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Strategies Snapshot: CTG Health in Action

To download a copy of the CTG Strategies Snapshot report, click here [PDF - 435Kb].

In 2011, the 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. These CTG grants are expected to operate for five years and with benefits reaching more than one in three Americans—approximately 120 million Americans. All awardees are working to improve health and wellness with strategies that focus on:

  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 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 report provides an overview of the current strategies and activities utilized by the 35 Implementation awardees to improve the health and wellness of all Americans.

Implementation Awardee Strategies

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

Example: The state of Maryland is working to protect residents from the negative health effects of tobacco use and secondhand smoke exposure. With an adult smoking rate of 15%, tobacco use is a serious health concern. Through CTG efforts, the state of Maryland has experienced early successes in accomplishing its goal of ensuring that 1.9 million residents have access to tobacco-free environments in various counties throughout the state. As of January 1, 2012, Hartford County, Maryland, implemented a tobacco-free requirement for all properties owned and operated by the county, including recreational facilities. This requirement ensures that 1,250 Hartford County employees and all residents and visitors to county recreation facilities are protected from secondhand smoke exposure. In addition, the Hartford County Health Department has worked closely with other county officials to provide dedicated tobacco cessation programs for all Hartford County government employees.

Active Living and Healthy Eating – Nutrition
Over 70% 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 have a positive impact on over one-third of Americans who are obese. They also have the potential to decrease the medical treatment of obesity-related diseases which currently costs approximately $147 billion annually in the United States.

Example: Travis County, Texas, including the city of Austin, is working to ensure that over one million residents have increased access to active living and healthy eating options. With an estimated obesity rate of 16% among school-aged children, increasing access to healthy food options is a priority health initiative. By September 2016, there will be an additional 50 schools in Travis County with new healthy food options consistent with the Institute of Medicine’s Nutrition Standards for Foods in Schools. Travis County is actively engaged with area school districts to increase healthy food and beverage consumption by working to limit access to competitive, low-nutrition foods and beverages that can be obtained in close proximity to K-12 schools. These select strategies will contribute to the larger goal and help to ensure that approximately 86,000 4 to 18 year-olds in the county have access to healthy food options.

Active Living and Healthy Eating – Physical Activity
Seventy-five percent of the awardees’ strategies focus on increasing access to physical activity opportunities to all community members. These strategies include activities such as improving physical education and school wellness policies to meet national standards, as well as increasing opportunities for recess, intramural, and other physical activity opportunities outside traditional physical education. Increased physical activity improves mental health and decreases the risk for heart disease, type 2 diabetes, and some cancers.

Example: The state of New Mexico, with a population of over 2 million, strives to ensure residents have access to active living and healthy eating options. With an estimated state obesity rate of 12% for children and with about 13% of children not participating in daily physical activity, increasing access to active living options is a major health objective for the state. New Mexico has experienced some early successes in accomplishing its goal. During the spring of 2012, the Las Cruces School District approved and began promoting the use of outdoor school space during non-school hours in all 25 elementary schools. Through this effort, nearly 11,500 students and their families now have access to physical activity options throughout the city.

Clinical and Community Preventive Services
Currently, 97% of awardees are engaging in using clinical and community preventive services to 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 one in three Americans who have high blood pressure, among whom only 47% are adequately controlled.

Example: Iowa strives to provide residents with increased access to clinical and community preventive services. With 26 rural Iowa counties identified as having high stroke mortality rates, increasing access to these services is an important health initiative. To address this, the CTG program will build on the “2009-2011 Iowa Dental Pilot” by asking dental practices throughout southeast Iowa counties to voluntarily participate in blood pressure and tobacco screening/referral training. The effort is aimed at ensuring that over 300,000 individuals are screened and referred to necessary resources. In addition, community health center dental clinics will offer this training to ensure that low-income and uninsured populations are reached through these activities.

Healthy and Safe Physical Environment
Sixty percent of awardees are engaging in comprehensive approaches to improve community designs to promote physical activity. These comprehensive approaches include improving access to public transportation, creating protocols to assess the impact of community changes, and engaging in urban design. Currently, the majority of awardees addressing this health focus area are engaging in activities that address a community’s urban design, land use, and zoning regulations.

Example: The state of South Carolina, with a population of over 4.6 million residents, is working to improve community designs in order to promote physical activity. With an estimated obesity rate of 30% in adults, creating healthy and safe physical environments to promote physical activity is an important initiative. Through CTG efforts, the state of South Carolina has had some early successes in accomplishing its goal of increasing the number of persons who are covered by systems that support healthy and safe work environments. Currently, 40 worksites throughout the state have committed to implementing the evidence-based Working Well Program. This program helps organizations and businesses create a comprehensive culture of wellness, thereby helping to ensure that employees throughout the state have increased access to a safe environment and have the opportunity to make healthy choices, including the opportunity to engage in physical activity during the workday.

Social and Emotional Wellness
Over 8% of awardees are addressing the health focus area of 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 due to mental or emotional problems. Through CTG efforts, by September 2016, many residents of Los Angeles County with low socio-economic 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 implement 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 and/or problem drinking.


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