[PPT] - Cen enter ers for D Diseas ease e Control an and P Preven PowerPoint Presentation

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Cen enter ers for D Diseas ease e Control an and P Preven ention Smo moke ke-free M ee Multi-Uni nit H Hous using ng

National al Cen enter er for Chronic Diseas ease e Preven ention an and Heal Health Promotion: Paul ul H Hun unting ng, MPH PH - Div ivis isio ion of Communit ity Healt lth Step ephen en B Bab abb, M MPH H – Office e on S Smoking an and Heal Health

December 5, 5, 2012 2012

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CDC Commitment to S State an and Community H Heal alth

Office on

n Smoking ng and nd Heal ealth (OSH)

Divi

vision n of Communi unity Heal ealth (DCH)

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DCH

Core Prin

rincip iple les

– Maximize health impact – Achieve health equity – Use and expand the evidence base for sustainable systems and environmental change

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OSH SH

Lead

ead f fed eder eral al ag agen ency for compreh ehen ensive e tobac acco con

ntrol
l
Goals:

– Prevent tobacco use initiation – Promote tobacco use cessation – Eliminate secondhand smoke (SHS) exposure – Identify and eliminate tobacco- related disparities

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Racial and Ethnic Approaches to Community Health

Serves as the cornerstone of CDC 's efforts to eliminate health disparities.

Healthy Communities Program

Mobilizes 306 communities and 50 states to prevent chronic diseases in

multiple community sectors.

Communities Putting Prevention to Work

Drives local initiatives that will make healthy living easier, for more than

50M people, through sustainable strategies and environmental changes.

Community Transformation Grants

Develops and implements initiatives to reduce chronic disease risk factors

creating healthier communities where people live, work, play, and go to school for both large jurisdictions, tribes and smaller communities.

The DCH Portfolio…

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In theory, policy and environmental improvements should affect all

equally. In practice, this may not be

the case.

Patchwork adoption in states, Counties and

Communities

Differential enforcement
Selection factors
Community relationships
Implementation challenges

Advancing ng h health e equity in a a population

n-wid

ide approac ach

Bec ecau ause o e of:

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Why P Population-wid ide?

St

State actio ion p paves the w way for lo local in l innovatio ion

Estab

ablishes es p prec eced eden ent

Broad

ad s stroke e ap approac aches es to p preven ention

Local

al ac action

Can

n be hi highl ghly i impactful ul

Freq

equen ently i informs the n e next phas ase e of state e an and n national al le level l polic licy

Can

an be e highly t tar arget eted ed

Stren

engthen ens l linkag ages es bet etween een local al an and s state e public h heal ealth

Increas

eases es l local al l level el cap apac acity t to support s state- le level s l strategic ic d dir irectio ion

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Reachi hing ng 1 1 in in 3 U.S. C Cit itiz izens Thr hrough ugh Communi unity T Trans nsformation n Gr Grants

Goal of CDC’s Community Transformation Grants (CTG) -

Create a healthier America by:

Building capacity to implement evidence- and practice-based

policy, environmental, programmatic, and infrastructure changes to prevent chronic disease

Supporting implementation of interventions across five broad

areas:

Tobacco–Free Living
Active Living and Healthy Eating
Community-Clinical and Other Preventive Services
Social and Emotional Wellness
Healthy and Safe Physical Environment

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Tobacco Control

l and D

DCH

In n DCH, CTG is j jus ust p part o

f the

he P Pictur ure

CPPW C

Com

mmunities are funded f

for

r T

Tob

bacco C
Con
ntrol
l
Counter

er ad adver ertising

SHS

HS/Tobac acco use e res estrictions (Compreh ehen ensive e CIA, , MUH, H, Outdoor Areas eas, et , etc.) .)

Pricing

ng and nd P Promotions ns

Heal

ealthy C Communities es P Program am

SHS/Tobacco use restrictions (Comprehensive CIA, MUH, Outdoor Areas,

etc.)

Ces

essat ation r ref efer erral al

Reg

egulat ation of r ret etai ail outlet ets

REA

EACH

Ident

ntification n of promising ng practices in n Ind ndian C n Count untry

Cultural

ally ap appropriat ate ap e approac aches es to smoke-free ee an and tobac acco- free ee policy

Enha

nhance commun unity inf nfrastruc uctur ure a and nd cessation n services

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Fund state tobacco control programs
Also fund:
8 Territories
7 National Networks
8 Tribal Support Centers
Evidence-based, comprehensive approaches
Develop and disseminate best practices
Work closely with:
ther federal agencies
e.g., FDA Center for Tobacco Products
national nongovernmental partners

State-level Tobacco Control Efforts

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Smo moke ke-free e MUH an and C CTG

CTG progr

grams w working ng in M n MUH settings ngs are b bui uilding o ng off ex exper erien ences es an and l lear earnings from CPPW an and other er community l lev evel el program ams.

For t

the n e nex ext s sev ever eral al year ears, 2 27 C CTG f funded ed c communities es ar are e working t to creat eate e smoke-free M ee MUH. For E Exam ample: e:

Increas

ease t e the n e number er o

f R

Roches ester er (NY) Hous using ng Aut uthority (RHA) uni units w with es estab ablished ed prohibitive e ex exposure e to tobac acco s smoke e prac actices es from 0 to 1100 by D Dec ecem ember er 2014.

Increas

ease e the he num number o

f cities in LA C

Coun unty that at i implem emen ent ev eviden ence-bas ased ed juris isdic ictio ion-wide s e strat ateg egies es that at will red educe e ex exposure e to S SHS HS in multi-uni unit housing an and as associat ated ed outdoor ar areas eas from 0 to 1 12 b by S Sep eptem ember er 2016. 2016.

Increase t

the number of f familie ilies liv livin ing in in smoke ke-/tobacco cco-free mul ultiuni unit housing to 126000 126000 by S September 2016 2016 in t the City of Austin.

Increas

ease t e the n e number er o

f s

smoke-free b buildings ngs w with h mul ulti-uni unit ho hous using i ng in n rur ural an and/or low SES ar areas eas o

f Ver

ermont f from 0 0 to 13, 13,000 000 by S September 2013. 2013.

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Smo moke ke-free e MUH an and O OSH

One

ne o

f OSH’s four

ur c core go goals is e elimina nating ng SHS e exposur ure

The h

e home i e is an an i importan ant s source o e of SHS ex exposure

Mai

ain p plac ace w e wher ere e children en ar are ex e exposed ed

Inc

ncreasingl ngly i important nt sour urce for no nons nsmoking a ng adul ults

MUH r

resident nts with ho h hous useho hold no no-smokin ing rule les c can s still ill be ex e exposed ed to SHS i infiltrat ation

Sm

Smoke-free h ee homes es an and s smoke-free M ee MUH:

protect nonsmokers from SHS
help smokers quit
address disparities (low-SES, racial/ethnic)
OSH

SH r role

Exten

end s scien ence e bas ase

Provide t

e tec echnical al as assistan ance e an and t trai aining

Work with partners (e

(e.g .g., H ., HUD)

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DCH S Successes in M MUH

Souther

ern N Nevad ada H a Heal ealth District

The Southern Nevada Regional Housing Authority (SNRHA) now requires all

public housing to be smoke free including all properties owned and managed by SNRHA, including the apartment rented by the resident, the building in which the dwelling unit is located, and all common areas inside and outside the building up to 15 feet from each building and 50 feet from the buildings entry.

Reach – 12,964 Residences.
Los
s A

Angeles Cou

unt

nty

LA County CPPW program has made significant contributions that have

supported seven cities in the implementation of population-wide smoke-free multi-unit housing policies. With approximately 40% of all county residents living in MUH, these improvements have created smoke-free housing for approximately 230,000 residents.

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DCH S Successes in M MUH

Boston Public

lic H Healt lth C Commis issio ion

Boston Public Health Commission is providing funding and technical assistance

to 5 non-profit community development corporations to offer 1,700 new units of smoke-free housing. Further, beginning in September of 2012 Boston Housing Authority began to transition all of its 64 public housing developments to be smoke-free

Reach – 12,000 Residences and over 23,000 residents.
Seattl

ttle, W WA

Washington’

s Seattle Housing Authority is implementing a policy that will make all 6,000 dwelling units owned by the agency smoke-free. The policy covers common areas, all residential apartment units, including L

w-Income Public

Housing (L IPH) units as well as all units in HOPE V I communities, special portfolio buildings, and privately managed buildings.

Reach - Over 26,000 low-income households in Seattle.

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OSH S Successes i in M MUH

Worked

ed w with ALA an and HUD t to o

rgan

anize e an ancillar ary meet eeting

n
n s

smok

ke-free M

ee MUH a at 2012 National al Confer eren ence e on Tobac acco O Or H Heal ealth

Supported

ed CDC Heal ealthy H Homes es Program am i in d devel eloping manua nual on t n thi his topic

Hel

eld w web ebinar ar an and c conducted ed trai ainings for state e an and local al progra rams ms

Working o

ng on s n stud udies estimating: ng:

# o
f M

MUH r res esiden ents exposed ed, national ally an and by state

Cost

st sa savings a s asso ssociated w with sm smoke-free M ee MUH

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Working T Together

Community an

and State e CTG A Awar ards can an be v e val aluab able p e par artner ers an and critical al stak akeh eholder ers i in s statewide ef e efforts.

Capacity bui

uilding ng communi unities ha have t the he o

pportuni

unity to design gn pilot im imple lementatio ion p projects t that alig lign wit ith state le level l prio iorit itie ies

Implementation a

n awards may be c cond nduc ucting ng work t tha hat aligns gns and nd su supplements st s state-level el ef efforts.

Community gran

antees ees c can an h hel elp build the e e eviden ence e bas ase e an and i iden entify an and dissem eminate b e bes est p prac actices es.

Following

ng is a a l list o

f C

CTG fund unded communi unities working o ng on n MUH

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CTG-funded M MUH w work is going on in…

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State of W

Wisc sconsi sin

Broward Cou
unt

nty, FL

City of Aus

ustin, n, T TX

Cou
unt

nty of

f L

Los

s Angeles, C

CA

Cou
unt

nty of

f San Diego, CA
Den

enver er, CO

Dou
uglas Cou
unt

nty, NE

Ne

New Y Y

rk, NY

NY

Henne

nnepin n Coun unty, MN

State of I

Illin llinois is

St

State of I Iowa

Lou
uisville/Jefferson
n C

Cou

unt

nty, KY

State

e of M Mar arylan and

Middlesex Cou
unt

nty, M MA

State

e of M Mas assac achuset etts

Kansa

sas C s City, MO

State

e of M Minnes esota

State of
f Nor
rth C

Carol

lina
Oklahom
ma City/Cou
unt

nty, O OK

Phila

iladelp lphia ia , , P PA

State of C

Calif lifornia ia

San

an F Fran ancisco, CA

State of
f Sou
uth Dakot
ta
Ta

Tacoma-Pier erce e County, WA

Roches

ester er, NY

State of
f V

Vermont

nt
State of W

Washi hingt ngton

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CTG-funde ded M d MUH w work rk is is bein ing further ered b by…

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Three ee CTG National al Net etworks – Accel eler eration Thes ese e ar are e Net etworks ar are e funded ed to

wor
rk a

acros

ss the c

cou

unt

ntry a and in par articular ar hel elp reac each r rural al an and f frontier er ar areas eas with h heal ealth d dispar arities

es. M

MUH is a a k key element of t the he w work fund unded thr hrough ugh the he:



American L n Lung ung Association; n;



The e National al Reac each Coal alition; an and



YMCA o

f the USA

SA.



HUD UD



ANR NR



Smo moke ke-free en ee environmen ents l law projec ect



EPA Indoor

or e

environ

nment

nts Division

n

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.

Additional Collaborations

The Centers for Disease Control and Prevention has funded a project being conducted in Los Angeles County California and three other communities to assess the health benefits of MUH interventions and to study the implementation of smoke-free policies in market-based and subsidized MUH, with the goal of understanding how best to implement smoke-free policies that will protect MUH residents from the adverse effects of secondhand smoke (SHS) The specific research aims of the project are:

To examine the health impact of smoke-free policies in reducing exposure to

SHS in MUH facilities through analysis of environmental and biometric data.

To examine the cost-effectiveness of smoke-free policies in reducing SHS

exposure in MUH complexes

To examine barriers and facilitators to the implementation of smoke-free

policies in reducing SHS exposure in MUH complexes.

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Paul Hunting, MPH, Project Officer Centers for Disease Control and Prevention Division of Community Health Program Implementation and Development Branch 770-488-1165 phunting@cdc.gov

Thanks!

Stephen Babb, MPH, Public Health Analyst Centers for Disease Control and Prevention Office on Smoking and Health Policy Branch 770-488-1172 sbabb@cdc.gov