Using Evidence to Move the Needle on Health Outcomes

Take a moment to consider the community where you live, work, learn, and play. What issues are affecting the health of your community? Obesity? Tobacco Use? Access to health care services? Access to healthy foods?

What if you know what issues affect the health of your community, but are not sure how to address those issues and understand how they affect all residents in your community? 

Let’s consider rural America. Evidence has shown that the health of populations in these communities are disproportionally affected by health outcomes when compared to urban communities.  Disparities in these communities are exacerbated by social, economic, and environmental factors, including poverty, limited employment opportunities, poor housing, or geographical isolation. So how might public health issues, such as obesity or access to healthy foods, be addressed in rural communities? What works in one setting may not work for others.

Decisions on how to address public health issues, albeit in a rural community, workplace, or otherwise, are often guided by various factors, including literature, funding, policy makers, or even the media. At times, these decisions may be made void of the evidence available, thus program and policies may fail if an ineffective intervention approach is utilized, inadequate evaluation methods are used to understand issues that affect all residents in a community, or poor adaptation of an intervention to a population.

Cue in Evidence-Based Public Health.  Advances in research over the past twenty years in approaches to population health and evidence-based public health practice have been informed by researchers, field experts, and practitioners to effectively…move the needle on health outcomes. So what is evidence-based public health? It is defined as “the development, implementation, and evaluation of effective programs and policies in public health through application of principles of scientific reasoning. The process involves integrating science-based interventions with community preferences to improve the health of populations.”[1]

Evidence can be acquired in different forms, from objective evidence available in scientific literature in systematic reviews, to program data, or from subjective evidence from worth of mouth or personal experiences. Regardless if evidence is gathered from objective or subjective sources, it is still evidence.

Why does it Matter?  Using an evidence-based approach to public health practice is essential to effectively impact health outcomes…essentially increase the likelihood to move the needle to achieve impact. Funding opportunities and accrediting bodies are also requiring public health agencies to integrate evidence into public health practice. Evidence can be used to inform strategic planning, grant writing and even working with partners and stakeholders to tell a story.

Specifically, evidence-based data has made notable differences in terms of policy, funding, or programmatic decisions that affect public health on various topics, from obesity to nutrition to healthy equity.[2]  For example, evidence-based reviews identified in The Community Guide recommend to address childhood obesity includes, “meal interventions and fruit and vegetable snack interventions, including school meal policies and fresh fruit and vegetable programs, to increase the availability of healthier foods and beverages provided by schools.”[3]

Strategies to integrate evidence-based decision making into public health practice can be guided by the Evidence-Based Public Health Framework, developed by leading public health researchers and practitioners.[4] The Framework helps public health professionals to “engage the community in assessment, use data systematically, make decision based on evidence, apply program planning framework, conduct sound evaluation and disseminate what is learned.”[5]

In my time as a public health professional, the amount of resources and tools available to support evidence-based public health practice has grown exponentially and continues to do so. Resources such as The Community Guide, What Works for Health available from the County Health Rankings, U.S. Preventive Services Task Force, or the Campbell Collaboration are examples of sources of quality, systematic reviews to guide evidence-base practice.

In addition, universities, prevention research centers, and leading public health agencies have resources and tools available to support training and education specific to evidence-based public health practice, including the Prevention Research Center in St. Louis, Rocky Mountain Public Health Training Center, University of Washington Health Sciences Library, Partners in Information Access for the Public Health Workforce and the Public Health Information & Data Tutorial. Local and state public health agencies are also implementing evidence-based public health practice and have resources available specific to their community or state.  

So, as you work to address the health of a community, remember that the wheel does not have to be reinvented.  Use what works to effectively practice evidence-based public health and move the needle on health outcomes.


[1] Brownson RC, Baker EA, Leet T, Gillespie KN, eds. Evidence-based public health. New York: Oxford University Press; 2003. Public Health and Information Tutorial. keyConcepts/4.2.2.html. Accessed December 2, 2008.

[2] Secretary’s Advisory Committee on National Health Promotion and Disease Prevention Objectives for 2020. (2010, July 26). Evidence-Based Clinical and Public Health: Generating and Applying the Evidence. Retrieved from

[3] Guide to Community Preventive Services. Obesity: Meal and Fruit and Vegetable Snack Interventions to Increase Healthier Foods and Beverages Provided by Schools. Page last updated: November 17, 2017. Page accessed: March 27, 2018

[4] Brownson RC, Fielding JE, Maylahn CM. Evidence-based public health: a fundamental concept for public health practice. Annu. Rev. Public Health. 2009;30175–201.

[5] Prevention Research Center in St. Louis. (2016, March 15-18). Evidence-Based Public Health: A course in chronic disease prevention. Proceeding from St. Louis, MO.