Giving a global voice to minority smoking inequities

Since 1965, smoking in the United States has declined by 50%. But a team of student and faculty re电子试玩ers from the Gillings School of 全球 Public 健康 电子试玩的研究人员PG电子试玩了一些因素，说明了为什么这一进展没有均匀分布，以及种族和少数民族以及低社会经济群体在烟草控制方面仍然存在健康差异.

的 team’s findings earned it a spot in the final round of the global 绘制系统竞争图 牛津大学主办, where the Carolina students and faculty placed third in the world among 3,500 teams from other top academic institutions.

With such a prominent platform in the competition, 这个由学生领导的团队能够在全球舞台上对少数民族仍然不成比例地困扰着的公共卫生问题发出声音, largely due to complex structural and systemic factors.

“我们在研究吸烟不平等的同时，考虑了潜在的结构和心理模型,佩吉·洛根说, 一名刚毕业的公共卫生研究生，在健康公平和烟草控制小组工作，并在比赛的最后一轮担任主要主持人. “We determined that an imbalance of resources and power, as well as discrimination and marginalization, contribute to these disparities.”

过去的一周, 卡罗莱纳团队的演讲名为“利用系统科学促进烟草控制中的健康公平”，他们在“地图系统”竞赛的决赛中取得了很高的成绩, 牛津大学(Oxford University) Saïd商学院举办了哪项活动来挑战学生使用 系统思考 to understand complex social or environmental challenges.

Although Oxford University has held the competition for five years, this is the first year UNC-Chapel Hill was involved. 在卡罗莱纳, 40 teams registered to participate, 学校的前五名队伍在四月代表学校参加了全球总决赛. 的 public health team won the top spot at UNC-Chapel Hill and then moved on to compete against 31 teams in a global semi-final. 的 team then placed in the top six and moved to the final round, ultimately securing its third-place finish and winning £2,000, 换算成2美元左右,500美元.S. 货币.

“我们为绘制系统团队的学生和教职员工感到非常自豪，他们不仅从电子试玩的众多竞争者中脱颖而出，在国际舞台上代表了电子试玩大学，更重要的是, 揭示了一个对少数群体有不成比例影响的重要问题所涉及的因素,梅丽莎·开利说, 的主管 卡罗莱纳的创新 社会创新办公室, who worked to bring the competition to the University for the first time. “对于学生和教师来说，这个比赛是一个很好的方式，可以利用问题映射和系统思维来PG电子试玩关于紧迫社会问题的新的、经常是令人惊讶的见解. 通过这样做, 我们可以找到机会，以不同的方式思考和行动，对我们处理公共卫生的方式做出重大改变, 环境, social justice and other areas of global concern.”

电子试玩的“地图系统”校园竞赛由电子试玩社会创新和卡罗莱纳荣誉办公室支持. 它向所有卡罗莱纳州的学生开放，并要求参与者创建关于他们有激情解决的问题的系统地图. 今年的获奖团队成员包括来自吉林斯全球公共卫生学院的以下学生和教师:

• Paige Logan, a recently graduated public health master’s student
• Meghan O’Leary, a public health doctoral student
• Shelley Golden, assistant professor of health behavior
• Kristen Hassmiller Lich,  associate professor of health policy and management
• Sarah Mills, assistant professor of health behavior

“One example we considered is smoke-free public housing,奥利里说, citing a 2018 policy change issued by the U.S. Department of Housing and Urban Development that required all U.S. public housing units to go smoke-free.

奥利里指出，虽然该政策在居民自我报告更高的戒烟率方面取得了一些成功, half of the residents violated the policy, 反过来, creates increased pressure and uncertainty regarding their housing status. “Housing instability is increased with residents who violate this policy, and this increases financial strain and stress and reduces feelings of control,奥利里说. “So, 这一政策产生了意想不到的后果，即吸烟人数增加，使低收入居民面临住房不稳定的进一步风险.”

该团队的工作包括创建一个新的系统地图，以确定吸烟的根本原因或差异因素, 解释了洛根. “This new map can demonstrate, 例如, how low-wage work is related to insurance coverage, which precedes access to cessation services,”她说。. “Other factors we identified include marginalization, discrimination and social capital, which may not be considered with using traditional approaches.”

奥利里注意到了这一点, 通过这个过程, 团队了解到，使用迭代过程来细化识别变量之间的新关系以及新的涉众的系统映射是很重要的.

“By applying a systems science approach and a health equity lens to our problem, 我们PG电子试玩，重点人群中不成比例的高吸烟率是传统吸烟危险因素以及权力和资源不平等的产物,”她说。. “我们更新的概念模型显示，即使是旨在促进烟草控制公平的政策也会产生意想不到的后果. 为了确保公平的结果，需要更广泛的利益攸关方的观点.”

O’leary还认为，比赛是学生们拓展课堂知识和加强研究的一个途径.

“个人, 我特别喜欢我在Gillings的系统思考课程, and I plan to use systems mapping methods in my dissertation. 我最初对参与“绘制系统”感兴趣，是为了获得使用我在课堂上学到的系统思维工具的实践经验,奥利里说. “Through my experience competing and interacting with the judges and other teams, 我拿走了更多的东西——比如如何在视觉上向不同的受众传达这些复杂问题的信息——这对我开始写论文非常有帮助.”

While finalist teams normally travel to Oxford University for an in-person final round, the COVID-19 pandemic changed the format. 幸运的是, O’Leary and team found that this year’s online structure still allowed students, 研究人员和其他领导人围绕重要议题召开会议，并证明他们已经准备好合作解决全球范围内的问题.

“With this year’s competition being virtual amid the COVID-19 pandemic, 看到公共卫生领域的学生和领导者们仍然在寻找有效的方式来聚在一起分享想法，并对系统性问题进行批判性思考，这真的令人鼓舞,”她说。. “全球一级的这类对话和集体行动现在尤其重要，而且将是应对这一流行病所必需的.”