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Impact Briefs
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The Impact Brief is the official newsletter for the National Association of Chronic Disease Directors. It is distributed monthly to approximately 4,800 NACDD members, partners, and stakeholders. You can view NACDD's Impact Brief archive here:


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Successes in Work@Health Program Training

Posted By Administration, Wednesday, August 28, 2019
NACDD is increasing state workplace health expertise by training chronic disease prevention staff to implement Work@Health®. See the latest stats in this infographic.

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Partnerships Result in Improved Lupus Data Collection

Posted By Administration, Wednesday, August 28, 2019

Since 2015, NACDD has collaborated with the American College of Rheumatology (ACR), The Lupus Initiative, The Georgia Council on Lupus Education and Awareness and the Big Bend Rural Health Network to develop state-based plans to address lupus that reflect the strategies identified in the National Public Health Agenda for Lupus.  These partnerships have resulted in improved data collection, as questions about lupus were added to the 2019 BRFSS in both states, and every school district in Florida and two in Georgia now collect data on students with a diagnosis of lupus. 

A training program has been developed for school nurses, complimented by an ACR developed Lupus Care Plan and Transition to Adult Care Plan for use by the nurses, with plans to expand training opportunities, starting in October 2019.

To bring home how important the work is we are doing, the co-chair of the Georgia Council on Lupus Education and Awareness conducted a presentation on lupus from the patient perspective to the entire DeKalb County School Health staff.  During the Q&A, one nurse stated that she took all of the information from the first school nurse lupus presentation in March, went to a rheumatologist and was diagnosed with lupus. Another nurse stated that she was able to have a parent send their child to a rheumatologist for a positive diagnosis.

Although lupus is most common in women between the ages of 18-45, it can affect men also.  Lupus can affect almost any organ in the body. The symptoms of lupus may differ from person to person. For example, one woman with lupus may have swollen knees and fever while another may be tired all the time or have kidney trouble. Someone else may have rashes. Over time, new symptoms can develop, or some symptoms may happen less often.  Lupus symptoms also usually come and go, meaning that you don’t have them all of the time.

Systemic lupus erythematosus (SLE), is the most common type of lupus. SLE is an autoimmune disease in which the immune system attacks its own tissues, causing widespread inflammation and tissue damage in the affected organs. It can affect the joints, skin, brain, lungs, kidneys, and blood vessels. There is no cure for lupus, but medical interventions and lifestyle changes can help control it.  The causes of SLE are unknown, but are believed to be linked to environmental, genetic, and hormonal factors.

Recent studies indicate that lupus incidence rates are almost three times higher in black women than white women and affect 1 in 537 young African American women. Minority women tend to develop lupus at a younger age, experience more serious complications and have higher mortality rates—up to three times the mortality rate of white women.

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CDC Investigates Death Possibly Linked to Vaping

Posted By Administration, Wednesday, August 28, 2019

We know that there are serious risks associated with e-cigarette use, including exposure to harmful chemicals, ultrafine particles, heavy metals, and volatile organic compounds. The Centers for Disease Control and Prevention (CDC) is investigating an outbreak of reported cases of severe lung illness that may be related to vaping. A patient in Illinois has died from a severe respiratory illness that may be associated with e-cigarette use, and there have been 193 reported cases, primarily in young adults, reported in 22 states. CDC is working with the Food and Drug Administration, the federal agency responsible for overseeing e-cigarettes, and state officials to gather more information on the devices and substances used by the patients.

CDC Director’s Statement on the first death related to the outbreak of severe lung disease in people who use e-cigarette or “vaping” devices

CDC, FDA, States Continue to Investigate Severe Pulmonary Disease Among People Who Use E-cigarettes

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NACDD Submits Comments on Proposed Changes to Discrimination Protections

Posted By Administration, Wednesday, August 28, 2019

Section 1557 of the Affordable Care Act prohibits covered health care providers and insurers from discriminating against anyone based on race, color, national origin, sex, age, or disability. Additional regulatory language expanded the definition of discrimination based on sex to include discrimination based on gender identity. In addition, the current regulations require covered entities to inform people with limited English proficiency about language assistance services using taglines provided in the top 15 languages spoken in their state.

On May 24, 2019, the Office of Civil Rights in the Department of Health and Human Services issued a proposed rule that would make substantial revisions to Section 1557 by eliminating the regulatory definition of sex discrimination and removing the prohibitions on discriminating based on gender identity. The proposed rule would also eliminate requirements around providing non-English taglines.

NACDD submitted comments on the proposed rule to bring attention to the affect these changes would have on barriers to preventive care as well as ensuring equitable access to health care. All people should have access to preventive health care services in order to prevent the development of chronic disease, and these changes will negatively impact the ability of vulnerable populations to get the preventive care they need.

NACDD and our Members are dedicated to identifying and working together with vulnerable and at-risk populations and creating and maintaining conditions that allow everyone to reach their full health potential. NACDD remains committed to ensuring broad and equitable access to programs and services that promote health. 

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Federal Appropriations Update

Posted By Administration, Wednesday, August 28, 2019

After returning from August recess on Sept. 9, Congress will have three weeks to pass 12 appropriations bills or a continuing resolution before government funding runs out on Sept. 30. Last month, both chambers of Congress passed the Bipartisan Budget Act of 2019 which raises the caps for discretionary spending for two years, provides funding for the Census, and suspends the debt limit until July 31, 2021. This legislation also ends sequestration on discretionary spending permanently. The passage of this budget deals sets the stage for the ongoing appropriations process.

The House of Representatives has passed 10 appropriations bills including the Labor, Health and Human Services, and Education bill which provides funding for the CDC. The Senate Appropriations Committee has yet to pass any appropriations bills and will spend September holding markups. As the process continues, NACDD will continue to work with members of Congress to address our funding requests.

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Diabetes Council Welcomes New Leadership

Posted By Administration, Wednesday, August 28, 2019

For more than 30 years NACDD’s Diabetes Council has provided leadership, learning, and networking opportunities for staff in State Health Departments working in diabetes prevention and management. The Diabetes Council includes about 260 participants and is governed by the Leadership Group, which is elected by Members. The Leadership Group identifies issues that are important to their colleagues in other states and work with each other, NACDD, and CDC representatives to discuss state and national issues and how best to support states with information and learning opportunities. The Leadership Group sponsors webinars, peer learning opportunities, and information on emerging topics. Their latest product is an introduction to working with Third Party Organizations (TPO). The document discusses what a TPO does, and how they can assist community-based organizations offering the National Diabetes Prevention Program with administrative and programmatic needs.

Learn more about the Diabetes Council and how to get more involved. State staff managing a project, providing evaluation, or working on any diabetes strategies are eligible to run for a position in the Diabetes Council Leadership Group. Become active now and prepare for spring elections!

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NACDD’s Inclusive Healthy Community National Pilot Project Nearing Its End

Posted By Administration, Monday, July 29, 2019

Almost four years ago, NACDD received funding from the CDC Disability and Health Branch to launch a national pilot project to make healthy choices the easy choices for people in areas where they live, learn, work, play, pray, and receive care – with a principle focus on disability inclusion. Through this Reaching People with Disabilities through Healthy Communities project, NACDD funded the five state Disability and Health Programs of Iowa, Montana, New York, Ohio, and Oregon and two communities from each of those states to receive training, technical assistance, and resources to achieve new policies, systems, or environments (PSE) that increase access and opportunity for healthy living behaviors, such as healthy eating, physical activity, tobacco prevention and reduction, and general accessibility and inclusion improvements.

State and community grantees were guided through a proven five-phased healthy community model by the NACDD Project Team to navigate the healthy community change process on the local level. Each community was paired with a State Expert Advisor, who provided state specific disability and health expertise to Community Coaches and coalitions throughout the entire project period. PSE strategies targeted the five community sectors of community-at-large (CAL), community institutions and organizations (CIO), schools, healthcare, and worksites.

With this year’s funding, the NACDD Project Team is focusing on broadly sharing the successes and lessons learned from this project in hopes to inspire other states and communities to integrate a focus on disability inclusion with their local and state healthy community efforts. To do this, NACDD and the state and community participants are implementing a number of communication and dissemination activities together, such as social media messaging, developing written testimonials, podcasts, recreating project webpages, presenting at conferences, submitting for publications, and developing new video success stories. 

NACDD is partnering with Rocket Camp to develop four new video success stories to showcase new project successes achieved within the last year. The four communities that were selected for the video success stories were Carroll County, Iowa, Sioux City, Iowa, Butte, Montana, and Helena, Montana. Below is a sneak peek at the soon-to-be-released video stories:

·      In Carroll County, Iowa, people with intellectual and developmental disabilities now have designated exercise time with certified personal trainers at a local fitness center, and construction of a new inclusive playground at Northeast Park is now underway.

·      In Sioux City, Iowa, Cone Park visitors now have winter and summer activity options with the creation of accessible sledding and ice rink in the winter, and an accessible splash pad in the summer.

·      In Butte, Montana, the new accessible pool and all-abilities playground is now open and serves as the main attraction at Stodden Park by park goers of all ages and abilities. The accessible pool is complete with zero entry options for wheelchair users, as well as features a lazy river, water slides, and a water park for kids of all ages. The all-abilities playground features multiple playgrounds for various ages of children and includes onsite exercise stations for adults. Another new Stodden Park feature includes recent updates to the park’s carousel, which now features new accessibility components so wheelchair users can participate in riding the carousel.

·      In Helena, Montana, a new inclusive employee workgroup was established at the Lewis and Clark Health Department, where local health department employees are now integrating new PSE changes that are inclusive to persons with disabilities who either work at, or are serviced by, the local health department.

The NACDD Project Team is currently reviewing all final PSE outcomes from the five states and 10 local communities, as well as reconstructing this project’s webpage on the NACDD website. Stay tuned for our release of the final project reports and the new project page!

For more information on how to integrate disability inclusion into your state or community efforts, please contact NACDD’s Project Lead Karma Harris at

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Wrapping Up Another Successful Walkability Action Institute Year

Posted By Administration, Monday, July 29, 2019

NACDD, with funding support from the CDC Division of Nutrition, Physical Activity, and Obesity (DNPAO), implemented the 5th Annual Action Institute to Increase Walking and Walkability in Decatur, Georgia on April 22 – 25, 2019. Referred to as the Walkability Action Institute (WAI), this multi-day course was implemented for 10 new, interdisciplinary teams who received expert faculty instruction from some of the nation’s most renowned leaders in public health, planning, advocacy, development, disability inclusion, and transportation and community design. The course included amazing keynote presentations, and experiential learning activities such as outdoor inclusive walk audits and scavenger hunts – all to assist attending teams with developing a Team Action Plan of their own respective walkability related strategies to pursue.

The 2019 cohort of teams includes the following locations, who competitively applied for and received travel stipends to attend this year’s course:

1)    Broward County, FL

2)    Clackamas County, OR

3)    Daytona, FL

 4)    Lane County, OR

5)    Larimer and Weld Counties, CO

6)    Marshall County, IN

7)    Maui, HI

8)    Montgomery County, PA

9)    Northwest VT

10) Spokane, WA

This year’s cohort of teams now marks 51 total teams who have participated across the five-year project period to make lasting PSE changes promoting improved environmental design, municipal policy structure, and systems improvements to improve active transportation. To date, an estimated 500 related changes have reached more than 20,000,000 people across the nation. 

For more information on NACDD’s WAI efforts, please visit NACDD’s WAI project page or contact NACDD’s Project Lead, Karma Harris, at

 PHOTO: WAI course faculty member Karin Korb leads participants through an outdoor walk audit activity in Decatur, GA.

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GEAR Groups Publish Accelerating Population Health

Posted By GEAR groups, Monday, July 29, 2019

NACDD is pleased to release Accelerating Population Health: Recommendations for Action, Resources, and Case Stories from the 2018 NACDD GEAR GroupsThis document is a compilation of resources shared through 2018 NACDD Generate, Educate, Activate, and Respond (GEAR) Groups, which focused on Accelerating Population Health.

GEAR Groups are NACDD’s professional development and leadership offering designed to provide peer-to-peer learning on various strategies that influence the health of populations. The 2018 GEAR Groups worked collectively across four domain areas and on the topic of health equity to draft these resources during their discussions over a six-month period. Additionally, the group developed a statement on population health that is provided along with recommendations for action, resources, and a series of case studies illustrating how State Health Departments are applying strategies to accelerate population health. Each case study highlights the actions, impact, challenges, successes, and includes contact information for the individuals implementing these promising population health practices. The document closes with a brief call to action and acknowledges the exceptional work of the 2018 GEAR Group members. State, Local, and Territorial Health Departments are encouraged to use this document as a guide for implementing promising or innovative population health strategies.  

 The 2018 NACDD GEAR Group focus on “Accelerating Population Health” was inspired by the CDC Preventing Chronic Disease article “Public Health 3.0: A Call to Action for Public Health to Meet the Challenges of the 21st Centuryand former NACDD Board President’s challenge to all Members to “Accelerate Population Health.” Improving population and public health outcomes require enhanced collaboration across public health, the healthcare delivery system, and the broader community.  

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NACDD Submits Comments on Lower Health Care Costs Act (S. 1895)

Posted By Administration, Monday, July 29, 2019

Chronic diseases account for 86% of health care costs in the United States. Investing in prevention methods will increase Americans’ quality of life, as well as decrease the trajectory of health care spending. The pressing issue of chronic disease and cost-effective preventive measures to avert such diseases should be part of any discussion about reducing health care costs.

On June 19, 2019, Senator Lamar Alexander (R-TN) and Senator Patty Murray (D-WA) introduced the Lower Health Care Costs Act (S. 1895), a bipartisan package of legislation intended to address factors driving health care costs. The legislation includes a provision on public health and chronic disease, specifically a section on evidence-based strategies for State Health Department obesity prevention programs.

NACDD submitted comments on the legislation, and as a result of NACDD’s comments, the Senate Health, Education, Labor & Pensions Committee changed the bill’s language to better reflect the work Chronic Disease Units are doing to prevent and reduce obesity. NACDD looks forward to continuing to work with members of Congress to address public health and health care policy issues.

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