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Chronic Disease Prevention

Chronic diseases, such as heart disease, stroke, and diabetes, characterize the top five leading causes of death in the City of Manchester. Heart disease is the number one cause of death for Manchester residents. Despite representing only 9% of the state’s total population, the City of Manchester accounts for nearly 12% of all deaths due to heart disease in the State of New Hampshire. A common thread among chronic diseases, such as heart disease and asthma, is that they are largely preventable or managed through behavior modification and environmental interventions. Accordingly, there are many steps individuals can take to reduce their risk factors associated with most chronic diseases, such as not smoking, getting more physical activity, and making healthier food choices. The chronic disease prevention initiatives of the Department aim to address these risk factors for disease by promoting healthy lifestyle changes that will reduce the frequency of chronic diseases among Manchester residents. 

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Asthma is a chronic lunge disease that has been increasing in prevalence in the United States. Nationally, New England States have a higher prevalence of asthma. If asthma is managed properly, emergency hospital care for issues related to asthma is largely preventable. The City of Manchester has higher rates of hospitalizations due to asthma in both adults and children than the rest of the State of New Hampshire.

  • Manchester’s Asthma Education and Outreach Program – This Outreach Program provides home-based asthma education and case management services for families with children (age 1-18 years) who have persistent, moderate to severe asthma. This program aims to reduce emergency room visits, hospitalizations, and school days missed due to uncontrolled asthma. For more information contact the Health Department at 603-624-6466.
  • For more information on living with asthma visit the NH Asthma Collaborative and the program brochure information listed below:


Cancer is the second leading cause of death for Manchester residents, which accounts for nearly 9% of all deaths due to cancer in the State of New Hampshire. Everyone is at risk for developing cancer. Increasing age, genetics or family history, and gender are known risk factors for cancer that are not modifiable. However, much like heart disease, several behavioral risk factors play a role in the development of certain cancers and can be targeted in prevention efforts. Additionally, the timely access and utilization of health screenings, such as mammography, are essential tools in the fight against cancer. Prevention and early detection are key strategies to decreasing cancer-related mortality.

We have several partnerships/initiatives working to promote prevention and early detection of cancer: 

Manchester Crusade Against Cancer (MCAC) – MCAC was formed to develop initiatives and interventions targeted at reducing the incidence of cancer among Manchester residents. Since it’s inception in 2005, several key community partner organizations have joined the Crusade – American Cancer Society, Breathe NH, Catholic Medical Center, Dartmouth Hitchcock-Manchester, NH Minority Health Coalition, and the Manchester VA Medical Center. Based on preventability and higher rates of mortality among Manchester residents, the MCAC targets it’s efforts at Breast, Lung, and Colorectal Cancer.

Recent activities include:

The MCAC is working with the Manchester Accesses Mammograms Project to assist with project deliverables, such as the development of a social marketing campaign.
Manchester Accesses Mammograms (MAM) – Through funding support provided by the American Cancer Society, the Department in partnership with the NH Minority Health Coalition has designed a program to assist uninsured/underinsured women with limited English proficiency access free mammograms through the NH Breast and Cervical Cancer Early Detection Program. For more information, please call the NH Minority Health Coalition at 627-7703. 


Obesity is on the rise among Americans of all ages, and has reached epidemic proportions. The number of obese adults has grown by nearly 20% over the past 30 years, and the number of overweight children has tripled in the same period. At the current rate of increase, 75% of Americans will be obese by the year 2050. The major causes of being overweight and obese include poor food choices, lack of physical activity, environmental factors, and family history of overweight or obesity. Obesity is associated with adverse health problems, such as high blood pressure, elevated cholesterol levels, heart disease, stroke, diabetes, and colon and breast cancer. Obese youth and adults are also more likely to face social discrimination, and to suffer from low self-esteem and mental health issues like depression. These and other health problems associated with an unhealthy diet and physical inactivity resulted in approximately 400,000 deaths in 2000 in the United States among people aged 18 years and older.  

Children’s Health and Nutrition Program – This program utilizes City CIP funds to combat the increasing epidemic of childhood obesity in Manchester targeting four Title One Elementary Schools. The program utilizes comprehensive, evidence-based initiatives that target all levels of change – individual/family, policy/systems, and community. Program initiatives are directed by a Registered Dietician. A total of approximately 1,940 Manchester families and school staff benefit from program services. 

Example of initiative:

Get Moving Manchester (GMM) began its fifth year of implementation within Manchester’s Elementary and Middle Schools in March 2008. Primarily targeted to grades 3-6, GMM is a four week nutrition and exercise journaling program to increase awareness for the importance of a healthy lifestyle. This year’s theme was based on the State’s campaign of 5-2-1-0. This campaign promotes that children/youth consume 5 fruits and vegetables per day, receive no more than 2 hours of screen time per day, participate in at least 1 hour of physical activity per day, and avoid drinking sweetened beverages, such as soda.


Tobacco use is the number one preventable cause of death in the United States. In 2005, the Behavioral Risk Factor Surveillance Survey, which is a telephone-based, health survey of the adults (18 and older) in New Hampshire, indicated that 28.3% or approximately 31,000 Manchester adults are current smokers. This is especially of concern because the smoking rate in the rest of NH and the national rates have shown to be decreasing. Tobacco use is a major risk factor for the development of chronic diseases.  

  • NH Try-To-Stop Tobacco Resource Center – If you, or someone you know, would like help quitting tobacco products, please visit http://www.trytostop.org/ for free resources and assistance. Telephone assistance is also available Monday through Thursday 9:00am to 7:00pm and Friday 9:00am to 5:00pm. Please call 1-800-TRY-TO-STOP (English), 1-800-8-DEJALO (Spanish), or via TTY at 1-800-TCC-1477.