In 1991, the Department of Health published Healthy New Jersey 2000: A Public Health Agenda for the 1990s. For the first time, New Jersey not only defined a comprehensive set of goals for preventing disease and improving the health of the State's residents over the coming decade, but also identified very specific targets for improvements as well as indicators to measure progress toward these targets. Sixty-seven objectives, or targets and their associated indicators, were established in eleven major health categories, ranging from improving maternal and child health to reducing the adverse impacts of diseases such as cancer, HIV/AIDS and cardiovascular disease. These priority areas and objectives were determined by the Department in partnership with health care providers, educators, researchers, consumer advocacy groups and grass roots organizations. In adopting this public health agenda, New Jersey followed the example set by the U.S. Department of Health and Human Services, which published Healthy People 2000, a set of 300 national health promotion and disease prevention objectives.

In 1996, the Department published Update Healthy New Jersey 2000, which evaluated initial progress, starting from baseline data from the late 1980s, toward achieving our State's objectives. Because of the length of time required to collect, process and analyze health indicator data, the latest data reflected in the 1996 update generally were from the years 1992 or 1993. With Update Healthy New Jersey 2000 - Second Update and Review, the Department of Health, the successor agency to the former Department of Health, has added data from 1995, 1996, or even, in some cases, 1997. This places us in a better position to see the trends associated with each objective, and to assess the likelihood of New Jersey's achieving its targets in the year 2000.

This update is also timely in helping the Department and its partners plan a public health agenda for the next decade. In September of 1998, the federal government released Healthy People 2010 Objectives, Draft for Public Comment, and will be publishing the final version of this document in January, 2000. In 1999, the Department will once again consult with its partners in developing New Jersey's goals and objectives for the first decade in the 21st Century. In the course of this process it is essential to see how well we have done in reaching our year 2000 objectives, assessing our methods of setting targets, as well as the ways in which we measure our progress and identify accountability for achieving our objectives.

The outlook for the year 2000 is mixed. We are very pleased to report that New Jersey is on track for reaching its year 2000 objectives in a number of areas, most notably:

• reducing the infant mortality rate for the population as a whole;

• reducing birth rates among females in their teens, both for the population as a whole and for minority teens;

• reducing breast cancer death rates for all women;

• reducing lung cancer death rates for the total population as well as for minority males;

• reducing colorectal cancer death rates;

• reducing death rates from coronary heart disease for the total population as well as for minorities;

• reducing the incidence of AIDS among children and males, and the prevalence of HIV infection among mothers of newborns;

• reducing death rates from AIDS;

• reducing the motor vehicle death rate for the population as a whole and among youths 15 through 24 years of age;

• reducing deaths and injuries from falls for people aged 65 through 84 years; and

• reducing work-related deaths among construction workers.
  

In a number of areas clear trends are not evident, and the likelihood of achieving year 2000 objectives in these areas is still too uncertain to predict.

Finally, in several key areas it is already apparent that achieving the year 2000 target is unlikely, including:

• the percentage of New Jerseyans without health insurance or without a primary care provider;

• the percentage of babies whose mothers received prenatal care, and the percentage of babies born with low birth weight;

• the homicide death rate for minority males aged 15 through 19;

• the prevalence of smoking and other drug use among high school students; and

• the percentage of women who take advantage of Pap tests to screen for cervical cancer, and the rate of cervical cancer deaths among women over 65.
  

These trends are disappointments, but an inevitable risk when ambitious goals are set. They should not overshadow the genuine progress that has been achieved in other areas.

In New Jersey, as in the rest of the nation, minority populations generally experience disproportionately more health problems and higher rates of death from preventable causes. Healthy New Jersey 2000 objectives were set, when possible, to identify separate targets for minority populations which, if achieved, would narrow the gaps between minority and majority groups. In its draft Healthy People 2010, the federal government is proposing to go further and eliminate gaps or disparities in health status based on race, ethnicity or other factors. New Jersey will also be examining this issue as we set our year 2010 targets. For example, although we may achieve our year 2000 objective for reducing black infant mortality, we have already recognized that narrowing the gap between black infants and the rest of the population is not enough. Starting in 1996, the Department convened a Blue Ribbon Panel to recommend ways to reduce black infant mortality even further, to bring us to the ultimate goal of eliminating the differences in infant mortality.