dissemination strategies to the demographic, structural, and cultural characteristics of different subgroups (Greenhalgh et al., 2004). To this end, resources routinely tapped by general and other non–M/SU specialty health care practitioners and policy makers should be used to help disseminate evidence on effective detection and treatment of M/SU illnesses. In short, M/SU health care needs to be better addressed in evidence dissemination efforts that are routinely employed to address providers of general health promotion and disease and disability prevention and treatment. The U.S. Centers for Disease Control and Prevention (CDC) and AHRQ’s Division of User Liaison and Research Translation (formerly called the User Liaison Program) are two highly regarded organizations with expertise in knowledge dissemination that can be utilized more fully for this purpose.

Centers for Disease Control and Prevention

CDC’s mission is “to promote health and quality of life by preventing and controlling disease, injury, and disability” (CDC, 2005a:1). It does so by serving as “the principal agency in the United States government for protecting the health and safety of all Americans and for providing essential human services, especially for those people who are least able to help themselves” (CDC, 2005b:1). Despite this mandate, CDC’s substantial and highly regarded expertise in these areas, and the large contribution of M/SU illnesses to morbidity, disability, and injury (see Chapter 1), M/SU illnesses could be better represented in CDC’s organizational structures, programs, and initiatives.

CDC encompasses multiple centers, institutes, and offices (CDC, 2005c) (see Box 4-3). Of these, the National Center for Chronic Disease Prevention and Health Promotion might reasonably be expected to address M/SU problems and illnesses, given their substantial contribution to chronic disease and general health problems. Yet the listing of chronic disease programs on the center’s website includes arthritis, cancer, diabetes, epilepsy, global health, healthy aging, healthy youth, heart disease and stroke, nutrition and physical activity, oral health, a block grant program to implement national objectives contained in the Healthy People report, prevention research programs, elimination of racial disparities, pregnancy-related illnesses, tobacco use, and an initiative for uninsured women (addressing high blood pressure and cholesterol, nutrition and weight management, physical inactivity, and tobacco use)—but not M/SU illnesses. Another key initiative of the center—Steps to a HealthierUS—is designed to advance the goal of helping Americans live longer, better, and healthier lives through 5-year cooperative agreements with states, cities, and tribal entities to implement chronic disease prevention efforts focused on reducing the burden of diabetes, overweight, obesity, and asthma and three related risk factors—



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