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Preventing Chronic Disease Dialogue

Preventing Chronic Disease (PCD) welcomes your comments on selected published articles and posts from experts from CDC’s National Center for Chronic Disease Prevention and Health Promotion. PCD encourages an open dialogue among chronic disease prevention researchers, practitioners, and advocates. Check in weekly for new content.

Community Water Fluoridation – One of the 10 Greatest Public Health Achievements of the 20th Century


The safety and benefits of fluoride are well documented. For 70 years, people in the United States have benefited from drinking water with fluoride, leading to better dental health. 

Improving Access to Physical Activity – Joint Use Agreements


The Centers for Disease Control and Prevention’s (CDC’s) Division of Community Health supports community-level health efforts to improve access to physical activity opportunities. Two-thirds of adults and nearly one-third of children and teens in the United States are overweight or obese – and physical inactivity is a leading contributor to this epidemic. In many communities, it’s hard to find safe places for children and their families to exercise and play. Parks, playgrounds, and other outdoor recreation areas may be inaccessible, poorly maintained, or locked. For too many communities, these factors combine to make physical activity a challenge.

The Problem With Sodium in America


Research shows Americans eat too much sodium, which can increase blood pressure and ultimately impact heart health. In a recent study conducted by CDC researchers, thousands of packaged foods sold in grocery stores in three parts of the US were analyzed to determine whether there were regional variations in sodium content that might contribute to differences in hypertension prevalence.

Making Healthy Living Easier


Mobile Food Markets: Increasing Access to Healthy Foods

CDC’s Division of Community Health (DCH) is strengthening community-level health efforts throughout the nation to improve access to healthy eating options. Eating healthy foods can reduce the risk of many health conditions, including obesity, heart disease, type 2 diabetes, and high blood pressure. Although these diseases are preventable, many low-income and rural areas have limited access to foods such as fruits, vegetables, and whole grains. These areas lack full-service grocery stores and/or farmers markets where residents can buy healthy foods. This lack of access to healthy foods makes it difficult for families to eat properly, fueling the country’s growing obesity epidemic.

Breast Cancer Awareness


Other than skin cancer, breast cancer is the most common cancer among American women. Getting mammograms regularly can lower the risk of dying from breast cancer. Women 50 to 74 years old, should have a screening mammogram every two years, while those 40 to 49 years old should talk to their doctor or healthcare provider about when to start and how often to get a screening mammogram.

Answering Questions About Childhood Obesity in America


Recent scientific monitoring studies are beginning to show progress in changing the tide of the childhood obesity epidemic, but the numbers of young people in the US affected by obesity remain high. Research has shown that declines in school-based physical activity programs and increased access to and consumption of sugar-sweetened beverages are among contributors of the increase in childhood obesity in the United States.

When should I talk with my doctor about memory concerns?

By Angela J. Deokar, MPH
Public Health Advisor
CDC Healthy Aging Program/Healthy Brain Initiative

“Where did I put my ____ (fill in the blank)?” is a common question in many households, but as people age, questions like this begin to take on new meaning. About 73% of adults are concerned or very concerned about their memory worsening with age, and Americans fear Alzheimer’s disease more than any other condition (1, 2).

Gestational Diabetes: A Window into the Future


Gestational diabetes (GDM) affects as many as 10% of pregnancies in the United States. Although glucose levels for most women with GDM return to normal shortly after delivery, 65% will develop GDM in a future pregnancy, and more than 50% will develop type 2 diabetes within 10 years.

Working Together to Reduce Childhood Obesity


Childhood obesity is a serious problem in the United States. Despite recent declines in the prevalence among preschool-aged children (from 13.9% in 2003-2004 to 8.4% in 2011-2012), obesity among children is still too high. For children and adolescents aged 2-19, the prevalence of obesity has remained fairly stable—at about 17% or 12.7 million children and adolescents—for the past decade.

Development of a Nationally Representative Built Environment Measure of Access to Exercise Opportunities

Anne M. Roubal, MS; Amanda Jovaag, MS; Hyojun Park, MA; Keith P. Gennuso, PhD

Suggested citation for this article: Roubal AM, Jovaag A, Park H, Gennuso KP. Development of a Nationally Representative Built Environment Measure of Access to Exercise Opportunities. Prev Chronic Dis 2015;12:140378. DOI: Web Site Icon.



We sought to develop a county-level measure to evaluate residents’ access to exercise opportunities. Data were acquired from Esri, DeLorme World Vector (MapMart), and OneSource Global Business Browser (Avention). Using ArcGIS (Esri), we considered census blocks to have access to exercise opportunities if the census block fell within a buffer area around at least 1 park or recreational facility. The percentage of county residents with access to exercise opportunities was reported. Measure validity was examined through correlations with other County Health Rankings & Roadmaps’ measures. Included were 3,114 of 3,141 US counties. The average population with access to exercise opportunities was 52% (range, 0%–100%) with large regional variation. Access to exercise opportunities was most notably associated with no leisure-time physical activity (r = −0.47), premature death (r = −0.38), and obesity (r = −0.36). The measure uses multiple sources to create a valid county-level measure of exercise access. We highlight geographic disparities in access to exercise opportunities and call for improved data.

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