Cross-Sector Responses to Obesity: Models for Change: Workshop Summary (2015)

B

National Prevention Council Cross-Sector Case Study

Submitted by presenters
Acting Surgeon General Rear Admiral Boris D. Lushniak,
Melissa Lim Brodowski, Susan Damour, Jeff Levi, and Brigette Ulin¹

DESCRIPTION OF CROSS-SECTOR MODEL USED

The National Prevention Council (NPC), created through the Affordable Care Act and chaired by the U.S. Surgeon General, provides coordination and leadership among 20 executive departments and agencies with respect to prevention, wellness, and health promotion activities. Such high-profile involvement demonstrates an unprecedented commitment to coordinated federal action to address prevention and wellness. The NPC released the nation’s first National Prevention Strategy in June 2011. The NPC engages leadership from across sectors to improve the health of the nation and advance the National Prevention Strategy’s goal to “increase the number of Americans who are healthy at every stage of life.” The NPC’s work is informed by the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health and by partners across the country working to advance the National Prevention Strategy. The Strategy’s vision is to move the nation from a focus on sickness and disease to one based on prevention and wellness.

NATIONAL PREVENTION STRATEGY FRAMEWORK

The National Prevention Strategy guides our nation in identifying the most effective and achievable means for improving health and well-being. It prioritizes prevention by integrating recommendations and actions across

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¹Reprinted as submitted by the presenters.

multiple settings to improve health and save lives. Since many of the strongest predictors of health and well-being fall outside of the health care setting, the Strategy envisions a prevention-oriented society where all sectors recognize the value of health for individuals, families, and society and work together to achieve better health for all Americans.

The National Prevention Strategy identifies four Strategic Directions—the foundation for all prevention efforts—and seven targeted Priorities designed to improve health and wellness for all Americans (see Figure B-1). It provides evidence-based recommendations for each Strategic Direction and Priority and supports Healthy People 2020, a 10-year set of science-based national health objectives.

In June 2012, the NPC released the National Prevention Council Action

FIGURE B-1 National Prevention Strategy Framework.

Plan, which demonstrates how departments are implementing prevention efforts in line with their respective missions and identifies three shared commitments to accelerate prevention through the high-impact efforts of all National Prevention Council departments (see Box B-1). The NPC continues to advance its commitments by integrating health and wellness into policies, practices, and programs to achieve better health for all Americans. For more information, visit http://www.surgeongeneral.gov/initiatives/prevention/index.html.

SECTORS INCLUDED

On June 10, 2010, the President signed an Executive Order (http://www.whitehouse.gov/the-press-office/executive-order-establishing-national-prevention-health-promotion-and-public-health) creating the NPC within the Department of Health and Human Services. Council members are cabinet secretaries, chairs, directors, or administrators from these departments:

Department of Health and Human Services (HHS)

Department of Agriculture

Department of Education

Federal Trade Commission

Department of Transportation

Department of Labor

Department of Homeland Security

Environmental Protection Agency

Office of National Drug Control Policy

Domestic Policy Council

Department of the Interior

Department of Justice

Corporation for National and Community Service

Department of Defense

Department of Veterans Affairs

Department of Housing and Urban Development

Office of Management and Budget

General Services Administration

Office of Personnel Management

LESSONS LEARNED FROM THE INITIATIVE

The most recent achievements of the NPC are included in the 2014 Annual Status Report—delivered to the President and members of Congress and posted online on July 1, 2014—demonstrate the nation’s progress and highlight the collective impact of the federal government and its partners to improve the health and quality of life for individuals, families, and communities. Highlights from the report include:

• The NPC is working to integrate the Health and Sustainability Guidelines into federal food concessions and vending operations as appropriate. These guidelines are the result of collaboration between HHS and GSA with the goal to increase healthy food and beverage choices and sustainable practices at federal work sites. Eighty-six percent of cafeterias in GSA-managed buildings now provide healthy food choices. By applying the Dietary Guidelines for Americans 2010 to food service operations, the Health and Sustainability Guidelines demonstrate HHS’s and GSA’s commitment to promoting a healthy workforce.
• The Department of Defense’s Healthy Base Initiative (HBI) aims to identify best-practice efforts in reducing obesity and tobacco use, while improving fitness. In a recent survey at one HBI site, 93 percent of employees said the initiative is helping change their behaviors, including eating habits and physical activity. The Environmental Protection Agency’s (EPA’s) Healthy Heart program (which complements HHS’s Million Hearts initiative) educates people—in particular, individuals with heart disease—about the health risks of air pollution and how to reduce exposure through the EPA-supported Air Quality Index.
• HHS is collaborating with the Department of Education to promote Birth to 5: Watch Me Thrive!, an initiative that encourages healthy child development through universal developmental screening for children.

BARRIERS TO ESTABLISHING THE INITIATIVE

Because of the diversity of the missions and priorities for each Department, the NPC recognizes that Department-specific actions to advance these shared commitments will vary. This variation presents opportunities and challenges. Identifying strategic opportunities to integrate prevention and health within the various Departments requires ongoing engagement and constant communication amidst changes in leadership and agency priorities.

Metrics are important to the NPC’s work because they can be used to measure how activities that serve an agency’s core mission also promote health. The 2014 Annual Status Report includes national data from a variety of sources including those managed by Centers for Disease Control and Prevention such as the National Health and Nutrition Examination Survey and the National Health Interview Survey, and the National Vital Statistics. Other data sources include the U.S. National Toxics Release Inventory from the EPA, the Monitoring the Future Survey from the National Institutes of Health, and the National Survey on Drug Abuse and Health from Substance Use and Mental Health Services Administration. Currently indicators are aligned with Healthy People 2020 (as appropriate), which creates efficiencies in data reporting at the national level. However, more comprehensive data sources are needed across the various indicators and longitudinal data will need to be available in timely and user-friendly format to allow the NPC and state and local stakeholders to truly measure the collective impact of the prevention work across sectors.

WHAT IS NEEDED TO ACCELERATE MOVEMENT FORWARD IN YOUR CROSS-SECTOR WORK?

National, state and local leadership is critical to creating a prevention-oriented society. The NPC will continue to prioritize prevention by collaborating across multiple settings. The National Prevention Strategy recognizes that policy, systems, and environmental changes can support healthy choices. Health and wellness are influenced by the places in which people live, learn, work, and play. Communities—including homes, schools, public places, and work sites—can better support well-being and make healthy choices easy and affordable. We need innovative approaches such as rethinking community design to improve community walkability and promote physical activity, and increasing availability of affordable, healthy food and drink options to support a nutritious diet.

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