Preventing Chronic Disease Dialogue

The study by Barile and colleagues in the current issue of Preventing Chronic Disease highlights the heavy toll of chronic diseases, especially multiple chronic conditions, on the health and economy of the United States. Far and away, chronic conditions cause more deaths, disability, years of reduced productivity and quality of life, and health care costs than all other health threats facing the nation.

Yet Americans’ support of government action to prevent, control, and manage chronic diseases lags far behind their support of action to protect them from the “big, scary” public health threats of Ebola, bioterrorism, and infectious disease outbreaks such as the foodborne E. coli illnesses recently tied to Chipotle’s and Costco.

That was a major finding from research that the CDC Foundation conducted earlier this year with consumers and business leaders to gauge their perceptions and support of CDC’s mission and work. It was the latest confirmation of a reality we have documented for decades: Americans remain focused on unconventional health threats beyond their control, not on the “conventional” threats of chronic diseases that typically involve at least a measure of individual control and personal responsibility.

What can be done to reduce this “competitive disadvantage” in terms of public recognition and support for chronic disease prevention?

We can start by acknowledging the issues Americans want to hear about, like combatting global threats, then move on to talk about what they need to hear about, like reducing obesity. We might say, “In addition to being America’s first line of defense against outbreaks and bioterrorism, CDC is working to protect our citizens from threats to their health, safety, and security that take far more lives.” Then we can delve into specific issues―smoking, nutrition, physical activity, cancer, diabetes, heart disease.

Communication is key to making the case for chronic disease prevention—and it’s needed at the national, state, and local levels.

• Communicating the burden of chronic disease builds concern: “This is an urgent problem for America.”
• Communicating opportunities for prevention builds hope: “We know what to do to prevent it in our state.”
• And communicating the impact of our interventions builds support: “Our work is making lives better for the people in our community.”

There is no better way to individualize, personalize, and humanize our work than telling real stories of real people. CDC’s well-funded tobacco education campaign, Tips From Former Smokers, is using this approach with remarkable results. But storytelling is a strategy that works for any issue and any budget. We can tell stories in elevator conversations and conference lectures; in tweets, blogs, and Facebook posts; in letters to the editor and phone calls to policy makers; in fact sheets and press releases; and in weekly newsletters and annual reports.

Our stories can show how our approaches to preventing, controlling, and managing chronic diseases and multiple chronic conditions are “best buys” for improving the public’s health.

• Environmental approaches: We can describe how the CDC-supported Market Mobile program brought affordable, locally grown fruits and vegetables to an inner-city neighborhood in Boston by enlisting restaurants, schools, hospitals, worksites, grocery stores, corner stores, and farm stands to serve 50,000 families throughout the region.

• Health care system interventions: We can tell how an older adult with a strong family history of heart disease was finally able to get his blood pressure under control through the efforts of his Cherokee Nation health care team—a Million Hearts Hypertension Control Champion—who taught him practical ways to cut his sodium consumption and helped him adhere to his prescribed blood-pressure medication.
• Community programs linked to clinical services: We can tell the story of a woman whose son excitedly told her, “Mommy, I can fit my arms around you now!”, thanks to her weight loss while completing CDC’s National Diabetes Prevention Program offered at her local Y in Atlanta.

Working together as public health promoters and storytellers, we can build widespread support for the life-saving work that PCD chronicles every issue. For help in writing and sharing your story, visit CDC’s Success Stories tool.

Jeffrey W. McKenna, MS

Associate Director for Communication Science

National Center for Chronic Disease Prevention and Health Promotion

Centers for Disease Control and Prevention

What we drink can affect our health, and calories from drinks can add up quickly. Sugar-sweetened beverages (SSBs) such as regular sodas, fruit-flavored drinks, coffees and teas, and sports and energy drinks, are the largest source of added sugars and are major contributors of calories to Americans’ diets.

Americans with mental illness smoke at higher rates and die on average 25 years earlier than the rest of the US population. They also often have substance abuse problems. People with mental illness often lack access to treatment, and those who do gain access often find themselves in programs that mistakenly believe using tobacco is an appropriate way to cope with and manage mental illness. While national recommendations for smoking cessation treatment for this population exist (e.g. those of the American Psychiatric Association), these recommendations are not routinely implemented. Moreover, little is known about the progress of state tobacco control programs (TCPs) toward addressing this population.

In 2010, excessive drinking cost the United States $249 billion and is responsible for 88,000 deaths in America each year, including 1 in 10 deaths among working age adults.

My dad lived until he was 85 and, although he officially retired at 60, he managed a quarter century more of productive and rewarding work activity.

Schools are part of our communities and the right place for a healthy start. Our children spend the vast majority of their day at school, so schools play a critical role in all aspects of their lives and can shape lifelong healthy eating habits. Additionally, giving students access to healthy foods in school can help them be better learners. Students who eat breakfast perform and behave better in school. Skipping breakfast, not eating enough fruits, vegetables, or dairy products; not getting specific nutrients, like vitamins A, C, and calcium; or just being hungry can have a negative effect on a student’s academic achievement.

What we drink can affect our health, and calories from drinks can add up quickly. Sugar-sweetened beverages (SSBs) such as regular sodas, fruit-flavored drinks, coffees and teas, and sports and energy drinks, are the largest source of added sugars and are major contributors of calories to Americans’ diets.

Daily SSB intake is associated with adverse health consequences, including tooth decay, obesity, type 2 diabetes, and cardiovascular diseases. Water is a zero-calorie and thirst quenching beverage that when substituted for SSBs provides health benefits such as reduced tooth decay and improved weight management. Increasing access to free drinking water is one strategy to support individuals who want to decrease SSB and caloric intake.

By Samuel F. Posner, PhD

Editor in Chief

Preventing Chronic Disease: Public Health Research, Practice, and Policy

National Center for Chronic Disease Prevention and Health Promotion

Centers for Disease Control and Prevention

One of the great pleasures of being the Editor in Chief of Preventing Chronic Disease: Public Health Research, Practice, and Policy (PCD) is to read the papers submitted by the next generation of public health professionals for the annual PCD Student Contest. This year was no exception. We received 59 papers on a range of critical public health topics that used novel analytic methods. In collaboration with members of the Editorial Board, it is my pleasure to announce that Nelly Mejia at the Pardee RAND Graduate School has won the 2015 PCD Student Contest. In this paper, Mejia and colleagues describe their analysis of the association between living in a food desert and eating fruits and vegetables (1). Understanding the influence of food deserts on public health is critical to designing, implementing, and evaluating the impact of policy and environmental changes to improve access to nutritious foods.

Tooth decay continues to be one of the most common chronic diseases of children and adolescents in the United States. By age 17, nearly 70% of adolescents have had tooth decay; most of the decay occurs in the pits and fissures of the back teeth. Children from low-income homes are about 20% more likely to have tooth decay than children living in higher income (> 200 percent of the federal poverty level) families. Tooth decay can lead to pain and infection as well as problems in learning.

What we drink can affect our health, and calories from drinks can add up quickly. Sugar-sweetened beverages (SSBs) such as regular sodas, fruit-flavored drinks, coffees and teas, and sports and energy drinks, are the largest source of added sugars and are major contributors of calories to Americans’ diets.

Daily SSB intake is associated with adverse health consequences, including tooth decay, obesity, type 2 diabetes, and cardiovascular diseases. Water is a zero-calorie and thirst quenching beverage that when substituted for SSBs provides health benefits such as reduced tooth decay and improved weight management. Increasing access to free drinking water is one strategy to support individuals who want to decrease SSB and caloric intake.