Healthy Communities:
What Local Public Health Can Do To Reduce
and Prevent Cardiovascular Disease and
Stroke
Truemenda C. Green, Director
Healthy Communities/Chronic Disease
Presentation Overview
1. What if we took what we learned from
local obesity prevention initiatives and
applied it to CVD?
2. Why Should Local Governments
Care?
3. Policy & Environmental Change to
Address Obesity and CVD
4. CDC Recommended Community
Strategies and Measurements to
Prevent Obesity, Should be Used to
Address CVD
Who is NACCHO?
• The National Association of County and City Health
Officials (NACCHO) is the national organization
representing local health departments.
• NACCHO supports efforts that protect and improve the
health of all people and all communities by promoting
national policy, developing resources and programs,
seeking health equity, and supporting effective local
public health practice and systems.
• Represents 3000 local health departments (LHDs)
Funding Drives The Local Prevention
Initiatives
All nationally funded obesity prevention
initiatives:
•REACH (CEEDs, Action Communities, CORE)
•Steps to a Healthier US
•Healthy Communities (Strategic Alliance for
Health or ACHIEVE)
•Pioneering Healthier Communities
•CPPW community funding
……now CTG’s fund local communities to address
CVD
Why Should Local Governments Care?
Local government officials are community leaders and can
enact policies that support healthy community design
and prevention initiatives
– For example, local zoning ordinances & economic incentives
affect the presence and absence of:
• Parks and open spaces for
recreation
• Increase access to screenings
• Mixed use developments
• Healthy food retailers &
farmers markets
Advantages of Policy & Environmental Change
to Address Obesity and CVD:
• Potential for systemic change in a community’s food and
physical activity environment.
• Broad Reach: Opportunity to “level the playing field” for
all members of a community, including disproportionately
impacted populations.
• Flexibility: Consider the unique characteristics and needs
of your community and implement prevention initiatives
to address them.
Example: New York City
• Goal: Decrease consumption of Sugar Sweetened
Beverages among children age six and under.
• Policy Change: The NY City Board of Health
amended its health code to prohibit serving
beverages with added sweeteners and places limits
on beverages served in licensed day care facilities.
– Limits the serving size of 100% fruit juice to 6 oz
per day for children 8 months and older
– When milk is served, children 2 years of age and
older must receive low-fat 1% or non fat milk
– Water must be readily available throughout the
day
Call To Action
• What can local governments do right now to address
obesity and CVD?
- Leverage lessons learned from CPPW-Obesity and apply to
CVD prevention initiatives
– Enact policy and environmental initiatives that support increased
opportunities for screenings, healthy eating and active living
– Partner with a variety of local agencies to leverage resources
and achieve greater impact (i.e. ACOs, FQHCs, Hospitals, Clinics,
Providers, Workplace Wellness, Planning Dept, Economic Redevelopment
Agency, Parks & Recreation Dept, Public Health Dept)
– Set feasible short and long term goals to address the unique
needs of your community/measure your community’s
performance and adjust goals as necessary
CDC Framework for Preventing Obesity
(adapted from IOM 2005)
Social Norms
and Values
 Home and Family
 Food and
Beverage Industry
 School
 Agriculture
Sectors of
Influence
 Community
 Work Site
 Education
 Media
 Healthcare
 Government
Behavioral
Settings
 Public Health
Systems
 Healthcare
Industry
 Genetics
 Psychosocial
Individual
Factors
 Other Personal
Factors
Food and
Beverage Intake
Energy Intake
 Business and
Workers
Physical
Activity
Energy Expenditure
Energy Balance
Draft – last revised, March 24, 2005
Prevention of Overweight and Obesity
Among Children, Adolescents, and Adults
 Land Use and
Transportation
 Leisure and
Recreation