1. Cancer in Tennessee Appalachian Roundtable Discussion TN Comprehensive Cancer Control Coalition Summit 2009 April 23-24, 2009

2. Funding Funded through Appalachian Regional Commission (ARC) with funding from Div. of Cancer Control of Centers for Disease Control and Prevention (CDC) Administered through East TN State University Via grant application submitted by Rural Health Association of Tennessee (RHAT) and the TC4.

3. Purpose and Focus Focus on Appalachian counties in TN whose cancer mortality rate was 25% higher than state rate Hear their ideas and beliefs Bring cancer survivor What can be done to reduce rate? Travel stipend

4. Collaboration Venue – Music Road Hotel, Pigeon Forge RHAT Annual Conference, November 19- 21, 2008 Cancer Plan rollout Trudy Stein-Hart – Rural Health Worker of the Year TC4 - agenda RHAT – invites and logistics

5. 20 Counties of Focus Anderson, Campbell, Claiborne, Clay, Cocke, Coffee, Cumberland, DeKalb, Fentress, Greene, Grundy, Hancock, Loudon, Overton, Polk, Roane, Smith, Sullivan, Unicoi, White Representation from 16 of the 20 and one out-of-state

6. Invitees and Attendees Invited: Health Council Chairs, county mayors, health department directors, State legislators, RHAT members and conference attendees from the 20 counties Attended: Coordinated School Health staff, breast cancer educators, county mayor, health council, survivors, health department, insurance company outreach, parish nurses, UT Extension

7. Format Networking luncheon Pre and post tests Cancer mortality rates in Appalachia TN Identify factors contribute to increased cancer burden Identify what works and what would help

8. Cancer Data in TN Dr. Martin Whiteside: Appalachian TN – elevated cancer burden – rural to urban, esp. lung Rural counties have increased cancer incidence and mortality compared to urban

9. Cancer Data in TN East TN- major contributor to observed rural vs. urban differences for incidence vs. mortality, also Upper and Mid Cumberland No stage differences observed at state level, but at TN Dept. of Health regional level, rural counties – fewer advanced stage tumors.

10. Roundtable Results New (sixth) regional coalition formed New objective added to 2009-2010 workplan Nine Appalachian residents joined TC4 State Cancer Plan disseminated More exposure for RHAT Data presented at roundtable from http://health.state.tn.us/downloads/TCRA nnualReport01-05.pdf http://health.state.tn.us/downloads/TCRA nnualReport01-05.pdf

11. What Works Coordinated School Health and peer education for healthy lifestyles Community awareness- Relay for Life Word of mouth survivor stories Working through county health councils Smoking Cessation in pre- and post-natal Mobile mammo Health fairs

12. What is Needed More, better and affordable health care and insurance Positive, culturally appropriate health education Ego-free coalition/partnerships to build healthy communities Smoking cessation programs Access to screening and information

13. What is Needed Legislation to protect children from second-hand smoke Community involvement – good health examples Public transportation

14. What is Needed Better jobs-better preventative health insurance More doctors More professional education for health care providers Understandable insurance benefits

15. Conclusions All attendees were emailed the summary report of the roundtable RHAT is proud to work with the TC4 in bringing awareness to cancer issues in rural areas Thank you for attending.