CDC's Winnable Battles: Improved Nutrition, Physical Activity, and Decreased Obesity

I n fall 2010, the CDC, under Director Dr. Tom Frieden’s leadership, identified six domestic winnable battles based on the magnitude of the public health burden and the ability to accelerate progress by expanding evidence-based practice. Nutrition, physical activity, and obesity along with food safety was identified as one of those battles in addition to human immunodeficiency virus, healthcare-associated infections, teen pregnancy, tobacco, and motor vehicle injuries. Since that time, the CDC has established 5-year goals, performance measures, and strategic plans for each winnable battle. Each battle area has identified optimal strategies and a process to leverage resources and partnerships to accelerate a measurable impact on health. CDC’s current battle plan for nutrition, physical activity, and obesity focuses on working with partners in (1) improving maternity care practices to support women who choose to breastfeed, (2) reducing artificial transfat in the food supply, (3) reducing sodium in the food supply, (4) reducing consumption of calories from added sugars, and (5) improving the food, beverage, and activity environments of child care centers, schools, workplaces, and communities. Many of these focus areas and targets are also consistent with the nation’s Healthy People 2020 objectives. Winnable battles have a special set of operational processes at the CDC. Leadership in the Office of the Director meet quarterly on each battle area to review progress, solve roadblocks, and accelerate progress through the involvement of senior offices, such as policy, communications, and science. Responsible Divisions provide monthly updates on their plans and progress. Most important, the CDC works to support progress through health departments and the broader public health community. Some state and local health departments have also chosen Winnable Battles. For example, the Health and Human Services Agency for San Diego County, California, has also identified nutrition, obesity, and physical activity as a winnable battle and utilized local data to assess burden and priority action, and the Colorado Department of Public Health and Environment has identified 10 winnable battles, including nutrition, physical activity, and obesity. Colorado’s specific strategies to fight this battle include the following: providing businesses with tools for creating incentives and welcoming environments for employees to be healthy and physically active; promoting best practices for schools to provide daily physical activity, adopt nutrition guidelines, and partner with farmers to serve fresh produce in meals; encouraging healthcare professionals to adopt Obesity Guidelines to provide healthy lifestyle advice to patients; and partnering with communities to design streets and neighborhoods to include bike paths and sidewalks and convenient linkages to parks, schools, grocery stores, and community gathering places. Many health departments across the nation include nutrition, physical activity, and obesity as priorities for their work, and the CDC supports these efforts through technical assistance and funding. Current support for state health department work on obesity prevention and control is housed within a new 5-year program that integrates work across diabetes, heart disease, obesity, and school health. The new program, called ‘‘State Public Health Actions to Prevent and Control Diabetes, Heart Disease, Obesity and Associated Risk Factors and Promote School Health,’’ has a first-year investment of $68 million and provides basiclevel funding to all states and enhanced funding to 32 states. This will be the first time that all 50 states and Washington, DC have a 5-year program that includes coordinated school health and nutrition, physical activity, and obesity strategies to support prevention. In addition, CDC support for community-level programs has included Communities Putting Prevention to Work (2010–2013), the Racial and Ethnic Approaches to Community Health (REACH) National Networks, the REACH Obesity and Hypertension Demonstration Projects, and the Community