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Frequently Asked Questions


Why were the Prevention Status Reports (PSRs) developed?
The reports were designed to highlight—for all 50 states and the District of Columbia—the status of certain policies and practices designed to prevent or reduce 10 of the nation’s most important health problems.

Although information about state public health policies and practices is publicly available in various locations, this information is widely dispersed and can be hard for decision makers to find and understand. The PSRs pull together this information in a simple, easy-to-use format that decision makers and other stakeholders can use to examine their state’s status and identify areas for improvement.

How were the PSR health topics and policies and practices selected? 
The health topics were selected for inclusion in the PSRs because

  • They reflect current public health challenges and leading causes of death and disability
  • They align with public health priorities and national initiatives, such as the  CDC Winnable Battles
  • Solutions drawn from scientific evidence and/or expert recommendations are available to address these public health challenges
  • There are opportunities for states to improve public health in these areas

The policies and practices were selected for inclusion in the PSRs because they

  • Can be monitored using state-level data that are readily available for most states and the District of Columbia
  • Meet one or more of the following criteria:
    • Supported by systematic review(s) of scientific evidence of effectiveness (e.g., The Guide to Community Preventive Services)
    • Explicitly cited in a national strategy or national action plan (e.g., Healthy People 2020)
    • Recommended by a recognized expert body, panel, organization, study, or report with an evidence­-based focus (e.g., Institute of Medicine)

There are other evidence-based public health policies and practices that aren’t included in the PSRs. Why were these not included?
The PSRs are designed to highlight several key policies and practices that indicate the current status in a state for each topic. This requires that data are available on the enactment of a policy or implementation of a practice, and that these data are in a form that enables a state rating. Therefore, the PSRs may exclude policies and practices if data collection systems and/or data are missing for most states and DC.

In addition, to maintain the simple, easy-to-use format, only a limited number of policies and practices are included in the reports. However, users are referred to other sources (e.g., The Guide to Community Preventive Services) for a more complete assessment of potential solutions. These additional sources are listed on each of the PSR topic pages.

Does the number of policies and practices in a topic signify that topic’s level of importance?
No, the number of policies and practices included in a topic does not signify level of importance for a particular topic.  The policies and practices selected for each topic were those that met the inclusion criteria identified above.

Where can I find comprehensive information about the support behind these policies and practices?
The PSRs do not provide a comprehensive analysis of the science or expert recommendations behind the policies and practices. However, the reports do provide references to the sources supporting each policy and practice.

Additional information is also provided on each of the PSR topic pages.

What do the ratings mean?
The PSRs use a simple, three-level rating scale—green, yellow, or red—to provide a practical assessment of the status of policies and practices in each state and the District of Columbia.

Green: A “green” rating indicates that the policy or practice is established in accordance with supporting evidence and/or expert recommendations.

Yellow: A “yellow” rating indicates that the policy or practice is established in partial accordance with supporting evidence and/or expert recommendations.

Red: A “red” rating indicates that the policy or practice is either absent or not established in accordance with supporting evidence and/or expert recommendations.

How were the ratings determined?
CDC subject matter experts determined rating categories by considering 1) the distribution of state data, 2) science regarding effectiveness of the policy or practice, and/or 3) expert recommendations regarding the implementation of the policy or practice.

Further details about the ratings are available on each of the PSR topic-specific web pages.

Do these ratings reflect how well a state is doing to address these public health problems or concerns?
It is important to note that the ratings in the PSRs reflect the status of policies and practices and do not reflect the status of efforts of state health departments, other state agencies, or any other organization to establish or strengthen those policies or practices. Appropriate strategies for improving public health vary by individual state demographics, disease burden, public health priorities, resources, and challenges.

How can the PSRs be used to improve public health policies and practices?
Below are some of the primary ways the PSRs can be used to improve public health policies and practices:

  • Assess a state’s status: Review PSR ratings to assess a state’s performance within the local context (i.e., consider PSR ratings in conjunction with additional state data and information about facilitators and barriers)
  • Communicate with partners and constituents: Foster dialogue with internal or external partners (e.g., co-workers, coalitions, community-based organizations, private businesses) about public health problems and solutions
  • Educate decision makers: Inform decision makers (e.g., elected officials, public health leaders, community leaders) about public health problems and solutions
  • Plan and set priorities: Identify public health policy and practice solutions across a range of public health topics, or within a specific topic of interest
  • Improve existing policies or practices: Influence the direction of existing programs or policy initiatives with the intent of improving PSR ratings, and, ultimately, public health
  • Implement new policies or practices: Influence the development of new programs or policy initiatives with the intent of improving PSR ratings, and, ultimately, public health

For additional guidance on how to use the PSRs, please refer to the PSR Quick Start Guide

Who is responsible for improving the health policies and practices in each state?
Improving each state’s health policies and practices is a shared responsibility of many sectors: government agencies, state legislatures and regulatory bodies, healthcare organizations, health coalitions, businesses, and individual citizens. Public health agencies are essential contributors, but they alone cannot solve the nation’s most pressing public health problems without the participation of key decision makers in many sectors of society.

Why don’t the PSRs show how the states rank or compare with one another?
The reports are not designed for comparisons across states, but rather are helpful in periodically tracking each state’s status against a select set of policies and practices supported by systematic scientific reviews, aligned with national action plans or strategies, and/or recommended by national expert bodies. Variations from state to state in public health priorities, disease burden, resources, and challenges make state-by-state comparisons complex and inappropriate.

When will the next set of the PSRs be available?
The next set of PSRs is scheduled for release in December 2015.

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