Health is impacted by the policies, systems and environments in which we live and function from day to day.Our communities, schools and worksites all have an impact on the access we have to a healthy lifestyle.Public health can have a large role in creating environments that make healthy lifestyle choices the easy, safe and default choice through policy, systems, and environmental changes.
In “A Framework for Public Health Action:The Health Impact Pyramid,”* Thomas R. Frieden, MD, MPH, director of the Centers for Disease Control and Prevention, illustrates how socioeconomic (i.e., income, education) factors can impact an individual’s health.The risk factors that most greatly impact a community and individual’s health can be lessened through policy, systems, and environmental interventions.Dr. Frieden uses the Health Impact Pyramid to demonstrate the effectiveness of intervention strategies:
Policy, systems, and environmental changes have the most widespread impact; they are represented in the two lower layers of the pyramid, where healthy choices become more accessible, easier, and the defaulted choice for individuals.Although the top three tiers of the pyramid are still important in preventing and managing chronic disease, they require larger effort from the at-risk individual to be effective. Policy interventions may take the form of a law, an ordinance, a resolution, a mandate, a regulation, or a rule (either formal or informal). Examples:
Legislative policies:taxes on tobacco products, provision of county or city public land for farmers' markets, or smoke-free laws
Organizational policies:menu labeling in restaurants, comprehensive healthcare plans, or a human resources policy that requires healthy foods to be served at meetings
Systems interventions are changes that impact all areas of an organization, institution, or community. Examples:
schools, transportation, parks and recreation
Environmental interventions involve physical changes to the economic, social, or physical environment. Example:
designing communities in which sidewalks, paths, and recreational areas are safe and easy to use
MCC Cancer Advocacy Toolkit www.michigancancer.org/Resources/CancerAdvocacyToolKit.cfm
This tool kit, developed by the MCC Advocacy Committee, includes a variety of resources, including: cancer facts; information on basic legislative and appropriations processes; guidelines on how to communicate effectively; and links to Internet resources of interest.
Centers for Disease Control and Prevention (CDC) — Communities Putting Prevention to Work: MAPPS (Media, Access, Point of decision, Price, Social support/services) Strategies
www.cdc.gov/CommunitiesPuttingPreventiontoWork/strategies/index.htm
Using a list of evidence-based strategies to design a comprehensive and robust set of strategies, Communities Putting Prevention to Work communities are expected to improve health outcomes with sustainable effects on policy, systems, and the environment.
CDC — Healthy Communities Program Success Stories www.cdc.gov/healthycommunitiesprogram/success_stories/index.htm
This free online
tool is designed to help to help users turn their successes into strong, professional, polished
stories that can engage Congress, community leaders, and other decision
makers in their policy, systems, and environmental change strategies. The site, which is accessible to CDC Healthy Communities Program grantees, as well as the public, collects stories illustrating the real-world impact of implementing policies that sustain environmental and systems changes that address the major risk factors of tobacco, physical inactivity, and unhealthy eating. Among its resources: an easy-to-use tool to help users develop their stories; guidance on how to write a success story; a downloadable worksheet to begin the pre-writing process; three professionally developed templates to share with stakeholders; a free photo library; and an archive of success stories that users can search and share.
Demonstrating Capacity of Comprehensive Cancer Control Programs to Implement Policy and Environmental Cancer Control Initiatives
The Michigan Department of Community Health (MDCH) Cancer Prevention and Control Section is working to implement policy and environmental changes for primary, secondary and tertiary cancer prevention strategies through funding from the Centers for Disease Control and Prevention.The policy interventions are focused at community, organizational and state levels to:
decrease tobacco use;
improve physical activity and nutrition;
increase screening rates for breast, cervical and colorectal cancers; and
improve survivorship programming to reduce the risk of recurrent or new cancers.
The interventions are defined by the following three current projects and collaborations.
Primary Prevention:
The MDCH Cancer Section has collaborated with the MDCH Cardiovascular Section and its Building Healthy Communities
The MI Healthy Communities Program is comprised of several nationally recommended initiatives and aims to improve the health of our residents, the viability of our communities, and the productivity of our work force. The primary goal of the program is to reduce chronic diseases by increasing physical activity, healthy eating, and tobacco-free environments.
As a result of the efforts of our partners and programs, Michigan is experiencing an increase in trail expansions and enhancements, park upgrades, bike lanes, sidewalks, walking paths, farmers markets, community and school gardens, fruit and vegetable availability in corner stores and food emergency assistance locations, and tobacco-free outdoor environments. These positive changes make it easier for residents to be physically active daily for recreation and transportation, to access fruits and vegetables, and to be in smoke-free environments indoors and outdoors.
Secondary Prevention:
The Michigan Cancer Consortium Challenge
The Michigan Cancer Consortium Challenge has begun as a pilot project of 10 organizations that are assessing their health care benefits and employee policies.
The organizations have dedicated human resources staff that is committed to changing policies within the organization, including working with their benefit plan providers, in order to create a healthier and more productive workforce through comprehensive worksite wellness strategies that include increasing cancer screening rates.
The model standard for worksite wellness is for an organization to be accredited by the CEO Cancer Gold Standard, which consists of five pillars of wellness: tobacco use; diet and nutrition; physical activity; cancer prevention, screening and early detection; and access to quality cancer treatment and clinical trials.
The goal of this project is to create systems changes to increase the number of oncology practices that provide survivorship care plans — including screening recommendations — to patients upon their discharge from cancer treatment.This is to reduce the risk of recurrence and diagnosis of additional cancers. The MDCH Cancer Section has spoken with representatives of national organizations that are also trying to accomplish this goal. They include:
*Please Note: You will need Adobe Acrobat Reader to open, view and print this file once it has been downloaded. If you need a free copy of Adobe Acrobat Reader, please click here.
