Strategies

What Works for Health includes evidence-informed strategies to create communities where everyone can thrive.

Administrative license suspension/revocation laws

Enable law enforcement to immediately take the license of a driver who fails or refuses to take a chemical test for alcohol

Evidence Rating:

Scientifically Supported

Adult drug courts

Use specialized courts to offer adults who are charged with an offense and have substance use disorders an alternative to adjudication or incarceration

Evidence Rating:

Scientifically Supported

Alcohol access restrictions in public places

Restrict alcohol availability and use at sporting events, other public events (e.g., concerts and street fairs) and in public spaces such as parks and beaches

Evidence Rating:

Expert Opinion

Alcohol advertising restrictions

Restrict the content and placement of alcohol advertisements on broadcasts, outdoor displays, internet marketing, etc. via state laws, local ordinances, industry self-regulation, or a combination of efforts

Evidence Rating:

Some Evidence

Alcohol brief interventions

Provide information and increase motivation to change or prevent problematic alcohol consumption in a short session; also called alcohol screening & brief intervention

Evidence Rating:

Scientifically Supported

Alcohol days of sale restrictions

Limit when alcohol can be sold in bars, restaurants, and/or liquor and convenience stores; limits may apply to days or times of sale

Evidence Rating:

Some Evidence

Alcohol outlet density restrictions

Limit increases in the number and concentration of alcohol outlets by area or by population through licensing or zoning regulations

Evidence Rating:

Scientifically Supported

Alcohol taxes

Increase the price of alcohol via taxes levied for beer, wine, and liquor purchases

Evidence Rating:

Scientifically Supported

Alternative fuels initiatives

Support alternative fuel and vehicle use via financial incentives (e.g., tax benefits, rebates, etc.), mandates (e.g., consumption targets or renewable fuel standards), research and development investments, etc.

Evidence Rating:

Expert Opinion

Bicycle & pedestrian master plans

Establish a framework to increase walking and biking trails and improve connectivity of non-auto paths and trails in a particular area

Evidence Rating:

Some Evidence

Blood alcohol concentration laws

Set legal limits for drivers’ blood alcohol concentrations (BACs)

Evidence Rating:

Scientifically Supported

Breath testing checkpoints

Implement checkpoints where law enforcement officers can stop drivers suspected of drinking and driving and assess their level of alcohol impairment

Evidence Rating:

Scientifically Supported

CAFO regulations

Establish local regulations for confined animal feeding operations (CAFOs) that address location, size, facility management, and pollution contributions to complement U.S. EPA regulations

Evidence Rating:

Expert Opinion

Campus alcohol bans

Restrict alcohol consumption anywhere on a college or university campus or only in specific areas (e.g., residence halls)

Evidence Rating:

Insufficient Evidence

Carpool & rideshare programs

Help participants share transportation via informal arrangements between individuals, formally arranged ridesharing programs, or other ride-matching services

Evidence Rating:

Expert Opinion

Clean diesel technology fleet transition programs

Replace or retrofit diesel buses or other vehicles to operate with clean diesel technology

Evidence Rating:

Scientifically Supported

Community gardens

Establish and support land that is gardened or cultivated by community members via community land trusts, gardening education, zoning regulation changes, or service provision (e.g., water or waste disposal)

Evidence Rating:

Some Evidence

Community supported agriculture (CSA)

Establish partnerships between farmers and consumers in which consumers purchase a share of a farm’s products in advance

Evidence Rating:

Expert Opinion

Competitive pricing for healthy foods

Assign higher costs to non-nutritious foods than nutritious foods via incentives, subsidies, or price discounts for healthy foods and beverages or disincentives or price increases for unhealthy choices

Evidence Rating:

Scientifically Supported

Complete Streets & streetscape design initiatives

Enhance streetscapes with greater sidewalk coverage and walkway connectivity, street crossing safety features, traffic calming measures, and other design elements

Evidence Rating:

Scientifically Supported

Composting

Use aerobic, natural decomposition to divert food and yard waste from landfills and create a nutrient-rich soil amendment product on an individual or large scale

Evidence Rating:

Scientifically Supported

Conservation tillage practices

Encourage methods of soil cultivation that keep at least one-third of cultivated soil covered with the previous year’s crop residue (e.g., mulch till, ridge till, strip till, or no-till)

Evidence Rating:

Scientifically Supported

Designated driver promotion programs

Encourage use of designated drivers via population-based mass media campaigns, incentive programs based in drinking establishments, and other efforts

Evidence Rating:

Insufficient Evidence

Dram shop liability laws

Hold alcohol retailers legally responsible for injuries or damage caused by providing alcohol to intoxicated or underage customers; also called commercial host liability laws

Evidence Rating:

Scientifically Supported

Drink special restrictions

Limit or ban alcohol establishments from serving alcohol at a reduced price as part of promotions; also called happy hour restrictions

Evidence Rating:

Some Evidence

Electric vehicle initiatives

Replace internal combustion engine vehicles with all-electric vehicles through financial incentives, regulations, and multi-component initiatives

Evidence Rating:

Scientifically Supported

Enhanced enforcement of laws prohibiting alcohol sales to minors

Initiate or increase retailer compliance checks, shoulder tap operations, parking lot observation outside alcohol establishments for laws that prohibit alcohol sales to minors

Evidence Rating:

Scientifically Supported

Family treatment drug courts

Use specialized courts to work with parents involved in the child welfare system who may lose custody of their children due to substance use; also called family treatment courts, family dependency treatment courts, or family drug courts

Evidence Rating:

Scientifically Supported

Farm to school programs

Incorporate locally grown foods into school meals and snacks, often with visits from food producers, cooking classes, nutrition and waste reduction efforts, and school gardens

Evidence Rating:

Some Evidence

Farmers markets

Support multiple vendor markets where producers sell goods such as fresh fruit and vegetables, meat, dairy items, and prepared foods directly to consumers

Evidence Rating:

Some Evidence

Fentanyl test strip distribution programs

Provide free fentanyl test strips to detect the presence of fentanyl in different kinds of drugs and drug forms

Evidence Rating:

Some Evidence

Food buying clubs & co-ops

Offer opportunities for group purchase and distribution of selected grocery items, generally at a reduced price

Evidence Rating:

Expert Opinion

Food hubs

Support businesses or organizations that aggregate, distribute, and market local and regional food products (e.g., fresh fruits and vegetables, meat, dairy, grains, and prepared items)

Evidence Rating:

Expert Opinion

Fruit & vegetable gleaning initiatives

Gather food left in fields after a primary harvest, food in fields where harvesting is not profitable, or excess produce from orchards, packing houses, urban agriculture sites, etc.

Evidence Rating:

Expert Opinion

Fruit & vegetable incentive programs

Offer participants with low incomes matching funds to purchase healthy foods, especially fresh fruits and vegetables; often called bonus dollars, market bucks, produce coupons, or nutrition incentives

Evidence Rating:

Scientifically Supported

Good Samaritan drug overdose laws

Provide immunity from arrest, charges, or prosecution for drug possession or paraphernalia when individuals experiencing or witnessing drug overdose summon emergency services

Evidence Rating:

Expert Opinion

Green space & parks

Increase green space through new parks or open spaces, renovation or enhancement of under-used recreation areas, rehabilitation of vacant lots, brownfields, etc.

Evidence Rating:

Some Evidence

Healthy food in convenience stores

Encourage convenience stores, corner stores, or gas station markets to carry fresh produce and other healthier food options

Evidence Rating:

Some Evidence

Healthy food initiatives in food pantries

Combine hunger relief efforts with nutrition information and healthy eating opportunities, often with on-site cooking demonstrations, recipe tastings, produce display stands, etc.

Evidence Rating:

Some Evidence

Healthy school lunch initiatives

Modify the school lunch food environment or school lunch schedules by increasing the convenience of healthy foods, providing healthy options, or ensuring students have enough time to eat

Evidence Rating:

Scientifically Supported

Ignition interlock devices

Strengthen policies that mandate ignition interlock installation in vehicles to prevent operation by a driver with a high blood alcohol concentration

Evidence Rating:

Scientifically Supported

Individual incentives for public transportation

Offer incentives such as free or discounted bus, rail, or transit passes, reimbursements, partial payments, or pre-tax payroll deductions to encourage individuals’ use of existing public transit

Evidence Rating:

Some Evidence

Keg registration laws

Require wholesalers or retailers to record an identification number for beer kegs and a purchaser’s information (e.g., name and address, date of birth, etc.) at the time of purchase

Evidence Rating:

Insufficient Evidence

Mass media campaigns against alcohol-impaired driving

Use mass media campaigns to persuade individuals to avoid drinking and driving or to prevent others from doing so; campaigns often focus on the negative consequences of alcohol-impaired driving

Evidence Rating:

Some Evidence

Mass media campaigns against underage drinking

Use television, radio, print, and social media efforts to increase awareness of underage drinking and its consequences

Evidence Rating:

Insufficient Evidence

Medical marijuana legalization

Allow eligible patients to use marijuana for medical purposes; often called medical marijuana laws (MMLs)

Evidence Rating:

Mixed Evidence

Medication-assisted treatment access enhancement initiatives

Provide medications such as methadone to individuals diagnosed with opioid use disorder in outpatient, residential, and hospital settings, usually with counseling and behavioral therapies; often called MAT

Evidence Rating:

Expert Opinion

Minimum drinking age laws

Maintain the current legal age when an individual can purchase alcoholic beverages; currently 21 years in all states

Evidence Rating:

Scientifically Supported

Mixed-use development

Support a combination of land uses (e.g., residential, commercial, recreational) in development initiatives, often through zoning regulations or Smart Growth initiatives

Evidence Rating:

Scientifically Supported

Mobile produce markets

Support fresh food carts or vehicles that travel to neighborhoods on a set schedule to sell fresh fruits and vegetables

Evidence Rating:

Some Evidence

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