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Epidemiology. Healthy People 2020 Program in Miami

Healthy People is a nationwide program set by the United States Department of Health and Human Services to accomplish health promotion and disease prevention goals. First launched in 1979, it is updated and reviewed every ten years to reflect the changes and address current public welfare concerns. The program is essentially a statement of national health objectives that identifies the most significant threats and establishes a strategy to prevent and reduce them. The development of the program’s goals is considered to be not solely the government’s concern but rather a collaborative effort of the state, and local businesses and communities.

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The Healthy People 2020 program was started in 2010 and established the national health agenda for the next ten years. Its goals include “attaining high-quality, longer lives free of preventable disease; achieving health equity; creating social and physical environments that promote good health; and promoting healthy behavior and quality of life” (About Healthy People, n. d.). The program contains 42 topics comprised of over 1,200 objectives, including 13 new topics compared to the Healthy People 2010 agenda.

The human immunodeficiency virus

The human immunodeficiency virus (HIV) is a retrovirus that attacks the immune system and makes it hard for the body to fight other infections. Over time, it progresses into acquired immunodeficiency syndrome (AIDS), causing a progressive failure of the immune system and allowing infections and cancers to thrive. In most cases, HIV is transmitted through sexual intercourse, injection drug use, or from an infected mother to her child during pregnancy. With successful treatment, HIV becomes a chronic condition with an increasingly rare progression to AIDS and a significantly reduced transmission rate.

HIV is a major public health concern in the USA. At the end of 2016, an estimated 1.1 million people were living with HIV, and around 14% of them were undiagnosed (Centers for Disease Control and Prevention, 2020b). Miami has the highest rate of new HIV diagnoses in the United States, with 1,194 people newly diagnosed cases in 2018 and approximately 25,650 people living with HIV as of 2018 (AIDSVu, 2018). The HIV epidemic in Miami is linked to the presence of many racial, ethnic, and sexually diverse risk groups, and geographic diversity (Escudero et al., 2019). The high rate of HIV and AIDS presents serious social and economic challenges, while early detection and treatment significantly reduce mortality and prevent future transmission. HIV testing, counseling, and treatment are the primary concerns of the national HIV/AIDS strategy.

The Healthy People 2020 program identifies HIV as an important health concern and sets 24 objectives to address it. They include reducing the number of new infections, preventing transmission risk, increasing access to testing and treatment, and improving health outcomes for people living with HIV (HIV, n. d.). Most objectives are also a part of the National HIV/AIDS Strategy, which focuses on four key goals in HIV prevention, care, and research. They include “widespread testing, broad support for people living with HIV to remain engaged in comprehensive care, universal viral suppression, and full access to comprehensive PrEP” services (Centers for Disease Control and Prevention, 2020a). Healthy People 2020 also identifies emerging issues, such as the decline in public perception of the seriousness of HIV and the increase in the number of people aware of their HIV status and living with HIV (HIV, n. d.). These issues should be addressed by organizing media campaigns to raise public awareness and the development of prevention strategies targeted at HIV-infected people.

Tobacco Use

Another important issue addressed in the Healthy People 2020 program is tobacco use. It is the largest preventable cause of death in the United States, with around 480,000 people dying from smoking-related diseases each year (Tobacco use, n. d.). As of 2017, 16.1% of adults smoke in Florida, with the national rate being 17.1% (Tobacco prevention and control, 2014). Smoking significantly affects the community, causing death, lung cancer, and an adverse impact on people’s overall health, being linked to reduced fertility, greater absenteeism at work, and greater health care costs. People who do not smoke are also affected by being exposed to secondhand smoke, which also constitutes a significant health hazard.

Healthy People 2020 sets a nationwide action framework to reduce tobacco use. The strategy includes measures aimed at increasing the price of cigarettes, introducing smoke-free policies, providing cessation treatment, implementing anti-tobacco media campaigns, controlling access to tobacco products, and reducing tobacco advertising (Tobacco use, n. d.). There are 21 objectives organized into three sections. The first is aimed at reducing the number of adult smokers and adolescents who first try tobacco products. The second establishes health system changes required to make tobacco screening, cessation counseling, and treatment more accessible and affordable. The third describes the desired social and environmental changes required to reduce the proportion of people exposed to secondhand smoke. They include the introduction of laws that prohibit smoking in public spaces and worksites.

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In Miami, smoking is prohibited in all public and private businesses, including restaurants and bars. In 2019, the law was introduced that bans vaping and the use of e-cigarettes in workplaces. The laws aim to protect people from the hazards of secondhand smoke and prevent health consequences and death that can result from constant exposure. The program greatly contributes to the decrease in smoking rates among both adults and teens.

Occupational Safety and Health

Occupational safety and health refer to the initiatives intended to prevent diseases, injuries, and deaths at the workplace, reduce health and safety risks, and improve workplace practices. Dependent on the employer and the type of work, people are exposed to different levels of risk coming from physical, mechanical, biological, or chemical hazards. In most cases, work-related injuries and deaths are preventable if certain health and safety instructions are observed by both employers and employees. In Miami, the issue is addressed by the Florida Department of Health through the Occupational Health and Safety Program that studies work-related injuries and designs the methods to prevent them.

The Healthy People 2020 program sets ten objectives related to occupational safety, all concerned with reducing the rates of deaths and injuries at the workplace. They cover repetitive motion injuries, homicide, assault, lead exposure, skin disorders, stress, and hearing loss (Occupational safety and health, n. d.). In order to prevent occupational and environmental safety hazards in the work environment, it is important to identify work-related exposures that are potentially hazardous. Then a list of recommendations should be developed for each particular workplace dependent on the level of risk.


The Healthy People 2020 program identifies the most important public health issues and provides a list of objectives to address them on the national and local levels. In Miami, the national agenda is implemented by local organizations that develop their own healthcare programs with consideration of local specifics. The significant reduction in HIV cases, the rate of tobacco use among both adults and teens, and work-related deaths and injuries is a result of the collective efforts of the government and community.


AIDSVu. (2018). Local data: Miami

Centers for Disease Control and Prevention. (2020a). National HIV/AIDS strategy: Updated to 2020. 

Centers for Disease Control and Prevention. (2020b). U.S. statistics. Web. 

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Escudero, D., Bennett, B., Suarez, S., Darrow, W., Mayer, K., & Seage, G. (2019). Progress and challenges in “getting to zero” new HIV infections in Miami, Florida. Journal of the International Association of Providers of AIDS Care, p. 18. 

About Healthy People. (n. d.). Healthy People 2020.

HIV. (n. d.). Healthy People 2020. 

Occupational safety and health. (n. d.). Healthy People 2020. 

Tobacco use. (n. d.). Healthy People 2020. 

Tobacco prevention and control. (2014). The Florida Department of Health. 

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