The Network

for LGBT Tobacco Control

Eldin the Cabbie: Wellness Policy Savant

by Scout

Stay tuned, Institute over but more posts to come

It’s been a busy week with posting to the blog, but stay tuned, it’s not done. We still have a few more posts to finalize about lessons from the Tobacco & Diabetes Training Institute 2010, and today our team splits forces to head into 2 more meetings, I’ll be up in DC meeting with Secretary Sebelius and members of the new HHS Task Force on LGBT Health, while Gustavo and Emilia stay in Atlanta to attend the all-day tobacco disparity network planning day. So stay tuned for blogs on all.

Eldin the amazing

How did it start? I jumped into the cab to race to the airport and I think my cabbie warned me about his New York style driving but next thing you know he’s launching on a world class high volume rant about how we’re messing up health in this country. Crazy part was, he’s like a policy savant, nailing every single problem us fancy wellness folk are trying to prioritize.

Eldin on city planning for health

“Now New York has it right, in NY you can walk everywhere. Now look at Atlanta downtown, go down after dark, do you see anything? No! And it’s dangerous. They need to build more stores in those big buildings, so people can have something to walk to at night.” Right on Eldin. “And look at it here.” We’re zipping through Atlanta sprawl-lands. “Those people can’t go anywhere without their car. They can’t even walk anywhere at all. Now in New York, you can walk for hours. And do you wanna know how many different juristictions we just went through? Four. All of those places have to agree to do anything new.”

Eldin on exercise

“And what about bicycles? We’re driving through a park right now, you see any people biking or even walking? You used to use your bicycle to go places, but now you have to put it in your car before you can get anywhere safe to bike, and then we don’t, we just don’t even use our parks. Now think if you were in New York City now, how many joggers would you see in Central Park?” I admit, plenty. “Yah, we don’t even use our parks here, it’s such a shame.”

Eldin on diet

“And look around you, have we passed any grocery stores at all?” No sir. “You see, where are you supposed to even get vegetables. Yet you wanna know what’s one block that way? Lines of fast food restaurants all the way into Atlanta. What is that stuff? It’s all fried. There’s no vegetables in it. People don’t even know to eat them any more. That’s why we’re all fat. Now back in Haiti when I was a boy, whenever my mama was pregnant, my grandma would be cooking spinach and greens for months because that made your blood strong. But here, where do you even find them?”

Eldin on tobacco

I tell Eldin one of the tidbits I learned at the training, that part of the aid we sent to Haita after the quake included cigarettes.  He’s incensed, “Like they can eat that? I mean people are going to do what they’re going to do, but we’re growing enough tobacco there already. We used to grow lots of our own food, now other countries keep teaching us how to get rid of our farms and buy things from companies instead. But none of it is healthier!”

“This country is messed up!”

“And it’s going to take a long time to fix!” Eldin finishes with a flourish. He’s gotten all worked up and I sigh thinking, yup, it’s going to take a lot of time to make it simpler for people stuck in the car wilds of Atlanta sprawl to have easy access to routine exercise. Back in my doctoral program I remember wondering why the World Health Organization had Transportation as one of their top 10 social determinants of health, now that link is becoming crystal clear. (I’m not even counting how naïve me thought their listing of Food as another major determinant of health was mostly about famine, not feasting. Ha!)

New health care reform prevention council

But change is afoot from top to bottom here. The passing of health care reform, also known as ACA or Affordable Care Act is setting some big pieces in motion to focus on wellness and prevention nationally. A large step is the creation of a new Prevention Council filled with cabinet members from all over government. And no, it’s not just filled with people from Health and Human Services, but with the head of the EPA, Dept of Transportation, Dept of Agriculture, etc. Folk realize we need changes at all these levels to clear the path to make it easy to be healthy in our country. Nicely, in the first report of this council, they are also naming sexual orientation (crossing fingers for gender identity soon) as a disparity population! So, I’m looking forward to this new top level coordination to change systems and the from-the-getgo inclusion of LGBTs. I know they’re putting together an attached community advisory council, I sure hope we have LGBT health experts on it. And I think we should have Eldin too!

October 7, 2010 Posted by | Uncategorized | , , , , , | 1 Comment

The Tobacco & Diabetes Training Institute Reports

by Scout, Network Director

This week the whole Network staff team and reps from each state are all down in Atlanta, attending The Institute 2010, a training event for people in tobacco and diabetes. We’ve been to one of these a few years ago, but this is the first time it’s combined with diabetes folk too, so this time it’s a joint production of the Tobacco Technical Assistance Consortium (TTAC) and the Diabetes Training and Technical Assistance Center (DTTAC).

So, since we’re all about linking people and information, watch this week as we keep posting info about what we’ve learned in our courses down here.

Just to start us off, we had an introduction by Dr. Ursula Bauer, the head of CDC’s Chronic Disease Center. As we know from some prior meetings, Dr. Friedan, the new head of CDC, is really taking a strong hand in shaping CDC direction now. Dr. Bauer reviewed the 6 “winnable battles” Dr. Friedan has identified as agency priorities:

  1. tobacco use
  2. nutrition/physical activity
  3. teen pregnancy
  4. iatragenic infections (caused by healthcare)
  5. motorvehicle injury
  6. HIV

Dr. Bauer says, chronic diseases account for nearly 3/4 of the $2 trillion dollars we spend on health care every year. Plus we know nearly every chronic disease is influenced by the 3 pillars of what’s now known informally as “wellness”, that’s tobacco, physical activity, and nutrition. So, right now there’s an increasing emphasis on changing these upstream factors to save some of that cash downstream. That’s right, run that balance sheet and show everyone how doing tobacco control work offers a great return on the healthcare dollar.

As I know we’ve reported before, Dr. Bauer continued to echo the new big emphasis on environmental policy change as a smart strategy for changing the arena. As she aptly noted, an investment in policy change lasts long after the original money is gone. Some of the ones she brought up as smart continue to echo some of the strategies we saw before at the big wellness conference, namely: banning transfats, taxing sugar sweetened beverages, increasing tobacco taxes, bolstering clean air laws, building better walking/biking options. She talked a lot about building structures that support health. As Dr. Bauer says, “Right now our communities are designed for disease. It’s unreasonable to expect people will change behaviors when so many social and cultural factors conspire against them.” (I believe part of that was a quote of B. Smedley).

I know I’m not alone in loving this larger persepective on structures to support health. Every time I’m at a conference on health, I struggle as a vegetarian to even get reasonable food to eat. And last time I was down here at the CDC wellness conference, I was biking on some of the overcongested streets to the local health store and a driver leaned out their window and yelled, “See you in the emergency room!”. Which, considering the 18″ rut that was my bike lane, I thought wasn’t terribly far fetched. So, again, loving this bigger perspective on real health and I for one can’t wait until we all do enough work to see more of those ground level changes. Just even 12 more inches of them!

Watch for more reports from the team about other things we learn at the Institute in the next few days.

Best,
Scout
Director, Network for LGBT Tobacco Control

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October 5, 2010 Posted by | Uncategorized | , , , | Leave a comment

Nutrition, physical activity & tobacco? Bring it on!

DNPAO

Using the bike to draw the interest of the diet and nutrition folk!

by Scout

Network Director

Doctuh Scout looking ever so "cool" at the CDC conference.

CDC’s Wellness Conference + hotmath

This is it folk, the first time ever CDC has convened not just the state tobacco control staff from around the country, but our new partners in the latest greatest health mashup, the nutrition and exercise folk too! So it seems like hot new math for health folk is the following.

Tobacco + Exercise + Nutrition = Wellness!!!

And of course ya really wanna understand the new math for health folk at a national and local level, it seems like maybe I should correct it to be the following.

(Tobacco + Exercise + Nutrition)policy = Wellness policy

Yup, it’s all about policy these days. Why? Well, after some great charts this morning (which I should write more about later) it seems to boil down like this… policy changes health behaviors in a way that all the good information in the world can’t seem to affect. Ok, take it even further, money appears to change health behavior in a way good information and intentions can’t. How? Well, for example we see that smoking rates are incredibly affected by taxes on cigarettes. One of the new things you might see coming to you soon are policy campaigns to add similar taxes to SSBs. Uh… what are they? Sugar Sweetened Beverages. Seems like folk are getting a crazy amount of their calories from SSBs, and so taking lessons from the tobacco arena, public health folk are starting to push excise taxes for SSBs. While it seems like a small bit of the overall obesity epidemic, apparently SSBs are a pretty large lever to create some change.

DNPAO? Worst acronym ever!

But I gotta say one thing, the nutrition and exercise folks need some acronym help! DNPAO <- what in the world does that mean? Wait wait… people tell me it’s Diet Nutrition Physical Activity Obesity. Oh yah that rolls off the tongue. But then, being part of the LGBTQQIA block, um, I guess I can’t really be the one to register the complaint.

Working on Wellness? We want you too!

With Healthcare Reform and this recent $650M of state stimulus money on Wellness the feds put out, the emphasis on Wellness is only going to increase in the coming years. Which as public health folk, I’m sure we all will love. Face it, there’s something comforting about working on a prevention-based model, instead of our usual uh-oh-look-what-kinda-disasterous-effects-years-of bad-health-creates model. (<- I believe that’s its formal name) But – there’s no LGBT network for wellness (yet!). So… we really wanna link up these wellness folk too and help connect them with the LGBT experts like we do for tobacco. You can see the picture up there of the sign I just tacked on my bike that this conference, me shamelessly using the bike to try to get the attention of the state Wellness policymakers here. Cause come on everyone, this $650M of Wellness money alone means there’s big new projects in every single state, and we definitely want these folk to be including LGBT outreach and programs in those projects. I mean, especially if it’s all about policy these days, don’t tell me LGBTs don’t have deep policy inroads in every single state. (can you say civil rights battles?)

And hurry up already!

Ya know. I’m thinking about this new nutrition, exercise, and tobacco mix, and I’m thinking hmmmm… I’m the Director of the Network for LGBT Tobacco Control, and I’ve worked hard to get myself a kit where I can take my folding bike everywhere I go. Take it off the luggage carousel, take it outta the bag, put the bag on back and roll right away from the airport. Why? Well, main reason I usually give is that it’s near impossible to eat in hotels. As a vegetarian, you put me in a hotel and I’m stuck with white pasta and salads until I can get free and go get my own food. Of course, I also love my biking, it makes me happy. (don’t even ask me how many bikes I have). But so… let’s see, healthy eating, exercise and tobacco all rolled into one ball? Like maybe I could go to a meeting, get some vegetarian food at the hotel, find a bike lane on the street, and have it be in a tobacco-free city? Yes siree, let’s hurry up and get this work integrated everywhere! It’s a natural fit, and I’ve been waiting a long time for it.

June 8, 2010 Posted by | CPPW, NatNet, Tobacco Policy | , , , | Leave a comment

   

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