Vermont takes steps to curb chronic disease
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* Julia Haskins

Public Health in Vermont boils down to three numbers that encompass the toll of chronic disease in the state: 3-4-50. Three behaviors — lack of physical fitness, poor diet and tobacco use — lead to four chronic diseases: cancer, heart disease and stroke, Type 2 diabetes and lung disease. Combined, those chronic diseases are responsible for more than 50 percent of deaths in Vermont. The Vermont Department of Health is working to change those numbers by promoting better health behaviors for all residents, during National Public Health Week and every day.

The success of 3-4-50 Vermont depends upon making connections with leaders across all sectors, from business to education, according to Julie Arel, MPH, MSW, division director of health promotion and disease prevention at the Vermont Department of Health. Inspired by San Diego’s own 3-4-50 campaign addressing similar health issues, Vermont’s version relies on partnerships with influential decisionmakers in communities to emphasize the role that all state residents have in reducing chronic disease.

“It’s terribly exciting, because how we make public health attainable is through these partnerships and engagement across municipalities,” Arel told *The Nation’s Health*.

Vermont health leaders used National Public Health Week to raise awareness of the 3-4-50 campaign through social media and encourage healthy habits. For example, the health department drew attention to the need to prevent chronic disease on its Facebook and Twitter accounts, sharing APHA infographics. Health advocates at the local level took up the 3-4-50 charge during NPHW, with relevant classes, workshops and activities for children and adults.

Vermonters are becoming more enthusiastic about achieving healthy lifestyles, but that has not always been the case, according to Arel.

![Figure1](http://www.thenationshealth.org/http://www.thenationshealth.org/content/nathealth/47/4/16.2/F1.medium.gif)

[Figure1](http://www.thenationshealth.org/content/47/4/16.2/F1)

A Vermont program targeting chronic diseases that disproportionately affect residents is promoting healthy behaviors.

Photo by Antonio Diaz, courtesy iStockphoto

“We found through research with some of our social marketing campaigns that the average Vermonter has sort of a fatalistic approach when it comes to chronic disease,” she said. “They kind of throw up their hands and say, ‘Well there’s nothing I can do about it,’ when in fact so much of those diseases is dependent upon the behaviors.”

The 3-4-50 campaign aims to show Vermonters that they do not have to take on such a defeatist attitude when it comes to their health, and that change is possible. The Vermont Department of Health’s website features tip sheets, by sector, offering suggestions and referrals to a range of health-oriented resources.

Interventions do not have to be costly, but they must be “sticky” enough that they have a long-lasting impact, Arel said. That does not necessarily mean a plan must be complicated, either. For example, the health department is collaborating with schools to implement wellness policies, such as providing healthier options for celebrations and using non-food rewards.

According to Arel, many partners and entities have been inspired to create their own initiatives related to the 3-4-50 campaign.

![Figure2](http://www.thenationshealth.org/http://www.thenationshealth.org/content/nathealth/47/4/16.2/F2.medium.gif)

[Figure2](http://www.thenationshealth.org/content/47/4/16.2/F2)

Image courtesy Vermont Department of Health

One initiative involved a raffle through Facebook to win a Fitbit, in which people posted what they were doing to lead healthier lives under the 3-4-50 framework. A campaign in the town of Springfield had Vermonters write about their healthy habits on postcards, which were then shared via local access television to encourage viewers to make changes in their own lives.

“My hope is that in 10, 15 years, communities will have transformed from places where it’s sort of an afterthought to be healthy to where it is front and center,” Arel said. Such a change would mean that healthy habits would be “so integrated into community life…that people feel not only invested in their own health but in the health of their neighbors and community members.”

For more information, visit [www.healthvermont.gov/3-4-50](http://www.healthvermont.gov/3-4-50).

*   Copyright The Nation’s Health, American Public Health Association