How We Prevent Chronic Diseases and Promote Health

Just as many of the same risk factors can cause or worsen most chronic diseases, many of the same approaches can prevent them or reduce their severity. National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) promotes chronic disease prevention efforts in four key areas, or domains. This approach to preventing chronic diseases and promoting health can help achieve NCCDPHP’s vision of healthy people in healthy communities.


Domain 1: Epidemiology and Surveillance
Business statistic documents

Measuring how many Americans have chronic diseases or chronic disease risk factors

CDC uses dozens of surveillance systems to collect data on chronic diseases and their risk factors. These systems—often the only source of such data—help epidemiologists understand how chronic diseases affect Americans.

Surveillance and epidemiology guide us in putting our resources to the best use. Without them, our prevention and control efforts would be guesswork.

Examples of Epidemiology and Surveillance
  • Gathering information from multiple data sources, including behavioral risk factor surveys, birth and death certificates, registries of cancer cases and deaths, and health care systems.
  • Measuring social and environmental factors that influence health, such as the number of fast food restaurants in low-income neighborhoods.
  • Tracking policies that affect chronic diseases, such as those related to smokefree air, access to healthy foods, and community water fluoridation.
  • Measuring the number of Americans who get health care preventive services, such as cancer screening, the “ABCS” of heart disease and stroke prevention (Aspirin use, Blood pressure and Cholesterol control, and Smoking cessation), and measures of diabetes control (e.g., hemoglobin A1C) and obesity (e.g., body mass index).
  • Using health information technology to improve efficiency and timeliness of public health surveillance (e.g., to speed reporting to state cancer registries).
Domain 2: Environmental Approaches
Rental of electric bicycles in city

Improving environments to make it easier for people to make healthy choices

Healthy environments promote health and support healthy behaviors in community settings such as schools, child care programs, and worksites. Approaches that improve the environment reach more people, are more cost-effective, and are more likely than individual approaches to have a lasting effect on population health.

Environmental Approaches That Work
  • Passing smokefree air laws that cover all workplaces, restaurants, and bars to protect nonsmokers from exposure to secondhand tobacco smoke.
  • Banning flavored cigarettes to make smoking less attractive to youth.
  • Banning artificial trans fats from the food supply to reduce the risk for heart disease.
  • Fluoridating community water systems.
  • Increasing prices for unhealthy products (e.g., tobacco, alcohol, and high-calorie, low-nutrition foods and beverages) to reflect the medical and societal costs of their use.
  • Designing communities to encourage walking and biking.
  • Giving children the chance to learn about physical activity and be physically active in child care programs and schools.
  • Increasing access to healthy foods and beverages (e.g., full-service groceries and farmers’ markets, healthier menu items in restaurants).
Domain 3: Health Care System Interventions
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Strengthening health care systems to deliver prevention services that keep people well and diagnose diseases early

The right health care system interventions can improve the use and quality of clinical preventive services. These services can help prevent disease or catch it early, reduce risk factors, and manage complications. Giving people better access to quality preventive services can reduce health disparities.

Examples of Health Care System Interventions
  • Improving access to health care for populations with little or no access.
  • Providing health insurance coverage of effective clinical preventive services.
  • Paying for health outcomes instead of health services.
  • Increasing use of health information technology and tools (e.g., reminders and clinical decision support).
  • Measuring and reporting on health system changes—both successful and unsuccessful.
  • Improving access to cancer screenings for people with little or no health insurance.
  • Improving management of high blood pressure through best practices like team-based care.
  • Increasing use of community health workers, patient navigators, and other allied health professionals to deliver high-quality care.
Domain 4: Community Programs Linked to Clinical Services
medical professional smiling and talking to man

Connecting clinical services to community programs that help people prevent and manage their chronic diseases and conditions

By linking people who have chronic diseases or chronic disease risk factors to community resources, CDC can help them improve their quality of life, prevent or slow down the disease, avoid complications, and reduce the need for more health care. Improved links between the community and clinical settings often mean that clinicians can refer patients to proven programs, ideally with community organizations and lay providers getting reimbursed by health insurance.

Examples of Community-Clinical Links
  • Increasing the use of effective community-delivered interventions—such as chronic disease self-management programs, the National Diabetes Prevention Program, and smoking cessation services—through clinician referrals and health insurance coverage.
  • Linking public health services, such as tobacco quitlines, to health care systems.
  • Using health care workers like pharmacists, patient navigators, and community health workers to help people manage their own health.
  • Educating people to become more involved in their own health care.