant status of a particular content area within HP 2000. " HP 2010: Understanding and Improving Health " was released in January 2000 (5). This review will briefly describe HP 2010; the diabetes focus area within HP 2010; indications of progress for diabetes within HP 2010; and challenges that remain for the greater diabetes community. Healthy People 2010 HP 2010 was noteworthy from several perspectives (1). First, because of a commitment to ensure broad participation, as well as to expand the scientific and program-matic content of the document, the process of establishing HP 2010 was both lengthy (lasting Ͼ4 years) and iterative, with multiple opportunities for public comment and advice with multiple regional hearings, focus groups, and establishment of mechanisms for written and electronic communications. Further, although various federal agencies had lead responsibilities for HP 2010, broadly representative work-groups actively participated in the evolution of each content area. Second, because of the consultative process, 2 overarching goals for HP 2010 were established for all focus areas: increasing quality and years of healthy life, and eliminating health …