Successful community-based strategies to address health equity in preventing chronic diseases: Examples from the CPPW initiative

Communities Putting Prevention to Work (CPPW) is an initiative supported by the Centers for Disease Control and Prevention to prevent chronic diseases related to obesity and tobacco use. A major focus of CPPW is targeting populations that are disproportionally burdened by chronic diseases by implementing targeted and jurisdiction-wide strategies to address barriers for populations experiencing disparities. To ensure equitable impact, this entails being intentional in the health equity focus when planning, implementing and evaluating targeted strategies. We describe approaches used by CPPW communities to implement strategies to address health equity. Preliminary analysis of the data indicate that the most frequently used health equity approach were interventions targeted to high risk, vulnerable populations, followed by low-income, low SES populations. Nutrition interventions were most used by communities addressing health equity. About 46% of communities targeting low-income, low SES populations implemented enhanced usability of SNAP/WIC/EBT at healthy food retailers, 32% implemented local food production and 18% used media to support improved nutrition. 22% of communities implemented enhanced access to healthy food retailer among those targeting high risk, vulnerable populations. For physical activity and tobacco interventions, 16% of communities used joint use agreements and 20% used hard hitting counter advertising targeted to high risk, vulnerable populations respectively. Reported successful interventions targeted to low-income populations included farmers' markets accepting EBT cards, smoke-free public housing, farm to school initiatives, and mini-grants distributed to food pantries to increase fresh fruit and vegetables in low-income communities. The findings have implications for understanding interventions that address health equity best.