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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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CEO Message - February Impact Brief

Posted By Stacey Evans, Saturday, February 29, 2020
Updated: Friday, February 28, 2020

NACDD has been a proud national partner of Million Hearts® since 2012, supporting efforts to improve outcomes for people with or at risk for cardiovascular diseases, which account for one in every three deaths in the United States.


This month, American Heart Month, we are excited to help launch the Million Hearts® Hospitals & Health System Recognition Program, which acknowledges institutions working to systematically improve the cardiovascular health of the population and the communities they serve.


NACDD has been working collaboratively with CDC to develop this program, and we invite our Members to help spread the word to hospitals and health systems in their communities, encouraging them to apply and join us in promoting their commitments and outcomes in cardiovascular health. You can learn more about this program at


In addition to our work with Million Hearts®, our Cardiovascular Health (CVH) team has a robust portfolio that supports implementing evidence-based, population health improvement strategies and capacity-building opportunities for health departments. Here are a few other ways we are helping promote heart health:


EHR-based Surveillance Learning Community: This monthly series for health departments and their potential data partners helps build chronic disease surveillance capabilities. The March session will highlight governance policies and procedures to consider when engaging in EHR-based surveillance. Register>>


GIS Capacity Building Project: This project includes GIS training, ongoing support from expert GIS analysts, development of tools to support mapping at the local level, and networking. Four county health departments in Maryland—Calvert, Charles, Prince George’s and St. Mary’s—were selected for the 2020 GIS Training for the Surveillance of Heart Disease, Stroke and Other Chronic Diseases in Local Health Departments program. State Health Departments participating in the 2019-2020 state training are Connecticut, Louisiana, Rhode Island, and Utah. Learn more >>


Pharmacy Learning Collaborative: The Advancing Pharmacy-Related Interventions to Control Hypertension and Manage Cholesterol Learning Collaborative focuses on innovative team-based approaches to hypertension control and cholesterol management. Staff from the State Health Departments of Colorado, Georgia, Missouri, Texas, and Virginia were selected to participate. The results will be disseminated through a fireside chat in September 2020. Learn more >>


SMBP PROJECT: NACDD and CDC commissioned a national analysis of self-measured blood pressure monitoring (SMBP) coverage and reimbursement policies within public and private payer insurance across the United States. Read the reports attached below.


PARTNERSHIP: NACDD has joined the National Hypertension Control Roundtable® (NHCR) as a founding member. The NHCR is a public, private and nonprofit partnership dedicated to improving national hypertension control rates from ~50% to 80% and reducing disparities in hypertension control by 2025. Learn more >>


Learn more about our programs and how we can support your work in cardiovascular health at I encourage you to also sign up for Off the Cuff, a weekly informative newsletter for health department staff working on cardiovascular health-related strategies. Email to get on the list.


Together, we can help prevent heart attacks and strokes, and improve the health of the population through the use of cost-effective, proven strategies. 

 Attached Files:

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New Toolkit to Enhance Vision and Eye Health

Posted By Carol McPhillips-Tangum, Tuesday, February 25, 2020
Updated: Friday, February 21, 2020

Vision health is critically important for all aspects of a person’s life, including physical health, social engagement, education, employment, and socioeconomic position. Reduced vision affects a person’s ability to perform daily activities and increases a person’s risk for developing other health problems and premature death. It can also cause economic stress on individuals and society from direct medical expenses and indirect expenses related to loss of mobility and productivity. Vision health is rarely included in public health programs designed to prevent or manage chronic diseases because of limited resources and competing priorities and, as a result, most public health agencies lack the framework or guidelines they need to appropriately address vision and eye health as a public health issue.


A new toolkit is available to build the capacity of public health agencies and their partners to assess the burden of vision impairment, develop effective partnerships, implement appropriate interventions, and evaluate the impact of their efforts.

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NEI’s New Website Puts Eye Health Info at Your Fingertips

Posted By Administration, Tuesday, February 25, 2020
Updated: Friday, February 21, 2020

The National Eye Institute’s (NEI) new website makes it easier than ever to find eye health information you can trust. The updated NEI site features easy-to-read information about chronic eye conditions and accessible resources that health directors can use to promote healthy vision.


NEI’s redesigned website is your one-stop shop for clear, accessible eye health information. Take a look at NEI’s A to Z index of eye conditions and diseases! It includes information on chronic eye conditions such as diabetic retinopathy, glaucoma, and dry eye.


NEI also has helpful resources for health educators, including toolkits that you can use to teach people in your community about topics like:

·  Diabetic eye disease

·  Vision and Aging

·  Low vision



You can also find materials that will help patients better understand their eye health in NEI’s outreach materials library. This includes materials on topics that may be particularly helpful to chronic disease directors, like:

·  Talk With Your Doctor About Glaucoma

·  Vision Rehabilitation: Helping People with Low Vision

·  The Aging Eye: Age-Related Diseases and Conditions


You can filter outreach materials by health topic, language, audience, or type of material — and best of all, it’s free!


NEI also has toolkits you can use to reach out to groups that have a high risk of eye diseases — like Hispanic/Latino communities. NEI’s ¡Ojo con su vision! program provides culturally-appropriate materials about eye health for Spanish-speaking communities — including eye health tips, questions to ask the eye doctor, and information on specific eye diseases.


African Americans are also at a higher risk of developing some eye conditions. NEI’s Write the Vision program provides materials you can use to promote healthy vision in African American communities such as infographics, articles, slides, and fact sheets.


Take a moment to explore these resources on the new and improved NEI site — and use them to help the public learn how to keep their eyes healthy!

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New 2020 Physical Activity and Nutrition (PAN) State Engagement Model (StEM) States Selected

Posted By Ann Forburger, Tuesday, February 25, 2020
Updated: Friday, February 21, 2020

Congratulations to the states of Hawai’i, Iowa, Vermont, and Wisconsin who successfully competed for the 2020 Physical Activity and Nutrition State Engagement Model (PAN StEM) request for technical assistance.


Through technical assistance support, NACDD and a team of subject matter experts will assist state teams in activating and sustaining multi-sector collaboration to address a priority public health issue around physical activity, nutrition, or obesity. 


NACDD provides peer networking and leadership opportunities to state contacts, which culminates in a strategic meeting with multi-sector state partners. States work through a collective impact approach, including discussions on a common agenda, shared measurement, mutually reinforcing activities, continuous communications, and backbone support.


·      Hawai’i will focus on solidifying the infrastructure in their state to support the wide-ranging needs of early childhood education (ECE) providers to implement the ECE Wellness Guidelines and provide a safe and healthy future for children.

·      Iowa will strengthen its strategies targeting school and youth programs.

·      Vermont will continue to support PAN health equity initiatives by focusing on Vermont residents with disabilities and maintain working with people of color, LGBTQ+, and low-income residents.

·      Wisconsin will leverage other initiatives and programs to support PAN activities, specifically SNAP-Ed, Tobacco Prevention, and the new Governor’s Healthy Communities Initiative.


For more information, contact Ann M. Forburger at

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State Health Departments Selected to Participate in 2020 NACDD Pharmacy Learning Collaborative

Posted By MaryCatherine Jones, Tuesday, February 25, 2020
Updated: Friday, February 21, 2020

NACDD congratulates staff from the health departments of Colorado, Georgia, Missouri, Texas, and Virginia for their selection as participants in the Advancing Pharmacy-Related Interventions to Control Hypertension and Manage Cholesterol Learning Collaborative. The intent for this unique learning opportunity is to support the priorities of 1817 by focusing on innovative team-based approaches to hypertension control and cholesterol management. These approaches include medication therapy management, the appointment-based model, and other tools and resources to increase medication adherence.


One cardiovascular disease prevention staff person from each health department will participate with up to two pharmacy partners to participate in expert-led virtual meetings and peer exchange. Participating pharmacy partners include those working in local colleges of pharmacy, state pharmacy associations, and quality improvement organizations.


The Learning Collaborative is designed to designed to accelerate team-based care by applying the Identify-Assess-Act Framework. This framework aims to identify and engage with payers, pharmacies, and/or the community to increase pharmacy-based interventions for hypertension control and cholesterol management. The teams participated in a kickoff call Feb. 4, 2020 and will continue work on the project through July 2020, with an in-person meeting in May/June 2020. The results and lessons learned from this project will be disseminated through a fireside chat in September 2020.

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Million Hearts® Hospitals & Health Systems Recognition Program Now Accepting Applications

Posted By Administration, Tuesday, February 25, 2020
Updated: Friday, February 21, 2020

Heart disease, stroke, and other cardiovascular diseases (CVDs) kill more than 800,000 Americans each year, accounting for 1 in every 3 deaths. CVD is the nation’s number one killer among both men and women and the leading cause of health disparities across the population.

Fortunately, we know that improving outcomes for people with or at risk for CVD is achievable. Million Hearts® is pleased to announce the Million Hearts® Hospitals & Health Systems Recognition Program, a program that recognizes institutions working to systematically improve the cardiovascular health of the population and communities they serve through the priority areas of (1) keeping people healthy, (2) optimizing care, (3) improving outcomes for priority populations, and (4) innovating for health. 

Eligible applicants include health systems with multiple hospitals, hospitals with and without ambulatory medical practices, and medical practices not affiliated with hospitals.

The Million Hearts® Hospitals & Health Systems Recognition Program is now open. Applications received by April 30, 2020, will be among the first to be considered and to be eligible for this designation. Applications will be reviewed and considered on a quarterly basis.


NACDD has been working collaboratively with CDC in the development of this program. Using recognition as a tool, chronic disease public health professionals will be better informed of the small set of high impact strategies needed to prevent heart attacks and strokes. We are excited about this launch and encourage our Members to help spread the word to hospitals and health systems in their communities, encourage them to apply, and to join us in promoting their commitments and outcomes.


For more information about the program, or to apply, visit Questions about the program should be directed to, with “Million Hearts® Hospitals & Health Systems” in the subject line.


Together, we can improve the cardiovascular health of the population, preventing heart attacks and strokes, through the use of cost-effective, proven strategies. 

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January CEO Message

Posted By Administration, Tuesday, January 28, 2020
Updated: Thursday, January 23, 2020
Earlier this month, we hosted our fourth annual Public Health Success Showcase, “Elevating Public Health to Social Health – Establishing Multisectoral Partnerships to Impact the Root Causes of Chronic Disease.” 
The event included a poster session featuring more than 60 projects from NACDD’s program portfolio and a live-streamed Fireside Chat with Dr. Karen Hacker, Director of CDC’s National Center for Chronic Disease Prevention and Health Promotion; Gov. Mike Leavitt, Founder of Leavitt Partners, former Secretary of Health and Human Services and former Governor of Utah; NACDD Board President Monica Morales, the Deputy Director for the Center for Healthy Communities at the California Department of Public Health; and Susan Winckler, President of Leavitt Partners Solutions, who served as moderator. 
This Showcase’s topic is especially important, because as this country continues to struggle with improving population health—from sedentary behavior, to less nutritious foods, to vaping—we also face challenges and inequalities in housing, transportation, education, and wages. 
The panel shared insights on how local and federal government can work together in the new era of value-based care to respond to the needs of our communities, and our poster session demonstrated the continuing, critical work being accomplished at the state and territorial level to create healthier communities.
Through our growing body of hundreds of projects, we are intensifying our reach and our impact, with military communities, an Obesity Prevention summit, and multiple thought-leader roundtables around forward-thinking topics. 
We also are using data like never before. We have new projects and new partners that have catapulted our ability to collect and leverage data to speed, track, and evaluate change. [Read Gov. Leavitt’s article “Examining Data and Value-Based Care” in our Insights magazine].
This expanded work is powered by deep partnerships at the state and federal level, across government agencies, and within industries, to implement effective strategies that improve the health of the public.
As Gov. Leavitt is fond of saying, “This is public health’s moment”— and at NACDD, we couldn’t agree more. 

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Trump Administration Vaping Ban

Posted By Administration, Tuesday, January 28, 2020
Updated: Sunday, January 26, 2020

On January 2, 2020, the Trump Administration announced a partial ban on flavored e-cigarettes. The ban applies to flavored e-cigarettes that use cartridges but does not include “open tank e-cigarettes” that are often sold in vape shops. The ban also exempts menthol and tobacco flavored products.

The ban falls short of earlier signals from the administration that indicated the Department of Health and Human Services would ban all flavors, except tobacco. The Trump Administration has said that the ban was scaled back due to concerns about job losses and other negative effects that a total ban might have on the vaping industry. In addition, administration officials have justified continuing to allow menthol products because research has shown that while mint flavored products are very popular with youth users, menthol products are not. Public health experts have expressed concerns that if menthol products continue to stay on the market youth e-cigarette users will substitute menthol products once the popular mint-flavored pods are no longer available.

After the announcement, NACDD put out a statement calling for stronger action by the Food and Drug Administration and a full ban on flavored e-cigarettes.

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FY 20 Appropriations Update

Posted By Administration, Tuesday, January 28, 2020
Updated: Sunday, January 26, 2020

The fiscal year 2020 (FY20) federal funding agreement was signed into law on December 20, 2019 and provides funding for the government through September 30, 2020. The agreement comes after months of negotiations and two continuing resolutions that pushed the appropriations process well passed the October 1, 2019 deadline.

The funding agreement includes an overall 8.7% increase for the Centers for Disease Control and Prevention (CDC). To address chronic disease, the bill includes increases for:

·      Alzheimer’s

·      Breast and cervical cancer

·      Heart disease and stroke prevention

·      National Diabetes Prevention Program

·      Oral health

·      Tobacco control


The deal also includes a provision that increases the legal age to purchase tobacco products, including e-cigarettes, to 21.

The FY21 process will kick-off when President Trump submits his budget to Congress. The Trump Administration has announced the budget will be submitted by February 10, 2020. After Congress receives the President’s budget, work will begin on crafting a congressional budget and eventually appropriations legislation that will provide funding for FY21.

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Integrating Alzheimer’s’ Messages into Chronic Disease Programs

Posted By Leslie Best, Thursday, January 23, 2020

The Alzheimer’s Disease and Healthy Aging Program at the Centers for Disease Control and Prevention (CDC) hosts the Healthy Brain Initiative (HBI). HBI provides data, information, and education to promote brain health, including information on Alzheimer’s disease and related dementias. Alzheimer’s disease is currently the fifth leading cause of death for persons over the age of 65. HBI applies principles, strategies, and expertise to promote public health actions related to brain health, Alzheimer’s disease, and caregiving. This work is guided by The Healthy Brain Initiative State and Local Public Health Partnerships to Address Dementia, The 2018-2023 Road Map.

NACDD is working in partnership with CDC to develop integrated messaging about brain health by adapting existing chronic disease risk reduction messages. This includes information about how behaviors related to these topics can also reduce the risk for cognitive decline. This purpose is consistent with the call to action in the most recent version of the Healthy Brain Initiative Roadmap, which is to integrate best available evidence about brain health and cognitive decline risk factors into existing health communications that promote health and chronic disease management for people across the lifespan.

This project focuses on integrating messages in five focus areas:

·      Heart health

·      Diabetes

·      Tobacco

·      Nutrition

·      Physical activity

NACDD and CDC have collaborated to identify subject matter experts in the field of Alzheimer’s disease and health communications to provide input and guidance on risk reduction messages that include information about brain health.

Alzheimer’s disease and related dementias have both social and economic impacts. According to the Alzheimer’s Association, 5.8 million Americans are living with Alzheimer’s Disease; by 2050 this number is expected to increase to 14 million. In 2019, Alzheimer’s and other dementias will cost the US $290 billion; these costs could reach $1.1 trillion by 2050.

NACDD and CDC together developed the State of Aging and Health in America Data Brief, Subjective Cognitive Decline: A Public Health Issue. This brief analyzed data from the Behavioral Risk Factor Surveillance System on the self-reported worsening or more frequent confusion or memory problems — known as subjective cognitive decline (SCD) — in adults 45 years of age and older from 2015–2017. These data showed that the prevalence of SCD is 11.1%, or 1 in 9 adults. The prevalence of SCD among adults aged 65 years and older is 11.7% compared to 10.8% among adults 45–64 years of age. The prevalence of SCD differs among racial/ethnic groups: 10.9% of non-Hispanic white adults reported SCD compared to 12.8% of black adults, and 11.0% of Hispanics, and 6.7% of Asians and Pacific Islanders.  Lower prevalence of SCD is reported in adults with more years of formal education.

For more information, visit the NACDD Healthy Aging website To learn more about the CDC Healthy Brain Initiative, visit

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