4. Infertility affects about 6% of married women ages 15-44 years in the U.S. Also, about 12% of women 15 – 44 years of age in the U.S. have difficulty getting pregnant or carrying a pregnancy to term, regardless of marital status. Infertility is defined as not being able to get pregnant after one year of unprotected sex. Several things increase a woman’s risk of infertility, including age, smoking, excessive alcohol use, extreme weight gain or loss, some untreated sexually transmitted diseases, or excessive physical or emotional stress that results in the absence of a menstrual period.
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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 to 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. Healthy People 2020 gives more prominence to health promotion and preventive approaches and adds a substantive focus on the importance of addressing social 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.