Healthy People 2010:

The Federal Government's Health Goals for the Coming Decade

By John Magisano

At the recent Gay Men's Health Summit in Boulder, CO, a great deal of time and energy was spent on the issue of Healthy People 2010, which is the central document laying out the Federal Government's priorities around health for the coming decade. This document, which is published every ten years, began as a project of the US Surgeon General in 1979, when the first such report both established national health objectives and served as the basis for the development of state and community plans.

This year's document lays out two overarching objectives for national, state and local health systems in their planning efforts; 1) Increase the quality and years of healthy life and 2) Eliminate health disparities, which are defined as differences in health status that occur by gender, race or ethnicity, education or income, disability, living in rural localities, or sexual orientation.

When a draft of this document was first circulated in January of this year, there was no mention of sexual orientation as a source of health disparities. There was an immediate protest from the Gay and Lesbian Medical Association and other organizations in response to this omission. As a result, sexual orientation was added to the list of factors affecting health disparities. In addition, US Department of Health and Human Services (HHS) Secretary Donna Shalala assigned her assistant, Marty Rouse, (a former employee of The NYC Lesbian and Gay Community Services Center) to travel the country and seek input from LGBT health organizations, administrators, activists, academics, consumers and policy makers in order to assure queer input into Healthy People 2010. As a part of this tour, Rouse visited the NYS LGBT Health and Human Service Network and other local organizations in the spring. He also coordinated the attendance of several high-level administrators from various HHS departments at the Gay Men's Health Summit, (including from the Center for Substance Abuse Treatment, which funds SpeakOUT). A great deal of feedback was given to these officials in a variety of workshops and plenary sessions at the summit, and many of the organizations represented there are taking it back to their communities to organize around.

While progress has been made on queer inclusion in the document, much more needs to be done. The struggle to gain inclusion is hampered by the fact that none of the national surveys conducted by HHS departments, including, the National Household Substance Abuse Survey, or any of the youth surveys administered by the states include questions about sexual orientation. Until our communities are represented in these surveys, it will remain a struggle to get on the map for federally funded services and research.

Because of the remaining shortcomings in the document around sexual orientation and gender identity issues, HHS has funded the Gay and Lesbian Medical Association to develop a companion document that fleshes out queer issues in more detail. This document is available on-line at www.glma.org. Healthy People 2010 is also available on line at health.gov.healthpeople/prevagenda/whatishp.htm.

Of special interest to SpeakOUT are the sections in both documents on substance abuse. While both documents make for somewhat dry reading, it is worth it to see how policy-makers are discussing (or not discussing) our lives. Can we afford not to pay attention?