In May 2011, "Ten Great Public Health Achievements-United States, 2001-2010," was published in the Morbidity and Mortality Weekly Report.1 These 10 achievements were vaccine-preventable diseases, prevention and control of infectious diseases, tobacco control, maternal and infant health, motor vehicle safety, cardiovascular disease prevention, occupational safety, cancer prevention, childhood lead poisoning prevention, and public health preparedness and response.1 Clearly, these are notable accomplishments and reflect amazing work on the part of public health and other health care professionals.
What is absent from the discussion of the public health achievements are the continuing causes of morbidity and mortality in which there are documented ways to reduce risks. For example, 3 health risk factors discussed in Health, United States, 2011,2 are cigarette smoking, obesity among children, and overweight and obesity among adults. Smoking is associated with an increased risk of heart disease, stroke, lung and other types of cancers, as well as chronic lung disease. Despite the considerable amount of information in the professional and lay press about the dangers associated with smoking, in 2010, 19% of high school seniors, 22% of men, and 17% of women were currently smoking.2
About obesity, in 2009-2010, nearly 1 in 5 children older than 5 years was obese, and between 2007 and 2010, 35% of adults were considered obese. Both smoking and obesity are considered as risk factors for several chronic diseases. Cheng3 discusses her role as a pediatrician in reporting a family to Child Protective Services, in which the 2 young girls were becoming morbidly obese. In her discussion, she says, "Obesity stems from energy imbalance derived from a complex interplay of behavioral, genetic, environmental, and social factors."3(p1976) Both diet and physical activity play an important role in weight control and the prevention of several chronic diseases.
Several of the articles in this issue talk about ways in which a healthy lifestyle can reduce the risk of some chronic diseases. Jilcott Pitts et al discuss reducing cardiovascular risks by obesity prevention. They point out an important fact-that is, some people live in neighborhoods that make it difficult to engage in physical activity. When neighborhoods are unsafe or unclean, the opportunity to engage in physical activity is greatly reduced. King et al, Helduser et al, and Bishop et al describe their work that deals with diabetes prevention and self-management with a variety of populations.
The remaining 4 articles describe innovative programs both for risk reduction through prevention and for managing health issues. Specifically, Dobe et al discuss the importance of effective hand-washing practices in a rural community in India and the effect of hand washing on risk reduction. Brawner et al describe a creative program that engages barbers in delivering health promotion information about HIV/AIDS to young heterosexual African American men. Wooldridge et al found that in a study of the use of pediatric health advocacy services, participants were more likely to use advisory services than supportive services, and Valenzuela et al used PhotoVoice to enable youth with sickle cell disease both to describe and reflect on their disease experiences and to communicate these experiences to others with this tool.
The articles in this issue describe creative strategies to prevent or intervene in chronic illness. They point out the importance of trying new approaches both to interrupt practices that are not health promoting and to deliver messages about risk reduction. They also emphasize the importance of learning from one another.
Jeanette Lancaster
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