Health promotion and disease prevention are central priorities in the Centers for Disease Control and Prevention (CDC) vision. To advance research in these areas, Congress authorized and CDC established a program of university-based Centers for Research and Demonstration of Health Promotion and Disease Prevention to explore improved ways of appraising health hazards and to serve as demonstration sites for new and innovative research in public health. Begun in 1986 with three centers, there are now fourteen. In response to a CDC request to evaluate the program, Linking Research and Public Health Practice examines the vision for the prevention research centers program, the projects conducted by the centers, and the management and oversight of the program. In conducting the evaluation, the IOM committee took a broad view of how prevention research can influence the health of communities, and considered both the proximal risk factors for disease prevention and the more distal conditions for health promotion and improved equity in the distribution of risk factors. Month?
For over half a century, the CDC Yellow Book has been a trusted resource, providing international travelers and clinicians with expert guidance for safe and healthy travel abroad. Along with disease-specific prevention and treatment recommendations, this comprehensive reference text provides readers with the background and context needed to understand and address health threats associated with all types of international travel. FEATURED IN THIS EDITION: · Precautions for international travelers during the coronavirus disease 2019 (COVID-19) pandemic, including links to updated information on related CDC and US government websites · Updates on practicing travel medicine in a virtual environment · New standalone vaccine tables for bacterial and viral diseases with links to the relevant Advisory Committee on Immunization Practices and US FDA websites · Safe international travel with pets and service animals · Advice for obtaining healthcare abroad including guidance on different types of travel insurance · Guidelines for self-treating common travel conditions including altitude illness, jet lag, motion sickness, and travelers' diarrhea · Detailed maps showing the distribution of travel-associated infections and diseases, including dengue and meningococcal meningitis · Country-specific mosquito avoidance, yellow fever vaccine, and malaria prevention recommendations · Food and drink precautions, plus updated water-disinfection techniques · Expanded content on safe international travel for specific groups including: LGBTQ+ individuals, highly allergic travelers, travelers with substance use issues, and medical tourists · Specialized recommendations for non-leisure travelers, study abroad, work-related travel, and travel to mass gatherings · Health insights for 14 popular destinations and itineraries in Africa and the Middle East, the Americas and the Caribbean, and Asia · Considerations for newly arrived adoptees, immigrants, and refugees
An up-to-date, definitive guide to staying safe and healthy anywhere in the world. Completely updated for 2018 with expanded guidelines for Zika virus, cholera vaccine, and more.
The National Research Council was asked by the Centers for Disease Control and Prevention (CDC) to review the draft report of the National Cancer Institute (NCI)-CDC's working group charged with revising the 1985 radioepidemiological tables. To this end, a subcommittee was formed consisting of members of the Council's Committee on an Assessment of the Centers for Disease Control and Prevention Radiation Programs and other experts. The original tables were mandated under Public Law 97-414 (the "Orphan Drug Act") and were intended to provide a means of estimating the probability that a person who developed any of a series of radiation-related cancers, developed the cancer as a result of a specific radiation dose received before the onset of the cancer. The mandate included a provision for periodic updating of the tables. The motivation for the current revision reflects the availability of new data, especially on cancer incidence, and new methods of analysis, and the need for a more thorough treatment of uncertainty in the estimates than was attempted in the original tables.
A NEW AND ESSENTIAL RESOURCE FOR THE PRACTICE OF EPIDEMIOLOGY AND PUBLIC HEALTH The CDC Field Epidemiology Manual is a definitive guide to investigating acute public health events on the ground and in real time. Assembled and written by experts from the Centers for Disease Control and Prevention as well as other leading public health agencies, it offers current and field-tested guidance for every stage of an outbreak investigation -- from identification to intervention and other core considerations along the way. Modeled after Michael Gregg's seminal book Field Epidemiology, this CDC manual ushers investigators through the core elements of field work, including many of the challenges inherent to outbreaks: working with multiple state and federal agencies or multinational organizations; legal considerations; and effective utilization of an incident-management approach. Additional coverage includes: � Updated guidance for new tools in field investigations, including the latest technologies for data collection and incorporating data from geographic information systems (GIS) � Tips for investigations in unique settings, including healthcare and community-congregate sites � Advice for responding to different types of outbreaks, including acute enteric disease; suspected biologic or toxic agents; and outbreaks of violence, suicide, and other forms of injury For the ever-changing public health landscape, The CDC Field Epidemiology Manual offers a new, authoritative resource for effective outbreak response to acute and emerging threats. *** Oxford University Press will donate a portion of the proceeds from this book to the CDC Foundation, an independent nonprofit and the sole entity created by Congress to mobilize philanthropic and private-sector resources to support the Centers for Disease Control and Prevention's critical health protection work. To learn more about the CDC Foundation, visit www.cdcfoundation.org.
The definitive reference for travel medicine, updated for 2020! "A beloved travel must-have for the intrepid wanderer." -Publishers Weekly "A truly excellent and comprehensive resource." -Journal of Hospital Infection The CDC Yellow Book offers everything travelers and healthcare providers need to know for safe and healthy travel abroad. This 2020 edition includes: · Country-specific risk guidelines for yellow fever and malaria, including expert recommendations and 26 detailed, country-level maps · Detailed maps showing distribution of travel-related illnesses, including dengue, Japanese encephalitis, meningococcal meningitis, and schistosomiasis · Guidelines for self-treating common travel conditions, including altitude illness, jet lag, motion sickness, and travelers' diarrhea · Expert guidance on food and drink precautions to avoid illness, plus water-disinfection techniques for travel to remote destinations · Specialized guidelines for non-leisure travelers, study abroad, work-related travel, and travel to mass gatherings · Advice on medical tourism, complementary and integrative health approaches, and counterfeit drugs · Updated guidance for pre-travel consultations · Advice for obtaining healthcare abroad, including guidance on different types of travel insurance · Health insights around 15 popular tourist destinations and itineraries · Recommendations for traveling with infants and children · Advising travelers with specific needs, including those with chronic medical conditions or weakened immune systems, health care workers, humanitarian aid workers, long-term travelers and expatriates, and last-minute travelers · Considerations for newly arrived adoptees, immigrants, and refugees Long the most trusted book of its kind, the CDC Yellow Book is an essential resource in an ever-changing field -- and an ever-changing world.
Health risks are real and ever-changing, especially while traveling abroad. To stay abreast of the most up-to-date health recommendations, experienced travelers and health care professionals have always relied on CDC's user-friendly Health Information for International Travel (commonly known as the The Yellow Book) as their one indispensable guide. Updated biennially by a team of almost two hundred experts-including both CDC staff and travel medicine experts--this book is the only publication that contains all of the official government recommendations for international travel. Clearly written and featuring full-color illustrations, the book provides easy-to-read disease risk maps, information on where to find health care during travel, advice for those traveling with infants and children, a comprehensive catalog of diseases, and detailed country-specific health warnings. For example, the section on the Caribbean lays out the recommended immunizations and examines specific health risks for travelers to the region, ranging from malaria to dengue, yellow fever, and traveler's diarrhea. But the book goes beyond the risk of disease to discuss dangers such as violent crime-fortunately, not a great danger to tourists in the area-and also to remind travelers that the single greatest cause of injury death among visitors are traffic accidents. The section on the Caribbean also notes hurricane season and outlines the risks involved in snorkeling, diving, and other water activities common to the area. Every facet of the previous edition has been revisited and revised where necessary, including country-by-country immunization suggestions and new drug information. For the primary care clinician, the specialized travel medicine clinician, or the avid or first-time international traveler, this book is an indispensable safety net, providing readers with everything they need to know to prevent or to seek treatment for illness abroad.
Amid recent changes in global health, the public interest in travelers' safety has never been greater. For both international travelers and the health professionals who care for them, CDC Health Information for International Travel (more commonly known as The Yellow Book) is the definitive resource for preventing illness and injury in a globalized world. This 2016 edition offers the US government's most current health recommendations for travelers to international destinations, including disease risk maps, country-specific guidelines, and vaccine requirements and recommendations. The book also offers updated guidance for specific types of travel and travelers, including: · Precautions for immunocompromised travelers and disabled travelers · Guidance for the pregnant, last-minute, or resource-limited traveler · Health considerations for newly arrived adoptees, immigrants, and refugees · Advice for air crews, humanitarian aid workers, and health care workers traveling to provide care overseas Written by a team of experts at CDC on the forefront of travel medicine, The Yellow Book provides a user-friendly, vital resource for those in the business of keeping travelers healthy abroad.
Designed for health departments, physicians, travel agencies, international airlines, shipping companies & other private & public agencies. Info. on vaccinations required by different countries, prophylaxis & foreign countries' entry requirements, geographical distribution of potential health hazards & how to avoid health problems while visiting foreign countries.
This is a comprehensive resource for travel doctors and individual travellers to consult before, during, and after travel. For the avid or first-time international traveller, this book is a both a prophylaxis and a safety net, providing readers everything they need to know to prevent (and address) illness abroad.
The definitive reference for travel medicine, updated for 2020 "A beloved travel must-have for the intrepid wanderer." -Publishers Weekly "A truly excellent and comprehensive resource." -Journal of Hospital Infection The CDC Yellow Book offers everything travelers and healthcare providers need to know for safe and healthy travel abroad. This 2020 edition includes: � Country-specific risk guidelines for yellow fever and malaria, including expert recommendations and 26 detailed, country-level maps � Detailed maps showing distribution of travel-related illnesses, including dengue, Japanese encephalitis, meningococcal meningitis, and schistosomiasis � Guidelines for self-treating common travel conditions, including altitude illness, jet lag, motion sickness, and travelers' diarrhea � Expert guidance on food and drink precautions to avoid illness, plus water-disinfection techniques for travel to remote destinations � Specialized guidelines for non-leisure travelers, study abroad, work-related travel, and travel to mass gatherings � Advice on medical tourism, complementary and integrative health approaches, and counterfeit drugs � Updated guidance for pre-travel consultations � Advice for obtaining healthcare abroad, including guidance on different types of travel insurance � Health insights around 15 popular tourist destinations and itineraries � Recommendations for traveling with infants and children � Advising travelers with specific needs, including those with chronic medical conditions or weakened immune systems, health care workers, humanitarian aid workers, long-term travelers and expatriates, and last-minute travelers � Considerations for newly arrived adoptees, immigrants, and refugees Long the most trusted book of its kind, the CDC Yellow Book is an essential resource in an ever-changing field -- and an ever-changing world.
A NEW AND ESSENTIAL RESOURCE FOR THE PRACTICE OF EPIDEMIOLOGY AND PUBLIC HEALTH The CDC Field Epidemiology Manual is a definitive guide to investigating acute public health events on the ground and in real time. Assembled and written by experts from the Centers for Disease Control and Prevention as well as other leading public health agencies, it offers current and field-tested guidance for every stage of an outbreak investigation -- from identification to intervention and other core considerations along the way. Modeled after Michael Gregg's seminal book Field Epidemiology, this CDC manual ushers investigators through the core elements of field work, including many of the challenges inherent to outbreaks: working with multiple state and federal agencies or multinational organizations; legal considerations; and effective utilization of an incident-management approach. Additional coverage includes: � Updated guidance for new tools in field investigations, including the latest technologies for data collection and incorporating data from geographic information systems (GIS) � Tips for investigations in unique settings, including healthcare and community-congregate sites � Advice for responding to different types of outbreaks, including acute enteric disease; suspected biologic or toxic agents; and outbreaks of violence, suicide, and other forms of injury For the ever-changing public health landscape, The CDC Field Epidemiology Manual offers a new, authoritative resource for effective outbreak response to acute and emerging threats. *** Oxford University Press will donate a portion of the proceeds from this book to the CDC Foundation, an independent nonprofit and the sole entity created by Congress to mobilize philanthropic and private-sector resources to support the Centers for Disease Control and Prevention's critical health protection work. To learn more about the CDC Foundation, visit www.cdcfoundation.org.
The National Institute for Occupational Safety and Health (NIOSH) requests help in protecting poultry workers from infection with viruses that cause avian influenza (also known as bird flu). Although human infection with avian influenza viruses is rare, workers infected with certain types of these viruses may become ill or die. Some types of avian influenza viruses can cause serious illness or death in poultry and other birds. These viruses are referred to as highly pathogenic viruses. Rarely, these viruses may be passed to humans who contact infected poultry or virus-contaminated materials or environments. All poultry workers and all owners and operators of poultry operations should take the appropriate steps to protect themselves from avian influenza.
For over half a century, the CDC Yellow Book has been a trusted resource, providing international travelers and clinicians with expert guidance for safe and healthy travel abroad. Along with disease-specific prevention and treatment recommendations, this comprehensive reference text provides readers with the background and context needed to understand and address health threats associated with all types of international travel. FEATURED IN THIS EDITION: · Precautions for international travelers during the coronavirus disease 2019 (COVID-19) pandemic, including links to updated information on related CDC and US government websites · Updates on practicing travel medicine in a virtual environment · New standalone vaccine tables for bacterial and viral diseases with links to the relevant Advisory Committee on Immunization Practices and US FDA websites · Safe international travel with pets and service animals · Advice for obtaining healthcare abroad including guidance on different types of travel insurance · Guidelines for self-treating common travel conditions including altitude illness, jet lag, motion sickness, and travelers' diarrhea · Detailed maps showing the distribution of travel-associated infections and diseases, including dengue and meningococcal meningitis · Country-specific mosquito avoidance, yellow fever vaccine, and malaria prevention recommendations · Food and drink precautions, plus updated water-disinfection techniques · Expanded content on safe international travel for specific groups including: LGBTQ+ individuals, highly allergic travelers, travelers with substance use issues, and medical tourists · Specialized recommendations for non-leisure travelers, study abroad, work-related travel, and travel to mass gatherings · Health insights for 14 popular destinations and itineraries in Africa and the Middle East, the Americas and the Caribbean, and Asia · Considerations for newly arrived adoptees, immigrants, and refugees
This Guidance for HIV Prevention Community Planning defines the Centers for Disease Control and Prevention's (CDC) expectations of health departments and HIV prevention community planning groups (CPGs) in implementing HIV prevention community planning. HIV Prevention Community Planning is one of nine required essential components of a comprehensive HIV prevention program as outlined in Program Announcement #04012 (2004-2008), HIV Prevention Projects, Notice of Availability of Funds.
The novel coronavirus that causes COVID-19 is now officially a global pandemic with over 130,000 confirmed cases and over 5,000 deaths. Its path is exponential, and panic is being felt around the globe. But the most important thing you can do to combat the virus is to understand how it works, how it spreads, and to STAY INFORMED. What Does This Coronavirus Outbreak Guide Contain? In-depth history of the virus since its inception Scientific explanation of what coronavirus is and how it works Actionable advice on how to stop the novel coronavirus from spreading Specific tips for employers, employers, and those who must travel during the outbreak Updated statistics on symptoms, treatment, and global survival rates. This 2019-2020 Coronavirus Outbreak Guide is from the CDC Website. Learn the truth about how this virus works. And whatever you do, don’t forget to wash your hands.
THE ESSENTIAL WORK IN TRAVEL MEDICINE -- NOW COMPLETELY UPDATED FOR 2018 As unprecedented numbers of travelers cross international borders each day, the need for up-to-date, practical information about the health challenges posed by travel has never been greater. For both international travelers and the health professionals who care for them, the CDC Yellow Book 2018: Health Information for International Travel is the definitive guide to staying safe and healthy anywhere in the world. The fully revised and updated 2018 edition codifies the U.S. government's most current health guidelines and information for international travelers, including pretravel vaccine recommendations, destination-specific health advice, and easy-to-reference maps, tables, and charts. The 2018 Yellow Book also addresses the needs of specific types of travelers, with dedicated sections on: · Precautions for pregnant travelers, immunocompromised travelers, and travelers with disabilities · Special considerations for newly arrived adoptees, immigrants, and refugees · Practical tips for last-minute or resource-limited travelers · Advice for air crews, humanitarian workers, missionaries, and others who provide care and support overseas Authored by a team of the world's most esteemed travel medicine experts, the Yellow Book is an essential resource for travelers -- and the clinicians overseeing their care -- at home and abroad.
Since 1995, the Centers for Disease Control and Prevention has published Emerging Infectious Diseases, a public health journal that endeavors to improve scientific understanding of disease emergence, prevention, and elimination. Widely known for its leading research in infectious disease, EID is also recognized for its unique aesthetic, which brings together visual art from across periods and, through prose, makes it relatable to the journal's science-minded readership. In Art in Science: Selections from Emerging Infectious Diseases, the journal's highly popular fine-art covers are contextualized with essays that address how the featured art relates to science, and to us all. Through the combined covers and essays, the journal's contents -- topics such as infections, contagions, disease emergence, antimicrobial resistance -- find larger context amid topics such as poverty and war, the hazards of global travel, natural disasters, and human-animal interactions. This collection of 92 excerpts and covers from Emerging Infectious Diseases will be of interest to readers of the journal or to anyone who wishes to reach across the aisle between art and science.
The Centers for Disease Control and Prevention (CDC) and health care professionals across the State of Alaska share a vision, a mission, and specific goals for improving the health and well-being of Alaska Natives.
The National Agenda for Public Health Action represents a monumental step in addressing a priority health issue for women. It has been a work in progress and a true collaboration among the Centers for Disease Control and Prevention (CDC), the American Diabetes Association (ADA), the Association of State and Territorial Health Officials (ASTHO), and the American Public Health Association (APHA) – and numerous additional partnering organizations. The National Agenda for Public Health Action challenges us as a nation to reach beyond our traditional boundaries of public and private health care, federal and state politics, community programs and academic research, and media and training. It poses a vision of a nation in which diabetes among women is prevented or at least delayed whenever possible, and it outlines a rational and feasible plan for making that vision a reality. We hope that the National Agenda will become a beacon for mobilizing the collective energies and resources of multiple entities to truly make a difference in the lives of women and their families who face the daily challenges of diabetes. Diabetes is a tremendous financial burden on patients, their families and society. It's a burden that grows in conjunction with America's obesity epidemic. Diabetes costs our country $132 billion a year in direct medical costs and in indirect costs such as disability, missed work and premature death. More importantly, it costs Americans their lives, their health and their well-being. But amidst all the bad news, there is also good news: Diabetes is often preventable. Of the more than 17 million Americans with diabetes, more than half are women. An additional 16 million more Americans have pre-diabetes. We must all work to fight this disease that affects so many of our friends, neighbors and loved ones. Fighting diabetes through research and public education is one of our top priorities at the Department of Health and Human Services. That's why HHS' Centers for Disease Control and Prevention, in cooperation with partners such as the American Diabetes Association, the American Public Health Association, and the Association of State and Territorial Health Officials, developed the National Agenda for Public Health Action. We hope this agenda will guide the nation in addressing diabetes and women's health. We want an America in which: Diabetes among women is prevented or at least delayed whenever possible; Women at risk for diabetes are provided the family and community support they need to prevent or delay diabetes and its complications; Appropriate care and management of diabetes among women is promoted across the life stages; And the occurrence of complications from diabetes among women is prevented, delayed, or minimized.~
“Health, United States, 2010” is the 34th report on the health status of the Nation and is submitted by the Secretary of the Department of Health and Human Services to the President and the Congress of the United States in compliance with Section 308 of the Public Health Service Act. This report was compiled by the Centers for Disease Control and Prevention's (CDC) National Center for Health Statistics (NCHS). The National Committee on Vital and Health Statistics served in a review capacity. The Health, United States series presents national trends in health statistics. The report contains a Chartbook that assesses the Nation's health by presenting trends and current information on selected measures of morbidity, mortality, health care utilization, health risk factors, prevention, health insurance, and personal health care expenditures. This year's Chartbook includes a special feature on death and dying. The report also contains 148 trend tables organized around four major subject areas: health status and determinants, health care utilization, health care resources, and health care expenditures.
The National Research Council was asked by the Centers for Disease Control and Prevention (CDC) to review the draft report of the National Cancer Institute (NCI)-CDC's working group charged with revising the 1985 radioepidemiological tables. To this end, a subcommittee was formed consisting of members of the Council's Committee on an Assessment of the Centers for Disease Control and Prevention Radiation Programs and other experts. The original tables were mandated under Public Law 97-414 (the "Orphan Drug Act") and were intended to provide a means of estimating the probability that a person who developed any of a series of radiation-related cancers, developed the cancer as a result of a specific radiation dose received before the onset of the cancer. The mandate included a provision for periodic updating of the tables. The motivation for the current revision reflects the availability of new data, especially on cancer incidence, and new methods of analysis, and the need for a more thorough treatment of uncertainty in the estimates than was attempted in the original tables.
Tobacco use in the United States is the single most preventable cause of death and disease. The Centers for Disease Control and Prevention's Office on Smoking and Health (CDC/OSH) created the National Tobacco Control Program (NTCP) to foster and support coordinated, nationwide, state-based activities to advance its mission to reduce disease, disability, and death related to tobacco use. CDC/OSH has identified four program goal areas: Preventing initiation of tobacco use among young people; Eliminating nonsmokers' exposure to secondhand smoke; Promoting quitting among adults and young people; and Identifying and eliminating tobacco-related disparities. To determine the effectiveness of NTCP programs, both their implementation and their outcomes must be measured. This manual is intended to provide process evaluation technical assistance to OSH staff, grantees and partners. It defines process evaluation and describes the rationale, benefits, key data collection components, and program evaluation management procedures. It also discusses how process evaluation links with outcome evaluation and fits within an overall approach to evaluating comprehensive tobacco control programs. Previous CDC initiatives have provided resources for designing outcome evaluations. This manual complements CDC's approach to outcome evaluation by focusing on process evaluation as a way to document and measure implementation of NTCP programs. The content of this manual reflects the priorities of CDC/OSH for program monitoring and evaluation, and augments two other CDC/OSH publications: Key Outcome Indicators for Evaluating Comprehensive Tobacco Control Programs and Introduction to Program Evaluation for Comprehensive Tobacco Control Programs. This manual: Provides a framework for understanding the links between inputs, activities, and outputs and for assessing how these relate to outcomes; and Can assist state and federal program managers and evaluation staff with the design and implementation of process evaluations that will provide valid, reliable evidence of progress achieved through their tobacco control efforts.
“Health, United States, 2011” is the 35th report on the health status of the Nation and is submitted by the Secretary of the Department of Health and Human Services to the President and the Congress of the United States in compliance with Section 308 of the Public Health Service Act. This report was compiled by the Centers for Disease Control and Prevention's (CDC) National Center for Health Statistics (NCHS). The National Committee on Vital and Health Statistics served in a review capacity. The Health, United States series presents an annual look at national trends in health statistics. The report contains a Chartbook that assesses the Nation's health by presenting trends and current information on selected measures of morbidity, mortality, health care utilization, health risk factors, prevention, health insurance, and personal health care expenditures. This year's Chartbook includes a Special Feature on Socioeconomic Status and Health. The report also contains 151 Trend Tables organized around four major subject areas: health status and determinants, health care utilization, health care resources, and health care expenditures.
In 1986, officials of the US Department of Energy revealed that the Hanford Atomic Products Operations in Richland, Washington, had been releasing radioactive material, in particular iodine-131, into the environment over a period of years. This information, which confirmed the suspicions of some people in the Pacific Northwest about what they called the Hanford Reservation or just Hanford, created quite a stir. Both the US Congress and citizens of the Northwest became keenly interested in knowing whether these radiation releases had caused human health effects. They were particularly concerned about whether Hanford releases of iodine-131 had led to an increase in thyroid disease among the population of the area. In 1988, Congress ordered a study of the human health effects of exposure to the iodine-131 released from Hanford. Funded by the Centers for Disease Control and Prevention (CDC), the study was carried out by the Seattle-based Fred Hutchinson Cancer Research Center over the last decade. The study examined estimate of exposure of the thyroid and rates of thyroid disease because iodine-131 concentrates in the thyroid and that organ would be the best indicator of radiation damage in the population. The Centers for Disease Control and Prevention (CDC) asked the National Academy of Sciences-National Research Council (NAS-NRC) to give an independent appraisal of the study methodology, results, and interpretation and of the communication of the study results to the public. Review of the Hanford Thyroid Disease Study Draft Final Report constitutes the response of the NRC subcommittee to that request. To respond to the charge, the NRC subcommittee felt that it needed to go beyond the specific questions addressed to it by CDC and develop a broad understanding and critique of the HTDS and the Draft Final Report. As part of those activities, the subcommittee solicited comments from outside experts and members of the public primarily in a public meeting held in Spokane, Washington, in June 1999, where 14 scientists and members of the public made formal presentations to the subcommittee about various aspects of the Draft Final Report. Other members of the public also spoke during four open-comment sessions at the meeting. In addition, efforts were made to evaluate all information materials prepared for the public and additional CDC communication plans. Information was gathered through interviews with journalists, members of concerned citizen groups in the Hanford region, members of the CDC scientific and media staff in Atlanta, and the HTDS investigators. In this summary, the main points follow the structure of our report and are presented under several headings: epidemiologic and clinical methods and data collection, dosimetry, statistical analyses, statistical power and interpretation of the study, and communication of the study results to the public. We then provide a brief synopsis of our response to the questions raised by CDC.
Diabetes is a serious public health issue affecting more than 17 million Americans, more than half of whom are women. With the increasing life span of women and the rapid growth of minority racial and ethnic populations in the United States (who are hardest hit by the diabetes burden), the number of women at high risk for diabetes and its complications will continue to increase, placing added demands on the health care delivery system and on other sectors of society. The estimated cost of diabetes to the United States for direct health care and other indirect expenditures is about $100 billion annually. In 2000, the Centers for Disease Control and Prevention (CDC) established the National Public Health Initiative on Diabetes and Women's Health, which has three phases. In Phase I, Diabetes & Women's Health Across the Life Stages: A Public Health Perspective was prepared. This report, published in 2001, examines the issues that make diabetes a serious public health problem for women; analyzes the epidemiologic, psychosocial, socioeconomic, and environmental dimensions of women and diabetes; and discusses the public health implications. In Phase II, the information contained in the Phase I report was converted into an interim report containing recommendations for needed strategies, policies, disease tracking, and research to improve the lives of women diagnosed with or at risk for diabetes. Phase III will involve preparing and implementing the National Public Health Action Plan on Diabetes and Women's Health. This final phase of the Initiative will translate the recommendations into con¬crete operational programs and policies for relevant agencies and organizations. This interim report culminates Phase II and was prepared jointly by four cosponsor-ing organizations: CDC, the American Diabetes Association (ADA), the American Public Health Association (APHA), and the Association of State and Territorial Health Officials (ASTHO). The purpose of this report is to offer priority recommendations for responding to diabetes as a prominent public health issue for women and to garner the attention of policy makers, public health professionals, other advocates for wom¬en's issues, researchers, and the general public. In particular, this document provides recommendations for persons charged with making decisions and affecting policies related to diabetes and women's health. This interim report outlines the vision and goals for the National Public Health Initiative on Diabetes and Women's Health, guiding principles, a public health framework, and a life stage approach for addressing diabetes and women's health. These life stages are the adolescent years (ages 10-17 years), the reproductive years (ages 18-44 years), the middle years (ages 45-64 years), and the older years (ages 65 years and above). Many of the recommendations for public health action pertain to all women, regardless of life stage; others are life stage-specific. While the emphasis is specifically on women's health, adopting and implementing many of the recommendations will improve the health and well-being of men and families as well.
The Centers for Disease Control and Prevention (CDC) and the Agency for Healthcare Research and Quality (AHRQ) are pleased to release this report, Women at High Risk for Diabetes: Access and Quality of Health Care, 2003-2006, on behalf of the U.S. Department of Health and Human Services (HHS). This collaboration examined the quality of preventive health care received by U.S. women at high risk and not at high risk for diabetes, using the most scientifically based measures and national data sources available. The report presents measures of health care quality showing the use of services in several areas: access to care, general health and well-being, and preventive care and behaviors. Diabetes is a chronic disease that is very common, serious, and costly. Diabetes can lead to serious complications, such as heart disease and stroke, high blood pressure, blindness, and kidney disease. However, people with diabetes can control the disease and reduce their likelihood of developing complications. An estimated 24 million people in the United States, or 8% of those age 20 years and over, have diabetes; of those, almost half are women. At least one-fourth of adults in the United States are also known to have prediabetes, a condition in which people have blood glucose levels higher than normal but not high enough to be diagnosed with diabetes. People with prediabetes have an increased risk of type 2 diabetes, heart disease, and stroke. Women are more likely than men to develop chronic diseases, such as diabetes, and to suffer disproportionately from disability compared to men. It is important to target women at high risk for diabetes for intervention to reduce their risk of diabetes. Evidence shows that people with prediabetes who lose 5 to 7% of their body weight and increase their physical activity can prevent or delay diabetes. Early interventions and access to preventive care services are important for women to reduce the risk of developing other diseases, such as cardiovascular disease. However, very few studies have examined preventive care measures for women at high risk for diabetes. To address this gap, CDC collaborated with AHRQ to develop this report, which assesses and describes the quality of care that women at high risk for diabetes receive in the United States. This report can be used to identify areas in which intervention can help women at high risk for diabetes across the lifespan, and to focus attention on possible gaps in public health programs, policies, research, and surveillance. Similar to the 2008 report, Women With Diabetes: Quality of Health Care, 2004-2005, this report analyzes a wide variety of measures selected by experts at CDC and AHRQ as highly relevant to an examination of the quality of health care for women at high risk for diabetes. Due to data availability and other constraining factors, the measures discussed in this report are not necessarily comprehensive. Still, they highlight important areas of health care quality of particular relevance to women at high risk for diabetes. Throughout the report, the comparison groups are: Women at high risk for diabetes; Women not at high risk for diabetes.
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