Fifty Communities Putting Prevention to Work: Accelerating Chronic Disease Prevention Through Policy, Systems and Environmental Change
The burden of preventable chronic diseases is straining our nation’s health and economy. Diseases caused by obesity and tobacco use account for the largest portions of this preventable burden. CDC funded 50 communities in 2010 to implement policy, systems, and environmental (PSE) interventions in a 2-year initiative. Funded communities developed PSE plans to reduce obesity, tobacco use, and second-hand smoke exposure for their combined 55 million residents. Community outcome objectives and milestones were categorized by PSE interventions as they related to media, access, promotion, pricing, and social support. Communities estimated population reach based on their jurisdiction’s census data and target populations. The average proportion of each community’s population that was reached was calculated for each intervention category. Outcome objectives that were achieved within 12 months of program initiation were identified from routine program records. The average proportion of a community’s jurisdictional population reached by a specific intervention varied across interventions. Mean population reach for obesity-prevention interventions was estimated at 35%, with 14 (26%) interventions covering over 50% of the jurisdictional populations. For tobacco prevention, mean population reach was estimated at 67%, with 16 (84%) interventions covering more than 50% of the jurisdictional populations. Within 12 months, communities advanced over one-third of their obesity and tobacco-use prevention strategies. Tobacco interventions appeared to have higher potential population reach than obesity interventions within this initiative. Findings on the progress and potential reach of this major initiative may help inform future chronic disease prevention efforts.
KeywordsChronic disease prevention Obesity Nutrition Physical activity Tobacco Community health Policy System Environmental change
- 1.Centers for Disease Control and Prevention. (2009). The power of prevention. Atlanta, GA: US Department of Health and Human Services. Retrieved from http://www.cdc.gov/chronicdisease/pdf/2009-Power-of-Prevention.pdf.
- 4.Institute of Medicine. (2011). For the public’s health: Revitalizing law and policy to meet new challenges. Washington, DC: Institute of Medicine.Google Scholar
- 8.Convergence Partnership. (n.d.). Who we are. Retrieved April 14, 2011 from http://www.convergencepartnership.org.
- 9.Liao, Y., Tucker, P., Siegel, P., Liburd, L., & Giles, W. H. (2010). REACH 2010 investigators. Decreasing disparity in cholesterol screening in minority communities–findings from the racial and ethnic approaches to community health. Journal of Epidemiology and Community Health, 64(4), 292–299.PubMedCrossRefGoogle Scholar
- 11.Brennan, L., Castro, S., Brownson, R. C., Claus, J., & Orleans, C. T. (2011). Accelerating evidence reviews and broadening evidence standards to identify effective, promising, and emerging policy and environmental strategies for prevention of childhood obesity. Annual Review of Public Health, 32, 199–223.PubMedCrossRefGoogle Scholar
- 12.Centers for Disease Control and Prevention. (n.d.). About MAPPS strategies. Retrieved October 14, 2011 from http://www.cdc.gov/CommunitiesPuttingPreventiontoWork/strategies/index.htm.
- 14.Baby Friendly USA. (2010). Guidelines and Evaluation Criteria for Facilities Seeking Baby- Friendly Designation. Sandwich, MA: Baby Friendly USA. Retrieved from http://www.babyfriendlyusa.org/eng/docs/2010_Guidelines_Criteria_4.19.11.pdf.
- 22.National Cancer Institute. (1991). Monograph 1: Strategies to control tobacco use in the United States: A blueprint for public health action in the1990′s. US Department of Health and Human Service, Public Health Service, National Institutes of Health. NIH Publication 92-3316.Google Scholar
- 25.Institute of Medicine. (2007). Ending the tobacco problem: A blueprint for the nation. Washington, DC: The National Academies Press.Google Scholar
- 26.US Department of Health and Human Services. (1989). Reducing the health consequences of smoking: 25 years of progress–A report of the surgeon general. Washington, DC: US Department of Health and Human Services, Centers for Disease Control, Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.Google Scholar
- 27.Institute of Medicine. (2000). State programs can reduce tobacco use. Washington, DC: The National Academies Press.Google Scholar
- 30.Dawkins N., Wethington H., Khan L.K., et al. (2010). Applying the systematic screening and assessment method to childhood obesity prevention. In L. C. Leviton, L. Kettel-Khan & N. Dawkins (Eds.). New directions for evaluation. special issue: The systematic screening and assessment method: Finding innovations worth evaluating 125, 33–49.Google Scholar
- 33.Centers for Disease Control and Prevention. (2011). Community transformation grant program. http://www.cdc.gov/ctg. Accessed October 14, 2011.
- 34.Centers for Disease Control and Prevention. (2011). Principles of community engagement, 2nd ed., NIH Publication No. 11-7782. Washington, DC: Government Printing Office.Google Scholar
- 35.World Health Organization. (2011). Spending on health: A global overview. World Health Organization Web site. http://www.who.int/mediacentre/factsheets/fs319.pdf. Accessed April 14, 2011.
- 36.Central Intelligence Agency. (2011). Country comparison: Life expectancy at birth. The World Factbook. Central Intelligence Agency Web site. http://www.cia.gov/library/publications/the-world-factbook/rankorder/2102rank.html. Accessed April 14, 2011.