public health division office of disease prevention and epidemiology an overview of oregon’s...
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PUBLIC HEALTH DIVISIONOffice of Disease Prevention and Epidemiology
An Overview of Oregon’s Cancer Policy Agenda
CDC National Cancer Conference
August 2012
Sabrina Freewynn and Kirsten Aird
Oregon Public Health Division
971-673-0984
HPCDP Vision 2020:
All people in Oregon live, work, play and learn in communities that support health and an optimal quality of life. So they can…
• Live tobacco-free,
• Eat well,
• Move more, and
• Take care of themselves.
HPCDP Mission:
To serve all people in Oregon by advancing policies, environments and systems that promote health, and prevent and manage chronic diseases.
Leading Causes of Death in Oregon, 2005
0% 5% 10% 15% 20% 25% 30%
Pneumonia/influenza
Alzheimer's disease
Diabetes
Unintentional injuries
Chronic lower respiratory disease
Stroke
Cancer
Heart Disease
Percentage (of all deaths)
Source: National Center for Health Statistics
What’s Really Killing Oregonians
0 1000 2000 3000 4000 5000 6000 7000 8000
Illicit Use of Drugs
Sexual behavior
Firearms
Motor Vehicles
Microbial Agents
Toxic Agents
Alcohol
Diet/Activity Patterns
Tobacco
* Includes alcohol-related crashes
Source: CD Summary, May 17, 2005, Vol. 54, No. 10
Up to 39% of the 30,813 deaths were attributable to behavioral causes
Oregon’s Comprehensive Cancer Plan Goals: Tobacco-free living
• Increase the percentage of Oregonians who do not use tobacco products.– Increase and stabilize funding for comprehensive tobacco
control programs.– Increase the proportion of Oregonians who want to quit, have
access to cessation resources and use available resources.
• Increase the percentage of Oregonians who are not exposed to secondhand smoke.– Increase the proportion of Oregonians who want to quit, have
access to cessation resources and use available resources.
Oregon’s Comprehensive Cancer Plan Goals: Eat Well
• Increase Oregon’s community support and promotion of healthy eating, daily physical activity and healthy weight as a means of cancer prevention and risk reduction.– Increase the percentage of Oregon’s youth and adults
who consume at least five daily servings of fruits and vegetables.
– Increase the percentage of youth and adults in Oregon who are at a healthy weight.• Increase access to fruits and vegetables in schools,
worksites and communities.
“There is nothing wrong with our obsession with health in America. Our perspective on the sources of disease and the way we spend money to prevent illness are what is wrong. Although we Americans are the ones who are becoming sick, the fundamental source of disease is not inside us. Disease arises from the world around us. We can use our everyday world to prevent our modern society’s epidemics. But to do that, we must start by rethinking our assumptions about what causes disease and health.”
-Farley and CohenFarley,C., Cohen, D. Prescription For a Healthy Nation, 2005.
LargestImpact
SmallestImpact
Health Impact Pyramid: Factors that Affect Health Examples
Your doctor tells you to eat healthy, and be physically active
Rx for high blood pressure, high cholesterol, diabetes
Cessation treatment, evidence-based self-management, colonoscopy
0g trans fat, smoke-free laws, tobacco tax
Socioeconomic Factors
Changing the Contextto make individuals’ default
decisions healthy
Long-lasting Protective Interventions
ClinicalInterventions
Counseling & Education
Frieden, TR. A Framework for Public Health Action: The Health Impact Pyramid. Am J of Public Health., 2010
Poverty, education, housing, inequality
Cancer Policy Agenda: Tobacco Prevention
• By 2013, the Oregon Legislature will allocate funds from Oregon’s Tobacco Master Settlement Agreement to bring funds will be allocated Oregon’s Tobacco Prevention and Education Program closer to CDC recommended funding. – Eighty-one percent of lung cancer deaths are tobacco-related in
Oregon, making tobacco by far the single greatest risk factor. – Oregon receives $160 million per biennium in MSA settlement
payments. To date, no MSA dollars have been used to fund tobacco prevention, education, or cessation in Oregon.
– In Oregon, eight out of ten people believe it is important to fully fund tobacco prevention and cessation.
Cancer Policy Agenda: Tobacco Prevention
• By 2015, all state agencies and institutions will be covered by a tobacco-free policy prohibiting tobacco-use indoors and on exterior grounds. – Tobacco-free worksite policy protects employees, clients, and
visitors from secondhand smoke exposure and helps people quit tobacco.
– Many public agencies (such as health and human services agencies) serve individuals and families from populations that bear a disproportionate burden of tobacco use and tobacco-related chronic diseases, including people with low incomes, people with disabilities, and racial and ethnic minorities.
Cancer Policy Agenda: Nutrition Standards
• By 2015, increase the proportion of state agencies and institutions with a healthful and sustainable food procurement policy from 0% to 100%.– Increase Oregon state employees’ access to healthful food and
beverages and reduce access to unhealthful foods and beverages, for promotion of healthful weight and diet as a means of cancer prevention and risk reduction.
– According to a recent study, state agencies employees are more likely to be obese (32.1% vs. 24.5%) and they are more likely to have diabetes (8.5% vs. 6.0%) when compared to Oregon general insured workers.
– Improved nutrition and weight management will lower the risk of certain cancers attributable to diet, overweight and obesity.