Ready: In the 1960s-1980s, advocacy groups and everyday drivers pushed for safer roads. They raised awareness about the importance of wearing seatbelts, which at the time were optional and not widely used.

Set: In 1984, New York became the first state to require seatbelt use. Other states soon followed. National public campaigns (“Click It or Ticket,” “Border to Border”) helped spread awareness, while schools, employers and communities reinforced the message. Over time, seatbelt use became a standard expectation.

Action: Preventing distracted driving and strengthening injury prevention education in schools and workplaces remains a priority. Additionally, always wear a seatbelt and encourage others to do the same. 

Health Outcomes Impact: Seatbelt use has increased from 58% in 1994 to over 91% in 2024 (NHTSA). Seatbelts have saved hundreds of thousands of lives, including over 20,000 lives in 2019 alone. It continues to be one of the simplest ways to prevent serious injury and death in car crashes.

Ready: As evidence grew linking smoking and secondhand smoke to serious health problems, health experts and community advocates began raising awareness.

Set: Cities and states passed laws banning smoking in workplaces and public spaces. These efforts were supported by public education campaigns and higher tobacco taxes by the Alcohol and Tobacco Tax and Trade Bureau. Together, these changes helped protect workers, families and communities from secondhand smoke and made smoking less common.

Action: Efforts continue to focus on addressing rising e-cigarette and vaping use while strengthening public education on tobacco risks. Recent movements have also focused on expanding smoke-free policies and supporting individuals in quitting tobacco and avoiding secondhand smoke. 

Health Outcomes Impact: Smoke-free laws have led to fewer heart attacks and respiratory illnesses. They have also reduced exposure to secondhand smoke in public spaces and workplaces (American Cancer Society). At the same time, U.S. smoking rates have dropped from over 40% in the 1960s to under 15% today (American Lung Association).

Ready: Starting in the late 1980s, individuals, clinicians, educators and public figures began speaking openly about mental health (NAMI). These conversations helped reduce stigma and encouraged more people to seek help. 

Set: Policies like the Affordable Care Act made it illegal to deny insurance coverage for people with pre-existing conditions and required mental health to be covered similarly to physical health care. Mental health screenings have also been added to schools, workplaces and primary care. In 2020, the U.S. launched the 988 Suicide & Crisis Lifeline, making it easier for people to get immediate help during a mental health crisis. 

Action: Improving mental health outcomes requires expanding early support for youth and increasing access to affordable, culturally responsive care. Individuals can also continue to normalize seeking help and understanding their own coverage rights.

Health Outcomes Impact: These efforts have made it easier for people to access care and get help in a crisis. Expanding support systems, reducing stigma and improving early intervention all contribute to better mental health and quality of life. The Substance Abuse and Mental Health Services Administration (SAMHSA) shares yearly data on mental health, substance use and treatment in the U.S.