(Smoking, Education, Lifestyle, Fitness)

The Chronic Disease Initiative program or SELF Improvement was approved by the Kate B. Reynolds Charitable Trust on November 15, 1999 for $10,000,000. The goal of the Health Care Division of the Kate B. Reynolds Charitable Trust is to provide grants that serve the health and medical needs of the people of North Carolina who may be in need of medical care or assistance for financial reasons. The Trust's intent in funding this initiative is to target populations at risk for chronic disease, through a strategy of primary and secondary prevention emphasizing consumer education. It is directed at the three core behaviors: tobacco use, poor nutrition, and physical inactivity which together are responsible for more than one third of U.S. deaths annually and, as noted by the North Carolina Heart Disease and Stroke Prevention Task Force, "two thirds of North Carolina's premature death and disability."

On July 1, 2001, 15 projects were funded for up to five years in North Carolina by the SELF Improvement Program. They are located across North Carolina from the far West (Swain County) to the far East (Dare County). Given the high prevalence of poor nutrition, physical inactivity, obesity, and smoking in North Carolina, and the even higher prevalence among its minority and low income residents, the KBR Trust has placed its emphasis on the critical core health behaviors that cause premature and avoidable illness, diminished quality of life, and premature death statewide. Yet, because these health problems are, to a large extent, caused by personal health behavior, an extraordinary commitment will be required by projects to make effective and long-term change in the most at-risk populations. For this reason, preference was given to organizations that not only serve populations at risk for chronic diseases, but also those organizations which demonstrate a support base that includes local physicians and other community-based organizations. Organizations funded demonstrated realistic plans for continuing the program beyond the funding period.

Kate B. Reynolds Charitable Trust Awards $10 Million in Grants to Prevent Chronic Disease in North Carolina

June 13, 2001 : dukemednews.duke.edu : --more

The Kate B. Reynolds Charitable Trust of Winston-Salem has awarded $10 million in grants to fund 16 projects designed to lower chronic disease rates in low-income areas across North Carolina through an initiative called the SELF (Smoking, Education, Lifestyle, Fitness) Improvement Program.

The program, which is administered by Duke University Medical Center, targets populations at greatest risk for chronic disease and seeks to prevent these diseases by educating groups about the dangers of tobacco use, poor nutrition and physical inactivity.

"Chronic diseases, such as heart disease, asthma and diabetes, are tremendous problems in North Carolina," said John H. Frank, director of the Health Care Division, Kate B. Reynolds Charitable Trust. "Through SELF Improvement, we hope to offer new ideas in chronic disease prevention that can be replicated in future years.

"This is a diverse group of 16 projects in 21 counties statewide. We established the initiative in hopes that it would be a catalyst for developing creative and innovative projects in areas with low-income populations and high chronic disease rates. We are very pleased with the projects selected for funding."

Projects considered were submitted by community organizations or existing community coalitions. Funding for the approved projects will be for five years.

"When the Trust originally brought together an advisory committee to discuss health care across the state, one message was loud and clear -- chronic disease in the state is a huge problem, and a program that focuses on prevention is needed," Frank said. Following that meeting, Frank began organizing what would become the SELF Improvement Program.

According to Dr. Lloyd Michener, chairman of Community and Family Medicine at Duke, seven out of every 10 Americans die from chronic disease, and preventable chronic illness accounts for 70 percent of all medical spending in the United States. He said 80 percent of all chronic disease is caused by three health behaviors: physical inactivity, poor nutrition and smoking.

Other statistics show the particular relevance of these behaviors among North Carolinians:

• Fewer than 20 percent of North Carolina adults exercise regularly;
  
• North Carolina youth are three to four times more likely to be obese than youth in other states;
  
• Thirty-six percent of North Carolina's current high school students are smokers.
  

In addition to administering the project for the trust, Michener said his department serves as a resource for the communities in which the projects are being developed.

"We didn't want to go into these communities and tell people what to do," Michener said. "Diet and exercise are woven into people's lives, so it can be very hard to effectively intervene. Instead, we attempt to help the communities identify what they want to work on, and we help them figure out what would work best."

Frank and Michener emphasized that while prevention is critically important in cutting chronic disease rates, it is very hard to accomplish and takes a substantial amount of time and money. "This accounts for the trust's willingness to invest five years and $10 million in this program," Frank said.

"We are pleased that the medical center is involved in the program," Michener said. "SELF Improvement is a great example of the way a private foundation or trust can work with an academic medical center to help keep communities healthy. Health care is not just about treating disease. It's not only about people coming to an academic medical center, such as Duke. It is important that Duke reaches out to people this way. Both Duke and the trust are committed to working with our communities to help prevent disease."

The Kate B. Reynolds Charitable Trust was created in 1947 by the will of Mrs. William N. Reynolds of Winston-Salem. Three-fourths of the income of the trust is designated for use for health-related programs and services across North Carolina. One-fourth is designated for the poor and needy of Winston-Salem and Forsyth County. The trust, which has assets of over $600 million, distributed over $18 million for health care projects across the state last year.