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CDC's Prevention Activities that Target
Actual Causes of Death
CDC has initiated numerous activities and programs aimed at addressing
the behavior and lifestyle factors that contribute to deaths from this
nation's leading killers including heart disease, cancer and stroke. These
factors – such as smoking, poor nutrition and physical inactivity – are
called "actual causes of death."
Tobacco Use, Smoking, and Health
- CDC supports programs to prevent and control tobacco use in all 50
states, the District of Columbia, seven territories, and seven tribal
- CDC funds nine national networks to reduce tobacco use among eight
priority populations and funds 23 states for coordinated school health
programs to help prevent tobacco use.
- HHS establishes a national network of quitlines. CDC in conjunction
with National Cancer Institute (NCI) is working on a national network of
quitlines to ensure that smokers throughout the United States have access
to toll-free quitline services regardless of their geographic location or
Obesity, Nutrition, and Physical Activity
- CDC supports the development of effective prevention and treatment
strategies through state obesity programs, state coordinated school health
programs, partnerships, and an applied research agenda to develop and
refine new approaches.
- Currently, CDC provides funding to 20 states to prevent and reduce the
prevalence of obesity and the chronic diseases associated with obesity.
CDC supports states in developing and testing nutrition and physical
activity interventions to prevent obesity through strategies that focus on
multiple levels of change including individual, environment and policy.
- CDC funds 23 states to manage statewide coordinated school health
programs. These programs address a range of health issues including
tobacco use, poor nutrition, physical inactivity, and asthma.
- CDC's Youth Media Campaign supports a comprehensive communications
approach designed to encourage young people aged 9-13 years to adopt
healthy behaviors, especially physical activity.
- CDC supports public health surveillance on alcohol-related conditions
and alcohol use, particularly binge drinking; conducts and supports
applied research to characterize the public health impact of alcohol
misuse and to evaluate the effectiveness of alcohol control measures; and
supports the building of state capacity to prevent excessive drinking.
- CDC also conducts public health research to develop effective
evidence-based interventions to prevent alcohol-exposed pregnancies and to
improve long-term outcomes for children with Fetal Alcohol Syndrome (FAS)
and Alcohol-Related Neurodevelopmental Disorders (ARND), and provides
information and training to medical and allied health professionals,
teachers and the public on all aspects of prenatal alcohol exposure and
- In addition, CDC is assessing the role of alcohol in unintentional
injuries (including motor vehicle crashes) and violence, and evaluating
the effectiveness of screening and brief intervention strategies in
reducing risky drinking behavior among persons treated in acute care
settings. Also, CDC and the Task Force of Community Preventive Services--
a non-federal panel of community health experts -- is
conducting systematic reviews of the effectiveness of community-based
interventions to reduce alcohol-impaired driving.
- CDC's strategy for combating infectious diseases focuses on building
domestic and global capacity for recognizing and responding to infectious
- To ensure the health of U.S. citizens everywhere, CDC's infectious
disease funding supports surveillance, epidemic investigations, research,
training and public education in all 50 states and across the globe.
- CDC recently established seven domestic and global sentinel
surveillance networks linking health care providers to detect and monitor
- Overuse of antibiotics has become a serious problem leading to
antimicrobial resistance. CDC's "Get Smart: Know When Antibiotics Work"
campaign was unveiled last year to lower the rate of antibiotic use. In
addition, 70 percent of the bacteria that cause hospital-acquired
infections are resistant to at least one of the drugs most commonly used
to treat them. CDC is also working to prevent antimicrobial resistance in
health care settings with a comprehensive campaign targeted to clinicians
in hospitals and long-term care settings.
- Through its biomonitoring efforts, CDC is working to determine which
environmental chemicals get into people's bodies and at what levels,
assessing the effectiveness of public health efforts to reduce people's
exposure to specific chemicals, determining whether exposure levels are
higher among minorities, children, women of childbearing age, or other
potentially vulnerable groups, tracking trends in levels of people's
exposure to environmental chemicals, and setting priorities for research
on human health effects of exposure to environmental chemicals.
- CDC is funding schools of public health to support state and local
health departments and to investigate possible links between the health
and the environment. CDC has also funded projects in nine states and New
York City that will link environmental exposure and health effects data.
Motor Vehicle Accidents
- To assess which community-based interventions are effective in
reducing motor vehicle injuries, CDC and the Task Force on Community
Preventive Services, an independent, nonfederal panel of community health
experts, published systematic reviews of the literature and a set of
evidence-based recommendations on community-level interventions to reduce
alcohol-impaired driving, increase child safety seat use, and increase
safety belt use.
- CDC is funding two state health departments and three Native American
tribes to implement and evaluate effective community-based interventions
selected from the Guide to Community Prevention Services to reduce motor
vehicle-related injuries and deaths in their communities.
- Firearms are involved in more than half of all homicides (55.9%) and
suicides (55.1%) in the United States. Homicide and suicide account for
more than 46,000 deaths each year in the United States. CDC supports
programs to prevent violence in all 50 states, the District of Columbia,
and nine territories.
- CDC is funding two states to develop suicide prevention programs. In
these states injury prevention experts are designing and implementing
suicide prevention programs specific to their needs. This funding provides
the necessary resources to advance from data gathering and analysis to
identifying best practices for suicide prevention.
- CDC funds several adolescent and school-based health programs in 48
states, 7 territories, and 18 large cities to plan, carry out, and
evaluate HIV prevention programs. These programs provide young people with
the skills and knowledge needed to avoid infection with HIV and other
sexually transmitted disease.
- CDC provides national leadership in helping to control the HIV
epidemic by working with community, state, local and international
partners. Strategies to reduce HIV infection include monitoring the
epidemic to ensure that prevention activities reach those people who need
it most, researching the effectiveness of prevention methods, funding
local efforts for high-risk communities and linking infected individuals
with care, treatment and prevention programs.
- Through CDC's National Breast and Cervical Cancer Early Detection
Program, uninsured and under-served women are screened for cervical
cancer, which is associated with human papillomavirus infection, a
Illicit Drug Use
- CDC conducts a national survey, the School Health Policy and
Programs Study, to help policymakers assess school health policies and
programs at the state, district, school, and classroom levels designed to
address alcohol and illicit drug use.
Steps to a HealthierUS
- CDC is working in conjunction with other HHS agencies on the HHS
Secretary's initiative, Steps to a HealthierUS, which is designed
to help Americans live longer, better, and healthier lives through
healthier lifestyle choices. The Steps to a HealthierUS cooperative
agreement program awarded $15 million (FY2003) and $44 million (FY2004) to
urban, rural and tribal communities throughout the United States. The
funding is used to implement chronic disease prevention efforts focused on
reducing the burden of diabetes, overweight, obesity, and asthma and the
three related risk factors for chronic disease — physical inactivity, poor
nutrition and tobacco use.
Tracking Trends in Health Behaviors
- CDC tracks trends in various health-related behaviors through the
Behavioral Risk Factor Surveillance System (BRFSS), a telephone survey
system conducted by health departments in all 50 states, the District of
Columbia, Puerto Rico, the Virgin Islands, and Guam. The BRFSS is the
primary national source of state- and territory-specific information about
health-related behaviors among adults. The surveys can be tailored to meet
the needs of individual states and territories.
- CDC collects Selected Metropolitan and Micropolitan Area Risk Trends
(SMART) data, which are derived from BRFSS data and used to assess health
behaviors in local communities. SMART data is currently available for 98
metropolitan areas and counties within those areas. The data are used to
help local communities identify emerging health problems, plan and
evaluate local responses, and allocate resources efficiently to meet
- CDC monitors national patterns and trends in health behaviors and risk
factors, such as alcohol and tobacco use and physical activity in the
National Health Interview Survey. This survey – based on personal
interviews conducted in the home – yields findings that can be analyzed by
many characteristics such as race, age, gender, education, and income to
identify groups at greatest risk. The National Health and Nutrition
Examination Survey collects data on the prevalence of obesity, overweight,
high cholesterol and many other physiological measurements through
standardized physical examinations. This survey produces unique data on
conditions that were previously undiagnosed and the most accurate data on
overweight and obesity prevalence.
To obtain Actual Causes of Death in the United States, 2000, visit
JAMA's web site at
www.jama.ama-assn.org. For more information on CDC's program efforts,
including tobacco control, nutrition, physical activity, and other health
behaviors and prevention strategies, visit CDC's web site at
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CDC protects people's health and safety by preventing and
controlling diseases and injuries; enhances health decisions by providing
credible information on critical health issues; and promotes healthy living
through strong partnerships with local, national, and international