REACH

CDC’s Racial and Ethnic Approaches to Community Health Program

mother and daughter reading book

Fast Facts

  • Chronic diseases and their risk factors can be more common or severe for some racial and ethnic minority groups than for non-Hispanic whites.
  • These health disparities can be caused by complex factors, such as differences in income, education, community conditions, or access to quality health care.
  • CDC’s Racial and Ethnic Approaches to Community Health (REACH) program works to end disparities by partnering with racial and ethnic communities with the highest risk or rates of chronic disease to make healthy choices easier.
  • REACH communities have reduced exposure to secondhand smoke, increased access to healthy foods and safe places to be active, and improved access to community health programs that address chronic disease.
mother holding child with book

Fast Facts

  • Chronic diseases and their risk factors can be more common or severe for some racial and ethnic minority groups than for non-Hispanic whites.
  • These health disparities can be caused by complex factors, such as differences in income, education, community conditions, or access to quality health care.
  • CDC’s Racial and Ethnic Approaches to Community Health (REACH) program works to end disparities by partnering with racial and ethnic communities with the highest risk or rates of chronic disease to make healthy choices easier.
  • REACH communities have reduced exposure to secondhand smoke, increased access to healthy foods and safe places to be active, and improved access to community health programs that address chronic disease.

Every person deserves the chance to be healthy, but in the United States, some racial and ethnic groups have worse health than others. Many complex factors drive these health disparities and risk factors, including:

  • Social determinants of health, such as poverty, lack of education, racism, or discrimination. These factors can limit access to resources for improved health.
  • Environmental and community conditions, such as lack of access to healthy foods and opportunities for physical activity.
  • Less access to high-quality health services.

The Racial and Ethnic Approaches to Community Health (REACH) program is at the forefront of CDC’s efforts to reduce health disparities. Since 1999, REACH has been the only CDC program that explicitly focuses on reducing chronic diseases for multiple racial and ethnic groups in communities with high rates of chronic diseases.

REACH strives to promote healthy behaviors and chronic disease management among five racial and ethnic groups: African Americans, American Indians/Alaska Natives, Hispanics, Asian Americans, and Native Hawaiians/Other Pacific Islanders.

In rural, urban, and tribal communities across the United States, REACH recipients use the following strategies to improve social and environmental conditions for better health:

  • Increase options for healthy nutrition across the lifespan.
  • Promote community planning and transportation plans that create places for safe and accessible physical activity.
  • Support tobacco-free living.
  • Connect clinics to community programs so people can manage chronic diseases such as heart disease and diabetes.

Racial and Ethnic Groups Most Affected by Chronic Diseases

Heart disease, cancer, diabetes, and stroke are among the most common causes of illness, disability, and death in the United States. These chronic conditions—and the factors that lead to them—can be more common or severe for some racial and ethnic groups. For example:

  • From 2015 to 2016, 47.0% of Hispanic adults and 46.8% of non-Hispanic black adults had obesity, compared to 37.9% of non-Hispanic white adults.
  • From 2013 to 2016, total diabetes (diagnosed and undiagnosed) was higher among Hispanic (19.8%) and non-Hispanic black (17.9%) adults compared to non-Hispanic white (12.4%) adults.
  • From 2013 to 2015, American Indian and Alaska Native adults had the highest age-adjusted rates of diagnosed diabetes among all racial and ethnic groups for both men (14.9%) and women (15.3%).
  • Native Hawaiians and Other Pacific Islanders are more than twice as likely as non-Hispanic whites to have diagnosed diabetes.

Locally Based and Culturally Tailored Solutions That Work

A cornerstone of the REACH program is engaging community members to help shape the strategies that will be most effective for their communities. REACH recipients routinely involve the priority population in program design, implementation, and evaluation; hire or partner with individuals and organizations that can represent the needs of the community; and adapt their programs to reflect cultural norms, language, and practices.

Because of REACH
program activities
during 2014-2018:
fruit, vegetables, and water
Over 2.9 million people
have better access to
healthy foods and
beverages.
no smoking sign
Over 322,000 people
have benefited from
smoke-free and
tobacco-free
interventions.
people riding bikes, walking dogs, lifting weights
About 1.4 million people
have more opportunities
to be physically active.
people at medical clinic
About 830,000 people
have access to local
chronic disease programs that
are linked to clinics.

REACH recipients also bring together interested groups to form coalitions to promote health. Examples of these groups include state and local health agencies, universities, community-based organizations, housing and transportation authorities, health care organizations, employers, faith-based organizations, and groups that represent the priority population.

Local evaluations show that REACH recipients have been successful at changing local environments to support healthier behaviors among racial and ethnic minority populations. From 2014 to 2018, REACH communities reported the following successes:

  • Partners in Health worked in rural communities in the Navajo Nation to increase access to healthier foods in small stores and at community venues for about 18,500 residents. The recipient also improved clinical and community links by training community health workers, which increased access to health services for about 90,000 community members.
  • In DeKalb County, Georgia, access to healthy food increased for about 242,000 African American residents. As a result, county officials reported a 34% increase in the consumption of fruits and vegetables among customers of farmers’ markets participating in the REACH program.
  • In Omaha, Nebraska, the REACH program at Creighton University partnered with the Omaha Housing Authority to create safer places
    for physical activity for more than 330 African American residents
    of three low-income housing towers.
  • In Orange County, California, the REACH program improved access to smokefree environments for an estimated 100,000 Asian American residents by increasing the number of commercial shopping plazas with voluntary smokefree policies.
  • In Cuyahoga County, Ohio, the Produce Prescription Program for Hypertension helped connect about 600 low-income Asian Americans and Pacific Islanders who had high blood pressure to information about healthy eating and affordable produce.
  • The Toiyabe Indian Health Project increased the availability of healthy foods for an estimated 3,000 American Indians in seven tribes and two tribal communities by increasing healthy food production in community gardens.
woman and child
tobacco-free campus sign

The Legacy of REACH

Over the last 20 years, the focus of REACH has evolved from addressing specific diseases, such as heart disease and vaccine-preventable diseases, to supporting broader, environmental-level improvements to reduce chronic disease risk factors.

REACH Recipients, Fiscal Year 2019

map of REACH Recipients for 2019

See the list of REACH recipients.

CDC launched the newest REACH program in September 2018, funding 31 recipients, including community organizations, universities, local health departments, tribal organizations, and states. Each recipient uses at least three of the following strategies:

Improve Nutrition
  • Work with food vendors, distributors, and producers to increase the number of healthy foods they buy and sell.
  • Help hospitals, early care and education centers, and worksites use nutrition standards that increase availability of healthy foods.
  • Improve local nutrition programs and food systems—for example, by using voucher incentive programs, increasing acceptance of electronic benefit transfer cards where food is purchased, improving public transportation routes to food stores, and improving access to healthy foods at community venues.
  • Support breastfeeding by making it more convenient to breastfeed in more places and by training health workers to give mothers the help and support they need to breastfeed.
Increase Physical Activity
  • Work with partners to connect activity-friendly routes to everyday destinations by using land-use and environmental design interventions.
Promote Tobacco-Free Living
  • Implement tobacco-free policies in workplaces and multi-unit housing.
  • Work with health care providers to ensure that patients are screened for tobacco use, advised to quit, and provided resources.
  • Communicate culturally tailored messages on the effects of tobacco and secondhand smoke exposure, quitting, and quitlines.
Increase Community-Clinical Links
  • Increase referral and access to community health programs—for example, by expanding the use of community health workers, patient navigators, and pharmacists.

As REACH continues to focus on strengthening community health efforts to prevent disease and reduce racial and ethnic health disparities, REACH communities will be empowered to create long-term, sustainable health solutions that break down barriers to health.

The REACH budget line provides (1) core REACH program funding to 31 urban, rural, and tribal areas to address health disparities in chronic diseases and related risk factors among five racial and ethnic minority groups and (2) focused funding to 54 awards directly to Tribes and Alaska Native Villages, Tribal Organizations, Tribal Epidemiology Centers, and Urban Indian Organizations to improve the health of American Indians and Alaska Natives as part of the Healthy Tribes Program. 

Page last reviewed: January 27, 2020