CDC's Prevention Activities that Target

Actual Causes of Death

CDC has initiated numerous activities and programs aimed at addressing the behavior and lifestyle factors that contribute to deaths from this nation's leading killers including heart disease, cancer and stroke. These factors – such as smoking, poor nutrition and physical inactivity – are called "actual causes of death."

Tobacco Use, Smoking, and Health

CDC supports programs to prevent and control tobacco use in all 50 states, the District of Columbia, seven territories, and seven tribal support centers.

CDC funds nine national networks to reduce tobacco use among eight priority populations and funds 23 states for coordinated school health programs to help prevent tobacco use.

HHS establishes a national network of quitlines. CDC in conjunction with National Cancer Institute (NCI) is working on a national network of quitlines to ensure that smokers throughout the United States have access to toll-free quitline services regardless of their geographic location or economic status.

Obesity, Nutrition, and Physical Activity

CDC supports the development of effective prevention and treatment strategies through state obesity programs, state coordinated school health programs, partnerships, and an applied research agenda to develop and refine new approaches.

Currently, CDC provides funding to 20 states to prevent and reduce the prevalence of obesity and the chronic diseases associated with obesity. CDC supports states in developing and testing nutrition and physical activity interventions to prevent obesity through strategies that focus on multiple levels of change including individual, environment and policy.

CDC funds 23 states to manage statewide coordinated school health programs. These programs address a range of health issues including tobacco use, poor nutrition, physical inactivity, and asthma.

CDC's Youth Media Campaign supports a comprehensive communications approach designed to encourage young people aged 9-13 years to adopt healthy behaviors, especially physical activity.

Alcohol

CDC supports public health surveillance on alcohol-related conditions and alcohol use, particularly binge drinking; conducts and supports applied research to characterize the public health impact of alcohol misuse and to evaluate the effectiveness of alcohol control measures; and supports the building of state capacity to prevent excessive drinking.

CDC also conducts public health research to develop effective evidence-based interventions to prevent alcohol-exposed pregnancies and to improve long-term outcomes for children with Fetal Alcohol Syndrome (FAS) and Alcohol-Related Neurodevelopmental Disorders (ARND), and provides information and training to medical and allied health professionals, teachers and the public on all aspects of prenatal alcohol exposure and its outcomes.

In addition, CDC is assessing the role of alcohol in unintentional injuries (including motor vehicle crashes) and violence, and evaluating the effectiveness of screening and brief intervention strategies in reducing risky drinking behavior among persons treated in acute care settings. Also, CDC and the Task Force of Community Preventive Services-- a non-federal panel of community health experts -- is conducting systematic reviews of the effectiveness of community-based interventions to reduce alcohol-impaired driving.

Microbial Diseases

CDC's strategy for combating infectious diseases focuses on building domestic and global capacity for recognizing and responding to infectious disease threats.

To ensure the health of U.S. citizens everywhere, CDC's infectious disease funding supports surveillance, epidemic investigations, research, training and public education in all 50 states and across the globe.

CDC recently established seven domestic and global sentinel surveillance networks linking health care providers to detect and monitor emerging diseases.

Overuse of antibiotics has become a serious problem leading to antimicrobial resistance. CDC's "Get Smart: Know When Antibiotics Work" campaign was unveiled last year to lower the rate of antibiotic use. In addition, 70 percent of the bacteria that cause hospital-acquired infections are resistant to at least one of the drugs most commonly used to treat them. CDC is also working to prevent antimicrobial resistance in health care settings with a comprehensive campaign targeted to clinicians in hospitals and long-term care settings.

Toxic Agents

Through its biomonitoring efforts, CDC is working to determine which environmental chemicals get into people's bodies and at what levels, assessing the effectiveness of public health efforts to reduce people's exposure to specific chemicals, determining whether exposure levels are higher among minorities, children, women of childbearing age, or other potentially vulnerable groups, tracking trends in levels of people's exposure to environmental chemicals, and setting priorities for research on human health effects of exposure to environmental chemicals.

CDC is funding schools of public health to support state and local health departments and to investigate possible links between the health and the environment. CDC has also funded projects in nine states and New York City that will link environmental exposure and health effects data.

Motor Vehicle Accidents

To assess which community-based interventions are effective in reducing motor vehicle injuries, CDC and the Task Force on Community Preventive Services, an independent, nonfederal panel of community health experts, published systematic reviews of the literature and a set of evidence-based recommendations on community-level interventions to reduce alcohol-impaired driving, increase child safety seat use, and increase safety belt use.

CDC is funding two state health departments and three Native American tribes to implement and evaluate effective community-based interventions selected from the Guide to Community Prevention Services to reduce motor vehicle-related injuries and deaths in their communities.

Firearms-related Violence

Firearms are involved in more than half of all homicides (55.9%) and suicides (55.1%) in the United States. Homicide and suicide account for more than 46,000 deaths each year in the United States. CDC supports programs to prevent violence in all 50 states, the District of Columbia, and nine territories.

CDC is funding two states to develop suicide prevention programs. In these states injury prevention experts are designing and implementing suicide prevention programs specific to their needs. This funding provides the necessary resources to advance from data gathering and analysis to identifying best practices for suicide prevention.

Sexual Behavior

CDC funds several adolescent and school-based health programs in 48 states, 7 territories, and 18 large cities to plan, carry out, and evaluate HIV prevention programs. These programs provide young people with the skills and knowledge needed to avoid infection with HIV and other sexually transmitted disease.

CDC provides national leadership in helping to control the HIV epidemic by working with community, state, local and international partners. Strategies to reduce HIV infection include monitoring the epidemic to ensure that prevention activities reach those people who need it most, researching the effectiveness of prevention methods, funding local efforts for high-risk communities and linking infected individuals with care, treatment and prevention programs.

Through CDC's National Breast and Cervical Cancer Early Detection Program, uninsured and under-served women are screened for cervical cancer, which is associated with human papillomavirus infection, a sexually-transmitted disease.

Illicit Drug Use

CDC conducts a national survey, the School Health Policy and Programs Study, to help policymakers assess school health policies and programs at the state, district, school, and classroom levels designed to address alcohol and illicit drug use.

Steps to a HealthierUS

CDC is working in conjunction with other HHS agencies on the HHS Secretary's initiative, Steps to a HealthierUS, which is designed to help Americans live longer, better, and healthier lives through healthier lifestyle choices. The Steps to a HealthierUS cooperative agreement program awarded $15 million (FY2003) and $44 million (FY2004) to urban, rural and tribal communities throughout the United States. The funding is used to implement chronic disease prevention efforts focused on reducing the burden of diabetes, overweight, obesity, and asthma and the three related risk factors for chronic disease — physical inactivity, poor nutrition and tobacco use.

Tracking Trends in Health Behaviors

CDC tracks trends in various health-related behaviors through the Behavioral Risk Factor Surveillance System (BRFSS), a telephone survey system conducted by health departments in all 50 states, the District of Columbia, Puerto Rico, the Virgin Islands, and Guam. The BRFSS is the primary national source of state- and territory-specific information about health-related behaviors among adults. The surveys can be tailored to meet the needs of individual states and territories.

CDC collects Selected Metropolitan and Micropolitan Area Risk Trends (SMART) data, which are derived from BRFSS data and used to assess health behaviors in local communities. SMART data is currently available for 98 metropolitan areas and counties within those areas. The data are used to help local communities identify emerging health problems, plan and evaluate local responses, and allocate resources efficiently to meet specific needs.

CDC monitors national patterns and trends in health behaviors and risk factors, such as alcohol and tobacco use and physical activity in the National Health Interview Survey. This survey – based on personal interviews conducted in the home – yields findings that can be analyzed by many characteristics such as race, age, gender, education, and income to identify groups at greatest risk. The National Health and Nutrition Examination Survey collects data on the prevalence of obesity, overweight, high cholesterol and many other physiological measurements through standardized physical examinations. This survey produces unique data on conditions that were previously undiagnosed and the most accurate data on overweight and obesity prevalence.

To obtain Actual Causes of Death in the United States, 2000, visit JAMA's web site at www.jama.ama-assn.org. For more information on CDC's program efforts, including tobacco control, nutrition, physical activity, and other health behaviors and prevention strategies, visit CDC's web site at www.cdc.gov.CDC protects people's health and safety by preventing and controlling diseases and injuries; enhances health decisions by providing credible information on critical health issues; and promotes healthy living through strong partnerships with local, national, and international organizations.