Q: In addressing tobacco-related disparities, one of the priority populations for Colorado is "people with disabilities". We would like to know which other states are targeting this population and how?  Based on what data? Is there a delineation between physical versus mental disabilities? Which physically challenged sub-groups exhibit a heavier tobacco burden in other states, i.e., people who are deaf, blind, with mobility impairments, etc.?  Which community-based organizations or advocacy groups are partners in this effort? How did the health departments get community partners involved?  We would like to know which other states are targeting this population and how?

A:

1. Alabama: Alabama is not currently targeting people with disabilities.
    
2. California: California currently has an Office on Disability and Health (ODH) funded by the Centers for Disease Control and Prevention (CDC).  ODH's primary mission is to promote health and reduce secondary conditions for people with disabilities (PWD). With that mission fueling the ODH work plan, ODH collaborates with the California Tobacco Control Program (CTCP) and the California Smokers' Helpline (Helpline) to address PWD in California who smoke.
    
   ODH has:
    
   • Included an objective in the work plan (see below)
   • Worked for two years in a row in writing and submitting a proposal to the CDC to fund a project (unsuccessfully) with CTCP and the Helpline to promote the Helpline to PWD in California (click here to see proposal) 
   • Worked on the Chronic Disease Integration Work Group with CTCP and other public health programs to address PWD
   • Contacted CTCP to include disability questions on the California Adult Tobacco Survey
    
   Based on what data?
   The data we use to look at the disability population in California comes from these sources:
    
   • Behavioral Risk Factor Survey (BRFS)
   • California Health Information Survey (CHIS)
   • American Community Survey (ACS) commonly known as the census
   • California Office of Women's Health Survey (OWHS)
    
   Is there a delineation between physical versus mental disabilities?
   No. The definition of disability for our purposes is defined as "long-lasting physical, mental or emotional condition."
    
   Which physically challenged sub-groups exhibit a heavier tobacco burden in other states, i.e., people who are deaf, blind, with mobility impairments, etc.?
   California is not able to discern which populations within PWD are more heavily burdened by tobacco use.  Our survey questions do not get down to that level of specificity at this time.
    
   Which community-based organizations or advocacy groups are partners in this effort?
   The California Federation of Independent Living Centers and State Independent Living Council are close allies with ODH and support the effort on tobacco cessation.  The community partners participate on the ODH Advisory Council and were instrumental in crafting  the ODH Strategic Plan and current CDC work plan.
    
   ODH work plan objective and activities:
   Objective 4.2: By March 31, 2012, ODH, in collaboration with the Department’s Tobacco Control Program, (TCP), and the California Smokers' Helpline, will disseminate information regarding tobacco cessation services statewide that will increase utilization of the Helpline by PWD by 20 percent above baseline level.  (HP 2010 Objective 6.10) (ODH Manager and Staff)*
    
   Activities:
   4.2(a) By March 31, 2008, ODH will review all Helpline materials and intake procedures to ensure appropriate program accessibility for PWD.
   4.2(b) By December 30, 2008, ODH/TCS will make appropriate changes to the Helpline materials and/or intake procedures.
   4.2(c) By August 30, 2008, ODH/TCS will implement the “Use the Gold Card” campaign for the state’s ILCs to promote use of the Helpline by PWD who smoke.
   4.2(d} By July 31, 2008, ODH, in collaboration with the Medi-Cal Managed Care Division, will identify up to six MCOs to disseminate Helpline information to enrollees with disabilities.
   4.2(e) By December 31, 2008, ODH will provide relevant information regarding the Helpline to participating MCOs for distribution to PWD.
   4.2(f) By June 30, 2009, ODH will conduct a survey of providers to determine their satisfaction with the project; and based on lessons learned, revise materials and procedures as needed.
    
   *Note: ODH was not fully funded by the CDC and consequently had to reduce the scope of work (SOW).  This objective was dropped but ODH is currently exploring other opportunities with CTCP and the Helpline to once again include this or other related tobacco control projects.
    
3. Kansas: The Kansas Disability and Health has been working the Tobacco Use and Prevention Program (TUPP) (both at the State health and environment department). The Disability and Health Program educated the grantees from TUPP about Centers for Independent Living and how they would be important to include when trying to reach this disparate population. For tobacco use data, we use the KS BRFSS. I hope this helps! Most sincerely,
    
4. West Virginia: In West Virginia, we do address "people with disabilities" and tobacco use, but have no specific programs for this at-risk group. We do NOT have any specific WV data that would suggest that this population is at more of a risk for tobacco use (based on a delineation between physical versus mental disabilities).

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