Applying What We Have Learned

CDC Use of Winnable Battles Approach

Another important aspect of the Winnable Battles initiative has been to test and apply the process itself as a way to approach public health challenges by CDC. Recognizing the benefits of the Winnable Battles framework as applied to the initial focus areas, the agency began deploying the Winnable Battles framework to address additional health challenges. Agency leadership encouraged the use of the Winnable Battles approach for a variety of issues and for different reasons. Areas that have adopted the Winnable Battles approach include:

Health Concern Using the Winnable Battles Approach
Public health impact of prescription drug overdose The Winnable Battles framework allowed the agency to address quickly this emerging public health threat with a dedicated and focused team and work in collaboration with other federal and non-federal partners in a dynamic environment.
Adoption of the Human papillomavirus (HPV) vaccine A small working group of subject matter experts from across the agency began this work but struggled to make progress. Adopting the Winnable Battles framework led to engagement with senior leadership and a coordinated high-level approach. As a result the team was able to prioritize strategies, tap into resources beyond the individual offices including experience of senior leadership in policy and communications, and gain strategic focus.
Health effects of excessive alcohol use Work on the health effects of excessive alcohol use involves several CDC offices, including the National Institute for Occupational Safety and Health, the National Center for Chronic Disease Prevention and Health Promotion and the National Center on Birth Defects and Developmental Disabilities. To better align these efforts and utilize resources efficiently as possible, CDC adopted the Winnable Battles framework to help guide its work on health effects of excessive alcohol use.
Treatment of attention deficit and hyperactivity disorder (ADHD) in young children The Winnable Battles approach enabled this small program in the CDC’s National Center on Birth Defects and Developmental Disabilities to garner agency-wide leadership support and collaboration to refine and advance its work on an initiative that can have great impact.

“Winnable Battles has fundamentally changed the way we work on high priority health issues,” said Kathleen Ethier, PhD, Director of the Program Performance and Evaluation Office,
CDC. “We now have a better way of moving forward with the most effective strategies when health concerns develop, like the public health impact of prescription drug overdose.”

While these different health issues presented specific challenges, all have benefited from the hallmarks of the Winnable Battles approach: leadership engagement and real-time feedback, establishing priorities, focus on data, accountability and partnerships.

State Adoption of Winnable Battles Approach

Screenshot of Colorado's Winnable Battles website

Additionally, individual states adopted the Winnable Battles framework to address their own public health priorities. Colorado unveiled its own Winnable Battles with a dedicated web site.External Colorado’s Winnable Battles are key public health and environmental issues where progress can be made in the next five years. These 10 Winnable Battles were selected because they provide Colorado’s greatest opportunities for ensuring the health of its citizens and visitors and the improvement and protection of the state’s environment.

Many of Colorado’s Winnable Battles align with CDC Winnable Battles or are consistent with the Seven Priorities for EPA’s Future, while others reflect Colorado’s own unique priorities.

In addition to Colorado, other states including Arizona, Georgia and Maryland have adopted the Winnable Battles language to frame their public health work. As part of a strategic plan, the Arizona Department of Health adopted five Winnable Battles to address including Promoting Nutrition and Physical Activity to Reduce Obesity, Reducing Tobacco Use & Substance Abuse, Reducing Healthcare-Associated Infections, Reducing Suicides, and Reducing Teen Pregnancy.

As stated on its web site, the Maryland Department of Health and Mental Hygiene adopted Winnable Battles as a platform to bring together diverse programs and staff to look at new ways to impact health outcomes and operations. Winnable Battles at the Maryland Department of Health and Mental Hygiene:

  • Identifies critical health issues in our State and opportunities for business improvements within the Department;
  • Brings together diverse teams to explore new and innovative ways to approach these opportunities; and
  • Selects specific, measurable actions to take over the course of one year.

Using a common framework and language creates a platform for collaboration between CDC, states and tribes to work together on public health priorities.

What’s Next/Closing Commentary

The CDC Winnable Battles began as a set of six priority public health areas where focused, coordinated effort across multiple levels of CDC in collaboration with states and tribes could lead to improved health outcomes in a shorter period of time. Although progress in targeted areas has been mixed with some areas achieving their goals and others not quite reaching the mark, the process itself has had a transformative effect on the agency and how we do our work.

Winnable Battles helped the agency articulate a set of priorities against the ever changing backdrop of our nation’s health. It provided an outcome-focused mechanism to combat select high-priority health issues as the agency continued its work to protect the health of our nation from established and emerging threats to our population across all aspects of health and well-being. The Winnable Battles framework gave its topic areas a focused path forward even as the agency rose to the challenge of several global health crises including H1N1, Ebola and Zika.

In addition, the Winnable Battles process has been infused into the way state, tribe and local public health professionals, policy makers and healthcare professionals, identify, prioritize and take action to improve health outcomes in their jurisdictions. It has served as a catalyst for states to engage across stakeholders to improve public health through the creation of Winnable Battles State Action Plans, drafted by 32 state teams of legislators and public health officials, with consequent programming and policy changes. The program fostered more awareness on the positive impact of identifying priorities, driving accountability and sustaining effort in public health work.

Winnable Battles has emerged as a framework on high burden, high priority public health work to help align and accelerate intra- and interagency work as well as encouraging programs to think more broadly about partnerships beyond traditional public health partners. Though the Winnable Battles process as it has been called will enter a new phase after this year, the successes achieved and lessons learned will continue to be applied to new public health challenges.

Page last reviewed: December 14, 2017