T he unequal burden of cancer among ethnic minorities and the medically underserved represents one of public health's most difficult challenges. It will require an unwavering commitment to finding real solutions to address this complex problem.
I know that this work can be especially challenging at times. It reminds me of the story Neal Lane told of a man flying in a hot air balloon who suddenly realizes he's lost. He reduces height and spots a man in a field. He lowers the balloon farther and shouts, "Excuse me, sir, can you tell me where I am?" The man below says, "Yes, you're in a hot air balloon, hovering approximately 30 feet above this field."
"You must work in science," says the balloonist. "I do," replies the man. "How did you know?" "Well," says the balloonist, "your answer is technically correct, but it's of absolutely no use to anyone."
The man below replies, "You, sir, must work in policy." "I do," replies the balloonist, "but how'd you know?" "Well," says the man, "you don't know where you are, or where you're going. You're in the same position you were before we met, but now it's my fault." This is the same position that we, in public health, often find ourselves-trying to find the manageable balance between public health and policy. Public health is science on one hand and policy on the other, with a great deal occurring between the time we start in the lab and the time we get to the people.
In February of this year, the Department launched Healthy People 2010, the nation's health plan for the next decade. Healthy People 2010 is the third in a series of decade-long health plans that date back to 1979, when Dr. Julius Richmond launched Healthy People 1990, the first version. Ten years later, we followed with Healthy People 2000, which just ended.
Our findings show that at the conclusion of Healthy People 2000, we were moving in the right direction on a majority-60%-of our goals. But we also found that we were moving in the wrong direction for 20% of our objectives. As for the remaining 20%, we just don't have enough data to know where we are.
We hope to do even better with Healthy People 2010, even though the challenges are greater. We have named two very important goals. The first goal is to increase the number of years and improve the quality of healthy life. The second goal is to eliminate racial and ethnic disparities in health care. The quality-of-life goal addresses the issues of pain and suffering and disability, areas that heretofore have been overlooked and that grow in significance as the nation ages. The disparities goal, which is particularly critical as it relates to cancer, addresses the rapid population shifts that are occurring in this coun-205