This question motivated staff to pursue more formative research and discussions. They began to equip themselves with background information from webinars on the topic sponsored by the Centers for Disease Control and Prevention and convened by the National Association of Chronic Disease Directors (NACDD) and partner organizations; aligned state climate change leaders, sustainability and environmental justice initiatives, and data from the Health Department’s Division of Environmental Health Epidemiology, and the state’s Department of Environmental Protection. With this background knowledge, the program began connecting with existing Cancer Coalition members interested and vested in environmental and occupational cancer risks to develop the framework for the state’s exposure reduction strategy. 

Program staff also pursued new relationships and partnerships, including reaching out to organizations involved in the Pittsburgh-based environmental and cancer initiative, the Cancer and Environment Network of SW Pennsylvania to become more active members of the state’s Cancer Coalition. In addition, staff developed new relationships with the state’s Office of Environmental Justice, given increasing attention to racial health disparities that emerged during the COVID-19 pandemic and opportunities to advance cancer prevention goals aligned with greater health equity and environmental risk reduction strategies. Staff emphasized the importance of leveraging partnerships to take on new areas of programmatic focus in the context of a state’s comprehensive cancer control plan with limited existing capacity – a common theme across states. Developing relationships and having conversations that focus on “here’s what you do, and here’s what I’ll do” helps to bridge gaps in capacity and a commitment to progress and impact. 

Pennsylvania’s approach to an environmental cancer risk reduction goal in their comprehensive cancer control plan was to keep strategies purposefully broad. “Keep it broad, let the data reveal the target, and let the coalition guide the implementation,” said a coalition member. Starting with broad targets, the big picture and increasing the degree of specificity over time was instrumental during the development of this strategy. Program staff felt it important to honor the formative work that was still needed – evaluating the streams of new environmental health data sources with a cancer lens and continued education and learning of the Coalition on environmental and occupational cancer topics – which are reflected in the strategies adopted.