ER Visits for Opioid Overdoses Soaring

March 7, 2018
by Dennis Thompson
HealthDay

America’s opioid epidemic is escalating at breakneck speed, with tens of thousands of overdose victims spilling into the nation’s emergency rooms seeking lifesaving treatment, a new government report shows.

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Preventive care is critical to America’s health security

March 4, 2018
by Former U.S. Senator Tom Harkin
Des Moines Register

In today’s busy world, it is easy to eat fast food or put your daily walk off until tomorrow. However, just like a budget, if you overspend in the short term, you will fall short in the long run. Likewise, saving today will yield dividends in the end. In fact, for every dollar we invest in evidence-based prevention services, we see $5.60 in savings, according to the Trust for America’s Health. Support for health care strategies that lead to better outcomes at lower costs to taxpayers should be a no-brainer for elected officials on both sides of the aisle.

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New Report: Funding for Public Health Has Declined Significantly since the Great Recession

Core Federal Emergency Preparedness Funding has been cut by More than One-Third Since FY 2002

Washington, D.C., March 1, 2018 – A new Trust for America’s Health (TFAH) analysis—A Funding Crisis for Public Health and Safety: State-by-State and Federal Public Health Funding Facts and Recommendationsfinds spending on public health is insufficient.

A healthy United States is a strong United States. A prepared nation is a safe nation. But persistent underfunding of the country’s public health system has left the nation vulnerable,” said John Auerbach, president and CEO, of TFAH. The country needs a long-term commitment to rebuild the nation’s public health capabilities – not just to plug some of the more dangerous gaps but to make sure each community will be prepared, responsive and resilient when the unexpected occurs.”

Flat Federal Funding

In Fiscal Year (FY) 2017, the U.S. Centers for Disease Control and Prevention’s (CDC) budget was $7.1504 billion ($21.95 per person). Adjusting for inflation, CDC’s core budget—not including the Prevention and Public Health Fund—has been essentially flat for the last decade.

Because much of CDC’s budget is distributed to states and localities, the impact of budget cuts is experienced directly at the state and local level. Of the roughly 75 percent of CDC funds that go to states and local communities, support ranges from a low of $5.74 per person in Missouri to a high of $114.38 per person in Alaska.

In addition, 12 percent of CDC’s budget consists of the Prevention and Public Health Fund, with about $625 million a year of that directed to state and local efforts. From FY 2013 through FY 2027, the Prevention Fund will receive nearly $12 billion less than the law intended.

Within CDC, the Public Health Emergency Preparedness (PHEP) Cooperative Agreement Program is the only federal program that supports the work of state and local health departments to prepare for and respond to emergencies. Except for one- time, short-term funding to contain the Ebola and Zika viruses, core emergency preparedness funding has been cut by more than one-third (from $940 million in FY 2002 to $667 million in FY 2017) since the program was established.

State Public Health Funding Declining

Spending for public health by states has been declining.  Based on a TFAH analysis (adjusted for inflation), 31 states made cuts to their public health budgets from FY 2015-2016 to FY 2016-2017.  Only 19 states and Washington, D.C. maintained or increased their budgets, making it hard for states to compensate for reduced federal funding.

According to the report, state public health spending is actually lower in 2016-2017 than it was in 2008-2009, as some of the funding cuts that occurred during the Great Recession have not been fully restored—and federal funding has been essentially flat (almost half of state public health spending comes from federal funds).

Local Public Health Funding Decreasing

Since 2008, local health departments (LHDs) have lost 55,590 staff due to layoffs or attrition. In addition, about 25 percent of LHDs reported a lower FY 2016 budget than the previous year, with fewer LHDs reporting an increase in their budget for the current year as compared to the previous.

Recommendations

Each year, we issue this report to examine the amount of public health funding each state receives and provide an independent analysis of how communities protect the public’s health. With life expectancy declining in the U.S. for the second year in a row—something unheard of in recent memory—policymakers must take the public’s health seriously and allocate the funds needed to improve well-being and prevent illness and injury,” said Auerbach.

The report includes eight key recommendations:

  1. Increase Funding for Public Health – at the Federal, State and Local Levels
  2. Preserve the Prevention and Public Health Fund
  3. Prepare for Public Health Emergencies and Pandemics
  4. Establish a Standing Public Health Emergency Response Fund
  5. Build a National Resilience Strategy to Combat Deaths of Despair
  6. Prevent and Reduce Chronic Disease
  7. Support Better Health and Top Local Priorities in Every Community
  8. Expand the Use of Evidence-Based, High-Impact Strategies to Improve Health in Every Community

The brief was supported by a grant from the Robert Wood Johnson Foundation (RWJF).

Trust for America’s Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority.

 

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Trump vs. “disease X;” The administration is setting up the US to botch a pandemic response

February 25, 2018
by Julia Belluz
Vox

“To go back to 2003 is really quite disturbing,” said John Auerbach, president and CEO of the public health nonprofit the Trust for America’s Health. “That was before we’ve seen the likelihood of what we used to consider very unusual emergencies — like significant weather emergencies and novel viruses creating epidemics that have now become almost routine.”

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Report: Alcohol, Drug, Suicide Deaths Reach New Highs

February 22, 2018
by Alexa Lardieri
U.S. News & World Report

DEATHS ATTRIBUTED TO alcohol, drugs and suicide increased at a record 11 percent in 2016, representing more than 14,000 additional deaths from the year before, according to a report published by Trust for America’s Health and the Well Being Trust.

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Deaths from Alcohol, Drugs and Suicide for People of Color Rise Dramatically, Although Still Below the Rates of White Americans

Deaths from Alcohol, Drugs and Suicide Reach Highest Level Ever Recorded

February 22, 2018

Washington, D.C., February 22, 2018 – According to a new Trust for America’s Health (TFAH) and Well Being Trust (WBT) analysis, there were disproportionately large increases in drug deaths among racial/ethnic minority groups, particularly among Black Americans, who experienced an increase of 39 percent in drug deaths between 2015 and 2016. And, Latinos saw drug death rates increase 24 percent, while the rate for Whites increased 19 percent from 2015-2016.

In addition, alcohol, drug and suicide deaths increased at a record pace in 2016 – by 11 percent – and represent more than 14,000 additional deaths over 2015. Now, for two years in a row, increases in these deaths have been at record highs.

Additional main findings:

  • 142,000 Americans, the highest number ever recorded, died from alcohol-induced fatalities, drug overdoses and suicide – an average of one every four minutes.
  • Deaths from synthetic opioids – including fentanyl and carfentanil – doubled from 2015 to 2016 from 9,600 to 19,400 and was the driving force for the increase in drug deaths (alcohol, other types of drug and suicide deaths also increased but by a much lower amount).
  • The Northeast and Midwest had the largest increase in alcohol, drug and suicide deaths between 2015 and 2016. Six states and Washington, DC saw alcohol, drug and suicide death rates increase by more than 20 percent: Delaware (25 percent); Illinois (21 percent); Maryland (40 percent), New Jersey (22 percent), Ohio (21 percent), Pennsylvania (25 percent) and Washington, D.C. (58 percent).

TFAH and WBT issued projections in the November 2017 Pain in the Nation: The Drug, Alcohol and Suicide Epidemics and the Need for a National Resilience Strategy report, which found that if alcohol, drug and suicide deaths continued on the trajectory of the past decade, they could reach 1.6 million over the next decade.  However, the substantial rise in deaths in 2016 puts the country past the “worst case scenario” projection trajectory. If deaths continue to grow at rates similar to those from 2015 to 2016, deaths could top more than 2 million from 2016-2025.

“These data should be a signal to every person – from our friends, family and neighbors to policy makers—that we have a crisis in our country with drugs, alcohol and suicide. These crises scream for action—this is a nightmare scenario—and our communities are suffering,” said Benjamin F. Miller, PsyD, Chief Strategy Officer, Well Being Trust. “We must recognize that it is beyond time to act. These data shouldn’t just be a talking point, these are lives—we need immediate, cross cutting systemic action.”

Trend Analysis

The new Pain in the Nation Update Brief features extensive trend analysis of synthetic opioids, alcohol, total drug, and suicide deaths.

  • Deaths from synthetic opioids surpassed, for the first time, the numbers of deaths related to heroin and common prescription opioids like morphine and codeine;
  • Latinos (24 percent increase), 15-34 year-olds (29 percent) and those living in the Northeast (32 percent) and Metro areas (22 percent) had relatively large increases in drug death rates between 2015 and 2016;
  • Opioid deaths that did not involve synthetic opioids dropped 3 percent – from 23,500 in 2015 to 22,800 in 2016;
  • Over the past decade (2007-2016), the alcohol death rate increased 40 percent; and
  • Suicide rates among Blacks and Latinos in 2016 escalated more than other demographic groups (10 and 9 percent increases, respectively). Suicide rates among those 45 years and older actually declined by 1 percent (while suicide among those under 45, increased by 4 percent).

“For each of these deaths, many more Americans are affected, either directly or through family and friends,” said John Auerbach, president and CEO of TFAH.  “These new data demand policymakers rethink what communities are affected and what multi-sector strategies are needed to address these three epidemics. We must ensure that funding, programmatic efforts and policies are directed to all the people and communities in need. The solution is a comprehensive National Resilience Strategy to combat the deaths from despair.”

State Analysis

  • Forty-four states and Washington, D.C. saw increasing rates of alcohol, drug and suicide deaths from 2015 to 2016. States with the highest alcohol, drug and suicide death rates in 2016 were: West Virginia (80.3 per 100,000), New Mexico (76.8 per 100,000), and Alaska (67.1 per 100,000)
  • Forty-one states had increasing alcohol death rates between 2015 and 2016—states with the highest alcohol death rates in 2016 were: New Mexico (32.1 per 100,000), Alaska (24.7 per 100,000), and Wyoming (23.7 per 100,000).
  • Forty-six states plus Washington, D.C. had growing rates of drug deaths between 2015 and 2016—states with the highest drug death rates in 2016 were: West Virginia (49.8 per 100,000), District of Columbia (40.5 per 100,000), and Ohio (38.5 per 100,000).
  • Twenty-six states plus Washington, D.C. had increasing suicide rates from 2015 to 2016 and 23 states had declining rates—states with the highest suicide death rates in 2016 were: Alaska (26.0 per 100,000), Montana (25.6 per 100,000), and Wyoming (24.6 per 100,000.).

National Resilience Strategy

TFAH’s and WBT’s 2017 Pain in the Nation report called for the creation of a National Resilience Strategy that takes a comprehensive approach by focusing on prevention, early identification of issues and effective treatment. These new data reinforce the need for additional focus and funding at the national, state and local levels to address the underlying causes of long-term increases in alcohol, drug and suicide deaths. TFAH and WBT recommend:

  • Improving Pain Management and Treatment;
  • Rebooting Substance Misuse Prevention and Mental Health in Schools;
  • Addressing the Impact of the Opioid Epidemic on Children – and the Need for a Multi-Generational Response
  • Expanding and Modernizing Mental Health and Substance Use Disorder Treatment Services – Toward a Goal of Focusing on the “Whole Health” of Individuals; and
  • Prioritizing Prevention, Reducing Risk Factors and Promoting Resilience in Children, Families and Communities.

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Trust for America‘s Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority.   Twitter: @HealthyAmerica1

Well Being Trust is a national foundation dedicated to advancing the mental, social, and spiritual health of the nation. Created to include participation from organizations across sectors and perspectives, Well Being Trust is committed to innovating and addressing the most critical mental health challenges facing America, and to transforming individual and community wellness. www.wellbeingtrust.org. Twitter: @WellBeingTrust

Five questions about the new Trump budget and health issues

February 10, 2018
by Rachel Roubein
The Hill

“That was quite a devastating cut that would have crippled the agency’s core activities that are effective in reducing injury, illness and death,” said John Auerbach, the president and CEO of Trust for America’s Health and a former CDC official.

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Trump campaign evangelical adviser raises furor with flu remarks

February 7, 2018
by Brianna Ehley
POLITICO

John Auerbach, president and CEO of Trust for America’s Health and a former Centers for Disease Control associate director for policy, said people are best protected against the flu by getting a flu shot. “It would be harmful to suggest that there is a non-scientific approach to preventing influenza particularly during a year where we’re seeing serious illness and even an increase in flu related deaths.”

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