Cultivating Healthy Communities: The CDC Perspective

Abstract

Local communities are currently facing a crisis as they attempt to cope with the growing burden of caring for people with chronic diseases. Today, nearly 7 of every 10 persons die from a chronic illness, and almost 50% of Americans suffer from one or more chronic conditions. Chronic diseases account for more than 75% of the $2 trillion spent annually on medical care in the United States and are the single largest factor affecting health-related quality of life. The underlying chronic conditions, such as physical inactivity, poor diet, tobacco use, and excessive alcohol use, are preventable risk factors that influence whether a person acquires a chronic illness as well as its timing and severity. Given the scope of chronic diseases in the U.S. population, community-based solutions are essential to effectively preventing chronic disease and to maintaining the best possible health among persons living with chronic illnesses. During the past decade, the Centers for Disease Control and Prevention (CDC) has worked intensively with more than 100 communities as they address the burden of chronic diseases. This special issue of Health Promotion Practice provides stellar examples from several of CDC’s community programs, including the Racial and Ethnic Approaches to Community Heath (REACH), Healthy Communities (formerly the Steps Program), and Pioneering Healthier Communities, in which communities are taking action to prevent chronic diseases and achieve health equity. Communities can achieve impressive results with appropriate resources and technical assistance. In Broome County, New York, 46 elementary and middle schools created a consolidated bid to purchase healthy foods, resulting in a 14% increase in the purchase of fruits and vegetables. In Austin, Texas, the community established a work-site wellness program for the region’s Capital Metropolitan Transit Authority’s workers. Employee absences dropped 44% and health care costs rolled back to a 9% annual increase, as opposed to a 27% increase the previous year. In Charleston, South Carolina, African Americans are learning effective strategies to reduce morbidity rates associated with diabetes. As a result of the community’s efforts, lower-extremity amputations among African American men with diabetes have been reduced by 54%. Finally, in Pinellas County, Florida, the community came together and instituted a policy mandating that all elementary and after-school programs include at least 30 minutes of physical activity daily. What began as a countywide policy is now a statewide policy mandating that all elementary schools in Florida include at least 30 minutes of physical activity every day of the week. When we reflect on these and many other community efforts, we find at least four key ingredients that are essential to success in preventing chronic diseases and achieving health equity. The first ingredient is a local invest ment in communities. The CDC provides resources for communities to develop and implement effective strategies for chronic disease prevention. In addition, a subset of communities in both the REACH and Healthy Communities programs are expected to serve as mentors to other communities across the country. Additional investments will be needed at local, state, and federal levels to achieve the full potential for community health efforts to promote health, prevent diseases, and achieve health equity nationwide. Forward