Posted on 15 May 2014
The Little Red Hen is an old Russian folk tale that was popularized by Little Golden Books in the 1940s.
In the tale, the little red hen finds a grain of wheat and asks for help from the other farmyard animals to plant it, but none of them volunteer. At each stage (harvest, threshing, milling the wheat into flour, and baking the flour into bread), the hen asks for help from the other animals, but again she gets no assistance.
Finally, the hen has completed her task and asks who will help her eat the bread. This time, all the previous non-participants eagerly volunteer. She declines their help, stating that no one aided her in the preparation work. Thus, the hen eats it with her chicks leaving none for anyone else. The story teaches children the virtues of the work ethic work and personal initiative. The moral is that those who show no willingness to contribute to a product do not deserve to share it.
Are You a Little Red Hen?
Often, coalition coordinators complain that their workload is overwhelming. If you work on your own, no matter how hard you work, you can do only a limited amount. Additionally, if you’re good at your job, members expect even more from you. This can lead to pressure and work overload and can leave you stressed, unhappy, and feeling that you’re letting your coalition or your community down. To avoid being a little red hen and overcome this limitation, you must begin to delegate, or entrust tasks or responsibilities to others, many of who are volunteers.
Decide When and To Whom You Should Delegate
Delegation can feel like more hassle than it’s worth, but it ultimately will expand the amount of work that you can deliver. When you work on the tasks that have the highest priority for you, and others work on meaningful and challenging assignments, you will succeed. To determine when delegation is most appropriate, ask yourself (Mind Tools, 2014)
- Is this a task that someone else can do or is it critical that you do it yourself?
- Does the task provide a growth opportunity and develop another’s skills?
- Is this a recurring task?
- Do you have the time to train, support, check progress, and rework if needed.
If you can answer “yes” to these questions, then it’s worth delegating this task.
In deciding to whom tasks should be delegated, consider a person’s:
- Experience, knowledge and skills as they apply to the delegated task
- Level of independence, goals and interests as they align with the proposed task
- Current workload and whether delegating this task will affect other responsibilities
Use the following principles to delegate successfully (Mind Tools, 2014):
- Emphasize results. Focus on what is accomplished, rather than how the work should be done. Your way is not necessarily the only or best way! Allow people to control their own methods and processes to build trust and success.
- Identify constraints and boundaries. Where are the lines of authority, responsibility and accountability?
- Include people in the delegation process. Empower them to decide what tasks are to be delegated to them and when.
- Match the amount of responsibility with the amount of authority. Even though you can delegate some responsibility, you can’t delegate away ultimate accountability.
- Provide adequate support. Practice ongoing communication and monitoring, and provide resources and credit.
- Avoid “upward delegation.” If a problem arises, don’t let the responsibility for the task shift back to you. Ask for possible solutions; don’t just provide answers.
- Build motivation and commitment. Discuss how success will impact financial rewards, future opportunities, informal recognition, and other desired benefits. Provide recognition where deserved.
- Establish and maintain control. Discuss a timeline and deadlines. Allow space for people to use their abilities while agreeing on a schedule of checkpoints for reviewing progress.
If you delegate well, you will build a strong, successful team and a coalition that is able to meet most demands. And you will no longer have to play the role of the little red hen!
Reference: Mind Tools. (2014). Successful Delgation. http://www.mindtools.com/pages/article/newLDR_98.htm
Posted on 08 May 2014
When you step up to lead a coalition, partnership or any collaborative effort, you may feel like you’ve crossed the border into another country – one with different values, priorities and ways of doing business. The leadership that is required here is very different because the leader is not in control of the group. Rather, he or she is responsible for guiding and coordinating the process by which the group chooses and carries out actions to accomplish its goals. It works well when community issues are complex and pervasive and when any individual or organization cannot change policies, systems and environments alone.
In their book Collaborative Leadership, Chrislip and Larson remind us that collaborative leaders lead a process not people. This process engages all community stakeholders in solving problems and making decisions. If done well, this process builds trust, openness and ownership. The solutions that arise from the collaborative process usually are more informed, based on evidence, innovative and more likely to work. As a result, community members become empowered and new leadership capacities are developed.
I’m sharing a photo here of a dynamic group of leaders of the Jenkins County Diabetes Coalition – their collaborative leadership effort has move this group on a pathway toward success in a very under resourced community.
Although the end result is worth it, collaborative leadership is not easy. It takes more time, and requires skills in dealing with conflict, turf issues, and resistance to change. Collaborative leaders must leave their “egos at the door” and move in the direction that the group desires. Collaborative leaders must be good facilitators, motivators and innovators.
If you are a credible, realistic and flexible leader, then you may be well suited to lead a collaborative effort. Above all, you must be committed to work for the common good – and isn’t that where collaboration starts?
Posted on 21 Apr 2014
According to a new study in the American Journal of Psychiatry, the effects of childhood bullying are “persistent and pervasive, with health, social and economic consequences lasting well into adulthood.” Over 25% of the 7,700 British children in the study had been bullied occasionally, and 15% bullied frequently, which compares to current averages.
The children were followed as they aged, and asked about their mental health, social relationships, quality of life, and professional and economic situations. Even after controlling for childhood IQ, the family’s socioeconomic status, and low parental involvement, people who’d been bullied as children had more problems across life. Being bullied infrequently or frequently was linked to:
- Greater psychological distress
- Greater risk for depression, anxiety, and suicide
- Poorer cognitive function
- Lower educational levels
- Greater likelihood of being unemployed and having a lower salary
- Less likelihood of living with a partner or spouse
- Less likelihood of meeting up with friends or calling on them when ill
The results clearly indicate that we need to take bullying even more seriously, since it’s no different from any other form of child abuse. Community-wide strategies can help identify and support children who are bullied, redirect the behavior of children who bully, and change the attitudes of adults and youth who tolerate bullying behaviors in peer groups, schools, and communities.
Bullying Doesn’t Only Happen At School – Engage Community Partners
Involve organizations and individuals who want to learn about bullying and reduce its impact in the community. Consider involving neighborhood associations, businesses, adults who work directly with kids, parents, and youth, service groups and faith-based organizations. Community members must use their unique strengths and skills to prevent bullying wherever it occurs. For example, youth sports groups may train coaches to prevent bullying. Local businesses may make t-shirts with bullying prevention slogans for an event. After-care staff may read books about bullying to kids and discuss them. Hearing anti-bullying messages from the different adults in their lives reinforces the message for kids that bullying is unacceptable.
- Study community strengths and needs and ask: Who is most affected? Where? What kinds of bullying happen most? How do kids and adults react? What is being done to help? Use opinion surveys, interviews, focus groups and forums with community leaders, businesses, parent groups, and churches to answer these questions and develop a common understanding of the problem.
- Establish a shared vision about bullying in the community, its impact, and how to stop it.
- Identify priority audiences and tailor messages as appropriate.
- Describe what each partner will do to help prevent and respond to bullying.
- Advocate for bullying prevention policies in schools and the community.
- Raise awareness of your message by developing/distributing print materials. Encourage local radio, TV, newspapers, and websites to give PSAs prime space.
- Track progress over time to ensure that you are refining your approach based on solid data.
Takizawa, R., Maughan, B., & Arseneault, L. (2014). Adult Health Outcomes of Childhood Bullying Victimization: Evidence from a 5-Decade Longitudinal British Birth Cohort. American Journal of Psychiatry, A1a:1-8.
Posted on 13 Mar 2014
For nearly two decades, public health professionals have united communities nationwide each April to celebrate National Public Health Week. Every year, NPHW uses a unique theme to explore and share health with our communities. While the theme may change from year to year, our core commitment to public health and prevention has remained unchanged. NPPW 2014 will take place from April 7–13 with the theme, "Public Health: Start Here."
The public health system that keeps our communities healthy and safe is changing as technologies advance, public attitudes toward health shift and more health and safety options become available through policy changes such as the Affordable Care Act (ACA). Public health professionals and organizations are the key to empowering people to participate in this exciting evolution of the public health system to improve the health and wellness of the whole community. NPPW 2014 breaks down these changes into daily themes that are easy to understand and navigate. Local NPPW events and activities will raise awareness of the critical role that public health and prevention play in keeping communities healthy.
Monday, April 7: Be healthy from the start. From maternal health and school nutrition to emergency preparedness, health starts at home.
Tuesday, April 8: Don’t panic. Disaster preparedness starts with community-wide commitment and action. We’re here to help you weather the unexpected.
Wednesday, April 9: Get out ahead. Prevention is now a nationwide priority. Let us show you where you fit in.
Thursday, April 10: Eat well. The system that keeps our nation’s food safe and healthy is complex. We can guide you through the choices.
Friday, April 11: Be the healthiest nation in one generation. Best practices for community health come from around the globe. We'd like to share them with you.
The NPHW 2014 toolkit includes materials and resources to help you effectively shape and promote activities and key messages during the week. The toolkit will help you engage your communities with health and prevention during National Public Health Week 2014 and beyond. http://www.nphw.org
Posted on 07 Mar 2014
When it comes to the time spent in the womb, letting nature take its course is best for most babies and mothers! The Leapfrog Group, an employer-backed organization that tracks hospital safety and quality, published data last week that showed a national decrease in the rate of deliveries before 39 weeks without a medical reason – from 17% in 2010 to 4.6 percent in 2013! We began collecting this data from hospitals nationwide as part of patient-safety efforts under the affordable Care Act.
Potential complications from early elective deliveries (those scheduled for the convenience of doctors, hospital or mothers) may include more cesarean section deliveries, as well as infant breathing and feeding problems, infections, or even death. The rate of infant deaths in the first year rises by 50% for those early births compared to babies who reach full term (39 to nearly 41 weeks). Each week of pregnancy increases the likelihood of delivering a healthy baby.
Unnecessary early deliveries are estimated to increase health care costs by as much as $1 billion annually. Some health insurers have stopped paying for early elective deliveries and many hospitals have adopted “hard stop” policies that ban doctors from scheduling deliveries before 39 weeks without a medical reason. The Midwest Business Group on Health (MBGH) has taken a more proactive role to assure that babies in Illinois are born healthy. Partnering with the Illinois Maternal and Child Health Coalition, America’s Health Insurance Plans, Blue Cross Blue Shield of Illinois, CBS2 Chicago, March of Dimes, and the Illinois Department of Public Health, MBGH is working in Chicago and other parts of Illinois to support adoption of preterm birth policies and programs by hospitals, employers, and health plans. According to Larry Boress, President and CEO of MBGH, the main goal is to reduce the number of early elective deliveries in Illinois below the national average.
Funded by United Health and the Robert Wood Johnson Foundation, MBGH created a community action plan and built the Illinois Perinatal Quality Collaborative to implement: 1) a standard, statewide performance data infrastructure that publicly reports results; 2) adoption of elective delivery policies aligned with best practices by every maternity hospital; and 3) payment reform that aligns financial incentives with best practice and full term births.
MBGH’s communications campaign highlights the importance of full term births and uses employer/health plan communications, television and the internet, and to reach women in the community, those covered by employer/health plan benefits, and physicians and hospitals providing maternity care. A toolkit of programs, materials and policies to reduce early elective deliveries in a covered population is being developed for employers. Being early isn’t always the best advice, especially when you are carrying precious cargo!
For more information:
The Leapfrog Group. (2014). Leapfrog Group Cautions Against Babies Being Born Too Soon, Hits National Target. http://www.leapfroggroup.org/policy_leadership/leapfrog_news/5164214
C. Terhune. Rate of babies delivered early at U.S. hospitals drops sharply. LA Times, March 2, 2014. http://lat.ms/1fLzAvQ
Midwest Business Group on Health. Preventing Early Elective Deliveries – Implementation Phase. http://www.mbgh.org/newitem4/communityintitiativesoverview/newitem1
Posted on 26 Feb 2014
Volunteering is a core American value. Volunteers working in coalitions and other nonprofit organizations enrich our communities and keep them strong.
The Corporation for National and Community Service (CNCS) and the National Conference on Citizenship (NCoC) just released findings from their annual study, Volunteering and Civic Life in America. The national volunteer rate continued to rise last year; more than one in four adults (26.5%) volunteered for a nonprofit organization and 64.5 million Americans contributed 7.9 billion hours of their time. The estimated value of that volunteer service is almost $175 billion, based on the average value ($22.14) of a volunteer hour (according to Independent Sector).
The 2012 study included the following highlights:
- Generation X (those born from 1965 – 1981) had the highest volunteer rate of any age group; it increased more than 5% in 2012
- Americans 65 and older donated 90 volunteer hours, nearly twice as many hours per volunteer than the population as a whole
- Volunteering among teenagers is up almost 3% since 2007
- Volunteers are twice as likely to donate to a charity as non-volunteers, 80% vs. 40%
- More than half of all citizens (50.7 percent) donated at least $25 to charity
According to Wendy Spencer, CEO of CNCS, “Helping others who are in need and working together to strengthen our communities is an important American tradition that helps make our nation so resilient.” She goes on to say that volunteering goes beyond helping other people – volunteers benefit by having increased job prospects, as well as better health and well-being.
Make this the year that your coalition or nonprofit celebrates the accomplishments of its volunteers!
Mark Hrywna. (2014). Volunteering continues upward trend in hours, value. The Nonprofit Times. http://www.thenonprofittimes.com/news-articles/volunteering-continues-upward-trend-in-hours-value-2/?utm_source=internal&utm_medium=email&utm_campaign=W140224
Posted on 20 Feb 2014
I just finished reading an editorial in our local newspaper (Daily Press, Feb 19, 2014) written by Steven S. Kast, the President and CEO of the Boys & Girls Club of the Virginia peninsula. He referred to the Search Institute’s elements for positive youth development as the keys for preventing and dealing with community violence. I think it is worth revisiting those elements as we think about how to make our communities safer.
1) Provide a safe, positive environment for youth that focus not only on physical and emotional safety, but also on continuity and predictability.
2) Provide a strong sense of belonging and community ownership.
3) Ensure that youth have the opportunity to develop meaningful relationships. That is, they feel connected to one or more adults and are able to forge friendships with peers.
4) Ensure that youth have a sense of hope and real opportunities to succeed.
As Kast says, “the time for talk is over. The best practices for violence prevention already exist and need to be replicated”. The choice for investing our resources wisely is obvious: It costs more than $100,00.00 to incarcerate one juvenile for one year, while a community youth center could serve 50 youth for that same investment. It begins by realizing that the solution to youth violence already exists in our communities; we just need passion and a commitment to action to get started!
Posted on 06 Feb 2014
Think of this – every infant is born free of dental decay! Yet, dental caries is the most prevalent childhood disease, affecting more than 25% of U.S. children aged 2-5 and 50% of those aged 12 to 15 (CDC, 2013). According to the American Academy of Pediatric Dentistry (2014): 1) early childhood tooth decay is increasing and can cause lasting harm to the child’s oral and general health, and social and intellectual development; 2) only 25% of parents bring their children to see a dentist in the first year of life as recommended; 3) nearly 1 in 5 parents and caregivers put their child to bed with a bottle of milk or juice, increasing the risk of early childhood caries, baby bottle tooth decay, and choking; and 4) 38% of parents and caregivers allow toddlers to brush without supervision (not recommended until a child is 7 to 8 years old).
Unfortunately, dental disease does not improve with age: 28% of those 35 to 44 years of age and 18% of adults 65 and older have untreated tooth decay; nearly half of adults over age 30 suffer from some form of gum disease. Tooth decay affects minorities and low-income populations disproportionately creating a “dental divide”. Nearly half of lower income adults report not having visited a dentist in one year or longer, while 70% of middle or high income adults have. For many American Indian communities, the occurrence of early childhood caries is approximately 3 times higher than in the U.S. overall.
Further, education level, age, language barriers, cultural factors, oral health literacy, ability to perform daily oral health care, chronic disease, insurance status and geography contribute to dental disease, often in combination with one another. Finally, unhealthy behaviors such as neglecting to brush and floss, using tobacco and alcohol, and eating poorly also adversely affects dental health (2013).
Most experts agree that the most cost-effective way to ensure optimal dental health in children and adults is through prevention, education and behavioral modifications. Community water fluoridation is a proven, prevention strategy. The estimated average cost for a community to fluoridate its water ranges from approximately 50 cents/year/person in large communities to approximately $3/year/person in small communities. By one estimate, the cost of providing fluoridated water throughout someone’s life is less than the cost of a single filling (2013).
Just in time for Dental Health Month, the American Dental Association (ADA) released its latest paper, Action for Dental Health: Bringing Disease Prevention into Communities (2013). This follows on the heels of their May, 2013 launch of the Action for Dental Health: Dentists Making a Difference campaign which aims to reduce the number of adults and children with untreated dental disease, by providing oral health education, prevention, and treatment to those who need care. Key actions of the campaign include:
- Providing care to people who are suffering, including the elderly in nursing homes, children from low-income families, and the uninsured, who are more likely to visit an emergency room for relief from dental pain;
- Strengthening the public/private dental safety net to dramatically increase its capacity to deliver care; and
- Focusing on disease prevention and oral health education through community water fluoridation, the use of Community Dental Health Coordinators, stronger collaboration between dentistry and other health professions, and public health programs in schools and other public and private settings.
Collaboration is vitally necessary for improving oral health. The U.S. National Oral Health Alliance provides the platform for a diverse network of stakeholders to forge common ground to create viable solutions for improved oral health through prevention and treatment for vulnerable populations across our country. The DentaQuest Foundation has funded 20 states through its Oral Health 2014 project that emphasizes prevention and improved collaborations among dentistry and primary care medicine, faith-based organizations, public health and social service groups. More than two dozen philanthropic organizations meet quarterly as the Funders Oral Health Policy Group to advocate for innovative public-private partnerships for better oral health in communities across the US. Finally, many states and local communities have forged coalitions to address the oral health needs of their populations. These collaborations can work to ensure all Americans understand the connection between their dental and overall health, so we can solve this crisis.
ADA Launches Nationwide Campaign to Address US Dental Crisis. May 15, 2013. http://www.orthodonticproductsonline.com/orp-orthodontic-news/15594-ada-launches-nationwide-campaign-to-address-us-dental-crisis
American Dental Association. (2013) Action for Dental Health: Bringing Disease Prevention into Communities. http://www.ada.org/sections/advocacy/pdfs/ADA_AfDH_Prevention.pdf
American Academy of Pediatric Dentistry. (2014). State of the Little Teeth Report. http://www.sacbee.com/2014/01/28/6107174/americas-pediatric-dentists-bite.html
Centers for Disease Control and Prevention (CDC). 2013 http://www.cdc.gov/OralHealth/publications/factsheets/childrens_oral_health/index.htm
American Academy of Pediatric Dentistry. http://www.mychildrensteeth.org/
U.S. National Oral Health Alliance. http://usnoha.org/home
American Dental Association. http://www.ada.org/
Posted on 27 Jan 2014
In reflecting on the meaning and spirit of Martin Luther King Day last week and the 50th anniversary of Lyndon Johnson’s Civil Right Act, I decided to share some information and resources on health disparities and what some coalitions and communities are doing to achieve health equity. It illustrates the continuing need to remind ourselves of why the courageous, groundbreaking work of Dr. King and others is very relevant for us today.
In a recent issue of the Center for Disease Control and Prevention’s (CDC) Health Equity Matters newsletter, Leandris Liburd, Associate Director for CDC’s Office of Minority Health and Health Equity, wrote (2013):
“In 2013, our nation celebrated the 50th anniversary of the March on Washington; we remembered the life and legacy of President John F. Kennedy on the occasion of the 50th anniversary of his assassination; and the whole world paused to honor the life, love, and revolutionary contributions of Nelson Mandela in his passing at the age of 95. Mr. Mandela wrote in Long Walk to Freedom (1995), “I am fundamentally an optimist. Whether that comes from nature or nurture, I cannot say. Part of being optimistic is keeping one’s head pointed toward the sun, one’s feet moving forward.” We salute these great men of courage, integrity, and sacrifice, and are inspired by their embodiment of leadership, hope, and perseverance. The same characteristics are needed if we are to win the battle to reduce preventable health disparities and premature mortality in the U.S. and globally.“
What is a Health Disparity? A health disparity is best defined as the incidence, prevalence, mortality, and burden of diseases and other adverse health conditions that exist among specific population groups in the U.S. The causes of racial and ethnic health disparities are complex and include individual, community, societal, cultural, and environmental factors. The World Health Organization’s Commission on Social Determinants of Health states that to achieve health equity, we must “improve the conditions of daily life – the circumstances in which people are born, grow, live, work, and age” (2008, p. 1). Income, education level, sex, race, ethnicity, employment status, and sexual orientation are all related to health and health outcomes for a number of Americans, according to the 2nd Health Disparities and Inequalities Report — United States, 2013 released last November (CDC, 2013).
Why is eliminating health disparities important? Every person should have the opportunity to attain his or her full health potential. The goal should be to eliminate barriers to achieving this potential because of social position or other socially determined circumstances. According to the CDC, health disparities remain widespread among members of racial and ethnic minority populations.
- Heart disease is the leading cause of death for people of most ethnicities in the U.S.
- Non-Hispanic blacks have the highest rates of obesity (44.1%) followed by Mexican Americans (39.3%)
- Compared to non-Hispanic whites, the risk of diagnosed diabetes is 18% higher among Asian Americans, 66% higher among Hispanics/Latinos, and 77% higher among non-Hispanic blacks
What is CDC’s Racial and Ethnic Approaches to Community Health (REACH). The best community-based interventions are community-centered, racially and ethnically appropriate, and practice/evidence based to advance policy, systems and environmental change at local, state and national levels. REACH is the strongest national initiative to eliminate racial and ethnic disparities in health. CDC supports partners, many of which are coalitions, to establish community-based programs and culturally-tailored interventions to eliminate health disparities among African Americans, American Indians, Hispanics/Latinos, Asian Americans, Alaska Natives, and Pacific Islanders. Coalitions and partners use community-based approaches to identify, develop, and disseminate effective strategies to address health disparities across health priority areas, such as heart disease, diabetes, infant mortality, asthma, and obesity. The initiatives focus on changes in weight, proper nutrition, physical activity, tobacco use, and emotional well-being and overall mental health. For more information about REACH, see: http://www.cdc.gov/nccdphp/dch/programs/reach/about.htm
Does REACH work? REACH Risk Factor Surveys indicate that from 2001-2011:
- Cholesterol screening increased among African Americans, Hispanics, and Asians in REACH communities, while it decreased or remained constant among the same population groups nationwide.
- The proportion of Hispanics who reported having hypertension and were taking medication for it increased.
- Pneumonia vaccination rates increased in black, Hispanic, Alaskan/Pacific Islander, and Native American communities.
Again, I hope this blog serves as food for thought as you engage communities in the work to end disparities in health. I’d like to end, as I began, with wisdom from Lenore Liburd from the Office of Minority Health:
“As we begin the New Year, it is worth reiterating that health disparities are a societal issue and not just the burden of selected populations. In the years ahead, we must identify ways to quantify and communicate to all of our society the benefits to everyone in eliminating preventable health disparities and achieving health equity” (2014).
CDC. CDC Health Disparities & Inequalities Report – United States, 2013. MMWR Supplement, November 22, 2013, 62(3):1-187. (The full report and other information is available at: http://www.cdc.gov/DisparitiesAnalytics
Liburd, L.C. Health Equity Matters Newsletter, 2(4), 2013. http://www.cdc.gov/minorityhealth/newsletter/current.html
Liburd, L.C. Reflections, Revisions, Renewals. Conversations in Equity blog. January 15, 2014. http://blogs.cdc.gov/healthequity/2013/01/15/reflections-revisions-renewals/
WHO Commission on Social Determinants of Health. (2008).Closing the gap in a generation: Health equity through action on the social determinants of health. Geneva, Switzerland: World Health Organization. http://whqlibdoc.who.int/hq/2008/WHO_IER_CSDH_08.1_eng.pdf?ua=1
Other Resources & Information
Federal Agencies and Offices
- Agency for Healthcare Research and Quality: Minority Health
- CDC: Minority Health
HHS Office of Minority Health
- HHS Office of Women’s Health: Minority Women’s Health
- Indian Health Service
- NIH National Center on Minority Health and Health Disparities
Other Health Equity Coalitions
- African American Health Coalition
- Coalition to Promote Minority Health
- Health Professionals for Diversity Coalition
- National Coalition for LGBT Health
- National Minorities with Disabilities Coalition
- National REACH Coalition
- Out of Many, One
News Sources on Minority Health
- Asian & Pacific Islander American Health Forum
- The Association of Minority Health Professions Schools, Inc
- The Disparities Solutions Center at Massachusetts General Hospital
- Diversity Rx
- Families USA: Minority Health
- Joint Center for Political and Economic Studies: Health Policy Institute
- Kaiser Family Foundation: Minority Health
- MEDLINEplus: African-American Health
MEDLINEplus: Asian American Health
MEDLINEplus: Hispanic American Health
- UNC: Minority Health Project
- National Minority Quality Forum
- NCSL Disparities in Health 20
Posted on 20 Jan 2014
Smoking causes a host of cancers and other illnesses and is still the leading preventable cause of death in the U.S. (CDC, 2010). 2014 marks 50 years after the first Surgeon General’s Report on Smoking and Health was released. Since then, smoking prevalence among U.S. adults has been reduced by half and the majority of Americans are protected by smoke-free laws in their state or local community (CDC, 2010).
For over 3 decades, tobacco control coalitions have mobilized communities to participate in tobacco free initiatives, combat the tobacco industry, and change the culture around tobacco. After the release of the landmark Surgeon General’s Report, individuals concerned about the health effects of tobacco and secondhand smoke and alarmed at the tobacco industry’s tactics to promote tobacco use, formed nonsmokers’ rights groups across the U.S. Eventually, these groups evolved into tobacco control coalitions that work at local, statewide, and national levels.
Coalitions focus on changing policies, systems and environments. The factors that most influence tobacco use initiation and cessation include: high tobacco taxes, anti-tobacco media campaigns, negative social acceptability of smoking, and limitations on where tobacco use is permitted and how it is accessed (CDC, 2010). Based on these factors, tobacco coalitions have implemented strategies to change behavior by changing policy, community education & mobilization, counter marketing and media advocacy.
Making the case for tobacco control coalitions. Through the efforts of tobacco control coalitions in every state, over 70% of Americans are protected from secondhand smoke due to smoke-free laws and ordinances; half of the states have implemented a tobacco tax of $1.00 or higher; and the tobacco industry is continually exposed for marketing to underage youth, manipulative advertising, and using other deceptive tactics (CDC, 2010). In your work, use the following points to make the case for tobacco control coalitions (CDC, 2010):
Coalitions’ long history and wide adoption as community interventions enhance the reach of tobacco control efforts. Science supports coalitions as an effective community intervention. Tobacco control coalition efforts change social norms through policy change, which leads to decreased morbidity and mortality.
Coalitions are low cost, but their efforts result in a high return on investment. While the financial investment in coalitions is fairly low, the return on investment is high considering the effects tobacco control policies and well-funded programs have on preventing initiation of tobacco use and increasing cessation. Successful coalitions are able to effectively leverage their resources (e.g., volunteer time, services) and member expertise.
Coalitions contribute to program sustainability. Through their advocacy role, coalitions are able to build political and public support for tobacco control programs, help secure and maintain tobacco control funding, and advocate for policy change.
To commemorate the 50th Anniversary of the Surgeon General’s Report on Smoking and Health, the Office of the Surgeon General developed several resources to help you promote and share highlights from the last 50 years of tobacco control efforts. You can be a part of the effort to share information on the dangers of tobacco use by accessing these resources: http://www.surgeongeneral.gov/initiatives/tobacco/resources.html
Centers for Disease Control and Prevention. (2010). Coalitions: State and Community Interventions. Best Practices for Comprehensive Tobacco Control Programs User Guide. Atlanta, GA: http://www.cdc.gov/tobacco/stateandcommunity/bp_user_guide/pdfs/user_guide.pdf
U.S. Department of Health and Human Services. (2014). Surgeon General’s Report on Smoking and Health. Wahington, DC. http://www.surgeongeneral.gov/initiatives/tobacco/index.html