Flanked by a dozen American flags, Health and Human Services Secretary Louis W. Sullivan yesterday unveiled a 298-point plan to improve Americans' health over the next decade, largely by encouraging people to adopt healthful habits to prevent disease.

"We can no longer afford to ignore the fact that, individually and as a nation, prevention is the single most important factor in maintaining good health," he told a roomful of trade association representatives and health-care providers. "We need a national priority for personal responsibility and for choices that maintain or improve the health status of our citizens."

The objectives of the plan, called Healthy People 2000, include reducing cancer and infant mortality rates, limiting the number of new AIDS cases and reducing the incidence of chronic disease.

The plan lists an array of ways to accomplish these goals, including reducing dietary fat and drug and alcohol use and increasing exercise. It also calls for an increase in the number of women who get prenatal care and immunizations for children.

Sullivan and Assistant Secretary for Health James O. Mason said they envision industry, government and local volunteers working together to achieve these goals, but the plan does not propose specific legislation or changes in funding.

"What is outlined is a series of things that can occur," Mason said. "It's simply a plan. Each state is going to have to go through these."

But some consumer advocates said that while they think the plan's objectives are laudable, they believe its release -- which features a two-day conference of seminars on public health, a walk through Rock Creek Park and a performance by the Environmental Protection Agency band -- is more of a public relations move than a realistic appraisal of what current government policy will achieve in the next 10 years.

"Maybe they should call it 'Fewer Healthy People by the year 2000,' given the policies of this administration," said Sidney Wolfe, director of the Public Citizen Health Research Group.

Over the past 10 years, he added, "there are more people who are uninsured; there's less Occupational Safety and Health Administration enforcement of workplace safety; the Food and Drug Administration is failing to prosecute companies that break food and safety laws."

"It's now become clear there's a double standard not only for health-care delivery but also for prevention," he added. "If you have money, you can afford to buy a pair of running shoes. If you're poor, you can't."

Public health officials, however, said they had reached many of the goals outlined in a similar report released 10 years ago, including reducing high blood pressure, smoking and car accidents and increasing the rate of immunizations.

Mason said he thinks the nation could increase the number of doctors working in medically underserved areas if states increased Medicaid reimbursement for physician services.

But he added that the final decision on such policies should be made locally and said the problem was more complex than simply increasing federal funding.

Some local health-care providers feel differently. If the government wants to reduce the spread of AIDS, they said, it will have to provide more funds to expand drug treatment programs.

"I really think the discussion is meaningless until you start to {talk about} dollars," said George Swales, acting administrator of the District's Whitman Walker clinic.


Exercise: Get 30 percent of Americans to exercise moderately for at least 30 minutes a day, an increase of 8 percent.

Obesity: Reduce from 26 percent to 20 percent the proportion of overweight adults.

Smoking: Nearly halve the proportion of adults who smoke, from 29 percent to 15 percent.

Pregnancy: Reduce pregnancies of girls under 18 to 50 per 1,000. In 1985, rate was 71 per 1,000.

Auto safety: Double the number of vehicle occupants who use automobile safety restraints from 42 percent to 85 percent.

Infant mortality: Reduce infant mortality to seven deaths per 1,000 births. Last year's provisional rate was 9.7 per 1,000.

Heart disease: Reduce the incidence of coronary heart disease deaths to 100 per 100,000 from 135 per 100,000.

AIDS: Confine the annual incidence of diagnosed AIDS cases to 98,000. Between 44,000 and 50,000 cases were diagnosed last year.