A Perspective on the Development of the Healthy People 2020 Framework for Improving U.S. Population Health
Author: Jonathan E. Fielding, MD, MPH, MA, MBA, Shiriki Kumanyika, PhD, MPH, Ronald W. Manderscheid, PhD
Fielding JE, Kumanyika S, Manderscheid RW. A perspective on the development of the Healthy People 2020 Framework for improving U.S. population health. Public Health Reviews. 2013;35: epub ahead of print.


Since the late 1970s, the federal Healthy People Initiative has been a visible component of the United States’ approach to improving population health. In each decade, a new version of Healthy People is issued, featuring updated goals and identifying topic areas and quantifiable objectives for health improvement during the succeeding ten years, with assessment at that point of progress or lack thereof. Progress has been limited for many objectives, leading to concerns about the effectiveness of Healthy People in shaping outcomes in the context of a decentralized and uncoordinated US health system. This article describes development of Healthy People 2020, launched in December of 2010, from the perspectives of three members of a public advisory committee appointed to guide the process: The Secretary’s Advisory Committee on Health Promotion and Disease Prevention Objectives for 2020 (SAC). The SAC made recommendations, almost all of which were adopted in some form, based on extensive assessments of strengths and weaknesses of the program and deliberations about critical areas to update. As a result, compared to prior versions, Healthy People 2020 gives more prominence to health promotion and preventive approaches, and adds a substantive focus on the importance of addressing societal determinants of health. A new expanded digital interface facilitates use and dissemination rather than bulky printed books as produced in the past. The impact of these changes to Healthy People will be determined in the coming years.

Keywords: Healthy People, population health, health objectives, health promotion, disparities,

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Jonathan E. Fielding, MD, MPH, MA, MBA

Director of Public Health and Health Officer, Los Angeles County, Department of Public Health; Professor, Schools of Public Health and Medicine, University of California at Los Angeles; Los Angeles, CA, USA.

Shiriki Kumanyika, PhD, MPH

Associate Dean for Health Promotion & Disease Prevention, Professor of Epidemiology, Department of Biostatistics & Epidemiology, University of Pennsylvania Perelman School of Medicine; Philadelphia, PA, USA.

Ronald W. Manderscheid, PhD

Executive Director, National Association of County Behavioral Health and Developmental Disability Directors; Washington, DC; Adjunct Professor, Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University; Baltimore, MD, USA.

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