The CDC is the health sentinel for our nation. Monitoring and surveillance are among our key functions, allowing the country to know the extent of health problems, which populations are most affected and whether interventions are working. We also focus on prevention to maximize health and help people live longer, healthier, more-productive lives with lower healthcare costs – particularly important in light of the ongoing budget issues facing every federal agency.
Thomas R. Frieden, MD, MPH, CDC Director
Cardiovascular disease is our nation’s leading cause of death, claiming more than 800,000 Americans a year and costing $445 billion in medical expenses and productivity losses each year. CDC, the Centers for Medicare & Medicaid Services, other federal agencies, and public and private clinical, community and other partners have launched the Million Hearts initiative to prevent one million heart attacks and strokes during the next five years. Million Hearts will use both clinical and community-based prevention measures to reduce the number of people who need treatment and improve care and treatment for those who need it.
Improved management of the ABCS – aspirin, blood-pressure control, cholesterol management, and smoking cessation – can save more lives than other clinical interventions. Currently, however, only 47% of Americans at highest risk of cardiovascular disease take daily aspirin or another anti-platelet agent, 46% with hypertension have it adequately controlled, 33% with high cholesterol receive adequate treatment, and 23% of smokers get help to quit. Increasing use of these simple clinical interventions could save more than 100,000 lives a year.
Blood-pressure control in clinical practice may be the most important of these interventions, with the potential to save the most lives. Clinicians need to check patients’ blood pressure at each visit and prescribe or adjust anti-hypertensive medications promptly. Pharmacists can monitor medication-refill patterns to ensure drugs are taken as prescribed and actively engage doctors and patients in blood-pressure management. Home monitoring can help people know if their medications are effective and provide early warning if they are not.
Improved clinical prevention and management of the ABCS will require a tighter focus on the importance of ABCS care by simplifying and aligning quality measures to emphasize what will save the most lives. Advances in health-information technology will help clinicians improve preventive care and treatment. Expanding use of prevention-oriented electronic health records will enable providers and health systems to improve ABCS care and enable quality improvement through clinical decision support, patient reminders, registries and technical assistance. Electronic health records also can be linked to quality recognition programs that may support approaches in which providers are paid more for better preventive care. Innovations including increased use of team-based care and interventions to promote medication adherence also will help clinicians make progress. The VA has made substantial progress in this area and can serve as a model for both public- and private-sector health systems.
Community-based prevention, which helps facilitate healthy choices, also is important. Million Hearts focuses on restrictions in three areas – smoking, sodium consumption and trans-fat consumption – that can substantially and rapidly improve cardiovascular health. We are working with government and private-sector partners to warn people about the harms of tobacco, reduce sodium and eliminate trans fat from processed and restaurant foods.
Million Hearts leverages and aligns existing resources and investments, so will generally not require new public spending, and will use the dedication, ingenuity and collaborative efforts of government and private sectors to succeed. Million Hearts can quickly achieve substantial and measurable health improvements that will prevent more than a million heart attacks and strokes over five years.
At CDC, we also are focusing on “winnable battles.” These are health problems that present a large burden as leading causes of illness, injury, disability and death, and for which there are evidence-based, scalable interventions we already know will work and can apply today. By concentrating on the biggest problems, our efforts can make a difference and achieve measurable results within a few years. Success will not be easy; it will require substantial effort by all segments of society. CDC has identified six important winnable battles:
- Tobacco control
- Nutrition, physical activity, obesity, and food safety
- Healthcare-associated infections
- Motor vehicle injuries
- Teen pregnancy
- HIV prevention
Tobacco remains the leading preventable cause of death, killing more than 440,000 Americans and costing nearly $200 billion in medical expenses and lost productivity annually. More than two-thirds of our country’s 46 million smokers want to quit. Most try each year but need support to succeed. We continue to make important progress to reduce tobacco use through implementation of proven tobacco-control policies contained in the WHO’s MPOWER strategy. Clinical interventions, including providing cessation advice at every patient encounter and medications where appropriate, encourage quit attempts and increase the likelihood of success. Virtually every adult who smokes and wants to quit, other than pregnant women, should be offered medications approved by the FDA, which can double or triple quit rates.CDC Tackles Hearth Health And Winnable Battles In 2012 Cont.
Outbreaks of foodborne illness are both common and costly. Each year, about 1,000 outbreaks occur in this country, sickening 1 out of 6 Americans, and killing 3,000 people and costing as much as $152 billion in healthcare expenses and lost productivity. With passage of the Food Safety Modernization Act, FDA, CDC, the Department of Agriculture and other partners at federal, state and local levels are identifying these outbreaks and stopping them more quickly, monitoring trends in foodborne illness and outbreaks more closely, conducting applied research for better diagnosis and prevention, and tracking the effectiveness of policies to reduce the spread of these illnesses.
|The goal of Million Hearts is to prevent one million heart attacks and strokes across the United States over five years. Campaign badges, such as this one, can be downloaded to a website, social network profile or email signature. Million Hearts campaign information can be found at http://millionhearts.hhs.gov/index.shtml|
About 1 in 20 patients who are hospitalized contracts a healthcare-associated infection (HAI), killing 100,000 Americans and costing roughly $30 billion each year. At least one-third of these infections can be prevented with tools and procedures that already exist but are currently underutilized. Basic infection-control procures, such as hand-washing, are simple, yet effective, preventive interventions that should be used in all clinical settings. There has recently been a decline in some types of HAIs, in part because more than half of states now require reporting of HAIs, and nearly 5,000 healthcare facilities throughout the country are enrolled in the Internet-based National Healthcare Safety Network (NHSN) surveillance system.
More than 400,000 of our nation’s girls age 15-19 years give birth each year. Pregnancy can have immediate and long-term negative effects for teen parents and their children and can perpetuate a cycle of poverty. Although rates of teen pregnancy are at their lowest recorded levels, they still are far too high, and considerable racial and ethnic disparities persist. Areas that expand access to information and services can substantially reduce teen pregnancy and reduce health disparities.
Motor-vehicle crashes, the leading cause of death among Americans between ages 5-34 years, kill about 33,000 people and send more than four million to emergency departments every year. Improvements in trauma care have contributed to the recent decline in motor-vehicle deaths, but rates could be reduced even further through simple, low-cost methods such as universal requirements for seat belts, helmets and child restraints; stronger enforcement of drunken driving laws; and graduated driver’s licenses for teens.
Despite being preventable, HIV continues to spread, with more than 50,000 Americans newly infected each year joining more than a million already living with HIV. Rates are increasing among younger men who have sex with men. Increasing testing in clinical and nonclinical settings and improving linkage to care so that those who are infected can start treatment as early as possible are important prevention strategies. Suppression of viral load has emerged as critical to reducing spread of HIV. CDC works with other federal agencies to implement the National HIV/AIDS Strategy, which is designed to achieve a more coordinated national response to the HIV epidemic.
At CDC, we work “24/7” to protect our nation and the world from threats to health, safety and security. Ambassador Johnnie Carson, assistant secretary of state for the Bureau of African Affairs, recently noted “CDC is the 9-1-1 for the world.” We take these responsibilities seriously and are expanding partnerships with state and local health departments as well as with ministries of health in other countries to better prevent illness, injury, disability and death from both communicable and noncommunicable diseases, and from natural and man-made threats. Global health issues have a direct impact on our nation. If we don’t prevent and control disease abroad, we are at higher risk here at home. Better health abroad also contributes to economic growth and improved political stability.
In the coming year and beyond, CDC will continue to fulfill our mission to help people live longer, healthier and more-productive lives. We will focus on the biggest problems, where we can have the greatest impact. We recognize the importance of strong public and private partnerships and will work even more closely with all sectors of society. Because we all are connected by the air we breathe, the food we eat and the water we drink, we will expand our efforts to protect and improve health globally through science, policy, partnership and evidence-based public health action.
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