State of CDC Archive
Implement Measures to Decrease Leading Causes of Death
In recent decades, the leading causes of death have shifted from acute, communicable diseases to chronic diseases. As a result, we must use science-based programs that address the leading causes of death by better preventing and treating chronic diseases.
When we help individuals quit smoking, prevent obesity and give them the tools and information they need to live healthier lives, we all benefit. Chronic diseases are the leading causes of death and disability in the United States including diabetes, heart disease and obesity – conditions that we know we can prevent.
2009
Preventing Injuries Related to Alcohol Abuse
Alcohol abuse is now the leading risk factor for serious injury in the United States and is the third leading cause of preventable death. It accounts for more than 75,000 deaths annually. Alcohol screening and interventions sometimes use brief counseling sessions for patients with drinking problems. CDC-supported research shows that these brief interventions can reduce subsequent emergencies caused by alcohol abuse by up to 50% and can significantly decrease the number of binge-drinking episodes and drinks consumed per week. These interventions also have helped to lower health care costs; one study indicated that each dollar spent on alcohol screening and brief interventions saved $3.81 in overall health care costs.
Smoke-Free Laws Can Reduce Heart Attacks
Exposure to secondhand smoke can be bad for our health. It can adversely affect our heart, blood, and vascular systems, which increases the risk for cardiac problems. Prolonged exposure to secondhand smoke can cause coronary heart disease. In 2009, CDC published a landmark study in the Morbidity and Mortality Weekly Report that documented fewer hospitalizations for Pueblo, Colorado, residents who had heart attacks—3 years after the city adopted a smoke-free ordinance. For Pueblo residents, the rate of hospitalizations for heart attacks decreased 27% during the 18 months after the ordinance took effect and an additional 19% during the next year and a half.
Improving Cancer Screening in Rural Alabama
With support from CDC, the Alabama Breast and Cervical Cancer Coalition at the University of Alabama at Birmingham has engaged a variety of stakeholders, key leaders, and concerned citizens from community- and faith-based organizations, state health departments, grassroots agencies, and public and private health care organizations to promote awareness of and increase participation in breast and cervical cancer screening services in selected counties throughout the state.
In Choctaw County, African American women were much less likely to get mammography screening compared with white women. Over the past decade, the percentage of African Americans who received mammography screenings increased from 29% to 61%, surpassing by 13% the rate for white women who were screened. During approximately the same time period in Dallas County, a lower mammography screening rate among African American women (30%) compared with white women (50%) was almost eliminated. According to data the gap in mammography screening rates between African American and white women decreased by 76%.
2008
Assessing Family History for Disease Risk and Prevention
Most disease results from a combination of genetic and environmental factors. Family members share genes, behaviors, lifestyles, and environments, which may make them more susceptible to certain chronic diseases. People who have close family members with a chronic disease—such as cancer, coronary heart disease, or diabetes—may have a higher risk of developing that disease.
As part of its family history initiative, CDC’s National Office of Public Health Genomics sponsored the creation of Family Healthware™. This tool is designed for individuals to collect and display their family history information. Individuals are asked to input information on six diseases (coronary heart disease, stroke, diabetes, and three cancers: colorectal, breast, ovarian) and specific behaviors, such as physical activity, diet, smoking, alcohol use, aspirin use, and the use of screening tests. In return, individuals receive a familial risk assessment (weak, moderate, strong) for each disease along with prevention messages tailored according to their risk. These messages encourage the adoption or maintenance of healthy lifestyles and early detection behaviors, such as scheduling regular screening tests.
A CDC-sponsored evaluation study of the clinical utility of Family Healthware™ was completed in 2007. About 3,600 participants and about 190 clinicians from 13 states participated in the study. Approximately 82% of the participants showed a moderate to high familial risk for at least one of the six diseases included in the tool.
Awareness and Behavior Change
- Most participants were aware of their familial risk and were also accurate in evaluating their risk level. However, participants in the high-risk category tended to underestimate their familial risk.
- Participants who were aware of their elevated familial risk for specific diseases were not more likely to undertake screening tests for the diseases involved.
- Participants who were informed of their familial risk and advised to take measures according to their risk were more likely to talk to their primary care physician about this risk at their next appointment. They were also more likely to collect additional family history information from their relatives.
This study showed that among people with access to primary health care and preventive services, it is possible to induce some positive changes using family history information. Family history could be an essential component of public health prevention strategies for diabetes, coronary heart disease, and cancer; family history can also help identify groups at risk for these diseases. It could also help health providers make decisions about screening and early testing for some diseases, which can lead to early disease detection among those at risk.
2007
CDC Heightens Its Response to HIV in African Americans
African Americans account for approximately half of the estimated one million Americans living with HIV, yet make up only 13 percent of the U.S. population. As well, one quarter of Americans living with HIV—more than 250,000—do not realize they are infected. Targeted funding, increased testing, and greater collaboration with African American leaders are part of CDC’s multipronged approach to address this public health crisis. An enhanced collaborative approach was the driving force behind the March 2007 launch of the “Heightened National Response to the HIV/AIDS Crisis among African Americans.” More than 80 influential African American leaders met with CDC leadership in Atlanta to hear about the impact of the epidemic, discuss how their sectors could contribute to the effort, and make leadership commitments. Their commitment to combat HIV among African Americans has lead to several unique initiatives, such as the one with TV and radio host Big Tigger. Big Tigger (top right), TV and radio show host, pledged to serve as an ambassador for the Heightened National Response to the HIV/AIDS Crisis in the African American Community. He is using his celebrity to support efforts to increase HIV awareness and testing among African Americans. The Heightened Response to HIV has been bolstered by CDC’s $35 million that was awarded in 2007 to state and local health departments to increase HIV testing opportunities among populations disproportionately affected by HIV, primarily African Americans. Supporting CDC’s Health Protection Goal of better preparing people for emerging health threats, especially those at greatest risk of health disparities, 23 states and major metropolitan areas received awards ranging from $690,000 to $5.4 million. The increased funds are providing testing for more than one million persons and increasing early diagnosis of HIV for as many as 20,000 people who are unaware that they are infected. The availability of HIV testing primarily in clinical settings, such as emergency departments, community health centers, clinics, and correctional health facilities, ensures that more persons know their HIV status. HIV testing activities are also being integrated with screening and prevention activities for other infections, such as viral hepatitis, sexually transmitted diseases, and tuberculosis. Integrating these services can significantly improve the health of populations disproportionately affected by HIV and at higher risk for these infections. CDC’s 2006 Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings make voluntary HIV screening a part of routine medical care for all patients aged 13 to 64 years. The recommendations complement the efforts to ensure people know their status. For more information on HIV prevention, visit www.cdc.gov/hiv.
Keeping Athletes Safe from Concussion
When a Texas high school football player sustained two concussions within 18 days, his coach told him to “shake it off.” Fortunately, the boy’s mother knew better, thanks to CDC’s multimedia educational tool kit, “Heads Up: Concussion in High School Sports.”Not only did she make sure her son received the medical attention he needed, she also shared the information in the kit with her son’s coach to educate him on the seriousness of concussions. The coach is now using the materials, and her son has recovered and is planning to present the kit information as part of a classroom project. Although stories like these are important in conveying the impact of CDC programs on individuals and its goal to increase the number of adolescents who are prepared to be healthy, safe, independent, and productive members of society, CDC uses more rigorous methods to evaluate its overall communication efforts. In 2006, it began a one-year evaluation study following the national launch of “Heads Up” in 2005. The tool kit demonstrated positive changes in high school coaches’ knowledge, attitudes, behavior, and skills related to concussion prevention and management. This study is the first to evaluate the concussion awareness campaign targeting high school coaches. The follow-up study has already helped to inform future initiatives, including the development of a multimedia educational tool kit for coaches and administrators of youth sports (“Heads Up: Concussion in Youth Sports), in partnership with the National Football League, YMCA of the USA, the American Academy of Pediatrics, and 23 other leading sports and medical organizations.To learn more, visit www.cdc.gov/ncipc/concussion.htm
Cardiovascular Health in Women
Well-Integrated Screening and Evaluation for Women across the Nation (WISEWOMAN) provides screening and lifestyle interventions to low-income, underinsured, or uninsured women in an effort to reduce risks for heart disease and other chronic diseases. From its inception, WISEWOMAN has provided more than 100,000 lifestyle interventions, reaching the CDC goal of having healthier people in every stage of life. For women who entered the program from 2000–2005, cholesterol levels dropped after one year from 211 to 206 milligrams per deciliter, and their estimated risk of heart attack in the next five years decreased. In the past four years, WISEWOMAN has identified more than 3,000 cases of previously undiagnosed hypertension, 3,600 cases of undiagnosed cholesterol, and more than 500 cases of undiagnosed diabetes.
Coal-Mining Safety
CDC has collaborated with manufacturers, labor, and industry, developed a new personal dust monitor (PDM) for assessing coal miners’ exposure to coal dust in underground coal mines. The PDM provides real-time exposure data during a work shift so that mine operators can reduce overexposures that might lead to the development of coal workers’ pneumoconiosis or “black lung.” This debilitating lung disease caused 14,000 deaths between 1991 and 2000. CDC and its partners received the prestigious R&D (Research and Development) 100 Award for development of the “Coal Dust Explosibility Meter—Model 100.” This is the first device created to immediately determine if coal dust concentrations in active areas of underground coal mines have been sufficiently mixed with rock dust to prevent risk of explosion.
President’s Malaria Initiative
The global toll of malaria is high: an estimated one million people die each year, most of them young children in Africa. The economic costs alone for malaria-related illness and mortality are estimated to cost Africa’s economy $12 billion per year. Since President Bush announced the $1.2-billion President’s Malaria Initiative (PMI) in 2005, CDC has been at the forefront of efforts to cut malaria deaths in half in targeted African countries. CDC worked closely with USAID not only to design the initiative, but to conceive and implement evaluation of PMI’s impact in achieving its goal. To date, PMI has provided life-saving interventions to more than six million people, and estimate that approximately 11 million people were reached with life-saving interventions by the end of 2007. An additional eight countries also will be added to initiative in FY2008.
Measles Initiative
Measles deaths have fallen by 60% worldwide, from an estimated 873,000 deaths in 1999 to 345,000 in 2005—a major public health success. This decline exceeds the United Nation’s goal to halve measles deaths by 2005. In Africa alone, deaths from measles have declined by 75% since the initiative started. This unprecedented decline is attributed to the collaborative work of the Measles Initiative with the American Red Cross, CDC, the United Nations Foundation, UNICEF, and the World Health Organization. CDC’s technical assistance supports the implementation of this high-quality measles campaign to strengthen field and laboratory surveillance for measles virus detection and for efforts to strengthen national routine immunization systems in priority countries. Since 2001, the agency has contributed more than $50 million to the UN Foundation for the purchase of bundled measles vaccine (more than 280 million doses). This contribution has generated additional funds of more than $16 million to reduce measles mortality and morbidity in priority countries supported by the partnership.
Vehicle Crash Response Study
The decision of whether a victim of a vehicle crash requires care at a trauma center is a matter of life or death. Recent CDC-supported research showed that care at a Level-1 trauma center lowers the risk of death by 25% for severely injured patients compared with treatment received at a hospital without trauma care services. CDC and the CDC Foundation recently partnered with On Star and the GM Foundation to develop procedures to help emergency responders quickly make treatment decisions. Through this partnership, OnStar and the GM Foundation also awarded the CDC Foundation a $250,000 grant that enables CDC to develop protocols that allow the emergency medical community to reduce injury or death through faster identification, diagnosis, and treatment of patients.
Road Safety
Native Americans are killed in motor vehicle crashes at about twice the rate of all Americans. To address this disparity, CDC began funding four tribes in the fall of 2004 to design, implement, and evaluate evidenced-based strategies to reduce alcohol-impaired driving and increase seat belt use. This effort is paying off with life-saving results:
- Ho-Chunk Indian Nation in Wisconsin—A partnership with local county police departments and the airing of a media campaign resulted in an 18% increase in driver safety belt use and a 64% increase in passenger safety belt use from 2005 to 2006.
- San Carlos Apache Reservation in Arizona—In 2004, the driving under the influence (DUI) sobriety checkpoints on reservation roads program began, publicizing the checkpoints through TV, radio, local newspaper ads, and local community events. Since 2004, total DUI arrests have increased 33%, and motor vehicle crashes have decreased 27%.
- Tohono O’odham Indian Nation in Arizona—The passage of a primary safety belt law and strengthening of the impaired driving law resulted in overall seatbelt use increase of 47% between 2005 and 2006.
Quit Now!
In 2007, CDC worked with the National Cancer Institute, North American Quitline Consortium, and all 50 states and five U.S. territories to establish the National Network of Quitlines, which provides smokers in the United States easy access to support and information to help them quit. Research shows that telephone counseling can significantly increase long-term quit rates compared with the effectiveness of self-help materials alone. By calling 1-800-QUIT-NOW, smokers can receive the resources they need to stop smoking. As of October 2007, more than 927,000 calls had been made to 1-800-QUIT-NOW. A Web site, www.smokefree.gov, provides complementary information and cessation support as well.
World Rabies Day
There were special reasons to celebrate this year’s work to control rabies. Not only was the United States declared free of canine rabies, but it also witnessed the first successful treatment of human rabies. Since she contracted rabies two years ago, Jeanna Giese, has fought this disease; today, she is cured and set to attend college. Her successful recovery has energized CDC efforts to better understand rabies as a disease process that can be treated. CDC is working with infectious disease physicians around the world on new strategies for future research and on the treatment of rabies. Jeanne Giese’s recovery from rabies is proof that the potential for finding a treatment for this historically fatal disease is within reach.
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