Tobacco-Related Health Equity: What Will It Take?

Aug 14, 2013, 11:05 AM

Tomorrow from 12 p.m. to 2 p.m. EST Legacy will hold a special online panel discussion as part of the Kenneth E. Warner Lecture Series that puts a spotlight on the social influences on tobacco use and tobacco-related death and disease. The panel will discuss the disproportionate impact of tobacco by race, ethnicity, sexual orientation and socio-economic status to help identify strategies to tackle tobacco-related health inequities.

>>View the live webcast Thursday, August 15, from 12 p.m. to 2 p.m. EST.

Paula Braveman, MD, MPH, a panelist as well as director of the Center on Social Disparities in Health at the University of California San Francisco and Research Director of the Robert Wood Johnson Foundation Commission to build a Healthier America, spoke with NewPublicHealth about the upcoming discussion.

“The purpose of the discussion,” said Dr. Braveman, “is to give wider attention to disparities in tobacco-related health consequences, and to reach a wider audience on the issue of disparities so that it can be dealt with in a more focused way than it has been up until now.”

Dr. Braveman says that a targeted focus is important for ethical and economic reasons. “The consequences of disparities in smoking and tobacco-related illness take a huge economic toll in terms of lost worker productivity and medical expenses that otherwise would not have been needed and in terms of suffering and loss of life. Using the disparities frame helps us to see that the health condition of people who are best off should be possible for everyone.”

It is unethical, says Dr. Braveman, to permit segments of the population to suffer needlessly when they have faced obstacles to healthy behaviors and to being in a healthy environment. In some cases, points out Dr. Braveman, there has been a widening of tobacco-related disparities in the United States, because the messages aimed at getting people to stop smoking have benefited those with greater economic resources and education. “No one intended that but it’s what happens when you make an assumption that one strategy will benefit all groups,” Dr. Braveman says.

Tobacco can also serve as a model for other public health issues when it comes to social equity. “The fact that many highly educated people have had a faster decline in their smoking than less educated people is a critical example that shows us that when we see a public health problem we need to apply an equity lens in thinking what to do about it. It requires us to go a little deeper and think about the resources and conditions of people in different social groups in order to put some effort into what will be obstacles that might be encountered particularly among the most disadvantaged groups,” Dr. Braveman says.

Living conditions and lack of resources can be barriers to healthy behavior changes like quitting smoking, said Dr. Braveman.

The other panelists for tomorrow’s discussion include:

  • Bridgette E. Garrett, PHD, MS, Associate Director for Health Equity, Centers for Disease Control and Prevention, Office on Smoking and Health
  • Marjorie Paloma, MPH, Senior Policy Advisor for the Health Group, Robert Wood Johnson Foundation
  • Edith Cabuslay, MPH, Program Services Manager, San Mateo County Health System, Chronic Disease and Injury Prevention Unit

>>View the live webcast Thursday, August 15, from 12 p.m. to 2 p.m. EST.

This commentary originally appeared on the RWJF New Public Health blog.