"Social position, economic status, culture, and environment are critical determinants of who is born healthy, who grows up healthy, who sustains health throughout their life span, who survives disease, and who maintains a good quality of life after diagnosis and treatment."
National Cancer Institute, 2002, The Nation's Investment in Cancer Research for Fiscal Year 2002
Furthermore, the Centers for Disease Control and Prevention reports:
“Unlike activities to prevent initiation of tobacco use by young people, eliminate nonsmokers’ exposure to secondhand smoke, and promote quitting among adults and young people, activities to identify and eliminate tobacco-related disparities lack a definitive evidence base for implementing a program and identifying target outcomes. Sufficient public health knowledge and experience exists, however, to provide a well-founded framework for approaching tasks associated with improving the public health infrastructure and related capacities so that tobacco control programs can address tobacco-related disparities among specific populations.”
Building on successful capacity-building and infrastructure activities during the past 10 years, CDC began the Disparities Pilot Training Project, an initiative to improve the state and territorial public health capacity and infrastructure needed to address tobacco-related disparities. North Carolina was among the first states to sign up for the Disparities Pilot.
In this pilot phase that ran from 2001-2003, North Carolina worked with a Parity and Diversity Action Team to develop a strategic plan for identifying and eliminating tobacco related health disparities. The strategic plan, Key Outcome Indicators for Evaluating Comprehensive Tobacco Control Programs, is available on the CDC's website.
The North Carolina Tobacco Prevention and Control Branch seeks to:
The Tobacco Prevention and Control Branch seeks to address parity issues in each of the the three goals: 1) prevent initiation of tobacco use by young people, 2) eliminate nonsmokers’ exposure to secondhand smoke, and 3) promote quitting among adults and young people. The Director of Parity and Diversity works to build capacity across all three goal areas for people of all ages, race and ethnic backgrounds, sexual orientation, education and income levels.
The Tobacco Prevention and Control Branch works with the Health and Wellness Trust Fund Priority Population grantees to increase parity and diversity in the Teen Tobacco Prevention and Cessation Programs, media and Quitline services.
The CDC Disparities Pilot project prepared a draft logic model based on state practices and published scientific findings and input from external partners. The purpose of the logic model is to assist state health departments and their partners with planning and implementing strategic activities to identify and eliminate tobacco-related disparities.
The logic model focuses on the minimum capacity needed by state and territorial health departments to pursue strategic activities that would identify and eliminate tobacco-related disparities, rather than focusing on traditional health outcomes.
In the CDC logic model (JPG, 160 kb), North Carolina has made much progress in inputs, activities, outputs and short term outcomes thanks to the CDC Pilot Project and funding from the Health and Wellness Trust Fund. Work continues on those aspects as well as intermediate and long term outcomes.
In cooperation with its partners, such as the NC Office of Minority Health & Health Disparities, CDC will continue the task of developing an approach to identifying, evaluating, and eliminating tobacco-related disparities. The draft logic model is a window to the work that is being done now and that needs to continue.