The Healthy People Initiative, launched in 1979 by the Surgeon General of the United States, was the nation’s first comprehensive health promotion plan. But prior to Healthy People 2030, the newly released plan, there had not been one objective that was specific to childhood trauma, ACEs, trauma-informed care, or toxic stress. Even with decades of research confirming the impact childhood adversity has on development, it has not been included until now!
Since the inception of the Health People project, the US Department of Health and Human Services has developed new objectives every decade to improve health outcomes for all Americans. The first edition consisted of a mere 5 goals, 15 priorities and 26 objectives, which sought to significantly reduce preventable deaths as evidenced by a reduction in mortality rates. A review of the five editions of Healthy People demonstrates that the plan has evolved into a more comprehensive health promotion and disease prevention plan moving beyond only measuring mortality rates and towards whole health.
The recent release of Healthy People 2030 reveals exciting and promising changes for resiliency advocates. First, health is not viewed merely the absence of disease but also focuses on well-being. Objectives are not grouped by diseases, but rather by topics including Health Conditions, Health Behaviors, Populations, and Social Determinants of Health. The overarching theme of Healthy People 2030 is based upon improving well-being by examining how Americans think, feel and function- a successful journey from only assessing morbidity or mortality rates.
Another change is significantly fewer objectives than the previous edition to give priority to urgent public health issues. While 1,300 objectives were highlighted in 2020, there are now only 355 in Healthy People 2030 and therefore higher standards are required to qualify as an objective. Substantial time and research went into identifying the 2030 objectives. Excitingly, because of public health champions strongly advocating to include trauma-informed care in the framework, there are now 3 developmental objectives that are specific to trauma & resiliency work:
- Increase the proportion of children and adolescents with symptoms of trauma who receive evidence-based treatment
- Increase the proportion of trauma-informed early childcare settings and elementary and secondary schools
- Reduce the number of young adults (aged 18 to 25 years) who report 3 or more Adverse Childhood Experiences (ACEs)
This is indeed an exciting time for resiliency advocates! To be able to see the shift over the last four decades from health being measured by reduced infant mortality rates to a framework that is focused on science and evidence-based interventions is truly astounding. The value of focusing on the well-being of the children by providing trauma-informed education and evidence-based trauma treatment, rather than standing downstream counting higher mortality rates of people with ACEs cannot be understated. The benefit of going upstream will impact generations to come as cycles are broken.
Dr. Jerome Adams, Surgeon General of the United States, shared that Healthy People 2030 is not a federal project but rather a national project. While the objectives are set by a federal entity, the project cannot be effective without the support of the nation requiring state and local leaders to join efforts to impact local community health and eliminate health disparities that can no longer be ignored.
Benchmarks’ Center for Quality Integration seeks to improve the well-being of the most vulnerable throughout North Carolina by developing critical partnerships to improve the health of our communities and nation. Our community-driven initiatives are designed to improve the well-being of child welfare involved children and families by reducing the need for higher end behavioral services through a more trauma-informed community which can lead to a reduction in health expenditures. By bringing together child welfare, Medicaid managed care, and other community partners, we are working to ensure children get trauma-informed care from the many systems they touch. The outcomes from our first project, Partnering for Excellence, has proven successful in children receiving an accurate diagnosis and timely treatment. This is just one example of the kind of partnership that is needed in the community to ensure that Healthy People 2030 objectives can be achieved. With a shared goal of Healthy People 2030, equity, well-being along the lifespan, and broad engagement, Benchmarks’ PFE is excited to see the improvements in our health as a nation as we embark on the Healthy People 2030 journey. Will you join us?
-post by Susan Willis, PFE Project Coordinator
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