For 4 decades, Healthy People has represented the United States' vision for a healthier future. Each decade, it serves as a public health road map and compass for the nation by establishing a broad set of overarching health goals while specifying actions to improve length and quality of life. For the current decade, this comprehensive national health promotion and disease prevention agenda encompasses more than a thousand specific objectives organized into 42 topic areas. To focus particular attention on the leading causes of preventable death and illness, Healthy People 2020 features Leading Health Indicators. This subset of 26 indicators from 12 topic areas offers high-priority targets for which concerted action could lead to major improvements for public health. This article reviews newly available Leading Health Indicators' data for the first third of the decade, thereby offering a timely snapshot of the nation's progress toward better health (eTable in the Supplement). The data demonstrate areas of both improvement and continued need. On the positive side, 14 of the 26 Leading Health Indicators (54%) have documented improvement, and 4 have met or exceeded their Healthy People 2020 targets. For example, for Environmental Quality, both indicators have surpassed their targets for improved air quality and reduced exposure of children to secondhand smoke. With respect to Nutrition, Physical Activity, and Obesity, the percentage of adults meeting federal guidelines for aerobic physical activity and muscle-strengthening activity has also met the 2020 target. Further progress extends to Injury and Violence, with the age-adjusted rate of homicides decreasing to reach, and even exceed, the Healthy People 2020 target. 1 Other topic areas reflecting improvement include the following: Clinical Preventive Services showed improvement in 3 of 4 of its indicators-colorectal cancer screening, hypertension control, and childhood immunizations; Maternal, Infant, and Child Health showed decreases in infant deaths and improvement in preterm live births; Substance Abuse showed a decrease in adolescents' use of alcohol or illicit drugs over the past 30 days; Tobacco showed declining cigarette smoking rates among adults; and Reproductive and Sexual Health showed that more individuals who are HIV positive know their serostatus. In the key area of Social Determinants of Health, the interrelated worlds of education and health 2 marked an improvement in the percentage of students who earned a high school diploma 4 years after starting ninth grade. 1 The new data also document no improvement for 11 of the 26 indicators (42%) and, of those, 3 show worsening health outcomes.
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