The State of the Cdc, Fiscal Year 2003. There’S a Lot More to CDC Than What Makes the Nightly News

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acute care • adenoviruses • adolescent and school health • AIDS/HIV • airbags • air pollution • alveolar hydatid disease (Echinococcosis) • anencephaly (neural tube birth defect) • anthrax • antimicrobial resistance • arbovira encephalitides • arenaviruses • arthritis • ascariasis (intestinal roundworms) • aspergillosis • assisted reproductive technology • asthma • autism • baby bottle tooth decay • back belts • bacterial diseases • behavioral risk factors • bicycle helmets • bicycle-related head injuries • bilharzia (schistosomiasis) • biomonitoring • biosafety • bioterrorism • birth defects • Blastocystis hominis infection • blindness • botulism (Clostridium botulinum) • bovine spongiform encephalopathy • brain injury • Brainerd diarrhea • breast cancer • brucellosis (undulant fever or Bang’s disease) • Campylobacteriosis • carbon monoxide poisoning • cardiovascular disease • cerebral palsy • cervical cancer • Chagas disease (American trypanosomiasis) • chemical weapons • child abuse • child health • child safety seats • chickenpox (varicella) • chlamydia • cholera (Vibrio cholerae) • chronic diarrhea • chronic fatigue syndrome • coccidioidomycosis • cold sores • colorectal cancer • condyloma acuminata • construction safety • cruise ships • Creutzfeldt-Jakob disease • cryptosporidiosis (crypto) • Cyclospora cayetanensis • dating violence • dengue fever • diabetes • Dientamoeba fragilis infection • diphtheria • disabilities • dog bites • domestic violence • dracunculiasis (Guinea worm disease) • drowning • drunk driving • earthquake • Ebola (Ebola viral hemorrhagic fever) • ehrlichiosis • elderly injuries • emerging health threats • Entamoeba histolytica infection (amebiasis) • Enterobiasis (pinworm infection) • enterovirus infection (nonpolio) • environmental health • epilepsy • epidemiology • ergonomic interventions • Escherichia coli O157:H7 • extreme cold and heat • falls and hip fractures • fetal alcohol syndrome • fi lariasis (Bancroftian fi lariasis) • fi re fi ghter deaths • fl oods • fl uoridation • foodborne illnesses • gastroenteritis • genetics • genital herpes • giardiasis • global health • gonorrhea (Neisseria gonorrhoeae) • group B streptococcus • Haemophilus infl uenzae (Hib) • hand, foot, and mouth disease (coxsackievirus A16) • hantavirus pulmonary syndrome • head injury • head lice infestation (pediculosis) • healtht communications co u cat o s • health ea hazard evaluations • health and safety manuals • health promotion and education • Helicobacter pylori (pepticeptic ulcer disease) • hearing hea loss and impairment • hemochromatosis (iron overload) • hepatitis • histoplasmosis (fungal disease) • hookworm infection • hospitalh infections • HIV/AIDS • hurricanes • hypertension • immunization • infants • infl uenza (fl u) • injuriess • intimate partner violence vio • intrauterine devices • job-related allergies • Kaposi’s sarcoma • laboratory standards • lead poisoning • leading causes of death • legionellosis • leishmaniasis • leptospirosis • listeriosis • lung cancer • Lyme disease • malaria • mammogramsms • managed care • maternal health • measles • meningitis • men’s health • microsporidiosis • minority health • motor vehicle-relatedle-related injuries • molecularmole • neurotoxicology • mumps • musculoskeletal diseases and disorders • multimedia communications • nonpathogeniconpathogenic intestinal aamebae infection • Norwalk-like viruses • nutrition • obesity • occupational health • onchocerciasis (river blindness) • oral health • osteoporosis • otitis media • Papanicolaou (Pap) tests • pertussis • Pfi esteria • physical activity and health • pinworm infection (Enterobius vermicularis) • plague • playground injuries • pneumococcal disease • pneumoconiosis • Pneumocystis carinii (Pneumocystis pneumonia) • polio vaccines • prevention research • prostate cancer • rabies • refugee health • rehabilitation • reproductive health • respiratory tract infections • Rift Valley fever (RVF virus) • ringworm • Rocky Mountain spotted fever • roseola • rotavirus • roundworms (ascarids and hookworms) • rubella • salmonellosis • Salmonella enteritidis (egg-associated salmonellosis) • SARS (severe accute respiratory syndrome) • scabies (Sarcoptes scabiei) • schistosomiasis (bilharzia) • sexual assault (rape) • sexually transmitted diseases • shigellosis (Shigella) • skin cancer • smallpox • smokeless tobacco • smoking • social marketing • spina bifi da • sporotrichosis (fungal disease) • staphylococcus aureus (Vancomycin-resistant) • suicide • surveillance • syphilis (Treponema pallidum) • technology transfer • tetanus • thrush • tobacco control • tornado • toxocariasis (roundworms) • toxoplasmosis • traumatic brain injury • traveler’s health • trichinosis (trichinellosis) • trypanosomiasis (sleeping sickness) • tuberculosis • typhoid fever • water sanitation • vaccine safety • vessel sanitation • Vibrio vulnifi cus • violence • viral hemorrhagic fever • vision loss and impairment • von Willebrand disease (bleeding disorder) • waterborne diseases • West Nile virus • western equine encephalitis • whipworm infection • women’s health • yellow fever • Yersinia enterocolitica • youth violence • zoonotic diseases • zoster •

SARS, diabetes, monkeypox, obesity, West Nile virus, autism, HIV, environmental hazards, cancer, birth defects, injuries, and countless other reasons we exist. the state of the cdc, Fiscal Year 2003. There’s a lot more to CDC than what makes the nightly news. We protect the health and safety of Americans and people around the world – not just from headline-making diseases like SARS and monkeypox, but from countless other diseases and health threats.

But CDC cannot – and does not – do it alone. We work in partnership with our sister agencies within the Department of Health and Human Services and across the U.S. government; with world, state, and municipal governments; with the private sector, health care organizations, academic institutions, and international and U.S.-based nongovernmental organizations to accomplish our mission. Learn more about CDC’s partners and how prevention is working in the Interactive Resource Guide, a reference tool that accompanies this report.

Table of Contents CDC Index P.1 Calendar P.2 Client Stories P.4 Secretary’s Message P.5 Director’s Message P.6 Key Priority One P.8 CDC Throughout Life P.20 Key Priority Two P.22 Key Priority Three P.34 CDC At A Glance P.50 Financials P.52

In fi scal year 2003, the management structures of CDC’s sister agency, ATSDR (The Agency for Toxic Substances and Disease Registry) and CDC’s National Center for Environmental Health consolidated, bringing together environmental health investigation and programmatic expertise. References to CDC’s environmental health activities in this report include ATSDR. Second Edition EldY\if]i\gfik\[[\Xk_j#nfic[n`[\#]ifdJ8IJ#AXelXip$J\gk\dY\i)''*1 ..+ EldY\if]J8IJ[\Xk_jèk_\Le`k\[JkXk\j#)''*1 ' EldY\if][fd\jk`ZXe[èk\ieXk`feXc_\Xck_èm\jk`^Xk`fejZfe[lZk\[Yp:;:ËjcfYXc8@;JGifîXd10' Gifgfik`fef]k_\nfic[ËjgfglcXk`feè]\Zk\[n`k_k_\YXZk\i`ldk_XkZXlj\jklY\iZlcfj`j1 Fe\$k_ì[ N`k_flkgi\m\ek`feXe[ki\Xkd\ek#gi\[`Zk\[XeelXceldY\if]e\nK9è]\Zk`fej#`cce\jj\jXe[[\Xk_j#nfic[n`[\# Yp)')'#i\jg\Zk`m\cp1 (#'''#'''#'''2)''#'''#'''2*,#'''#'''

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> CDC’s annual budget for fiscal year 2003 totaled $7 billion > If CDC were a public company, it would rank about midway in the Fortune 500, and it would be among the top 15 companies in Georgia > In FY 03, CDC provided about $5 billion to state and local health organizations, academic institutions, and other public health partners > CDC awarded 2,700 public health grants to more than 1,800 different external organizations in FY 03 CDC Contributions to 6. Mental Health Supported groundbreaking research Progress on Ten Leading on suicide causes and innovative prevention strategies. Health Indicators in www.cdc.gov/ncipc/factsheets/suifacts.htm Fiscal Year 2003

7. Injury and Violence 1. Physical Activity Funded programs to prevent adolescent dating Expanded VERB, an integrated awareness violence – psychological, physical, and sexual campaign to encourage positive physical activity – through Families for Safe Dates, and school among tweens, youth ages 9-13. violence through Crossing the Bridge. www.cdc.gov/youthcampaign/ www.cdc.gov/ncipc/dvp/fivp/page3.htm

2. Overweight and Obesity 8. Environmental Quality Advanced the President’s HealthierUS Published the largest and most extensive initiative through programs to reduce assessment of the U.S. public’s overweight, obesity, heart disease, stroke, exposure to environmental chemicals. diabetes, and other chronic diseases. www.cdc.gov/exposurereport/ www.cdc.gov/nccdphp/dnpa/obesity/index.htm

9. Immunization 3. Tobacco Use Posted record lows in childhood illnesses Provided financial and technical assistance to prevented by four vaccines: measles, health departments of all 50 states, the District of rubella, tetanus, and polio. Columbia, and 7 territories; 6 tribal support centers; www.cdc.gov/nip/ and 9 national networks of organizations to reduce tobacco use. www.cdc.gov/nccdphp/bb_tobacco/index.htm 10. Access to Health Care Sponsored WISEWOMAN, a program to provide uninsured women comprehensive services for 4. Substance Abuse breast and cervical cancer detection and Evaluated the effectiveness of mandatory interventions for obesity, sedentary behavior, substance abuse assessment on repeat arrests poor dietary habits, high blood pressure, for driving under the influence. and high cholesterol. www.cdc.gov/ncipc/res-opps/subabu.htm www.cdc.gov/nccdphp/bb_wisewoman/ index.htm

5. Responsible Sexual Behavior Launched the Advancing HIV Prevention initiative, “Increasing Americans’ years of healthy, quality life and eliminating persistent health disparities in our nation–the two overarching goals with new prevention strategies focusing on HIV+ of Healthy People 2010–are integral to CDC’s core values and to every individuals and their sexual partners. activity we undertake. These are top priorities for CDC, and all of www.cdc.gov/hiv/partners/ahp.htm HHS. With our partners, we are making real progress on them, and on the ten leading health indicators for our country.” Julie L. Gerberding, MD, MPH, CDC Director