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A Joint Venture to Improve the Health of the Appalachian Region Sarah E. Kercsmar, PhD Co-Director, Kentucky Center for Smoke-free Policy University of KentuckyCollege of Nursing June 7, 2011
As public health professionals… We have the passion to make the world healthier and the expertise to make it happen.  We are used to trying to accomplish a lot with scarce resources. ,[object Object],WE NEED YOU!
As funders…. You have the resources to fund a limited number of projects. Everyone thinks THEY have the best idea for you to fund. You want to make the biggest impact in a community that you can.
TOGETHER…We Can Improve…
Healthy Communities Approach “When a healthy community initiative is undertaken, a communal spirit develops, linking public, private, and nonprofit sectors to address the underlying causes of poor health. Healthy community participants represent the wide spectrum of interests and roles that make a community work. Focusing on systems change, the Healthy Communities Approach seeks to build broad participation, encourage new players, honor diversity, create a shared vision and values, and build true collaborations that utilize the assets and resources of the community. Integral to this approach are the measurement of results and the establishment of benchmarks for progress.”
Tobacco: A Global Epidemic “By 2025, 500 million people worldwide will die of tobacco-related disease…that is 9/11 every two hours for 14 years.”       C. Everett Koop, March 2004 1 person dies every 6 seconds from tobacco
Tobacco and Rural America
Low Income Disproportionately Affected 31.1% of adults below the poverty level smoke, compared to 19.4 % who are at or above the poverty level. 40 yrs. median duration of smoking in poor smokers vs. 22 yrs. in smokers 3 x poverty level. Low income more likely to suffer from smoking-attributable diseases and more exposed to SHS. Limited access to healthcare and more likely to delay Cigarette consumption linked to food insecurity
Case Study #1: Tobacco Cessation
Personal Narratives from Smokers and Former Smokers from One Rural Distressed County (N = 21) Easy access to treatment programs Quitting with support of family and friends Faith Quitting for health reasons Freedom of individual choice Pride of place “Big” tobacco Meaningful messages to smokers Quitting because it is the right time Quitting for one’s children Butler, K.M. et al., Telling Their Stories: Rural Smokers’ Experiences with Tobacco (pending review)
Outreach Intervention based on Personal Narratives
Quilt (Pride of Place) ,[object Object]
Appliquéd tree in the center of the quilt represents life in Lawrence County.
Log Cabin and Appalachian Trail motifs in the borders reflect the history of the people living in this region of Kentucky
Incorporates strong sense of pride about the beauty of the land, and the history, arts, and friendliness of the people of Lawrence County ,[object Object]
The good news is that, unlike some public health hazards, secondhand smoke exposure is easily prevented. Smoke-free indoor environments are proven, simple approaches that prevent exposure and harm. 		United States Department of Health 			and Human Services (2006)
Work in Progress: Smoke-Free Northern Kentucky
Smoke-free Lexington = 16,500 Fewer Smokers, Saving $21 Million per Year in Healthcare Costs Hahn, E.J., Rayens, M.K., Butler, K.M., Zhang, M., Durbin, E., and Steinke, D. (2008). Smoke-free laws and adult smoking prevalence. Preventive Medicine, 47: 206–209.
22% Decline in Emergency Department Visits for Asthma in Lexington-Fayette County Rayens, M.K., Burkhart, P.V., Zhang, M., Lee, S., Moser, D.K., Mannino, D., Hahn, E.J. (2008). Reduction in asthma-related emergency department visits after implementation of a smoke-free law. Journal of Allergy and Clinical Immunology. 122(3):537-541.
NKY Case Study: Policy Change is Cyclical and Ongoing
Policy Changing the Culture of Expectations

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Gathering 2011 Breakout Session - Health - A Joint Venture to Improve the Health of the Appalachian Region - Sarah Kercsmar of KY Center for Smoke-free Policy

  • 1. A Joint Venture to Improve the Health of the Appalachian Region Sarah E. Kercsmar, PhD Co-Director, Kentucky Center for Smoke-free Policy University of KentuckyCollege of Nursing June 7, 2011
  • 2.
  • 3. As funders…. You have the resources to fund a limited number of projects. Everyone thinks THEY have the best idea for you to fund. You want to make the biggest impact in a community that you can.
  • 5. Healthy Communities Approach “When a healthy community initiative is undertaken, a communal spirit develops, linking public, private, and nonprofit sectors to address the underlying causes of poor health. Healthy community participants represent the wide spectrum of interests and roles that make a community work. Focusing on systems change, the Healthy Communities Approach seeks to build broad participation, encourage new players, honor diversity, create a shared vision and values, and build true collaborations that utilize the assets and resources of the community. Integral to this approach are the measurement of results and the establishment of benchmarks for progress.”
  • 6. Tobacco: A Global Epidemic “By 2025, 500 million people worldwide will die of tobacco-related disease…that is 9/11 every two hours for 14 years.” C. Everett Koop, March 2004 1 person dies every 6 seconds from tobacco
  • 8. Low Income Disproportionately Affected 31.1% of adults below the poverty level smoke, compared to 19.4 % who are at or above the poverty level. 40 yrs. median duration of smoking in poor smokers vs. 22 yrs. in smokers 3 x poverty level. Low income more likely to suffer from smoking-attributable diseases and more exposed to SHS. Limited access to healthcare and more likely to delay Cigarette consumption linked to food insecurity
  • 9. Case Study #1: Tobacco Cessation
  • 10. Personal Narratives from Smokers and Former Smokers from One Rural Distressed County (N = 21) Easy access to treatment programs Quitting with support of family and friends Faith Quitting for health reasons Freedom of individual choice Pride of place “Big” tobacco Meaningful messages to smokers Quitting because it is the right time Quitting for one’s children Butler, K.M. et al., Telling Their Stories: Rural Smokers’ Experiences with Tobacco (pending review)
  • 11. Outreach Intervention based on Personal Narratives
  • 12.
  • 13. Appliquéd tree in the center of the quilt represents life in Lawrence County.
  • 14. Log Cabin and Appalachian Trail motifs in the borders reflect the history of the people living in this region of Kentucky
  • 15.
  • 16. The good news is that, unlike some public health hazards, secondhand smoke exposure is easily prevented. Smoke-free indoor environments are proven, simple approaches that prevent exposure and harm. United States Department of Health and Human Services (2006)
  • 17.
  • 18. Work in Progress: Smoke-Free Northern Kentucky
  • 19. Smoke-free Lexington = 16,500 Fewer Smokers, Saving $21 Million per Year in Healthcare Costs Hahn, E.J., Rayens, M.K., Butler, K.M., Zhang, M., Durbin, E., and Steinke, D. (2008). Smoke-free laws and adult smoking prevalence. Preventive Medicine, 47: 206–209.
  • 20. 22% Decline in Emergency Department Visits for Asthma in Lexington-Fayette County Rayens, M.K., Burkhart, P.V., Zhang, M., Lee, S., Moser, D.K., Mannino, D., Hahn, E.J. (2008). Reduction in asthma-related emergency department visits after implementation of a smoke-free law. Journal of Allergy and Clinical Immunology. 122(3):537-541.
  • 21.
  • 22. NKY Case Study: Policy Change is Cyclical and Ongoing
  • 23. Policy Changing the Culture of Expectations
  • 24.
  • 25. For More Information Kentucky Center for Smoke-free Policy www.kcsp.uky.edu Facebook and Twitter Search : kysmokefree Sarah Kercsmar scave2@email.uky.edu 859-323-0603

Notas del editor

  1. Explain KSCP – emphasize the connection between research and practice. Talk about how we get requests for help from all over the Appalachian/Southern region.
  2. Explain how public policy makes a big impact by changing systems for a whole community.
  3. Talk about how having a healthy community = physical health, business development, and the economic bottom line
  4. findings from a recent study indicate that cigarette consumption is associated with increased “food insecurity” – not always being able to put enough food on the table. According to researchers, low-income families who were food insecure were more likely to have a head of household or spouse who smoked cigarettes than low-income families who were food secure (43.6% vs. 31.9%, respectively). On average, low-income families with an adult smoker spent almost $34 per week on cigarettes (assuming an average price of $3.37 per pack). The extent to which cigarettes are substituted for food in low-income families negatively impacts the household’s food security.
  5. Note that while we’re making progress, there is a clear work to be done in the Appalachian region
  6. Explain that while I’m not going to talk about all the details, this is just one example of the intricacies of policy change – and all of these need to be funded and someone has to coordinate, etc.
  7. Describe the elements of policy change and how they are constantly changing
  8. Explain how it’s a windy road – things go right, things go wrong – but the work isn’t done! Funders like you can help greatly influence the health of your local communities by supporting public health interventions and policy changes like the ones we’ve discussed here.