Did Americans get any healthier over past decade?

About 10 years ago the government set some lofty health goals for the nation to reach by 2010.

So how did we do?

By many measures, not so hot.

There are more obese Americans than a decade ago, not fewer. We eat more salt and fat, not less. More of us have high blood pressure. More of our children have untreated tooth decay.

But the nation has made some progress on many other goals. Vaccination rates improved. Most workplace injuries are down. And death rates from stroke, cancer and heart disease are all dropping.

As we move into a new decade, the government is analyzing how well the nation met the 2010 goals and drawing up a new set of goals for 2020 expected to be more numerous and - perhaps - less ambitious.

"We need to strike a balance of setting targets that are achievable and also ask the country to reach," said Dr. Howard Koh, the federal health official who oversees the Healthy People project.

The Healthy People objectives were first created in the late 1970s to set an agenda for getting Americans to live longer, healthier lives.

Every 10 years, the U.S. Department of Health and Human Services reassesses the goals, and reports on progress made in the previous decade.

Many call the effort a success. The report has been imitated by states and other nations. Because of its importance within public health circles, interest groups jockey to add their goals to the document, which is expanding to more than 1,000 targets. And health agency workers have Healthy People goals memorized.

"It is something that we think about all the time," said Dr. Lance Rodewald, a vaccination expert at the U.S. Centers for Disease Control and Prevention.

But after more than 30 years, the goals aren't well known to the public and only a modest number have been met.

About 41 percent of the 1990 measurable goals were achieved. For the 2000 goals, it was just 24 percent. As for the 2010 goals, a final report is not due until 2011. But it looks like the results will be around 20 percent, according to the CDC's National Center for Health Statistics.

Worse, the CDC analysis done this fall found that the nation actually retreated from about 23 percent of the goals.

One example: Healthy People 2010 called for the percentage of adults who are obese to drop to 15 percent. That goal was set when nearly a quarter of all adults were obese. Now, about 34 percent of adults are obese.

Some other backslides:

• An estimated 28 percent of adults had high blood pressure in 2000. The goal was to reduce that to 16 percent. But the latest data say the proportion has risen to 29 percent.

• About 16 percent of young children had untreated tooth decay in 2000. The target was 9 percent. The latest statistic is about 20 percent.

• The proportion of births by cesarean section increased despite a 2010 goal of lowering them, and the percentage of infants born very small and fragile also increased.

To many health officials, simply making progress is a victory. An analysis of 635 of the nearly 1,000 targets for the past decade shows there was improvement in 70 percent of the measures.

"That's evidence of a healthier nation," Koh said.