PUBLIC HEALTH DIVISION Office 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

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 Source: National Center for Health Statistics

What’s Really Killing Oregonians * 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 Cohen Farley,C., Cohen, D. Prescription For a Healthy Nation, 2005.

Largest Impact Smallest Impact 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 Context to make individuals’ default decisions healthy Long-lasting Protective Interventions Clinical Interventions 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.