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Steps to a HealthierUS is a bold new initiative from the Department of Health and Human Services (HHS) that advances President George W. Bush’s HealthierUS goal of helping Americans live longer, better, and healthier lives.

Recognizing that the United States is in a health care crisis, HHS Secretary Tommy G. Thompson launched Steps to a HealthierUS in 2003. At the heart of this program lie both personal responsibility for the choices Americans make and social responsibility to ensure that policy makers support programs that foster healthy behaviors and prevent disease.

The Steps initiative envisions a healthy, strong U.S. population supported by a health care system in which diseases are prevented when possible, controlled when necessary, and treated when appropriate. This initiative is a shift in the traditional approach to the health of our citizens, moving us from a disease care system to a health care system.

Why Steps to a HealthierUS Is Needed

Our current health care system is not structured to deal with the escalating costs of treating diseases that are largely preventable through modifiable behaviors. Policy makers, the health community, and the public must come together to establish programs and policies that support behavior changes, encourage healthier lifestyle choices, and reduce disparities in health care.

Health disparities and differences in treatment and other medical practices among racial and ethnic groups also exist within the current medical care system. Removing these differences and promoting quality health care for every American are achievable.

What Steps to a HealthierUS Will Accomplish

Realizing that small changes over time can yield dramatic results, the Steps initiative is committed to identifying and promoting programs that encourage small behavior changes, realizing that small changes over time can yield dramatic results. Steps will unite the forces of all HHS agencies, including the Centers for Disease Control and Prevention, Centers for Medicare & Medicaid Services, Food and Drug Administration, and National Institutes of Health.

With a strong emphasis on proven interventions and existing science, Steps will promote the following:

  • Health promotion programs to motivate and support responsible health choices.
  • Community initiatives to promote and enable healthy choices.
  • Health care and insurance systems that put prevention first by reducing risk factors and complications of chronic disease.
  • State and federal policies that invest in the promise of prevention for all Americans.
  • Cooperation among policy makers, local health agencies, and the public to invest in disease prevention instead of spending our resources to treat diseases after they occur.

Reducing the Burden of Disease


Diabetes is a serious, costly disease that is on the rise. Currently, 17 million Americans have diabetes, and nearly one-third are unaware that they have the disease. More than 200,000 people die each year of diabetes-related complications. Diabetes can cause heart disease, stroke, blindness, kidney failure, leg and foot amputations, pregnancy complications, and deaths related to flu and pneumonia.


Obesity is the nation’s newest health epidemic. More than 64% of the U.S. adult population is overweight or obese, and obesity is responsible for at least 300,000 deaths each year.


More than 31 million people in the United States have diagnosed asthma, and although a lot is known about how to prevent its symptoms and consequences, many people are not applying this knowledge. Asthma can be controlled by preventing or managing the symptoms with medication and eliminating or controlling the environmental factors that trigger it.

Heart Disease and Stroke

Heart disease and stroke account for more than 40% of all annual deaths. They are the first and third leading causes of death for both men and women in all U.S. racial and ethnic groups. Much of the burden of heart disease and stroke could be eliminated by reducing their major risk factors: high blood pressure, high cholesterol, tobacco use, diabetes, physical inactivity, and poor nutrition.


Cancer is the second leading cause of death in the United States, killing more than half a million people each year. Poor nutrition, overweight, and inactivity contribute to about one-third of all cancers. Over 150,000 deaths each year are attributable to cigarette smoking.

Addressing Lifestyle Choices

Poor Nutrition and Physical Inactivity

Poor nutrition and physical inactivity contribute to many diseases, including type 2 diabetes, hypertension, heart disease, stroke, some forms of cancer, and obesity. Many Americans do not eat enough fruits and vegetables, get enough regular exercise, or maintain a normal weight despite the proven benefits of these behaviors.

Tobacco Use

Tobacco use is the leading preventable cause of death and disease in the United States. Smoking contributes to several chronic diseases, including lung disease, cancer, heart disease, and stroke. Cigarette smoking is responsible for more than 440,000 deaths each year (1 in 5 deaths).

Youth Risk Taking

Health risk behaviors that are often established in youth contribute dramatically to heart disease, cancer, and injury. Examples include tobacco use, unhealthy dietary habits, inadequate physical activity, alcohol and other drug use, and behaviors that result in violence and unintentional injuries.

“Approximately 95% of the 1.4 trillion dollars that we spend as a nation on health goes to direct medical care services, while an estimated 5% is allocated to preventing disease and promoting health. This approach is equivalent to waiting for your car to break down before you take it in for maintenance.  By changing the way we view our health, the Steps initiative helps us move from a disease care system to a true health care system.”

Secretary Tommy G. Thompson
   U.S. Department of Health and Human Services

For more information about Steps to a HealthierUS
and related topics, please contact

U.S. Department of Health and Human Services
Office of Disease Prevention and Health Promotion
Office of Public Health and Science
1101 Wootton Parkway, Suite LL100
Rockville, MD 20852
T 240-453-8280
F 240-453-8282

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U.S. Department of Health and Human Services

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