Devising and Attaining National Health Objectives: A Case Study in PolicyFormulation Using Asthma Targets in Healthy People 2000

摘要

Devising policies for the nation's health is the context for the researchproposed in the following pages. Asthma effects approximately eleven million Americans, causing work and school days to be lost, millions of outpatient visits, and thousands of hospitalizations annually (Weinstein, 1987). In 1989, asthma-related costs exceeded $6 billion (Weiss et al 1990). In an era when chronic diseases are increasingly manageable and the mode of treatment for asthma well recognized, mortality and morbidity from this disease are rising (Buist and Vollmer, 1990). The burden of illness falls disproportionately on lower socioeconomic groups and minorities (Gergen and Weiss, 1990). As an example, the death rate in blacks is three times higher than in whites (Centers for Disease Control, 1990). Prevention and control of asthma is one of the many conditions addressed in the document Healthy People 2000: National Health Promotion and Disease Prevention Objectives (HP2000) (United States Public Health Service, 1990).