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Strategies Snapshot: Community Transformation Grants in Action

In 2011, the Community Transformation Grants (CTG) Program awarded approximately $103 million to 61 states and local government agencies, tribes and territories, and nonprofit organizations in 36 states, along with nearly $4 million to 6 national networks of community-based organizations. In 2012, CTG expanded to support small communities targeting populations with less than 500,000 people. Approximately $70.3 million was awarded to 40 communities, with $18 million (26%) directed to rural and frontier areas. These CTG grants are expected to benefit millions of Americans. All CTG community awardees are working to improve health and wellness of their residents by implementing strategies that support the following:

  1. Tobacco-free living
  2. Active living and healthy eating
  3. Clinical and community preventive services

Many CTG awardees also focus on other areas of chronic disease prevention and health promotion, including social and emotional wellness (e.g., early identification of mental health needs and access to quality services), and healthy and safe physical environments. The following overview provides information about the current strategies and activities used by CTG awardees to improve the health and wellness of all Americans and to prevent chronic disease.

Awardee Strategies

Tobacco-Free Living

Seventy-six percent of awardees are engaging in interventions to limit tobacco use and secondhand smoke exposure. Examples of these interventions include educating on the benefits of indoor/outdoor smoke-free policies, creating tobacco-free environments, and protecting people from secondhand smoke exposure. Secondhand smoke causes an estimated 46,000 premature deaths each year in the United States among nonsmokers, and tobacco use currently results in $96 billion in tobacco-associated medical costs each year.

Example: As of June 2013, the Maryland Department of Health and Mental Hygiene increased access to tobacco-free or smoke-free environments for approximately 570,000 Maryland residents living in 19 counties. With more smoke-free stadiums, state universities and colleges, and county government buildings, Maryland residents can breathe easier because of increased protections from secondhand smoke exposure. The Maryland Stadium Authority (responsible for Oriole Park at Camden Yards and M&T Bank Stadium for the Baltimore Ravens), the University System of Maryland, and county governments in Dorchester, Harford, and Kent have all put into action changes to reduce Maryland residents’ exposure to secondhand smoke and increase the number of areas providing smoke-free air.

Healthy Eating – Nutrition

Ninety-seven percent of awardees are focusing their strategies on addressing nutrition policies, standards, or guidelines through a variety of activities. These activities include supporting healthy vending options, improving nutrition standards to meet national guidelines, and focusing on reducing sodium content in food products. These efforts will benefit more than one-third of Americans who are obese. They also have the potential to decrease medical treatment costs associated with obesity-related diseases that currently amount to approximately $147 billion annually in the United States.

Example: As of June 2013, the Texas Department of State Health Services increased access to healthy food options for 254,772 residents across 7 Texas counties (Burnet, Presidio, Starr, Hale, Hood, Parker and Hopkins) by establishing or expanding sustainable community gardens, recruiting local farmers to participate in farmers’ markets, and sharing crop yield donations to organizations serving underserved populations. Starr County harvest reports alone show a collection of about 750 pounds of produce gathered from their gardens that is being made available to the community and used in salad bars in school cafeterias. In January 2013 alone, the county’s Mobile Market program sold 3,290 pounds of produce. Affordable produce is now available in food deserts across Hood and Parker counties with the distribution of fresh fruits and vegetables boxes to churches for low income families.

Active Living – Physical Activity

Ninety-seven percent of the awardees’ strategies focus on increasing access to physical activity opportunities to all community members. These strategies include interventions such as improving physical education and school wellness policies to meet national standards, and increasing opportunities for recess, intramural, and other physical activity opportunities outside traditional physical education classes..

Example: The Ozarks Regional YMCA in Springfield, Missouri has their Let’s Go Smart initiative to educate the public about transportation options, active living, and the value of improving the built environment so that more people can exercise by walking. To this end, Springfield put into action Complete Streets principles, conducted a walk-ability assessment, and offered public awareness events. This initiative will provide access to physical activity opportunities for the community’s 159,498 residents.

Clinical and Community Preventive Services

Currently, 76% of awardees are using clinical and community preventive initiatives that focus on heart disease, tobacco use, dental care, diabetes, and cancer. Approximately 86% of awardees have focused their activities on high blood pressure, high cholesterol, and cardiovascular disease. Furthermore, 60% of awardees are using community resource extensions and linkages to connect patients and practitioners with preventive resources. This work will help to benefit the 1 of 3 Americans who have high blood pressure, among whom only 47% adequately control their high blood pressure.

Example: Ten community health centers and two rural health clinics in Montana are completing blood pressure and cholesterol quality improvement projects. As of June 2013, more than 31,000 patients have increased access to these improved clinical and community preventive services.

Healthy and Safe Physical Environment

Seventy-six percent of awardees are engaging in comprehensive approaches to improve community designs to promote physical activity. These comprehensive approaches include enhancing access to public transportation, assessing the effect of community changes, and engaging in urban design.

Example: As of June 2013, the Minnesota Department of Health has increased access to opportunities for physical activity for an estimated 292,000 residents. Four active transportation regional plans are nearing completion. These plans will establish community design standards that will increase walking and bicycling and will help lead to rapid use of these standards across Minnesota. Additionally, these plans offer valuable insight based on biking and walking assessments, outline safe cycling principles, and provide guidance on land use design principles.

Social and Emotional Wellness

Twenty-three percent of awardees are addressing social and emotional wellness.

Example: Los Angeles County, California is working to improve the social and emotional wellness of its residents. Currently, an estimated 15% of adults within the metropolitan area of Los Angeles have been identified as binge drinkers. In addition, an estimated 16% of adults are limited in their daily activities because of mental or emotional problems. Through CTG efforts, many residents of Los Angeles County with low socioeconomic status will have greater access to preventive screening services for depression and problem drinking. The county is currently working to increase the number of clinic sites within the county ambulatory care network that put into action standard protocols for screening individuals for depression and problem drinking. The county is also working to provide brief interventions for many of those suffering from depression, problem drinking, or both.

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