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Coordinated Chronic Disease

Domain 2:  Environmental Approaches


Domain 2: Environmental approaches that promote health and support and reinforce healthful behaviors (statewide in schools, worksites, and communities). 


Improvements in social and physical environments make healthy behaviors easier and more convenient for Americans. A healthier society delivers healthier students to our schools, healthier workers to our businesses and employers, and a healthier population to the health care system. These types of interventions support and reinforce healthy choices and healthy behaviors and make it easier for Americans to take charge of their health. They have broad reach, sustained health impact and are best buys for public health.

Examples of Activities

Expand access to and availability of healthy foods and beverages through a variety of strategies, including:

  • Nutrition standards for food and beverages offered in settings including state, local and tribal governments, private sector businesses, schools, child care and education facilities, senior centers and other facilities serving older adults, and other settings.
  • Accessible, available, and affordable healthful foods in communities, including provision of full service grocery stores, farmers markets, small store initiatives, mobile vending carts, and restaurant initiatives.
  • Comprehensive school strategies to promote healthful nutrition, such as:
    • Implementing IOM recommendations on competitive foods (e.g., vending or a la carte items);
    • Increasing access to healthy foods and beverages in schools through a variety of strategies, such as offering drinking water free of charge throughout the day and implementing farm-to-school initiatives.

Promoting increased physical activity through a variety of strategies, including:

    • Increasing the amount of daily, quality physical education in schools;
    • Increasing the amount of daily physical activity through standards in early care/after school settings;
    • Increasing access to physical activity for employees through worksite wellness initiatives;
    • Facilitating joint use agreements to increase the number of safe, accessible places for physical activity in communities;
    • Implementing strategies for the built environment that promote active transportation (e.g., complete street designs, safe routes to school programs, promoting bicycling as a mode of transportation, health impact assessments).

Reducing tobacco use, preventing youth initiation, and eliminating exposure to secondhand smoke through a variety of evidence-based strategies, including:

    • Comprehensive smoke-free air policies in workplaces and public places; smoke-free policies in multi-unit housing and outdoor areas; and tobacco-free campus policies for colleges, workplaces, and health care settings, among others;
    • Strategies to reduce youth access to tobacco products (e.g., reducing the affordability, availability, and visibility of tobacco products).

Increasing the proportion of the U.S. population served by community water systems with optimally fluoridated water.