Jun 20 2011
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NewPublicHealth Q&A: Doug Ulman, President and CEO, Livestrong

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Livestrong, Lance Armstrong's foundation to unite and aid people with cancer, recently awarded the Campaign for Tobacco-Free Kids a five-year, $500,000 grant to help support several initiatives of the Campaign. Those initiatives include supporting tobacco control campaigns at the state and local levels in the United States, advancing international tobacco control efforts, and working on establishing non-communicable disease prevention and control as a global priority.

NewPublicHealth recently spoke with Doug Ulman, president and CEO of Livestrong, about the award to the Campaign as well as Livestrong’s ongoing work.

Editor's Note: Doug Ulman will join us for a live Twitter Q&A on Wednesday, June 22 at 2pmEST. Follow @RWJF_PubHealth and tag your questions with #AskDoug.

NewPublicHealth: How did you choose the Campaign for Tobacco Free Kids for this contribution?

Doug Ulman: We had long admired the work of the Campaign. Given the current economic situation, we just felt like their work is absolutely critical in pursuing our mission as well as theirs, so it was a decision that was fairly easy on our part.

NPH: How does funding tobacco advocacy fit with Livestrong’s mission and goals?

Doug Ulman: At Livestrong, we get asked all the time--if you could do one thing to help reduce the suffering and burden of cancer- what would it be? And the easy first answer is always reducing the usage of tobacco. And so clearly as the number one cause of all cancer-related deaths, tobacco is a huge burden. So for us to be able to support not only policy change but also advocacy around the topic of tobacco control fits squarely within our mission.

NPH: How is Livestrong currently working with the Campaign?

Doug Ulman: We’ve worked closely with the Campaign on some state initiatives here in Texas as well an initiative in California and last year in Wisconsin. So we sort of see ourselves as adding ammunition when the campaign calls on us to come in and help with something they are working on.

NPH: What are examples of some of the initiatives you’ve worked on in those states?

Doug Ulman: In Texas we’ve worked repeatedly now for two legislative sessions on smoke-free workplace legislation, which is moving forward but not as fast as we had hoped. And in Wisconsin, Lance Armstrong and some of our staff went with some of the campaign staff to do some events with the governor about 18 months ago, which ultimately led to the passage of workplace, smoke-free workplace legislation in that state. In California, we are working on a one dollar tobacco tax increase, which would ultimately yield upwards of 700 million dollars a year that the state could use to fund public health programs around prevention and awareness and screening. So, those are a few examples, and we defer to the Campaign on their strategic priorities and goals and stand ready to help in any possible way.

NPH: Declines in tobacco use in the U.S. have stalled. What do you think, looking ahead, are the most important things that could be done to reverse the recent trend?

Doug Ulman: That’s a good question; I think it’s going to take a new energy and vigor. Policy change is key; we know taxation to be effective, as well as basic education and awareness, especially among youth. To me, it’s going to take a combination of all of those things and unfortunately given the current economic conditions, funding is not as readily available as it once was. So, if we want to prevent those gains from evaporating, those gains that we’ve realized over the last decade or two, we are really going to have to double down on our commitment, and I think that is why we felt that now was the time to invest in the Campaign.

NPH: Have you had conversations with other private foundations about putting money into either this or other public health needs for which funding isn’t as strong as it might be if the budget situations were different?

Doug Ulman: Yes, we have. A lot of organizations in the social sector are seeing the impact of the economy, not surprisingly. We’ve been very fortunate to have weathered the last few years remarkably well and continue to grow, and as such I think our resources become much more critical when you see, for example, cuts at significant levels to both National Institutes of Health and Centers for Disease Control and Prevention programs. So we have to be judicious with our spending, but I think we also have to realize that now is not the time to pull back.

NPH: What are some unique aspects of Livestrong that can helppublic health efforts?

Doug Ulman: Our mission is to inspire and empower people affected by cancer, but that means really focusing on two fronts. One is direct service for individuals and families who are impacted by the disease. The other side is how we can mobilize a true grassroots movement of people to get involved in the broader issue of cancer. One of the unique things about this organization is that we have never and don’t ever sit around and think about how we can become a bigger organization. There are so many great organizations out there that we partner with and our goal is to use our unique assets. So one of the things we’ve been able to do is build a brand. So the Livestrong brand, we see the Livestrong brand really as a way to galvanize and mobilize people, whether it is for tobacco related partnerships with the Campaign or whether it is around physical activity related partnerships with the YMCA. Our goal is to reach as many people as possible without having to build tremendous infrastructure. So we do that by not only raising funds but by leveraging this brand through partnerships, as well as using social media and other innovative sort of communications tactics to have a broad reach, and yet have one sort of central headquarters based in Austin, Texas.

NPH: How long have you been at Livestrong?

Doug Ulman: I’ve been here about ten years. The organization is about 14 years old. And when I joined the organization, I was the fourth employee. And we obviously had no idea we would be where we are today. But I was diagnosed with cancer when I was in college and I started a foundation for 15-35 year olds with cancer, the Ulman Cancer Fund for Young Adults. Because I was 19 when I was diagnosed and it felt like I was in college and educated, and yet I knew nothing about the disease. I also couldn’t find anyone else my age to interact with. It felt like the medical system had been set up for both pediatrics and adult medicine, but that young adult population was sort of left out. And so I ran that organization for about three years and then one day, out of the blue, I got an email from Lance Armstrong. He said, “I read about your story and I think we have a lot in common. We started a foundation and we are trying to figure out how to have the biggest impact. Would you be interested in helping us?” And so I moved down here and my role initially here was to start programs and figure out how to spend the money that they were raising to have the biggest impact on people’s lives. I sort of worked my way up through the organization over time. I feel quite honored to be where we are.

NPH: How do you see the Livestrong making the biggest impact going forward?

Doug Ulman: I think at the highest level we’d like to change the way the world fights cancer. And what I mean by that is we need to ensure that at the highest level, people around the world are addressing what is not only a massive physical burden, but ultimately it’s also a massive economic and development burden. So we’re working very closely with the United Nations on their Non Communicable Disease Summit, this fall. We’re working closely with the World Health Organization to really show that there are things we can today to save millions and millions of lives. And so, you know, one example would be if we did no additional biomedical research on cancer, not one more dollar of research, and we just applied the treatments that we know work today to those who need them, we could reduce the number of deaths per year in the world from cancer from 8 million to 4 million.

We already have treatments, for instance, for breast cancer or cervical cancer. If we delivered those treatments to those who need them in the developing world, we could save millions and millions of lives. And so it is a public health crisis. Unfortunately, we as an organization and with our partner organizations can only do so much without massive buy in and scale that can be established by such entities as the World Health Organization and the United Nations. That’s what we’re striving to get--those entities to participate actively and invest in our shared cause.

NPH: What is a key innovative idea on the front burner at Livestrong?

Doug Ulman: One of the things that we launched recently that we will be continuing to develop and expand is what we call a Livestrong Navigation Center. It’s a community based center here in Austin that is a walk-in center, open to the public and free of charge. It’s a navigation resource for anyone dealing with anything related to cancer. And the idea here is that if you put a navigation center like this in a community, that is not tied directly to a medical setting, we believe that you can not only get people into the system when they need access to resources, but you can also ultimately improve quality of life and save money on the entire system because people know where to go and when to go. And so, we’re piloting it right now and the results so far have been phenomenal. And we’re looking to figure out how we can improve this model and expand it. The beauty of this is that it is community based and it is agnostic to where someone ends up getting their medical treatment. Our role is simply to facilitate the removal of whatever barrier or burden someone is dealing with.

The example I always give is about one of the first individuals to walk into our center when we opened at the end of March--a gentleman who was walking from East Austin to downtown Austin every day for his radiation treatment. He wasn’t aware that the city transportation authority had a free program to give him a ride. It was a two minute phone call for us to alleviate and remove that burden for that individual. Our navigators are trained to understand what those resources are and how to get people into the system. It is hopefully a model for many, many other communities in the future. The pilot started in earnest at the end of March, and our goal is to have preliminary data by the end of September, at which point, we would start seriously discussing next steps and where we might go.

Read previous NewPublicHealth.org Q&As with newsmakers and difference makers in public health.

Tags: Cancer, Prevention, Public and Community Health, Q&A, Tobacco