Healthy Weight

You may not get down to the number you saw on the scale 20 years ago, but you can still get to a weight that enhances your health and your life.

First, what does “healthy weight” mean to you? Is it the weight you think you should be? The same as you weighed 20 years ago? Ten pounds less than your sister-in-law? We can’t provide an exact number for you personally, but we can give you some pointers on how to get to a weight that’s healthy for you and stay there.

Two ways to get a ballpark idea if your weight is healthy or not: body mass index (BMI) and waist circumference.

BMI measures your height compared to your weight. For example, a person who is 5’7” and weighs 170 pounds has a BMI of 26.6, which is in the overweight range:

But experts note that BMI doesn’t measure belly fat, and that’s important. Too much belly fat can increase your risk for type 2 diabetes, heart disease, and stroke. Waist circumference (waist size) takes belly fat into account and helps predict your risk of health problems from being overweight. Women whose waist measures more than 35 inches and men whose waist measures more than 40 inches are at higher risk. Losing weight can reduce belly fat and lower that risk!

To measure your waist correctly, stand and place a tape measure around your middle, just above your hipbones. Measure your waist just after you breathe out.

Read about these three people who were able to shed the pounds (and keep them off).

Getting Started

Losing weight doesn’t have to mean losing a lot of weight. Taking off just 5% to 10%—that’s 10 to 20 pounds for a 200-pound person—can improve your health and well-being. If you have diabetes, you may find your blood sugar levels are easier to manage and that you need less diabetes medicine after you lose weight. Many people who lose weight notice that they have more energy and sleep better too.

A healthy weight goal is one thing; dropping the pounds is quite another. If there were an easy way to lose weight and keep it off, everyone would be doing it. We’ve all known someone who follows a popular diet plan and loses weight fast but then gains it all back (and then some). After trying and failing over and over, it’s easy to see why people give up.

Food for Life

Instead, create an eating plan that you can follow for life. It just needs two key ingredients:

  1. It’s based on healthy food.
  2. You can keep doing it long term.

With that in mind, you may need to try different things to figure out what works best for you day to day. Some people cut back on sugar and eat more protein to stay fuller longer. Others focus on filling up with extra fruits and vegetables, which leaves less room for unhealthy food. Still others limit variety for most meals and stick with choices that they know are healthy and filling. The details will depend on what you like and what fits in best with your life. If you need ideas and support, talk to a registered dietitian or diabetes educator (your doctor can give you a referral).

Physical Activity

Physical activity can make you feel better, function better, and sleep better. You’re not likely to lose a lot of weight with physical activity alone, but combining it with your diet strategy can improve weight loss. Here are the basic guidelines:

  • Every week: do at least 150 minutes of moderate physical activity, such as brisk walking, or 75 minutes of vigorous activity, such as jogging, or an equivalent combination of the two.
  • Two or more days a week: do strength-training activities, such as lifting weights or using a resistance band, that involve all major muscle groups.

If you have diabetes, physical activity can help you manage the condition along with your weight. Being active makes you more sensitive to insulin (the hormone that allows cells in your body to use blood sugar for energy). Your body won’t need to make as much insulin or you won’t need to take as much. Lower insulin levels can help prevent fat storage and weight gain. Learn more about being active when you have diabetes here.

While how you lose weight will be highly personalized, these pointers have helped others reach their goal and could help you, too.

Willpower Isn’t Enough

Don’t get us wrong: willpower is great. It just isn’t enough. You can’t count on it to reach and maintain the healthier weight you want.

But don’t worry; there are other ways. Control your environment so temptation is out of the picture and healthy habits are in. Some ideas:

  • Don’t bring home food you don’t want to eat. Make home a safe zone!
  • Avoid buffet-style restaurants.
  • Don’t let yourself get too hungry.
  • Cook your own food so you can control the calories.
  • Lay out your workout clothes before you go to sleep.
  • Keep the dog’s leash and your walking shoes by the door.

Sleep Helps

Too little sleep makes dieting much harder because it increases your hunger and appetite, especially for high-calorie, high-carb foods. Too little sleep also triggers stress hormones, which tell your body to hang onto fat. Outsmart this problem by being physically active, which has been shown to help you fall asleep faster and sleep better. A relaxing nighttime routine can also help you get your zzz’s. And these tips are tried and true: no screens an hour before bedtime, avoid heavy meals and alcohol before bedtime, and keep your bedroom dark and cool.

Balancing Food and Activity

Try this interactive Body Weight Planner to calculate calories and activity needed to get to your goal weight and maintain it.

Write It When You Bite It

Writing down what you eat is the single best predictor of weight loss success. But most people don’t do it because they think it will be too time-consuming. Guess how long it takes (yes, studies have been done)? Less than 15 minutes a day on average. You don’t need to add lots of detail, but aim for at least 3 entries each day and do it consistently day after day for the best results. Use this handy food diary [PDF – 105 KB] to get started.

Find Your Motivation

People who keep the weight off tend to be motivated by more than just being thinner. For some, it might be a health scare. Others want more energy to play with their grandkids. Focus on a goal that’s meaningful to you, and you’ll be more likely to keep the pounds off too.

More Tips

  • Eat higher-protein, lower-carb meals to control hunger and appetite. For people with diabetes who take insulin, eating fewer carbs like bread, pasta, rice, desserts, sugary beverages, and juice can lower how much insulin they need. Using less insulin can help prevent hunger, fat storage, and weight gain.
  • Choose carbs that are higher in fiber and lower in added sugar. For example, say yes to beans and sweet potatoes; say no to sugary drinks and chips.
  • Drink more water and fewer sweetened beverages. This one change can cut lots of calories and mean fewer blood sugar swings!
  • Keep moving. Physical activity helps you stay motivated and keep the weight off.
  • Learn from a bad day. Everyone slips up from time to time; figure out what went wrong and plan for it next time. You’re only human, and humans are great learners.

About Flu

Influenza (flu) is a contagious respiratory illness caused by influenza viruses that infect the nose, throat, and lungs. Some people, such as older people, young children, and people with certain health conditions, are at higher risk of serious flu complications.  There are two main types of influenza (flu) viruses: Types A and B. The influenza A and B viruses that routinely spread in people (human influenza viruses) are responsible for seasonal flu epidemics each year.

The best way to reduce the risk of flu and its potentially serious complications is by getting vaccinated each year.

Preventive Steps

Take time to get a flu vaccine.

  • CDC recommends a yearly flu vaccine as the first and most important step in protecting against flu viruses.
  • Flu vaccines help to reduce the burden of flu illnesses, hospitalizations and deaths on the health care system each year. (Read more about flu vaccine benefits.)
  • This season, all flu vaccines will be designed to protect against the four flu viruses that research indicates will be most common. (Visit Vaccine Virus Selection for this season’s vaccine composition.)
  • Everyone 6 months and older should get an annual flu vaccine, ideally by the end of October. Learn more about vaccine timing.
  • Vaccination of people at higher risk of developing serious flu complications is especially important to decrease their risk of severe flu illness.
  • People at higher risk of serious flu complications include young children, pregnant people, people with certain chronic health conditions like asthma, diabetes or heart and lung disease, and people 65 years and older.
  • Vaccination also is important for health care workers, and other people who live with or care for people at higher risk to keep from spreading flu to them. This is especially true for people who work in long-term care facilities, which are home to many of the people most vulnerable to flu.
  • Children younger than 6 months are at higher risk of serious flu illness but are too young to be vaccinated. People who care for infants should be vaccinated instead.

Take everyday preventive actions to stop the spread of germs.

  • Take everyday preventive actions that are recommended to reduce the spread of flu.
    • Avoid close contact with people who are sick.
    • If you are sick, limit contact with others as much as possible to keep from infecting them.
  • Cover coughs and sneezes.
    • Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
  • Wash your hands often with soap and water. If soap and water are not available, use an alcohol-based hand rub.
  • Avoid touching your eyes, nose, and mouth. Germs spread this way.
  • Clean and disinfect surfaces and objects that may be contaminated with viruses that cause flu.
  • For flu, CDC recommends that people stay home for at least 24 hours after their fever is gone except to get medical care or other necessities. Fever should be gone without the need to use a fever-reducing medicine. Note that the stay-at-home guidance for COVID-19 may be different. Learn about some of the similarities and differences between flu and COVID-19.
  • In the context of the COVID-19 pandemic, local governments or public health departments may recommend additional precautions be taken in your community. Follow those instructions.

Take flu antiviral drugs if your doctor prescribes them.

  • If you are sick with flu, antiviral drugs can be used to treat your illness.
  • Antiviral drugs are different from antibiotics. They are prescription medicines (pills, liquid or an inhaled powder) and are not available over-the-counter.
  • Antiviral drugs can make flu illness milder and shorten the time you are sick. They may also prevent serious flu complications. For people with higher risk factors [308 KB, 2 Pages], treatment with an antiviral drug can mean the difference between having a milder illness versus a very serious illness that could result in a hospital stay.
  • Studies show that flu antiviral drugs work best for treatment when they are started within 2 days of getting sick, but starting them later can still be helpful, especially if the sick person has a higher risk factor or is very sick from flu.
  • If you are at higher risk from flu and get flu symptoms, call your health care provider early so you can be treated with flu antivirals if needed. Follow your doctor’s instructions for taking this drug.

Flu symptoms include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. Some people also may have vomiting and diarrhea. People may be infected with flu and have respiratory symptoms without a fever. Visit CDC’s website to find out what to do if you get sick with flu. Learn about some of the similarities and differences between flu and COVID-19, and the difference between flu and the common cold.

Planning for Pregnancy

Pregnant? Don’t Smoke!

Smoking during pregnancy can cause babies to be born too small or too early (preterm birth), certain birth defects, and stillbirth. Quitting smoking can be hard, but it is one of the best ways a woman can protect herself and her developing baby. For free help, call 1-800-QUIT-NOW (1-800-784-8669).

Many people know that smoking causes cancer, heart disease, and stroke. But women who smoke during pregnancy put themselves and their developing babies at risk for other health problems. Even being around tobacco smoke puts a woman and her developing baby at risk for health problems.

Smoking during Pregnancy Affects Your Developing Baby’s Health

Smoking during pregnancy can cause babies to be born too small or too early. Women who smoke during pregnancy are more likely to have a baby with a birth defect of the mouth and lip called an orofacial cleft.

Babies who breathe in other people’s tobacco smoke are more likely to have ear infections and lung infections, like bronchitis and pneumonia; if they have asthma, breathing in other people’s tobacco smoke can trigger asthma attacks. These babies are also more likely to die from Sudden Infant Death Syndrome (SIDS), a sudden and unexpected infant death that has no immediately obvious cause after investigation.

It Is Never “Too Late” to Quit Smoking During Pregnancy!

Quitting smoking before getting pregnant is best. But for women who are already pregnant, quitting as early as possible can still help protect against some health problems for their developing babies, such as being born too small or too early. It is never too late to quit smoking.

It is important to quit smoking for good. A women might think it is safe to start smoking again after her baby is born. But babies of mothers who smoke may breathe in the secondhand tobacco smoke that can harm their health. Although quitting for good can be hard, the benefits are worth it—a healthy baby and many more years of good health to enjoy with him or her.

If you or someone you know wants to quit smoking, talk to your healthcare provider about strategies. For support in quitting, including free quit coaching, a free quit plan, free educational materials, and referrals to local resources, please call 1-800-QUIT-NOW (1-800-784-8669); TTY 1-800-332-8615.

Planning for Pregnancy

If you are trying to have a baby or are just thinking about it, it is not too early to start getting ready for pregnancy. Preconception health and health care focus on things you can do before and between pregnancies to increase the chances of having a healthy baby. For some women, getting their body ready for pregnancy takes a few months. For other women, it might take longer. Whether this is your first, second, or sixth baby, the following are important steps to help you get ready for the healthiest pregnancy possible.

1. Make a Plan and Take Action

Whether or not you’ve written them down, you’ve probably thought about your goals for having or not having children, and how to achieve those goals. For example, when you didn’t want to have a baby, you used effective birth control methods to achieve your goals. Now that you’re thinking about getting pregnant, it’s really important to take steps to achieve your goal [PDF – 764 KB]—getting pregnant and having a healthy baby!

2. See Your Doctor

Before getting pregnant, talk to your doctor about preconception health care. Your doctor will want to discuss your health history and any medical conditions you currently have that could affect a pregnancy. He or she also will discuss any previous pregnancy problems, medicines that you currently are taking, vaccinations that you might need, and steps you can take before pregnancy to prevent certain birth defects.

If your doctor has not talked with you about this type of care―ask about it! Take a list of talking points so you don’t forget anything!

Be sure to talk to your doctor about:

Medical Conditions

If you currently have any medical conditions, be sure they are under control and being treated. Some of these conditions include: sexually transmitted diseases (STDs), diabetes, thyroid disease, high blood pressure, and other chronic diseases.

Lifestyle and Behaviors

Talk with your doctor or another health professional if you smoke, drink alcohol, or use certain drugs; live in a stressful or abusive environment; or work with or live around toxic substances. Health care professionals can help you with counseling, treatment, and other support services.

Medications

Taking certain medicines during pregnancy can cause serious birth defects. These include some prescription and over-the-counter medications and dietary or herbal supplements. If you are planning a pregnancy, you should discuss the need for any medication with your doctor before becoming pregnant and make sure you are taking only those medications that are necessary.

People may use opioids as prescribed, may misuse prescription opioids, may use illicit opioids such as heroin, or may use opioids as part of medication-assisted treatment for opioid use disorder. If a woman is pregnant or planning to become pregnant, the first thing she should do is talk to a healthcare provider. Some women need to take an opioid medication during pregnancy to manage pain or to treat opioid use disorder. Creating a treatment plan for opioid use disorder, as well as other co-occurring health conditions, before pregnancy can help a woman increase her chances of a healthy pregnancy. If you are struggling with an opioid use disorder, take a look at CDC’s and partner resources.

Vaccinations (shots)

Some vaccinations are recommended before you become pregnant, during pregnancy, or right after delivery. Having the right vaccinations at the right time can help keep you healthy and help keep your baby from getting very sick or having lifelong health problems.

3. Take 400 Micrograms of Folic Acid Every Day

Folic acid is a B vitamin. If a woman has enough folic acid in her body at least 1 month before and during pregnancy, it can help prevent major birth defects of the baby’s brain and spine.

Learn more about folic acid »

4. Stop Drinking Alcohol, Smoking, and Using Certain Drugs

Smoking, drinking alcohol, and using certain drugs can cause many problems during pregnancy for a woman and her baby, such as premature birth, birth defects, and infant death.

If you are trying to get pregnant and cannot stop drinking, smoking, or using drugs―get help! Contact your doctor or local treatment center.

Alcohol and Drug Resources

Substance Abuse Treatment Facility Locator
The Substance Abuse and Mental Health Services Administration (SAMHSA) has a treatment facility locator. This locator helps people find drug and alcohol treatment programs in their area.

Alcoholics Anonymous (A.A.)
Alcoholics Anonymous® is a fellowship of men and women who share their experiences, strengths, and hopes with each other so that they can solve their common problem and help others to recover from alcoholism. Locate an A.A. program near you.

Learn more about alcohol and pregnancy »

Smoking Resources

1-800-QUIT-NOW (1-800-784-8669)

Learn more about smoking during pregnancy »

5. Avoid Toxic Substances and Environmental Contaminants

Avoid harmful chemicals, environmental contaminants, and other toxic substances such as synthetic chemicals, metals, fertilizer, bug spray, and cat or rodent feces around the home and in the workplace. These substances can hurt the reproductive systems of men and women. They can make it more difficult to get pregnant. Exposure to even small amounts during pregnancy, infancy, childhood, or puberty can lead to diseases. Learn how to protect yourself and your loved ones from toxic substances at work and at home.

Learn about the effects of toxic substances on reproductive health »

Learn how CDC tracks Children’s Environmental Health »

6. Reach and Maintain a Healthy Weight

People who are overweight or obese have a higher risk for many serious conditions, including complications during pregnancy, heart disease, type 2 diabetes, and certain cancers (endometrial, breast, and colon).1 People who are underweight are also at risk for serious health problems.2

The key to achieving and maintaining a healthy weight isn’t about short-term dietary changes. It’s about a lifestyle that includes healthy eating and regular physical activity.

If you are underweight, overweight, or obese, talk with your doctor about ways to reach and maintain a healthy weight before you get pregnant.

Learn more about healthy weight »

7. Get Help for Violence

Violence can lead to injury and death among women at any stage of life, including during pregnancy. The number of violent deaths experienced by women tells only part of the story. Many more survive violence and are left with lifelong physical and emotional scars.

If someone is violent toward you or you are violent toward your loved ones―get help. Violence destroys relationships and families.

Learn about violence prevention »

8. Learn Your Family History

Collecting your family’s health history can be important for your child’s health. You might not realize that your sister’s heart defect or your cousin’s sickle cell disease could affect your child, but sharing this family history information with your doctor can be important.

Other reasons people go for genetic counseling include having had several miscarriages, infant deaths, trouble getting pregnant (infertility), or a genetic condition or birth defect that occurred during a previous pregnancy.

Learn more about family history »

Learn more about genetic counseling »

9. Get Mentally Healthy

Mental health is how we think, feel, and act as we cope with life. To be at your best, you need to feel good about your life and value yourself. Everyone feels worried, anxious, sad, or stressed sometimes. However, if these feelings do not go away and they interfere with your daily life, get help. Talk with your doctor or another health professional about your feelings and treatment options.

Learn about mental health »

Learn about depression »

10. Have a Healthy Pregnancy!

Once you are pregnant, be sure to keep up all of your new healthy habits and see your doctor regularly throughout pregnancy for prenatal care.

Learn how to have a healthy pregnancy »

References

  1. NIH, NHLBI Obesity Education Initiative. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. Available online:
    http://www.nhlbi.nih.gov/guidelines/obesity/ob_gdlns.pdf (PDF-1.25Mb)
  2. Moos, Merry-K, et al. Healthier women, healthier reproductive outcomes: recommendations for the routine care of all women of reproductive age. AJOG Volume 199, Issue 6, Supplement B , Pages S280-S289, December 2008.
Pregnant woman sitting in childbearing center

Sexually Transmitted Disease Surveillance, 2020 serves as a reminder that STDs remain a significant public health concern, even in the face of a pandemic. In 2020, COVID-19 significantly affected STD surveillance and prevention efforts. This report reflects the realities of a strained public health infrastructure, while simultaneously providing the most current data on reported cases of STDs in the United States. Trends presented in this report should be interpreted cautiously. 

Chlamydia

In 2020, a total of 1,579,885 cases of Chlamydia trachomatis infection were reported to the CDC, making it the most common notifiable sexually transmitted infection in the United States for that year. This case count corresponds to a rate of 481.3 cases per 100,000 population, a decrease of 13% compared with the rate in 2019. During 2019–2020, rates of reported chlamydia decreased among both males and females, in all regions of the United States, and, except for rates among non-Hispanic persons of multiple races, among all racial/Hispanic ethnicity groups.

Decreases in rates of reported chlamydia in 2020 are unlikely due to a reduction in new infections. As chlamydial infections are usually asymptomatic, case rates are heavily influenced by screening coverage. During the COVID-19 pandemic, many health care clinics limited in-person visits to patients with symptoms or closed entirely, and it is likely that preventive health care visits where STD screening usually happens, such as annual reproductive health visits for young women, decreased. During the initial shelter-in-place orders in March and April of 2020, the number of chlamydia cases decreased substantially when compared to the number of cases reported in 2019 and the deficit persisted throughout the year.

Rates of reported chlamydia are highest among adolescents and young adults. In 2020, almost two-thirds (61%) of all reported chlamydia cases were among persons aged 15–24 years. Decreases in rates of diagnosed and reported chlamydia during 2020 were most noticeable among females aged 15–24 years, one of the populations targeted for chlamydia screening. Although still high, rates of reported chlamydia decreased 15% among 15–19-year-old females and decreased 10% among 20–24-year-old females during 2019–2020.

Deaths from Excessive Alcohol Use in the United States

Excessive alcohol use was responsible for more than 140,000 deaths in the United States each year during 2015–2019, or more than 380 deaths per day. These estimates are from the CDC’s Alcohol-Related Disease Impact (ARDI) application, using a new methodology. The ARDI application shows estimates of alcohol-attributable deaths and years of potential life lost from 58 conditions by age, sex, and state. See how use of this methodology would affect previous ARDI estimates.

Each year, deaths from excessive drinking:

  • Shortened the lives of those who died by an average of 26 years, for a total of nearly 3.6 million years of potential life lost.
  • Usually involved adults aged 35 or older and males.
  • Were mostly due to health effects from drinking too much over time, such as various types of cancer, liver disease, and heart disease.
  • Led to premature deaths. Deaths from drinking too much in a short time (from causes such as motor vehicle crashes, poisonings involving substances in addition to alcohol, and suicides) accounted for more than half of the years of potential life lost.

Excessive drinking is a leading cause of preventable death in the United States, and it is also costly. It cost the nation $249 billion in 2010 (the most recent year of data available).

Everyone Can Help Prevent Excessive Alcohol Use

You can:

  • Choose not to drink or to drink in moderation by limiting intake to 2 drinks or less in a day (if you’re a man) and 1 drink or less in a day (if you’re a woman), on days when alcohol is consumed. Some people should not drink any alcohol, including if they:
    • Are pregnant or might be pregnant.
    • Are younger than 21.
    • Have certain medical conditions or are taking certain medicines that can interact with alcohol.
    • Are recovering from an alcohol use disorder or are unable to control the amount they drink.
  • Check your drinking, and learn more about the benefits of drinking less alcohol.
  • Support effective community strategies to prevent excessive alcohol use, such as those recommended by the Community Preventive Services Task Force.
  • Not serve or provide alcohol to anyone who should not be drinking, including people younger than 21 or those who have already consumed too much.
  • Talk with your health care provider about your drinking behavior and request counseling if you drink too much.

Check your drinking. This quick assessment can help.

States and communities can:

  • Implement effective strategies for preventing excessive alcohol use to reduce the availability and accessibility of alcohol and increase its price, including regulating the number and concentration of alcohol outlets, limiting days and hours of alcohol sales, and avoiding further privatization of alcohol sales. Check out CDC’s alcohol outlet density measurement resources.
  • Enforce existing laws and regulations about alcohol sales and service.
  • Partner with law enforcement, community groups, health departments, and doctors, nurses, and other health care providers to reduce excessive drinking and related harms.
  • Track the role of alcohol in injuries and deaths, with more routine alcohol toxicology testing among patients and people who have died.
  • Routinely monitor and report on measures of excessive alcohol use and the status of effective alcohol policies.

Healthy Weight

Achieving and maintaining a healthy weight includes healthy eating, physical activity, optimal sleep, and stress reduction. Several other factors may also affect weight gain.

Healthy eating features a variety of healthy foods. Fad diets may promise fast results, but such diets limit your nutritional intake, can be unhealthy, and tend to fail in the long run.

How much physical activity you need depends partly on whether you are trying to maintain your weight or lose weight. Walking is often a good way to add more physical activity to your lifestyle.

Managing your weight contributes to good health now and as you age. In contrast, people who have obesity, compared to those with a healthy weight, are at increased risk for many serious diseases and health conditions. See examples of programs that can help.

Helping people maintain a healthy weight is part of CDC’s work to achieve health equity.

Health Equity

In the United States, chronic diseases are leading causes of death and disability, and some groups are affected more than others. For example, obesity is a chronic disease that increases the risk of heart disease, type 2 diabetes, and many types of cancer. The US prevalence of obesity varies by racial and ethnic group, education, age, location, and physical ability.

What Is CDC’s DNPAO Doing?

CDC’s Division of Nutrition, Physical Activity, and Obesity (DNPAO) leads the nation’s public health efforts to promote good nutrition, regular physical activity, and a healthy weight for everyone. These priorities help improve overall health and well-being and prevent, delay, and manage many chronic diseases.

Yet everyone does not have access to affordable, nutritious food and safe places to be physically active. We work with partners and state, tribal, local, and territorial health agencies and organizations to remove environmental and systemic barriers to health. Health equity is when everyone has the opportunity to be as healthy as possible. Our health equity work focuses on three areas:

What Influences Health Equity?

Social Determinants of Health

The conditions in which we are born, live, learn, work, play, worship, and age are  social determinants of health (SDOH). Examples include access to safe and affordable housing, quality education, and quality health care.

Differences in SDOH contribute to persistent chronic disease disparities among racial, ethnic, and socioeconomic groups as well as in different geographies and among people with different physical abilities.

Racism

Racism is a system of structures, policies, practices, and norms that assigns value and determines opportunity because of the way people look or the color of their skin. This results in conditions that unfairly give advantages to some and disadvantages to others. These advantages and disadvantages are passed down through generations.

Racism, both interpersonal and systemic, limits the ability for some groups to build wealth by determining who owns land, buys houses, gets a quality education, and gets living wage jobs. Racism also affects access to quality health care.

Aligned Work

Within the CDC, DNPAO is part of the National Center for Chronic Disease Prevention and Health Promotion. Our work is aligned with the center’s focus on five social determinants of health: built environment, community-clinical linkages, food and nutrition security, social connectedness, and tobacco-free policies.

Along with more than 25 federal agencies, CDC participates in an Interagency Workgroup developing a Long-Term Recovery and Resilience plan [PDF-181KB]. The purpose is toalign federal actions, outline strategies to improve vital conditions, support community and individual recovery from the effects of COVID-19, and positively affect health and well-being over the next 10 years and beyond. Vital conditions are characteristics of places and institutions that communities and individuals need to reach their full potential and serve as the guiding framework for the federal plan. Vital conditions include basic needs for health and safety, life-long learning, a thriving natural world, reliable transportation, humane housing, and a community-centered environment with meaningful work and wealth.

Healthy People 2030, a Department of Health and Human Services project, offers measurable, objectives as well as developmental and research objectives to improve health and well-being. The social determinants of health objectives include economic stability, education access and quality, health care access and quality, neighborhoods that promote health and safety, and increased social and community support

The World Health Organization works to address social determinants of health by compiling and disseminating evidence on what works to address these determinants to help build capacity and advocate for more action.

Diabetes and Your Skin

If you notice any unusual changes in your skin, it’s important to see your doctor. Early diagnosis and treatment are key to preventing serious complications.

Did you know that diabetes can affect many parts of your body, including your skin? In fact, skin changes are one of the most common signs of diabetes. Learn about the signs of diabetes that can appear on your skin.

The skin is the largest organ of the human body. It’s packed with nerves and blood vessels that allow us to sense touch, temperature, pain, and pressure. Diabetes can affect the nerves and blood vessels in your body, including those in your skin. Changes in your skin can be a sign that something is going on beneath the surface.

When diabetes affects your skin, it’s often a sign that your blood sugar levels are too high over time. Some skin changes can appear even before you’ve been diagnosed with diabetes. Others could be a sign that your diabetes treatment needs to be adjusted. Either way, you’ll want to make an appointment with a doctor to be screened for diabetes or to talk about adjusting your treatment. They can help you prevent serious complications with your skin and other parts of your body.

Keep reading to learn about 9 skin conditions that can occur with diabetes and what you can do to treat or prevent them.

1. Acanthosis nigricans (AN)

This skin condition causes a dark patch or band of velvety skin that can appear in body creases such as your neck, armpits, or groin. Sometimes the patches can also appear on your hands, elbows, or knees.

What causes it: AN is a sign of insulin resistance and can be a sign of prediabetes or type 2 diabetes. It is common in people who have obesity.

What to do: Some creams can help make the spots look better, but the most effective treatment is to address the root cause, like obesity or insulin resistance. Lifestyle changes such as being physically active and maintaining a healthy weight can help reverse insulin resistance.

2. Diabetic dermopathy

This condition is also known as shin spots, and it’s harmless. The spots look like red or brown round patches or lines in the skin and are common in people with diabetes. They appear on the front of your legs (your shins) and are often confused with age spots. The spots don’t hurt, itch, or open up.

What causes it: Diabetes can cause changes in small blood vessels that reduce blood supply to the skin.

What to do: This skin condition is harmless and doesn’t need treatment. If you do have any concerns about shin spots, talk to your doctor.

3. Necrobiosis lipoidica

This condition causes yellow, reddish, or brown patches on your skin. It usually begins as small, raised bumps that look like pimples. As it gets worse, the bumps turn into patches of swollen, hard skin. This skin condition is rare, but if it does develop it can be itchy and painful.

What causes it: The cause of necrobiosis lipoidica isn’t completely clear, but women are more likely to have it than men. It usually develops when changes in fat and collagen (a fiber-like protein in your body) happen beneath the skin’s surface.

What to do: There is no cure for the condition, so treatment is focused on managing signs and symptoms. In the early stages, topical steroid creams can be used to keep it from getting worse. You’ll want to talk with your doctor so they can find the right treatment plan for you.

4. Bullosis diabeticorum (diabetic blisters)

This condition looks like burn blisters. They can develop on your lower legs and feet, and sometimes on your arms and hands. They can look scary, but they are painless and usually heal on their own.

What causes it:  The cause of diabetic blisters is unknown. They can appear with no known injury to the skin. You’re more likely to get diabetic blisters if your blood sugars levels are high over time.

What to do: Most blisters heal on their own without leaving a scar. Daily inspection of your feet and skin is the best way to find early signs of blisters. The best way to prevent them from developing or getting worse is to bring your blood sugar down to normal levels.

5. Eruptive xanthomatosis

This condition causes small, reddish-yellow bumps on the back of your hands, feet, arms, legs, and buttocks. They can be tender and itchy.

What causes it: This condition is rare. It’s caused by having high levels of cholesterol and triglycerides (fat in the blood).

What to do: The best treatment is to bring blood fat levels under control. Your doctor may also want to prescribe medicine to help lower your cholesterol. Talk to your doctor about having your cholesterol checked so that you can take steps to prevent high cholesterol.

6. Digital sclerosis

This condition starts with tight, thick, waxy skin on your fingers and can cause your finger joints to become stiff and hard to move. If blood sugar levels remain high, digital sclerosis can cause your skin to become hard, thick, and swollen and can spread throughout your body.

What causes it: This condition is more common in people with type 1 diabetes who have high blood sugar levels.

What to do: The only treatment for digital sclerosis is to bring blood sugar levels down into the normal range. Physical therapy may help improve the range of motion of affected joints.

7. Bacterial infections

Bacterial infections cause tissue (cells that make up organs and other body parts) to become inflamed, hot, swollen, red, and painful. Common bacterial infections include those on the eyelids, hair follicles, and fingernails.

What causes it: Anyone can get a bacterial infection, but people with diabetes tend to get more than people without diabetes. Bacteria thrive when there is too much glucose (sugar) in the body. A common type of bacteria responsible for bacterial infections in people with diabetes is staphylococcus (staph).

What to do: Bacterial infections usually can be treated with antibiotics. Keeping your blood sugar levels within the normal range can help you avoid infections. Healthy eating, getting physical activity, and taking your medicine as instructed can help you manage your blood sugar.

8. Fungal infections

Fungal infections create itchy rashes surrounded by tiny red blisters and scales. They usually develop in warm, moist folds of the skin. Common fungal infections include jock itch, athlete’s foot, ringworm, and vaginal infections.

What causes it: Like bacterial infections, anyone can get a fungal infection, but they are common in people with diabetes. Fungal infections are more likely to occur when blood sugar levels are high.

What to do: Talk to your doctor about prescription or over-the-counter medicine that can help treat fungal infections. Keeping blood sugar levels within the normal range by checking your blood sugar often, eating healthy, and getting regular exercise is the best way to prevent fungal infections.

9. Dry, itchy skin

This skin condition is common, even for people who don’t have diabetes. But dry, itchy skin can be a result of poor circulation, which is more likely when you have diabetes.

What causes it: Too much sugar in the blood causes the body to pull fluid from its cells so that it can produce enough urine to remove the excess sugar. This can make your skin dry.

What to do: You’ll want to monitor your blood sugar levels and keep them in your target range as much as possible. It also helps if you limit your time in the shower, use mild soaps, and use lotion after showering. Exercise is one of the best ways to improve circulation—and has many other health benefits.

Be Good to Your Skin

Skin is a good indicator of health. If you notice any unusual changes in your skin, it’s important to see your doctor. Early diagnosis and treatment are key to preventing serious complications from skin problems caused by diabetes.

What is Monkeypox?

Monkeypox is a rare disease caused by infection with the monkeypox virus. Monkeypox virus belongs to the Orthopoxvirus genus in the family Poxviridae. The Orthopoxvirus genus also includes variola virus (which causes smallpox), vaccinia virus (used in the smallpox vaccine), and cowpox virus. Monkeypox is not related to chickenpox.

Monkeypox was first discovered in 1958 when two outbreaks of a pox-like disease occurred in colonies of monkeys kept for research. Despite being named “monkeypox”, the source of the disease remains unknown. However, African rodents and non-human primates (like monkeys) may harbor the virus and infect people.

The first human case of monkeypox was recorded in 1970. Since then, monkeypox has been reported in people in several other central and western African countries. Prior to the 2022 outbreak, nearly all monkeypox cases in people outside of Africa were linked to international travel to countries where the disease commonly occurs, or through imported animals.

Sign & Symptoms: 

Monkeypox is a rare disease caused by infection with the monkeypox virus. Monkeypox virus is part of the same family of viruses as smallpox. Monkeypox symptoms are similar to smallpox symptoms, but milder; and monkeypox is rarely fatal. Monkeypox is not related to chickenpox.

Symptoms of monkeypox can include:

  • Fever
  • Headache
  • Muscle aches and backache
  • Swollen lymph nodes
  • Chills
  • Exhaustion
  • A rash that can look like pimples or blisters that appears on the face, inside the mouth, and on other parts of the body, like the hands, feet, chest, genitals, or anus.
    • The rash goes through different stages before healing completely. The illness typically lasts 2-4 weeks.

Sometimes, people get a rash first, followed by other symptoms. Others only experience a rash.

Prevention:

There are number of measures that can be taken to prevent infection with monkeypox virus:

  • Avoid contact with animals that could harbor the virus (including animals that are sick or that have been found dead in areas where monkeypox occurs).
  • Avoid contact with any materials, such as bedding, that has been in contact with a sick animal.
  • Isolate infected patients from others who could be at risk for infection.
  • Practice good hand hygiene after contact with infected animals or humans. For example, washing your hands with soap and water or using an alcohol-based hand sanitizer.
  • Use personal protective equipment (PPE) when caring for patients.

Practice good hand hygiene after contact with infected animals or humans.

JYNNEOSTM  (also known as Imvamune or Imvanex) is an attenuated live virus vaccine which has been approved by the U.S. Food and Drug Administration for the prevention of monkeypox. On November 3, 2021, the Advisory Committee on Immunization Practices (ACIP) voted to recommend JYNNEOS pre-exposure prophylaxis as an alternative to ACAM2000 for certain persons at risk for exposure to orthopoxviruses.

Diarrhea and Swimming

You can get sick with diarrhea if you swallow contaminated recreational water—water in pools, hot tubs, water playgrounds, or oceans, lakes, and rivers. In fact, diarrhea is the most common illness reported for outbreaks linked to recreational water.

Which germs in recreational water cause diarrhea?

You can get diarrhea from germs such as

These germs can survive in properly chlorinated water for minutes to days, depending on the germ.

How do germs that cause diarrhea spread in recreational water?

If someone is sick and has diarrhea in the water, millions of germs can contaminate the water. These germs can make other people sick if they swallow even a small amount of contaminated water. Swallowing 10 or fewer germs can make people sick. Germs can also get in the water if swimmers have poop, even tiny amounts, on their bottoms.

Pool chemicals and filters help kill germs

Filters and disinfectants (chemicals that disinfect the water, such as chlorine or bromine) work together to help kill germs in pools, hot tubs, and water playgrounds. Filters remove debris (such as leaves), which use up the disinfectant in the water. Pool staff make sure chlorine or bromine is at the level needed to kill most germs in the water within minutes. You can still be exposed to germs during the time it takes for the water to go through filters and for the disinfectant to kill germs. You can also get diarrhea from germs that are hard to kill, such as Crypto. Crypto stays alive for more than 7 days, even if water is properly filtered and disinfected.

Many places with pools use one filtration system for more than one pool, which causes water from multiple pools to mix. This means germs from one person’s body could contaminate the water in more than one pool.

How do I protect myself and those I care about?

We all share the water we swim, play, or relax in. Each of us can help protect ourselves, our families, and our friends from germs that can cause diarrhea.

Take the following steps when swimming in any type of water:

  • Stay out of the water if you are sick with diarrhea.
    • If you have Crypto, don’t go in the water until 2 weeks after diarrhea has completely stopped.
  • Don’t poop in the water.
  • Don’t swallow the water.
  • Take kids on bathroom breaks and check diapers every hour.
    • Change diapers away from the water’s edge to keep germs from getting in the water. Wash your hands after.

Before going in pools, water playgrounds, and hot tubs, also take these steps:

  • Use test strips to make sure the water has proper free chlorine (amount of chlorine available to kill germs) or bromine level and pH.
    • Free chlorine level: at least 1 part per million (ppm) in pools and water playgrounds and at least 3 ppm in hot tubs
    • Bromine level: at least 3 ppm in pools and water playgrounds and at least 4 ppm in hot tubs
    • pH (affects how well chlorine and bromine can kill germs): 7.2–7.8
    • Most superstores, hardware stores, and pool supply stores sell test strips. Follow the directions on the test strip package.
  • Shower before you get in the water.
    • A 1-minute shower removes most of the dirt, sweat, and oils on your body that use up chlorine or bromine needed to kill germs.

Follow these and other healthy swimming steps to help protect you and those you care about from getting sick.

Loneliness and Social Isolation Linked to Serious Health Conditions

Social isolation was associated with about a 50% increased risk of dementia and other serious medical conditions.

Loneliness and social isolation in older adults are serious public health risks affecting a significant number of people in the United States and putting them at risk for dementia and other serious medical conditions.

A report from the National Academies of Sciences, Engineering, and Medicine (NASEM) points out that more than one-third of adults aged 45 and older feel lonely, and nearly one-fourth of adults aged 65 and older are considered to be socially isolated.1 Older adults are at increased risk for loneliness and social isolation because they are more likely to face factors such as living alone, the loss of family or friends, chronic illness, and hearing loss.

Loneliness is the feeling of being alone, regardless of the amount of social contact. Social isolation is a lack of social connections. Social isolation can lead to loneliness in some people, while others can feel lonely without being socially isolated.

Health Risks of Loneliness

Although it’s hard to measure social isolation and loneliness precisely, there is strong evidence that many adults aged 50 and older are socially isolated or lonely in ways that put their health at risk. Recent studies found that:

  • Social isolation significantly increased a person’s risk of premature death from all causes, a risk that may rival those of smoking, obesity, and physical inactivity.1
  • Social isolation was associated with about a 50% percent increased risk of dementia.1
  • Poor social relationships (characterized by social isolation or loneliness) was associated with a 29% increased risk of heart disease and a 32% increased risk of stroke.1
  • Loneliness was associated with higher rates of depression, anxiety, and suicide.
  • Loneliness among heart failure patients was associated with a nearly 4 times increased risk of death, 68% increased risk of hospitalization, and 57% increased risk of emergency department visits.

Immigrant, LGBT People Are at Higher Risk

The report highlights loneliness among vulnerable older adults, including immigrants; lesbian, gay, bisexual, and transgender (LGBT) populations; minorities; and victims of elder abuse. It also points out that the literature base for these populations is sparse and more research is needed to determine risks, impacts, and appropriate actions needed.

Current research suggests that immigrant, and lesbian, gay, bisexual populations experience loneliness more often than other groups. Latino immigrants, for example, “have fewer social ties and lower levels of social integration than US-born Latinos.” First-generation immigrants experience stressors that can increase their social isolation, such as language barriers, differences in community, family dynamics, and new relationships that lack depth or history, the report states. Similarly, gay, lesbian, and bisexual populations tend to have more loneliness than their heterosexual peers because of stigma, discrimination, and barriers to care.

What Can You Do If You Are Experiencing Loneliness?

Your doctor can assess your risk for loneliness and social isolation and get you connected to community resources for help, if needed. The following national organizations also offer helpful resources:

AARP—Provides helpful information to seniors to help improve quality of life and provides access to Community Connection Tools.

Area Agencies on Aging (AAA)—A network of over 620 organizations across America that provides information and assistance with programs including nutrition and meal programs (counseling and home-delivered or group meals), caregiver support, and more. The website can help you find your local AAA, which may provide classes in Tai Chi and diabetes self-management.

Eldercare Locator—A free national service that helps find local resources for seniors such as financial support, caregiving services, and transportation. It includes a brochure that shows how volunteering can help keep you socially connected.

National Council on Aging—Works with nonprofit organizations, governments, and businesses to provide community programs and services. This is the place to find what senior programs are available to assist with healthy aging and financial security, including the Aging Mastery Program® that is shown to increase social connectedness and healthy eating habits.

National Institute on Aging (NIA)– Provides materials on social isolation and loneliness for older adults, caregivers, and health care providers. Materials include health information, a print publication available to view or order no-cost paper copies, a health care provider flyer, and social media graphics and posts.

Health Care System Interventions Are Key

People generally are social by nature, and high-quality social relationships can help them live longer, healthier lives. Health care systems are an important, yet underused, partner in identifying loneliness and preventing medical conditions associated with loneliness.

Nearly all adults aged 50 or older interact with the health care system in some way. For those without social connections, a doctor’s appointment or visit from a home health nurse may be one of the few face-to-face encounters they have. This represents a unique opportunity for clinicians to identify people at risk for loneliness or social isolation.

NASEM recommends that clinicians periodically assess patients who may be at risk and connect them to community resources for help. In clinical settings, NASEM recommends using the Berkman-Syme Social Network Index (for measuring social isolation) and the three-item UCLA Loneliness Scale (for measuring loneliness).

But patients must make their own decisions. Some people may like being alone. It is also important to note that social isolation and loneliness are two distinct aspects of social relationships, and they are not significantly linked. Both can put health at risk, however.

Old lonely woman sitting near the window in his house with flowers