Established in 2016, 15 GEAR Groups have covered topics developed by NACDD members and in alignment with the CDC’s Four Domains for chronic disease prevention and board strategic priorities.

2022 GEAR Groups

• Examining the Disparate Impact of and Solutions to Health Debt after the COVID-19 Pandemic (April & May 2022)
  • Strategist: Liz Ruth
  • Facilitator: Sana Hashim
  • Resources and References Document
  • As health departments and Chronic Disease Units emerge from the worst of the COVID-19 pandemic with an eye to the future, new challenges and opportunities lie ahead. Crises often vary in their impact on residents by race, gender, income level, or housing status. Many Americans have delayed or forgone preventive healthcare like cancer screenings due to the pandemic, leading to what is known as health debt. Health debt is the accumulated impact of changes in health behaviors during the pandemic that will have long-term negative effects on health. This GEAR Group will explore strategies that chronic disease practitioners can use to transition to a post-pandemic world with a focus on addressing and mitigating health debt. Using chronic disease programming as a foundation, case presentations or proposals will explore effective or promising practices that enable state health departments to address health debt and emerge as more equitable and strengthened entities ready to embrace the new normal.

• Using Data to Promote Equity in Policy and Programming (June & July 2022)
  • Strategist: Sandte Stanley
  • Facilitator: Sana Hashim
  • Note: This GEAR Group was offered in the 2020-2021 cycle and is being repeated twice in the 2022 cycle due to popular demand.
  • Resources and References Document (June)
  • Resources and References Document (July)
  • The ways in which data are collected and presented often drive the programmatic priorities and policies developed by state health departments. When it comes to how resources are allocated, screenings are made available, and prevention programming is distributed, chronic disease practitioners have a unique opportunity to address and eliminate unintentional bias in the collection and utilization of data that might favor resource rich communities over those that have been historically disenfranchised. This GEAR Group will explore how unintentional bias may show up in state health policy and programming and strategies to address, avoid, and prevent it. Case presentations or proposals may explore effective or promising practices that enable state health departments and chronic disease units to take a more equitable path in how data drive policy and programming.

• First, Second, and Third Generation: Immigration and Health (Aug. 2, 9, 16, 23, 2022)
  • Strategist: Jennifer Barnhart
  • Facilitator: Sana Hashim
  • Resources and References Document
  • This GEAR Group will take a nuanced look at immigrant health, including refugee/asylee health, and the areas of opportunity to create a positive ripple impact on health of newer Americans and the generations that come after them. The United States is a country of people from around the globe and the health of those who come to the country is impacted by the experience of coming here. Health behaviors and outcomes are impacted by a confluence of factors including, but not limited to: country of origin, education, generation, income, and trauma status. Case presentations or proposals may elevate approaches for promoting health and preventing chronic disease in immigrant communities.

• Not Racist is Not Enough: Journey towards Anti-Racism  (Oct. 4, 11, 18, 25, 2022)
  • Strategist: Renaldo Wilson
  • Facilitator: Sana Hashim
  • Resources & References Document
  • This GEAR Group will explore the frameworks and application of anti-racism to chronic disease prevention and health promotion and elucidate the distinction between anti-racism and “not racist.” The national awakening around racism, catalyzed by the 2020 murder of George Floyd, has propelled many institutions and organizations, including health departments, on a journey toward becoming anti-racist. Case presentations or proposals will highlight efforts to elevate anti-racist work by chronic disease units and programs.

2021 GEAR Groups

The 2021 GEAR Groups covered Using Data to Promote Equity in Policy and Programming, Supporting Communities in Building Resilience During Times of Crisis, and Not Racist is Not Enough: Journey Towards Anti-Racism.

GEAR Groups met for four weeks exploring mid and upstream factors to chronic disease through state case presentations, didactic presentations, reflection, and action planning. The overall theme for the 2021 groups was Equity as a Foundation and Community Voice at the Center.

2020 Gear Groups

The 2020 GEAR Groups covered Food Security; Building Healthy, Active, and Inclusive communities; Prevention through Early Care and Education Centers, and Preventing Adverse Community Experiences.

GEAR Groups met weekly for four weeks exploring mid and upstream factors to chronic disease through state case presentations, didactic presentations, reflection, and action planning.

The resources and references shared within each group are linked below.

• Food Security
• Building Healthy, Active, and Inclusive Communities
• Prevention through Early Care and Education Centers
• Preventing Adverse Community Experiences
• Foundations of Addressing Systemic Racism as a Public Health Crisis

2019 Gear Groups

The 2019 GEAR Groups covered Housing and Health, Education and Health, Leading with Race, Adverse Childhood Experiences, and Building Healthy Communities.

In 2019, NACDD initiated a new approach to GEAR Groups. Rather than meeting monthly, GEAR Groups met in four sessions, typically weekly, exploring mid and upstream factors to chronic disease through state case presentations, didactic presentations, reflection, and action planning.

The resources and references shared within each group are linked below.

• Housing and Health
• Education and Health
• Leading with Race
• Adverse Childhood Experiences
• Building Healthy Communities

2018 GEAR Groups

The 2018 NACDD GEAR Groups examined innovative models that align population health improvement with chronic disease prevention and health promotion efforts carried out by State Health Departments.

Accelerating Population Health: Recommendations for Action, Resources, and Case Stories from the 2018 NACDD GEAR Groups – Members developed this document to share recommendations and resources and to highlight the ways in which states have successfully aligned population health improvement with chronic disease prevention and health promotion across the chronic disease domains and health equity.

2017 GEAR Groups

The 2017 NACDD GEAR Groups examined communicating the value of public health across the four CDC Domains and Health Equity. Products of each group are linked below.

GEAR Group 1: Communicating the Value of Public Health through Data and Surveillance — Members of this group shared experiences in using quantitative data, qualitative data, and epidemiological methods to help decision-makers, project partners, and other groups understand the value of chronic disease data and evidence-based public health approaches. The product presents examples from seven state health departments and includes an infographic describing how epidemiology and surveillance contribute to the value of public health across the four chronic disease domains and health equity.

GEAR Group 2: The Value of Policy, System, and Environmental Change in Public Health — GEAR Group 2 members discussed environmental approaches, specifically those implemented by the public health workforce in collaboration with partners. This fact sheet describes the Health Impact Pyramid, emphasizing the importance of Policy System and Environmental change and encourages public health professionals to invest resources into these.

GEAR Group 3: The Value Public Health Offers Health Systems — Members of GEAR Group 3 chose to focus on the value that public health brings to health systems as it relates to the chronic disease domains defined by CDC’s National Center for Chronic Disease Prevention and Health Promotion as well as health equity. The above product describes the value to health systems and is available as either slides or an infographic.

GEAR Group 4: The Value of Clinical-Community Linkages in Healthcare — GEAR Group 4 members addressed the role of public health in implementing health system interventions that increase the use and improve the quality of clinical and other preventive services. The GEAR Group developed a template that serves as a general guideline to open dialogue with clinicians about the benefits of their participation in clinical-community linkages. The information was purposely left broad as to allow agencies utilizing this tool to substitute more specific examples of programs, benefits, etc. as they relate to the clinical-community linkages available in their state or territory.

GEAR Group 5: Communicating the Value of Public Health through Health Equity — The health equity GEAR group members explored and developed strategies to communicate the value of public health services by addressing upstream and structural inequalities that contribute to poor health outcomes. Valuing public health services requires understanding and employing systems to ensure all individuals have opportunities to live their full health potential thereby facilitating health equity. To achieve this desired population health outcome, state health departments must consider upstream approaches that drive poor health outcomes and inequalities.

Communicating the Value of Public Health through GEAR Groups — This product is designed to aid GEAR Group members and State Health Departments identifying common themes through peer learning. Group members learn to communicate the value of public health through the definition of value, recognizing the audience, and sharing key messages. This was developed by GEAR Groups 1-5, 2017.

2016 GEAR Groups

The 2016 NACDD GEAR Groups examined data and methods for communicating impact, community benefit, payment reform, and communicating the value of public health across the chronic disease domains defined by CDC’s National Center for Chronic Disease Prevention and Health Equity. A description of the topics and links to products from each group are below.

GEAR Group 1: Understanding Chronic Disease Data and Methods for Communicating Impact — This group explored chronic disease data, levels of evidence, methods for analyzing data, data visualization, return on investment, working with media, small area estimation, health system and quality improvement initiatives. The group prepared a document with examples of state uses of chronic disease data, including demonstrating a return on investment.

GEAR Group 2: Understanding Community Benefit. Community Benefit Infographic — This GEAR group learned about the Internal Revenue Service (IRS) Community Benefit requirement and how it links to their state and local partners. The group explored how it may enhance collaboration and outreach within states to further their partnership efforts to reduce chronic diseases and its risk factors. The group’s product provides information and best practice examples on Community Benefit for non-profit hospitals and other organizations and describes its linkage to the Triple Aim.

GEAR Group 3: Understanding Payment Reform — This group addressed how public health needs to understand payers and payment reform in the context of population health management. The National Payment Reform Initiatives – Related to Chronic Disease Prevention Payment Reform Matrix is intended as a resource for public health practitioners interested in understanding specific national payment reform initiatives and how some state chronic disease prevention programs have been involved in these initiatives.

GEAR Group 4: Communicating the Value of Public Health — Members of this GEAR Group shared state and local examples of public health and health system goals that are aligned for mutual benefit and identified key messages that communicate the value of public health. This product is intended to aid in communicating with legislators about the value of public health.

GEAR Group 5: Health Equity — This group focused on strategies to integrate health equity into all aspects of state chronic disease and health promotion programs. GEAR Group members shared and built upon lessons learned to approach chronic disease prevention with a health equity lens.