The development of the Connecticut Cancer Plan, 2014-2017 has occured in a rapidly changing health care environment. Topics covered briefly in the following pages are examples of issues to be reviewed at the annual action planning meetings and explored by the Connecticut Cancer Partnership through one of its existing committees or new workgroups.
Some of these topics reflect activity to be undertaken by the Connecticut Cancer Partnership and others represent conditions in the environment that will affect our work.
POLICY, SYSTEMS AND ENVIRONMENTAL CHANGES
Policy, systems and environmental changes (PSE) are selfsustaining interventions that can improve health on a population-wide basis for years, affecting the ways through which health and public health services are delivered. The Connecticut Cancer Plan, 2014-2017 embraces the use of the PSE approach to achieve results, following the 2012 recommendations of the National Comprehensive Cancer Control Program (NCCCP) that all state cancer control plans “implement PSE changes to guide sustainable cancer control.”
The use of policy, systems and environmental changes are increasingly viewed as the most effective way to enable long-term transformation. The “Health Impact Pyramid” proposed and described by Dr. Thomas R. Frieden, Director of CDC, in 2010 illustrates how PSE strategies can have a broader and longer lasting impact on public health when compared with more limited counseling, education and treatment interventions.
Decisions and actions made by local, state and national government leaders and legislatures influence the health of residents. Smoke-free public spaces, mandates for insurance coverage for evidence-based early detection techniques and cancer genetic tests are examples of policies that can prevent or reduce the burden of cancer. Policy action can improve access to therapy, support programs and services for cancer patients and survivors. Advocacy at all levels is an important component for implementing the Connecticut Cancer Plan 2014-2017.
“The Connecticut Cancer Partnership helps build relationships to work towards the same goals, coordinate activities and leveraging of resources. Having people come together for a common goal allows for greater information sharing and collaboration.”
One-year Partnership member
The Advocacy Committee of the Connecticut Cancer Partnership plays an active role in supporting implementation of Plan objectives and strategies. It coordinates advocacy efforts on behalf of the Connecticut Cancer Partnership. Working closely with the Partnership’s Communications Committee, it informs membership, public officials, other cancer stakeholders and the public of the goals and progress of this PSE approach to comprehensive cancer control.
The Committee supports the Board by providing background information on policy issues related to cancer and assists with seeking funding to help support programs and projects across the continuum of the Plan, as approved and recommended each year by the Connecticut Cancer Partnership Board of Directors.
While all the objectives in this Plan are designed to work within the PSE change approach, the Advocacy Committee will monitor the following evolving issues, among others.
Taxation of tobacco products is a policy supported by health care advocates, who cite both the reduced numbers of young people starting smoking and cessation among current smokers. It is also a valuable revenue stream. Connecticut’s current rate is $3.40 per pack compared to neighboring states: New York at $4.35 per pack, Rhode Island at $3.50 per pack and Massachusetts at $2.51 per pack. Snuff is taxed at $1.00 per ounce. Cigars are taxed at 50 percent of the wholesale sales price not to exceed $0.50 per cigar. All other tobacco products are taxed at 50 percent of the wholesale sales price.
More research is needed to determine health consequences of the use of electronic cigarettes, a vapor-based nicotine delivery system, unregulated as yet by the Federal Drug Administration. Since electronic cigarettes are used in an attempt to quit smoking, the use of the “e-cig,” becomes a public health issue. It has not been proven to be a safe and effective cessation aid, while other evidence-based aids, such as the nicotine patch, are available.