CDC - Winnable Battles

To keep pace with emerging public health challenges and to address the leading causes of death and disability, CDC initiated an effort to achieve measurable impact quickly in a few targeted areas. CDC's Winnable Battles are public health priorities with large-scale impact on health and with known, effective strategies to address them.
The current Winnable Battles have been chosen based on the magnitude of the health problems and our ability to make significant progress in improving outcomes. By identifying priority strategies and clear targets and by working closely with our public health partners, we can make significant progress in reducing health disparities and the overall health burden from these diseases and conditions.

Patients Face More Lethal Infections from CRE

Photo: Guidance for Control of Carbapenem-reisstant Enterobacteriasceae (CRE) - 2012 Toolkit

A new Vital Signs report shows that antibiotics are being overpowered by lethal germs called carbapenem-resistant Enterobacteriaceae (CRE).These germs cause lethal infections in patients receiving inpatient medical care, such as in hospitals, long-term acute care facilities, and nursing homes.
In their usual forms, germs from the Enterobacteriaceae family (e.g. E. coli) are a normal part of the human digestive system. However, some of these germs have developed defenses to fight off all or almost all antibiotics we have today.When these germs get into the blood, bladder or other areas where germs don’t belong, patients suffer from infections that are difficult, and sometimes impossible, to treat.
While CDC has warned about CRE for more than a decade, new information shows that these germs are now becoming more common. One type of CRE has been detected in medical facilities in 42 states. Even more concerning, this report documents a seven-fold increase in the spread of the most common type of CRE during the past 10 years.

Why are CRE so alarming?

Even though these infections are not common, their rise is alarming because they kill up to half of people who get severe infections from them. In addition to causing lethal infections among patients, CRE are especially good at giving their antibiotic-fighting abilities to other kinds of germs.This means that in the near future, more bacteria will become immune to treatment, and more patients’ lives could be at risk from routine bladder or wound infections. Without serious efforts to stop CRE in medical facilities, and without rapid improvement in the way doctors everywhere prescribe antibiotics, CRE will likely become a problem in the community, among otherwise healthy people not receiving medical care.

How can CRE be stopped?

There have been major successes in stopping CRE in medical facilities in the United States, and nationally in other countries. Stopping CRE will take a rapid, coordinated, and aggressive "Detect and Protect" action that includes intense infection prevention work and antibiotic prescribing changes. CDC released a CRE prevention toolkit in 2012 reiterating practical CRE prevention and control steps. Leadership and medical staff in hospitals, long-term acute care hospitals, nursing homes, health departments, and even outpatient practices must work together to implement these recommendations to protect patients from CRE.

Breaking the Cycle of Teen Pregnancy

Pregnancy during the teen years can change the lives and futures of the mother, father, child, and their families. Repeat teen births—two or more pregnancies ending in a live birth before age 20—can limit the mother's ability to finish her education or get a job.
Giving birth and raising a child during the teen years can carry high health, emotional, social, and financial costs for teen mothers and their children. Teen mothers want to do their best for their health and their child's, but some can become overwhelmed by life as a parent. Teen births may also cause other problems. Babies born from a repeat teen birth are often born too soon or too small. This can lead to more health problems for the baby.

Learn the Facts

Although teen birth rates have been falling for the last two decades, more than 365,000 teens aged 15–19 years gave birth in 2010. Of these births, 66,800 were repeat teen births—
- 57,200 were second births.
- 8,400 were third births.
- 1,200 were fourth or higher births.

American Indian and Alaska Natives, Hispanics, and black teens are about 1.5 times more likely to have a repeat teen birth, compared to white teens.

Source: CDC's National Vital Statistics System
Teen Birth Control Use Postpartum

91% of sexually active teen mothers used some form of birth control, but only about 22% used the most effective types of birth control.
White (25%) and Hispanic (28%) teen mothers were almost twice as likely as black teen mothers (14%) to use the most effective types of birth control.
Long-acting reversible birth control can be a good option for a teen mother. Implants and IUDs are two types. These do not require her to do something on a regular basis—such as take a pill each day.

Source: CDC's Pregnancy Risk Assessment Monitoring System

Learn What You Can Do to Reduce Repeat Teen Births

Doctors, nurses, and other health care professionals can—

Counsel parenting teens on how they can avoid additional pregnancies by not having sex.
Discuss with sexually active teens the most effective types of birth control to prevent repeat pregnancies. Refer to CDC guidelines: United States Medical Eligibility Criteria for Contraceptive Use (USMEC).
Remind sexually active teens to also use a condom every time to prevent sexually transmitted diseases, including HIV/AIDS.
Connect teen mothers with support services that can help prevent repeat pregnancies, such as home visiting programs.
Advise teen mothers that births should be spaced at least 2 years apart to support the health of the baby, and that having more than one child during the teen years can make it difficult for teen parents to reach their educational and work goals.

Parents, guardians, and caregivers can—

Talk about how to avoid repeat births with both male and female teens.
Check with your insurer about coverage of preventive services. In some cases, preventive services, such as birth control methods and counseling, are available with no out-of-pocket costs.
Talk with community leaders, including faith-based organizations, about using effective programs that can help prevent repeat teen pregnancies.

Teens, including teen parents, can—

Choose not to have sex.
Use birth control correctly every time if you are having sex. Use condoms every time to prevent disease.
Discuss sexual health issues with your parents, partner, health care professionals, and other adults and friends you trust.
Find a family planning clinic near you for birth control if you choose to be sexually active.

What CDC and the Federal Government Are Doing

The federal government is—

Funding states and tribes through the Pregnancy Assistance Fund to provide pregnant and parenting teens with a complete network of support services.
Promoting home visiting and other programs shown to prevent repeat teen pregnancy and reduce sexual risk behavior.
Conducting and evaluating programs that work, as well as innovative approaches to reduce teen pregnancy and births in communities with the highest rates.
Helping other groups with information to duplicate teen pregnancy prevention programs that have been shown to be effective through rigorous research.

More Information

Tips From Former Smokers 2013 Campaign

In 2012, CDC launched the first-ever paid national tobacco education campaign—Tips From Former Smokers (Tips). Tips ads were placed in a variety of media channels, showing people living with the real and painful consequences of smoking. The ads featured suggestions or "tips" from former smokers, such as how to get dressed when you have a stoma or artificial limbs, what scars from heart surgery look like, and reasons why people have quit smoking. The goal of the campaign was to encourage people to quit smoking.
The 2012 Tips campaign lasted 12 weeks and was very effective. Compared with the same 12-week period in 2011, overall call volume to 1-800-QUIT-NOW more than doubled during the Tips campaign, and visits to the Web site (www.smokefree.gov

) increased by more than five times.
Now CDC is building on the success of the Tips campaign by launching a new round of advertisements scheduled for airing in April 2013. The campaign continues to raise awareness of the negative health effects caused by smoking and encourages smokers to quit and nonsmokers to protect themselves and their families from exposure to secondhand smoke. The Tips campaign will run through the early summer and includes TV, radio, print, PSA, billboard, and digital ads.

Why the Tips Campaign Is Important

Beginning with the publication of the first Surgeon General's report nearly 50 years ago, we have learned that smoking causes a wide variety of severe health problems. Cigarette smoking and exposure to secondhand smoke result in more than 440,000 deaths a year in this country and are also among the main causes of early disability. For every person who dies from smoking, another 20 live with illnesses related to smoking, such as COPD (a group of respiratory diseases that include emphysema and chronic bronchitis) and asthma. Smoking can also make other health conditions—such as diabetes—much worse.
The new campaign focuses on how smoking can affect people's quality of life. "These ads will tell the stories of brave people struggling with the COPD and complications from diabetes – the kinds of smoking-related diseases doctors see every day," said Tim McAfee, M.D., M.P.H, Director of the CDC's Office on Smoking and Health. "The commercials accurately show the devastating diseases that are completely preventable."

What Are the Main Messages of the Campaign?

The campaign's main messages are:

Smoking causes immediate damage to your body, which can lead to long-term health problems.
For every person who dies from a smoking-related illness, 20 more Americans live with an illness caused by smoking.
Now is the time to quit smoking, and if you need help, free assistance is available.

The campaign includes an ad focused on the effects of secondhand smoke exposure, as well as an emotionally compelling cessation ad. The campaign will expand upon the first campaign and include additional health conditions that were not featured in the first phase of the Tips campaign, such as:

Chronic obstructive pulmonary disease (COPD).
Asthma in adults.
Smoking-related complications in a person with diabetes.

The 2013 Tips campaign also expands the population groups to include American Indian/Alaska Native and Lesbian, Gay, Bisexual, and Transgender (LGBT) populations.

Watch the New Videos From Tips From Former Smokers

Following are the commercials you may see on TV. You can also view the radio, print, PSA, billboard, and digital ads that have been developed by visiting the Tips From Former Smokers Web site.

In high school, Terrie was a cheerleader who competed on the North Carolina cheer circuit. Because a lot of her friends smoked, Terrie soon found herself lighting up in social settings. In 2001, Terrie was diagnosed with oral cancer and with head and neck cancer. Today, Terrie speaks with the aid of an artificial voice box inserted in her throat.
This is Terrie's second appearance in the Tips campaign. Read more about Terrie.

Michael is an Alaskan Native and member of the Tlingit tribe. He is also a Veteran. He was addicted to cigarettes for most of his adult life. At 44, he was diagnosed with chronic obstructive pulmonary disease, or COPD. He ignored the symptoms until age 52, when he awoke gasping for air. He quit smoking that day. His doctor gave him 5 years to live. Since then, Michael has had to have part of his lungs removed to improve his breathing.
Read more about Michael.

Bill is a 40-year old with diabetes whose concurrent smoking led to heart surgery, blindness in one eye, amputation, and kidney failure.
Read more about Bill.

Nathan, an American Indian and member of the Oglala Sioux tribe, has never smoked cigarettes. For many years he worked at a casino that allowed smoking. The exposure to secondhand smoke triggered asthma attacks. It also caused him to develop serious infections that eventually led to permanent lung damage called bronchiectasis.
Read more about Nathan.

Tiffany was 16 when she lost her mother to lung cancer. Despite that, Tiffany started smoking in her late teens. A lot of friends at her school smoked, and she wanted to fit in. She quit smoking in 2012, when her own daughter turned 16. Tiffany didn't want her daughter to think that her Mom loved cigarette smoking more than she cared about her.
Read more about Tiffany.

All of the people featured in the campaign hope their stories will help other smokers quit. As Bill says, "Make a list. Put the people you love at the top. Put down your eyes, your legs, your kidneys, and your heart. Now cross off all the things you're OK with losing because you'd rather smoke."

More Resources—You Can Quit Today!

The following Web sites provide free, accurate, evidence-based information and professional assistance to help support the immediate and long-term needs of people trying to quit smoking. If you want to quit, here's where you can find help:

Tips Web site: provides more information about the Tips campaign, including additional videos and links to podcasts by participants.
CDC's Smoking & Tobacco Use Web site: CDC's one-stop shop for information about tobacco and smoking cessation.
BeTobaccoFree.gov is the Department of Health and Human Services' comprehensive Web site providing one-stop access to tobacco-related information from across its agencies. This consolidated resource includes general information on tobacco as well as federal and state laws and policies, health statistics, and evidence-based methods on how to quit.
Smokefree.gov provides free, accurate, evidence-based information and professional assistance to help support the immediate and long-term needs of people trying to quit smoking.
Women.smokefree.gov provides free, accurate, evidence-based information and professional assistance to help support the immediate and long-term needs of women trying to quit smoking.
Quit Tobacco: Make Everyone Proud is a Department of Defense-sponsored Web site for military personnel and their families.
Help for Smokers and Other Tobacco Users: Quit Smoking is an easy-to-read guide issued by the Agency for Healthcare Research and Quality.
http://teen.smokefree.gov is a site devoted to helping teens quit smoking.
http://teen.smokefree.gov/smokefreeTXT.aspx is a teen texting site.
http://espanol.smokefree.gov is a Spanish-language quitting site
www.cdc.gov/tobacco/quit_smoking/how_to_quit/index.htm provides more useful information from CDC to help you quit.
American Heart Association Web site is the home page for the American Heart Association and provides useful information about the tobacco and heart health.
Million Hearts™ is a national initiative to prevent 1 million heart attacks and strokes by 2017. Million Hearts™ brings together communities, health systems, nonprofit organizations, federal agencies, and private-sector partners from across the country to fight heart disease and stroke.

Winnable Battle Areas

Winnable Battles Resources

Background information about CDC's Winnable Battles, including PowerPoint presentations, Frequently Asked Questions, and more.

Winnable Battles Targets

Learn more about CDC's targets for the Winnable Battles initiative, what CDC is doing, and what you can do to support Winnable Battles.

New data and analysis tools – including Sortable Stats, Policy Implementation Analyses and Burden Assessments – that serve as resources in the promotion of policy, system and environmental changes to improve health.