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CDC Winnable Battles 2010-2015
Centers for Disease Control and Prevention
Office of the Director CS254894
Winnable Battles 2010-2015 Progress Report
An update to the first CDC Winnable Battles Progress Report released in November 2013, this document captures
recent data and contributions across each CDC Winnable Battle: Tobacco, Nutrition / Physical Activity / Obesity,
Food Safety, Healthcare-Associated Infections, Motor Vehicle Injuries, Teen Pregnancy, and HIV. CDC Winnable Battles utilize evidence-based, cost-effective strategies to tackle specific health challenges working together with partners in public health.
Notable in this update is the continued progress of several Winnable Battles. Teen birth rates continue to fall.
Fatalities due to motor vehicle crashes are fewer. The percentage of adults who smoke is decreasing, and the percent of youth who smoke has declined past the 2015 Winnable Battles target. Some healthcare-associated infections, including methicillin-resistant Staphylococcus aureus (MRSA) and central line-associated blood stream infections (CLABSI) have declined. And, the percent of people living with HIV who know their status is increasing.
Rates of breastfeeding, which helps protect against childhood obesity and other illnesses, continue to climb. While not yet evident in the data, indications of progress are emerging in other areas as well. Better, more focused use of food safety data to inform agencies who have oversight of food industries is poised to help prevent foodborne illness and outbreaks. Despite these gains, much work remains. For instance, new potential health threats such as e-cigarettes are emerging and need evaluation to determine how they may affect our health.
Together with our partners, we are having a positive impact on health by focusing on what works now. We’ve made progress in most areas, but still have more to do to meet our 2015 goals. The Winnable Battles were chosen based on the magnitude of the health problems and the ability of CDC and its public health partners to make significant progress to improve outcomes. There are evidence-based strategies available now to address the critical health challenges presented by each of the Winnable Battles areas. By continuing to work closely with our public health partners and educating stakeholders about these evidence-based strategies, we can achieve our Winnable Battles goals.
PHYSICAL ACTIVITY, HEALTHCARE-ASSOCIATED
OBESITY & FOOD SAFETY INFECTIONSTOBACCO MOTOR VEHICLE SAFETY TEEN PREGNANCY
TARGETS A comprehensive set of indicators establishes baselines and targets for all Winnable Battle areas. These indicators help us measure the impact of programs and policies on our nation’s health, and support the Department of Health and Human Services’ strategic plan and other priorities. Derived from Healthy People 2020 and other established measures, the related targets are ambitious yet achievable, evidence-based, and specific to the priorities and opportunities within each of these health areas.
This dashboard gives a snapshot of each indicator by comparing recent data trends to the 2015 Winnable Battle targets.
Reduce central line-associated blood stream infections (CLABSI) in hospitals by 60% On track to reach 2015 target Reduce healthcare-associated invasive methicillin-resistant Staphylococcus aureus On track to reach 2015 target
Key Highlights 2014 2014 Surgeon General’s Report: The Health Consequences of Smoking – 50 Years of Progress was released in ● January 2014. The new report concluded that that despite progress, smoking and exposure to tobacco smoke are responsible for more than 480,000 premature deaths annually, as well as at least $289 billion in health care expenses and other economic costs each year.
The evidence-based guide Best Practices for Comprehensive Tobacco Control Programs was updated and ● released in 2014. The report describes an integrated programmatic structure for implementing interventions proven to be effective and provides levels of state investment to prevent and reduce tobacco use in each state.
The report includes expanded information on health equity from the previous versions of Best Practices.
In 2014, CDC launched the third Tips from Former Smokers campaign, focusing on health conditions such as ● premature birth, periodontal (gum) disease and tooth loss, and HIV complications. The campaign resulted in 80% call volume increase to 1-800-QUIT-NOW and a more than 1,000% increase in average weekly unique visitors to the TIPS website.
Two states and the District of Columbia increased tobacco taxes in 2014, a proven strategy to reduce tobacco ● use. Additionally, 63 jurisdictions around the country acted to protect the public from secondhand smoke by implementing smoke free ordinances.
CDC staff examined poison control calls related to e-cigarettes for the first time. The analysis assessed total ● monthly poison center calls related to e-cigarettes or conventional cigarettes, and found the proportion of e-cigarette calls jumped from 0.3 percent in September 2010 to 41.7 percent in February 2014. More than half of the calls related to e-cigarettes were for children five years of age or younger.
CDC researchers found that prohibiting smoking in subsidized housing would yield annual cost savings of $496.82 ● million, including $310.48 million in secondhand smoke-related care, $133.77 million in renovation expenses, and $52.57 million in smoking-attributable fire loses. By state, annual overall cost savings ranged from $0.58 million in Wyoming to $124.68 million in New York. See King, B.A., Peck, R.M. and Babb, S.D., National and State Cost Savings Associated with Prohibiting Smoking in Subsidized and Public Housing in the United States, Preventing Chronic Disease, October, 2014.
Key Highlights 2014 Illustrating the extent of the U.S. obesity burden, the State Adult Obesity Prevalence and Maps were released in ●
Today, 11% of all births in the U.S. occur at Baby-Friendly hospitals, up from less than 2% in 2007. This achievement ● surpasses the Healthy People 2020 goal of 8.1%. The CDC funded Best Fed Beginnings project contributed to the acceleration of Baby-Friendly designated U.S. hospitals. Nearly one third of all hospitals earning designation as Baby-Friendly in 2014 and early 2015 enrolled in Best Fed Beginnings, a nationwide effort to make quality improvements to maternity care to better support mothers and babies to be able to breastfeed.
Breastfeeding rates continue to rise, according to the 2014 Breastfeeding Report Card. Professional breastfeeding ● support can help mothers start and continue breastfeeding to meet personal goals and national health recommendations; the Report Card tracks such support. From 2006 through 2013, the number of International Board Certified Lactation Consultants increased from 2.1 to 3.5 per 1,000 live births.
Released in July 2014, The State Indicator Report on Physical Activity presents state-level information on physical ● activity behaviors and on environmental and policy supports for physical activity.
The Comprehensive School Physical Activity Program (CSPAP) Guide was developed to assist schools and school ● districts to develop, implement, and evaluate comprehensive physical activity programs. For example, teachers that participated in a CSPAP training in Monroe County, Tennessee changed academic testing days to coincide with mornings that students had before-school physical activities because teachers noticed a positive difference in student behavior.
Participation in Let’s Move Child Care by early care and education providers increased from 11,981 to 15,963 ● providers, who serve over 910,000 children. In 2014, learning collaboratives were launched in California (Los Angeles), Kentucky, and Virginia (in addition to 6 states in 2013), and thousands of additional ECE providers across the nation pledged to meet best practices for food, beverages, breastfeeding support, physical activity, and screen time through participation in Let’s Move Child Care.
Through the Sodium Reduction in Communities Program (SRCP), ten grantees across the country are working ● with partners to increase access to and accessibility of healthier food options, focusing on lower sodium products.
Each community is working with a combination of independent restaurants, distributive food programs and/or governmental and non-governmental organizations that sell and serve food. Communities are seeing quantifiable success in reducing sodium. For example Philadelphia, a SRCP awardee, is working with multiple partners to reduce sodium content in meals in Chinese take-out Restaurants. As of January 2015, 185 restaurants were enrolled in the initiative. Over 24 months, significant reductions in sodium content in three main dishes were seen, ranging from 13% to 34%.
As of August 2014, 100% of the U.S. General Services Administration-managed cafeteria’s contracts include the ●
diagnostic testing with advanced technologies.
Key Highlights 2014 Available for hands-on web access for the first time, the Atlas of Salmonella in the United States, 1968-2011 ● summarizes surveillance data on 32 types of Salmonella isolates from people, animals, and other sources. The information is organized by demographic, geographic and other categories. The Atlas enables the reader to compare trends in Salmonella serotypes by following their spread or decline over time and location. This could lead to tailored prevention efforts targeted at specific serotypes.
Since CDC began applying advanced molecular detection (AMD) and enhanced epidemiology methods for ● nationwide surveillance of Listeria infections, CDC has been able to detect seven clusters of illness that would not have been detected by the older methods. The percentage of Listeria clusters for which a food source was found increased from 6% in FY 2013 to 21% in FY 2014. One example of a success is a Listeria outbreak that affected at least 32 people in 11 states between October and December 2014. Seven of those people died. Using whole genome sequencing, CDC was able to identify the illnesses as a cluster one week faster than would have occurred with the older methods. CDC worked with state and local health departments, the Food and Drug Administration, and food industries to identify prepackaged caramel apples as the source of the outbreak. Investigation partners were then able to take action to inform the public and get caramel apples off the shelves to keep more people from becoming ill. The country’s largest grocery retailer is partnering with CDC to decrease pathogens such as Salmonella and ● Campylobacter in chicken products provided by its suppliers. The new program, announced in December 2014, requires the retailer’s poultry suppliers to implement holistic controls from farm to final product and is designed to significantly reduce potential contamination levels, in fresh whole chickens and chicken parts. It also requires suppliers to validate that the measures they have implemented are effective through specialized testing. All poultry suppliers of this grocery retailer must be in compliance with the new requirements by June 2016.
CDC released the 2012 National Antimicrobial Resistant Monitoring System (NARMS) Annual Human Isolates ● Report to aid in better understanding trends in antibiotic resistance, which helps doctors prescribe effective treatment and helps public health officials investigate outbreaks faster.
Researchers provided evidence for the importance of kitchen manager certification in restaurant food safety ● through a CDC-funded study on “Restaurant manager and worker food safety certification and knowledge” (December 2014 Foodborne Pathogens and Disease). Findings from this study and others indicate certified managers have better food safety knowledge with improvement in food safety practices.
Researchers also identified gaps in restaurant policies and practices concerning ill workers (e.g., lack of policies ● requiring sick workers to stay home), that if addressed, could help prevent foodborne illness outbreaks, according to a CDC-funded study on “Managerial practices regarding workers working while ill” (January 2015 Journal of Food Protection).
The National Voluntary Environmental Assessment and Information System (NVEAIS), launched in April 2014, ● is a national effort to systematically collect, analyze, interpret, and disseminate environmental factor data from foodborne illness outbreak investigations. More than half of all foodborne illness outbreaks are associated with restaurants, banquet halls, and schools and other institutions. The environmental factor data collected through NVEAIS will be used to help determine the causes of outbreaks in these settings, improve outbreak response efforts, and prevent future outbreaks. 8 state and 3 local health departments have registered for NVEAIS since its launch, and 44 outbreaks have been reported by sites in NVEAIS.
CDC’s e-Learning on Environmental Assessment of Foodborne Illness Outbreaks is new, free virtual training that ● teaches state, local, territorial and tribal environmental health professionals how to collect environmental factor data during foodborne illness outbreak investigations. Over 1,100 people from 48 states and 282 localities across the nation have participated in the e-Learning course since its April 2014 launch.
FOOD SAFETY Progress to Date