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 Summer 2011                                                                                                                                  Vol. 3, No. 4


Using Community Health Workers to Combat Cancer 

Community health workers (CHWs) can be an important resource for preventing and treating cancer in underserved communities. Although community health workers do not replace traditional methods of care, theiraim is to help people in their community understand health-related behaviors, recognize health options and make decisions to improve their health. Often, these workers are fluent in the community’s primary language, sensitive to the culture and active leaders who serve as a bridge between health care providers and people in the community. Many people newly diagnosed with cancer find that diagnosis and learning about treatment options and aftercare are overwhelming and complicated. In addition, they may have insurance coverage questions. One service that CHWs may provide is patient navigation support to help guide people through medical diagnosis, treatment and recovery from conditions such as cancer. A study of the Cultivando La Salud program that promotes breast and cervical cancer screening among low-income Hispanic women showed that CHWs significantly increased women’s trust in mammograms and Pap tests and their belief that they could survive cancer. 
Community health workers also may extend the reach of primary care by providing a less expensive way to deliver care in underserved communities. CHWs not only provide a personal, specialized level of care and education for people with whom they are well acquainted because of their shared community and experience but also can encourage them to maintain healthy behaviors and seek preventive care. Many public health departments view the cost of employing CHWs as well worth the potential savings and reduction in health disparities. A study at Denver Health found that health worker interventions decreased urgent care and inpatient and outpatient behavioral health visits, resulting in savings of more than $14,000 per month, or $2.28 for every $1 invested.
Ensuring that underserved populations receive adequate health care is a challenge for both public health workers and policymakers.

The Centers for Disease Control and Prevention trains CHWs to promote cancer screenings through its National Breast and Cervical Cancer Detection program. States also are integrating CHWs into Medicaid programs to connect underserved populations with health resources. A certification process has been created in at least 18 states to define training and qualifications for CHWs. A shortage of physicians and nurses to serve both an aging population and accommodate people newly covered under the Affordable Care Act, makes use of CHWs a cost-effective way to increase the health care workforce, improve health access and reduce health disparities.

Community Health Worker Resources
Centers for Disease Control and Prevention:  A Handbook for Enhancing Community Health Worker Programs
Cancer Patient Navigation Overview
National Association of Community Health Representatives

 

Upcoming Events and NCSL Resources

Legislative Summit, August 8-11, 2011, in San Antonio, TX. Registration is open and the housing deadline is July 8, 2011. Come meet and learn from legislators, legislative staff and policy experts from across the country and around the globe about key state issues.  Hear about solutions from the states tailored specifically for legislatures. The work of NCSL Standing Committees helps to preserve state authority and flexibility. Continuing Legal Education from meeting sessions may give you up to a year’s worth of credit.

NCSL has launched the first-of-its-kind database tracking state actions on major provisions in the Affordable Care Act. The database contains 2011 legislation, including pending, failed and enacted bills and resolutions.

Technical Assistance
NCSL can provide testimony to legislatures on chronic disease prevention; health promotion; preventing injuries and violence; reducing health disparities; access to health care; community health centers; and other health policy topics. Contact Alise Garcia at Health-info@ncsl.org.

NCSL Resources 
NCSL Community Health Worker Brief
LegisBrief: Healthy Communities: Reducing Cancer Risks
Cancer At-a-Glance

 

 In the News

USDA unveiled a new food icon on June 2, 2011 that will serve as a reminder to help consumers make healthier food choices. Replacing the familiar, MyPyramid, the new icon is a simple plate-shaped symbol, sliced into four colored wedges for the basic food groups and half-filled with fruits and vegetables. It is designed to be an easy-to-understand visual cue to help consumers adopt healthy eating habits consistent with the Dietary Guidelines for Americans 2010. More information is available at:  http://www.choosemyplate.gov/ 

On June 7, 2011, the U.S. Department of Health and Human Services announced the availability of $40 million in FY 2011 funding from the Prevention and Public Health Fund “to strengthen and better coordinate activities within state health departments aimed at preventing chronic diseases and promoting health.” Grants targeting the nation’s five leading chronic disease-related causes of death and disability:  heart disease, cancer, stroke, diabetes, and arthritis, will be awarded for 3-year coordinated statewide chronic disease programs to all 50 U.S. states and the District of Columbia. CDC will soon post the grant opportunity on www.grants.gov with a July 22nd deadline.  

On May 13, 2011, the U.S. Department of Health and Human Services announced the availability of over $100 million in funding for up to 75 Community Transformation Grants for state and local governmental agencies, tribes and territories, and national and community-based organizations. Created by the Affordable Care Act, these grants are aimed at helping communities implement projects proven to reduce chronic disease, violence and injury, and health disparities, and improve mental health.  

The U.S. Department of Health and Human Services recently announced $10 million for Healthy Food Financing Initiative grants and loans to help open new supermarkets, farmers' markets, and expand convenience stores in low-income and underserved communities.   Applications are due July 11, 2011.

As part of the Robert Wood Johnson Foundation and The Pew Charitable Trusts Health Impact Project, researchers at Upstream Public Health in Portland, Oregon received funding to conduct a health impact assessment of how a proposed farm-to-school policy can influence health. They found that a proposed Oregon farm to school bill would create jobs and improve the health of state residents.  According to the researchers, the bill would provide incentives to deliver fresh local food to schools  and create hundreds of new farm-industry jobs over a five-to 10-year period. 

The U.S. Department of Agriculture's Economic Research Service developed an online mapping tool that locates "food deserts" across the nation, it provides data about areas where residents have limited access to affordable and nutritious foods. The tool can be used to help plan for increased the availability of nutritious food in food deserts or in underserved communities.

For decades The World Health Organization (WHO) has focused on infectious diseases, but are now putting chronic diseases, like heart disease, diabetes and cancer near the top of its agenda. Chronic illness accounts for 63 percent of deaths worldwide and most can be prevented by leading a healthy lifestyle.

Measles cases are rising around the world because non-immunized travelers acquire the disease while traveling abroad, become infected and return home. Cases of the measles are rising in Europe and certain parts of the United States, including California. This year 98 cases of the disease have been reported in 23 U.S. states, according to the Centers for Disease Control and Prevention.

On March 30, 2011, the Robert Wood Johnson Foundation released the 2011 County Health Rankings that provide information about the overall health of nearly every county in all 50 states. Included with the release is a county health calculator that shows the effect that education and income have on health and wellness.

Public Health Project Partner News

NCSL collaborates with the Centers for Disease Control and Prevention and other national organizations—including the National Governors Association, the Association of State and Territorial Health Officials and the Society for Public Health Education—on public health projects. Recent resources available from partner organizations on public health topics include the following.

ASTHO Archived Webinar: The Role of HRSA in Supporting the State Public Health Safety Net
On May 19, 2011, ASTHO and the Health Resources and Services Administration (HRSA) hosted a webinar, "The Role of HRSA in Supporting the State Public Health Safety Net."  Speakers discussed how state and local public health departments can collaborate with community health centers. Click here to view the archived webinar.

CDC National Center for Injury Prevention Releases State Factsheets on the Costs of Crash-Related Deaths
In May 2011 the National Center for Injury Prevention and Control released new state factsheets on state-based costs of deaths from crashes.  CDC’s recommendations for saving lives and money include enforcing seat belt laws, requiring age-and size-appropriate child safety seats and providing comprehensive graduated drivers license systems.  

CDC Releases 2011 Children’s Food Environment State Indicator Report 
The CDC recently released a state indicator report highlighting selected behaviors, environments and policy options that may affect childhood obesity by promoting nutritious food choices in child care facilities, schools and communities. 


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