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Deaths from Injuries Up Significantly Over Past Four Years in 17 States; Majority of States Score 5 or Lower out of 10 on Injury Prevention Report Card

Washington, D.C., June 17, 2015– According to The Facts Hurt: A State-By-State Injury Prevention Policy Report, West Virginia has the highest numbers of injury-related deaths of any state (97.9 per 100,000 people), at a rate more than double of the state with the lowest rate, New York (40.3 per 100,000 people). In the past four years, the number of injury deaths increased significantly in 17 states, remained stable in 24 states and decreased in 9 states. The national rate is 58.4 per 100,000 people. Injuries are the leading cause of death for Americans ages 1 to 44 – and are responsible for nearly 193,000 deaths per year.

Drug overdoses are the leading cause of injury deaths in the United States, at nearly 44,000 per year. These deaths have more than doubled in the past 14 years, and half of them are related to prescription drugs (22,000 per year).  Overdose deaths now exceed motor vehicle-related deaths in 36 states and Washington, D.C.

West Virginia has the highest number of drug overdose deaths (33.5 per 100,000 people) – accounting for more than one-third of the state’s overall injury deaths, rates are lowest in North Dakota (at 2.6 per 100,000 people). In the past four years, drug overdose death rates have significantly increased in 26 states and Washington, D.C. and decreased in six.

The Facts Hurt report, released today by the Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF) also includes a report card of 10 key indicators of leading evidence-based strategies that help reduce injuries and violence. The indicators were developed in consultation with top injury prevention experts from the Safe States Alliance and the Society for the Advancement of Violence and Injury Research (SAVIR).

Twenty-nine states and Washington, D.C. scored a five or lower out of the 10 key injury-prevention indicators. New York received the highest score of nine out of a possible 10, while four states scored the lowest, Florida, Iowa, Missouri and Montana, with two out of 10.

“Injuries are not just acts of fate. Research shows they are pretty predictable and preventable,” said Jeffrey Levi, PhD, executive director of TFAH. “This report illustrates how evidence-based strategies can actually help prevent and reduce motor vehicle crashes, head injuries, fires, falls, homicide, suicide, assaults, sexual violence, child abuse, drug misuse, overdoses and more.  It’s not rocket science, but it does require common sense and investment in good public health practice.”

Some key findings include:

  • Drug abuse: More than 2 million Americans misuse prescription drugs. The prescription drug epidemic is also contributing to an increase in heroin use; the number of new heroin users has doubled in the past seven years. Key report indicators include:
    • 34 states and Washington, D.C. have “rescue drug” laws in place to expand access to, and use of naloxone – a prescription drug that can be effective in counteracting an overdose – by lay administrators. This is double the number of states with these laws in 2013 (17 and Washington, D.C.)
    • While every state except Missouri has some form of Prescription Drug Monitoring Program (PDMP) in place to help reduce doctor shopping and mis-prescribing, only half (25) require mandatory use by healthcare providers in at least some circumstances.
  • Motor vehicle deaths: Rates have declined 25 percent in the past decade (to 33,000 per year). Key report indicators include:
    • 21 states have drunk driving laws that require ignition interlocks for all offenders;
    • While most states have Graduated Drivers Licenses that restrict times when teens can drive, 10 states restrict nighttime driving for teens starting at 10 pm; and
    • 35 states and Washington, D.C. require car safety or booster seats for children up to age 8.
  • Homicides: Rates have dropped 42 percent in the past 20 years (to 16,000 per year). The rate of Black male youth (ages 10 to 24) homicide victims is 10 times higher than for the overall population. One in three female homicide victims is killed by an intimate partner. A key report indicator includes:
    • 31 states have homicide rates at or below the national goal of 5.5 per every 100,000 people.
  • Suicides: Rates have remained stable for the past 20 years (41,000 per year).  More than one million adults attempt suicide and 17 percent of teens seriously consider suicide each year.  Seventy percent of suicides deaths are among White males.
  • Falls: One in three Americans over the age of 64 experiences a serious fall each year, falls are the most common nonfatal injuries, and the number of fall injuries and deaths are expected to increase as the Baby Boomer cohort ages. A key report indicator includes:
    • 13 states have unintentional fall-related death rates under the national goal (of 7.2 per 100,000 people – unintentional falls).
  • Traumatic brain injuries (TBIs) from sports/recreation among children have increased by 60 percent in the past decade.

“Injuries are persistent public health problems.  New troubling trends, like the prescription drug overdose epidemic, increasing rates of fall-related deaths and traumatic brain injuries, are serious and require immediate response,” said Corrine Peek-Asa, MPH, PhD, Professor and Associate Dean for Research at the College of Public Health, University of Iowa. “But, we cannot afford to neglect or divert funds from ongoing concerns like motor vehicle crashes, drownings, assaults and suicides. We spend less than the cost of a box of bandages, at just $.028 per person per year on core injury prevention programs in this country.”

“This report provides state leaders and policymakers with the information needed to make evidence-based decisions to not only save lives, but also save state and taxpayers’ money,” said Amber Williams, Executive Director of the Safe States Alliance. “The average injury-related death in the U.S. costs over $1 million in medical costs and lost wages. Preventing these injuries will allow for investments in other critical areas including education and infrastructure.”

The report provides a series of specific, research-based recommendations for reducing the harm caused by a range of types of injury and violence – with a focus on prevention. It was supported by a grant from the Robert Wood Johnson Foundation and is available on TFAH’s website.

Score Summary: 

A full list of all of the indicators and scores, listed below, is available along with the full report on TFAH’s web site. For the state-by-state scoring, states received one point for achieving an indicator or zero points if they did not achieve the indicator. Zero is the lowest possible overall score, 10 is the highest.

  • 9 out of 10: New York
  • 8 out of 10: Delaware
  • 7 out of 10: California, New Jersey, North Carolina, Tennessee, Washington and West Virginia
  • 6 out of 10: Alaska, Colorado, Hawaii, Indiana, Kentucky, Louisiana, Maine, Minnesota, Nevada, New Mexico, Oregon, Rhode Island and Virginia
  • 5 out of 10: Alabama, Arkansas, Connecticut, Georgia, Illinois, Kansas, Massachusetts, Oklahoma, Utah, Vermont and Wisconsin
  • 4 out of 10: Arizona, District of Columbia, Idaho, Maryland, Michigan, Mississippi, New Hampshire, North Dakota and Pennsylvania
  • 3 out of 10: Nebraska, Ohio, South Carolina, South Dakota, Texas and Wyoming
  • 2 out of 10: Florida, Iowa, Missouri and Montana

The 10 indicators include:

  • Does the state have a primary seat belt law? (34 states and Washington, D.C. meet the indicator and 16 states do not.)
  • Does the state require mandatory ignition interlocks for all convicted drunk drivers, even first-time offenders? (21 states meet the indicator and 29 states and Washington, D.C. do not.)
  • Does the state require car seats or booster seats for children up to at least the age of 8? (35 states and Washington, D.C. meet the indicator and 15 do not.)
  • Does the state have Graduated Driver Licensing laws – restricting driving for teens starting at 10 pm? (11 states meet the indicator and 39 states and Washington, D.C. do not.  Note a number of other states have restrictions starting at 11 pm or 12 pm.)
  • Does the state require bicycle helmets for all children? (21 states and Washington, D.C. meet the indicator and 29 states do not.)
  • Does the state have fewer homicides than the national goal of 5.5 per 100,000 people established by the U.S. Department of Health and Human Services (HHS) (2011-2013 data)? (31 states meet the indicator and 19 states and Washington, D.C. do not.)
  • Does the state have a child abuse and neglect victimization rate at or below the national rate of 9.1 per 1,000 children (2013 data)? (25 states meet the indicator and 25 states and Washington, D.C. do not.)
  • Does the state have fewer deaths from unintentional falls than the national goal of 7.2 per 100,000 people established by HHS (2011-2013 data)? (13 states meet the indicator and 37 states and Washington, D.C. do not.)
  • Does the state require mandatory use of data from the prescription drug monitoring program by at least some healthcare providers? (25 states meet the indicator and 25 states and Washington, D.C. do not.)
  • Does the state have laws in place to expand access to, and use of, naloxone, an overdose rescue drug by laypersons? (34 states and D.C. meet the indicator and 16 states do not.)

STATE-BY-STATE INJURY DEATH RANKINGS

Note: Rates include all injury deaths for all ages for injuries caused by injuries and violence (intentional and unintentional). They are based on a methodology used to compare rates across all states – including using three-year averages of the most recent data (2011-2013). National data sources may differ from how some states calculate their data (because of use of different time frames, inclusion/exclusions, etc.). 1 = Highest rate of injury fatalities, 51 = lowest rate of injury fatalities. The 2011-2013 data are from the U.S. Centers for Disease Control and Prevention’s Web-based Injury Statistics Query and Reporting System — age-adjusted using the year 2000 to standardize the data. This methodology, recommended by the CDC, compensates for any potential anomalies or unusual changes due to the specific sample in any given year in any given state. States with statistically significant (p<0.05) increases since 2007-2009 are noted with an asterisk (*), while states with a statistically significant decrease are noted with two asterisks (**).

1. West Virginia (97.9*); 2. New Mexico (92.7**); 3. Oklahoma (88.4*); 4. Montana (85.1); 5. Wyoming (84.6); 6. Alaska (83.5); 7. Kentucky (81.7*); 8. Mississippi (81.0); 9. Tennessee (76.7); 10. Arkansas (75.3); 11. Louisiana (75.3**); 12. Arizona (73.4); 13. Alabama (73.3); 14. Utah (72.8*); 15. Missouri (72.4); 16. Colorado (70.7); 17. South Carolina (69.9); 18. Idaho (69.1); 19. (tie) Nevada (67.1**) and South Dakota (67.1*); 21. Vermont (66.0); 22. Kansas (65.0*); 23. Pennsylvania (64.3*); 24. Ohio (63.9*); 25. Indiana (63.7*); 26. North Carolina (62.1**); 27. Wisconsin (62.0*); 28. Oregon (61.8); 29. Florida (61.3**); 30. Michigan (60.6*); 31. Maine (60.1); 32. Delaware (60.0); 33. North Dakota (59.3); 34. Rhode Island (58.6*); 35. Georgia (58.1**); 36. Washington (57.1); 37. New Hampshire (56.6*); 38. Iowa (56.4*); 39. Texas (55.3**); 40. Minnesota (54.9*); 41. District of Columbia (53.7); 42. Maryland (53.4**); 43. Nebraska (52.5); 44. Virginia (52.0); 45. Illinois (50.0); 46. Connecticut (49.6); 47. Hawaii (48.8); 48. California (44.6**); 49. New Jersey (44.0*); 50. Massachusetts (42.9); 51. New York (40.3*).

STATE-BY-STATE DRUG OVERDOSE DEATH RANKINGS

Note: Rates include drug overdose deaths, for 2011-2013, a three-year average. 1 = Highest rate of drug overdose fatalities, 51 = lowest rate of drug overdose fatalities. States with statistically significant (p<0.05) increases since 2007-2009 are noted with an asterisk (*), while states with a statistically significant decrease are noted with two asterisks (**). States with a § have an overdose death rate higher than the state’s overall motor vehicle mortality rate for 2011 to 2013.

1. West Virginia (33.5*§); 2. (tie) Kentucky (24.6*§) and New Mexico (24.6§); 4. Nevada (21.6*§); 5. Utah (21.5§); 6. Oklahoma (20.0§); 7. Rhode Island (19.4*§); 8. Ohio (19.2*§); 9. Pennsylvania (18.9§); 10. Arizona (17.8*§); 11. Tennessee (17.7*§); 12. Delaware (17.1*§); 13. Wyoming (16.4*); 14. Missouri (16.2*§); 15. Indiana (16.0*§); 16. Colorado (15.5§); 17. Alaska (15.3§); 18. (tie) Michigan (14.6§) and New Hampshire (14.6§); 20. Louisiana (14.5§); 21. (tie) District of Columbia (13.8*§) and Massachusetts (13.8§); 23. (tie) Florida (13.7**§) and Washington (13.7**§); 25. Montana (13.6); 26. Maryland (13.3*§); 27. (tie) New Jersey (13.2*§) and North Carolina (13.2*§); 29. (tie) Connecticut (13.1*§) and Wisconsin (13.1*§); 31. Vermont (13.0§); 32. South Carolina (12.9§); 33. Idaho (12.7*); 34. Oregon (12.4§); 35. Arkansas (12.3**); 36. (tie) Alabama (12.2**) and Maine (12.2**§); 38. Illinois (11.8*§); 39. Hawaii (11.4*§); 40. Kansas (11.2); 41. (tie) California (10.7*§) and Georgia (10.7*) and Mississippi (10.7); 44. New York (10.4*§); 45. (tie) Texas (9.6) and Virginia (9.6*); 47. Minnesota (9.3*§); 48. Iowa (8.8*); 49. Nebraska (7.2*); 50. South Dakota (6.5); 51. North Dakota (2.6**).

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.

For more than 40 years the Robert Wood Johnson Foundation has worked to improve health and health care. We are striving to build a national Culture of Health that will enable all to live longer, healthier lives now and for generations to come. For more information, visit www.rwjf.org. Follow the Foundation on Twitter at www.rwjf.org/twitter or on Facebook at www.rwjf.org/facebook.

The Safe States Alliance is a national, non-profit organization and professional association whose mission is to strengthen the practice of injury and violence prevention.

SAVIR is a national professional organization dedicated to fostering excellence in the science of preventing and treating violence and injury. Our vision is a safer world through violence and injury research and its application to practice. 

Trust for America’s Health’s Statement on the Environmental Protection Agency’s Latest Clean Water Act Rule: Important for the Nation’s Health

Washington, DC, May 27, 2015 – The Trust for America’s Health (TFAH) is pleased the Environmental Protection Agency (EPA) has released a final rule clarifying the definition of Waters of the United States under the Clean Water Act. This will enable relevant agencies to better safeguard our nation’s headwaters, streams and wetlands and ensure the water we drink is free from pollution.

The following is a statement by Jeffrey Levi, PhD, Executive Director of TFAH.

“TFAH applauds the EPA and the Obama Administration for advancing this final rule, which applies to the headwaters that supply more than 117 million Americans with their drinking water. It is vital for the nation’s health to ensure everyone has access to safe and clean water.

Because these headwaters are one source of many rivers and streams, they are a precious health resource. Yet, today carcinogens, crude oil and harmful bacteria are still being dumped upstream—with little oversight—and flowing down to our communities and into one in three American’s drinking glasses.

With this final rule, we are one step closer to ensuring one of our nation’s largest supplies of water is safe to drink.

TFAH looks forward to working with federal, state and local governments, the public health community, and other critical partners to monitor ongoing implementation of this rule.

Each day we delay is another we put Americans’ health and lives at risk.”

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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. 

Collaborative Applauds HHS Move to Expand Efforts to Confront Opioid Abuse Epidemic

WASHINGTON, D.C. (March 27, 2015) – The Collaborative for Effective Prescription Opioid Policies (CEPOP) provided a ringing endorsement today for new actions to confront the opioid abuse epidemic announced March 26 by Health and Human Services Secretary Sylvia M. Burwell. The Administration’s initiative includes new funding to support health professional decision-making, the use of naloxone (a medication used to counter the effects of opioid overdose), and the expansion of medication-assisted treatment.

“Far too many families have been devastated by this epidemic,” observed CEPOP co-founder, Hon. Mary Bono. “These strategies are part of a comprehensive and coordinated effort to prevent opioid addiction and save lives. I’m encouraged by these positive steps.”

Community Anti-Drug Coalitions of America Chairman and CEO and CEPOP co-founder General Arthur Dean also commented that “the organizations participating in our Collaborative are dedicated to developing and advocating for solutions like these. I am confident that CEPOP will be mobilizing support for initiatives like this both in the federal budget process and on the ground in communities that are so deeply affected by this crisis.”

Jeffrey Levi, PhD, Executive Director of Trust for America’s Health and CEPOP co-founder, said “by promoting evidence-based strategies, these actions will help coordinate and align public health’s and traditional healthcare’s efforts to reduce opioid dependence and address the overdose crisis. CEPOP will continue to build a diverse and engaged group of organizations that advocate for a wide range of policy solutions to the opioid epidemic at the local, state and national level.”

About CEPOP

The Collaborative for Effective Prescription Opioid Policies (CEPOP) brings together a broad array of stakeholders interested in the appropriate use of opioid medications. Specifically, CEPOP supports a comprehensive and balanced public policy agenda that reduces abuse and promotes treatment options, both for those living with pain and confronting addiction. CEPOP’s advocacy is focused on driving actions in the public sector that develop and deploy evidence-based solutions to these challenges.

Measles Vaccination Rates for Preschoolers Below 90 Percent in 17 States

February 4, 2015

Washington, D.C., February 4, 2015 – An analysis released today by Trust for America’s Health (TFAH) finds that fewer than 90 percent of children ages 19-to-35 months old have received the recommended vaccination against measles, mumps and rubella (MMR) in 17 states.

New Hampshire has the highest MMR vaccination rate for preschoolers at 96.3 percent, and Colorado, Ohio and West Virginia have the lowest at 86 percent. (Data based on the latest completed National Immunization Survey from 2013). No state in the Northeast was below 90 percent, while eight states in the South, five in the West and four in the Midwest had rates below 90 percent. Nationally 91.1 percent of preschoolers are vaccinated.

“Sadly, there is a persistent preschooler vaccination gap in the United States. We’re seeing now how leaving children unnecessarily vulnerable to threats like the measles can have a tragic result,” said Jeffrey Levi, PhD, executive director of TFAH. “We need to redouble our national commitment to improving vaccination rates.”

Healthy People 2020 set 90 percent as the baseline national goal for preschooler MMR vaccinations. Reaching the national rate of 91.1 percent has helped reduce measles rates by 99 percent. Achieving even higher vaccination rates would help protect even more individuals and increase “herd immunity” protection for the wider community. The U.S. Centers for Disease Control and Prevention (CDC) and the Advisory Committee on Immunization Practices (ACIP) recommend that every child receive a first dose of the MMR vaccine after reaching the age of 12 months old. A second MMR dose is recommended for 4-to-6 year olds.

“It is so important that communities maintain high levels of MMR vaccination—because measles is so infectious—and especially when outbreaks are occurring around them,” said Litjen (L.J) Tan, MS, PhD, chief strategy officer of the Immunization Action Coalition. “To have pockets where community immunity is below 90 percent is worrisome as they will be the ones most vulnerable to a case of measles exploding into an outbreak.”

Rates of preschooler vaccinations are typically lower than for school-age children, since they are not yet in the school system, which require vaccinations for children to attend. Among kindergarteners, 94.7 percent have been vaccinated for measles, with a high of 99.7 percent in Mississippi and a low of 81.7 percent in Colorado. States differ significantly in policies allowing parents to “opt-out” of the attendance requirements. Within states, even states with high MMR vaccination rates, there can be communities with groups of individuals who are unvaccinated, making these communities vulnerable to measles and other preventable diseases.

In January 2015, CDC issued a Health Advisory about an ongoing multi-state measles outbreak, which has been linked to more than 102 cases in 14 states so far. Most individuals who get the measles are not vaccinated – including infants. In 2000, measles was declared virtually eliminated in the United States, when cases dropped to around 60. Measles rates remained below 100 from 2002 to 2007, with many of those cases linked to overseas travel. In 2014, there was a surge in measles, with at least 23 outbreaks and more than 600 cases.

Measles is a highly contagious, viral illness that can lead to health complications, including pneumonia, encephalitis and eventually death. Prior to routine vaccination, measles infected approximately three to four million Americans, killed 400 to 500 individuals and led to 48,000 hospitalizations each year.

Vaccines undergo rigorous review and testing for effectiveness and safety by the Food and Drug Administration (FDA) before they are released to market and safety is also tracked through several monitoring systems once they are in use. Numerous reviews, including by all of the existing studies by the Institute of Medicine (IOM), have concluded that the MMR vaccine is safe and has no causal link to developmental disorders.

Overall, there is a long-standing preschooler vaccination gap in the United States. More than 2 million preschoolers do not receive all recommended vaccinations on time: 27.4 percent do not receive the full childhood series (4:3:1:3:3:1:4); 27.4 percent do not receive the rotavirus vaccine; 18 percent do not receive the pneumococcal vaccine; 16.9 percent do not receive the diphtheria, tetanus and whooping cough vaccine; 9.2 percent do not receive all three doses of the hepatitis B vaccine; 8.8 percent do not receive the chickenpox vaccine; and 7.3 percent do not receive the polio vaccine.

In addition, many infants (by 13 months) do not receive all recommended vaccines: 43.2 percent do not receive the chickenpox vaccine; 12.6 percent do not receive the pneumococcal vaccine; 10.7 percent do not receive the meningitis, pneumonia and epiglottis Hib vaccine; 10.6 do not receive the diphtheria, tetanus and whooping cough vaccine; 15.4 percent do not receive all three doses of the hepatitis B vaccine; and 6.3 percent do not receive the polio vaccine.

Some key recommendations for improving vaccination rates include:

  • Increasing public education campaigns about the safety and effectiveness of vaccines;
  • Minimizing vaccine exemptions – states should enact and enable universal childhood vaccinations except where immunization is medically-contraindicated. Non-medical vaccine exemptions, including personal belief exemptions, enable higher rates of exemptions in those states that allow them;
  • Increasing provider education and vaccine standard of practice to help ensure providers are responsibly promoting the importance of vaccination to their patients and actively tracking whether patients have received all recommended vaccinations and providing them when they have not;
  • Bolstering immunization registries and tracking to help ensure children’s and adults’ immunizations are up-to-date, and providers can identify when an individual is missing a recommended vaccination. Immunizations registries should be integrated with electronic health records (EHRs) and be interoperable across providers, so, for instance, if a child goes to the doctor with a stomach virus or visits a specialist, they can easily flag if a child has not received a vaccine and can provide it then. There should also be increased education for providers to support and expand vaccinations as standard practice and to discuss and track vaccination histories with their patients;
  • Expanding alternate delivery sites – the National Vaccine Advisory Committee (NVAC) has recommended including expansion of vaccination services offered by pharmacists and other community immunization providers, vaccination at the workplace and increased vaccination by providers who care for pregnant women; and
  • Supporting expanded research and use of alternatives to syringe administration of vaccination – experiences with alternative delivery methods, such as using the nasal mist intranasal administration of live-attenuated influenza vaccine (LAIV), have been well-received by the public and have contributed to increased uptake in pediatric and adult vaccinations.

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State-by-state estimated vaccination coverage with the recommended one or more does of measles, mumps, rubella (MMR) vaccine among children ages 19-to-35 months old (Data source: National Immunization Survey, 2013).

1. New Hampshire (96.3%); 2. Washington, D.C. (96.2%); 3. North Carolina (96.0%); 4. Massachusetts (95.8%); 5. (tie) New Jersey (95.6%) and Rhode Island (95.6%); 7. New York (95.5%); 8. Maryland (95.3%); 9. Mississippi (95.2%); 10. Delaware (94.8%); 11. Iowa (94.5%); 12. Georgia (93.9%); 13. Washington (93.5%); 14. Florida (93.4%); 15. Pennsylvania (93.3%); 16. Wisconsin (93.2%); 17. South Dakota (93.1%); 18. Hawaii (92.8%); 19. Texas (92.7%); 20. Utah (92.6%); 21. Nebraska (92.5%); 22. Tennessee (92.3%); 23. Indiana (92.0%); 24. (tie) Arizona (91.4%), Connecticut (91.4%), Illinois (91.4%) and North Dakota (91.4%); 28. Vermont (91.2%); 29. Idaho (91.1%); 30. Maine (91.0%); 31. Minnesota (90.8%); 32. California (90.7%); 33. Alaska (90.5%); 34. Nevada (90.4%); 35. (tie) Missouri (89.8%) and Oklahoma (89.8%); 37. Alabama (89.7%); 38. Kentucky (89.5%); 39. (tie) Kansas (89.4%) and Oregon (89.4%); 41. (tie) South Carolina (89.2%) and Michigan (89.2%); 43. New Mexico (89.1%); 44. Wyoming (89.0%); 45. Virginia (88.6%); 46. Arkansas (88.3%); 47. Louisiana (88.1%); 48. Montana (87.3%); 49. (tie) Colorado (86.0%), Ohio (86.0%) and West Virginia (86.0%).

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.

Trust for America’s Health’s Statement on the Public Health Aspects of the President’s Proposed Budget

February 3, 2015

Washington, DC, February 3, 2015 – The following is a statement from Jeffrey Levi, PhD, executive director of the Trust for America’s Health (TFAH) and chair of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health.

“If adopted, the President’s budget would take a major step toward building a culture of health in the United States, as it invests in programs and policies that enable Americans to be healthier – and to be better protected from infectious diseases, foodborne illnesses and other threats.

TFAH strongly supports the President’s proposal to end sequestration. Sequestration has resulted in sharp and indiscriminate cuts to public health programs – and ending it shows a commitment to the need for a strong, effective public health system in this country.

We are pleased to see increased support for programs that can improve health in people’s daily lives – where they live, learn, work and play. Mounting evidences shows programs like the Earned Income Tax Credit, the Child Care Tax Credit, early childhood education, family home visiting and the Children’s Health Insurance Program contribute to the long-term health of children and their families and are essential building blocks to a lifetime of wellbeing.

The proposal also recognizes the need for increased resources to fight one of the country’s fastest growing, most troubling and most preventable public health epidemics – devoting more than $100 million in new investments to combat prescription drug misuse and related heroin abuse.

In addition, the budget demonstrates how important ongoing investments into a standardized set of core “foundational capabilities” for all health departments are. All Americans should be assured that their state and local health departments have the same ability to help them be healthy. To this important end, the President’s budget identifies $8 million to start down the path of this kind of assurance.

However, while this is important, it is more than offset by the zeroing out of the $160 million Preventive Services Block Grant, a mechanism that is currently used by health departments to maintain capabilities and services. We recommend restoration of the block grant funding, along with clear direction that the funding be used for foundational public health capabilities and services.

Another low-point of the budget is the proposal to significantly cut chronic disease prevention programs – including some of the most important programs that support preventing obesity, tobacco cessation and related health problems. Given the national priority to reduce healthcare costs, this is particularly ironic since we know chronic diseases are one of the biggest drivers of these costs.

Some key public health highlights in the budget include:

  • A $36 million increase to the Strategic National Stockpile, which provides medicine and medical supplies to protect the American people during a public health emergency;
  • A $264 million investment to help the Centers for Disease and Prevention (CDC) combat antibiotic resistance;
  • A $107 million increase for the Biomedical Advance Research and Development Authority (BARDA) to spark the research and development of new antibiotics, vaccines, medical treatments and medical devices;
  • The creation of a single, independent food agency to provide leadership and prevent and respond to outbreaks of foodborne illness and an increase of $109.5 million to the Food and Drug Administration to implement the Food Safety Modernization Act (though much of this increase is in the form of unauthorized user fees which Congress should enact regardless of a policy decision on user fees). The creation of a single food safety agency has been a long-standing priority for TFAH and we hope it is the start of a broader coordination of public health programs across the federal government;
  • A $31.5 million increase in programs to combat viral hepatitis, almost doubling the nation’s resources;
  • A $10 million increase for the CDC climate and health program to fund 30 additional state and local grantees, though this is offset by an $11 million cut to the National Environmental Public Health Tracking program; and
  • A $128.1 million increase in the Vaccines for Children Program, though this is offset to some degree by a $50 million cut in the discretionary immunizations program.

Some key public health low-lights include:

  • Zeroing out the $160 million Preventive Services Block Grant – which is a key mechanism state and local public health agencies use to maintain capabilities and services;
  • A $20 million cut to the Partnerships for Improving Community Health (PICH), which works to address common risk factors for chronic disease;
  • A $7.5 million cut from the Division of Nutrition, Physical Activity and Obesity for programs focused on reducing obesity in high obesity rate counties; and
  • Elimination of the Racial and Ethnic Approaches to Community Health (REACH), which helps address key chronic disease conditions in the hardest hit populations.

TFAH looks forward to working with the Administration and Congress to ensure strong and sustained funding for public health – to foster a nationwide culture of health and improve the health and wealth of the nation.”

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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. 

“Outbreaks” Report Finds Gaps in Nation’s Ability to Respond to Ebola and Other Infectious Diseases; 25 States Reach Half or Fewer of Key Indicators

December 18, 2014

Washington, D.C., December 18, 2014 – A report released today by Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF) finds that the Ebola outbreak exposes serious underlying gaps in the nation’s ability to manage severe infectious disease threats.

Half of states and Washington, D.C. scored five or lower out of 10 key indicators related to preventing, detecting, diagnosing and responding to outbreaks.  Maryland, Massachusetts, Tennessee, Vermont and Virginia tied for the top score – achieving eight out of 10 indicators.  Arkansas has the lowest score at two out of 10.  The indicators are developed in consultation with leading public health experts based on data from publicly available sources or information provided by public officials.

“Over the last decade, we have seen dramatic improvements in state and local capacity to respond to outbreaks and emergencies.  But we also saw during the recent Ebola outbreak that some of the most basic infectious disease controls failed when tested,” said Jeffrey Levi, PhD, executive director of TFAH.  “The Ebola outbreak is a reminder that we cannot afford to let our guard down. We must remain vigilant in preventing and controlling emerging threats – like MERS-CoV, pandemic flu and Enterovirus – but not at the expense of ongoing, highly disruptive and dangerous diseases – seasonal flu, HIV/AIDS, antibiotic resistance and healthcare-associated infections.”

Some key findings from the Outbreaks: Protecting Americans from Infectious Diseases report include progress and gaps in the areas of:

  • Preparing for Emerging Threats:  Significant advances have been made in preparing for public health emergencies since the September 11, 2001 and the anthrax attacks, but gaps remain and have been exacerbated as resources were cut over time.
    • 47 states and Washington, D.C. reported conducting an exercise or using a real event to evaluate the time it took for sentinel laboratories to acknowledge receipt of an urgent message from the state’s laboratory.
    • Only 27 states and Washington, D.C. met a score equal to or higher than the national average for the Incident and Information Management domain of the National Health Security Preparedness Index.
  • Vaccinations:  More than 2 million preschoolers, 35 percent of seniors and a majority of adults do not receive all recommended vaccinations.
    • Only 14 states vaccinated at least half of their population against the seasonal flu (from fall 2013 to spring 2014).
    • Only 35 states and Washington, D.C. met the goal for vaccinating young children against the hepatitis B virus (Healthy People 2020 target of 90 percent of children ages 19 to 35 months receiving at least 3 doses).
  • Healthcare-Associated Infections:  While healthcare-associated infections have declined in recent years due to stronger prevention policies, around one out of every 25 people who are hospitalized each year still contracts a healthcare-associated infection.
    • Only 16 states performed better than the national standardized infection ratio for central-line-associated bloodstream infections.
    • Only 10 states reduced the number of central line-associated bloodstream infections between 2011 and 2012.
  • Sexually Transmitted Infections and Related Disease Treatment and Prevention:  The number of new HIV infections grew by 22 percent among young gay men, and 48 percent among young Black men (between 2008 and 2010); more than one-third of gonorrhea cases are now antibiotic-resistant; and nearly three million Baby Boomers are infected with hepatitis C, the majority of whom do not know they have it.
    • 37 states and Washington, D.C. require reporting of all (detectable and undetectable) CD4 and HIV viral load data, which are key strategies for classifying stage of disease, monitoring quality of care and preventing further transmission of HIV.
  • Food Safety:  Around 48 million Americans suffer from a foodborne illness each year.
    • 38 states met the national performance target of testing 90 percent of reported E.coli O157 cases within four days (in 2011).

“The best offense to fighting infectious diseases is a strong and steady defense,” said Paul Kuehnert, a Robert Wood Johnson Foundation director. “Infectious disease control requires having systems in place, continuous training and practice and sustained, sufficient funding.  As we work with communities across the nation to build a Culture of Health, we recognize that promoting and protecting health, and readiness to respond to wide-scale health threats are essential.”

The Outbreaks report recommends that it is time to rethink and modernize the health system to better match existing and emerging global disease threats.  Priority improvements should include:

  • Core Abilities:  Every state should be able to meet a set of core capabilities and there must be sufficient, sustained funding to support these capabilities.  Some basic capabilities include: investigative expertise, including surveillance systems that can identify and track threats and communicate across the health system and strong laboratory capacity; containment strategies, including vaccines and medicines; continued training and testing for hospitals and health departments for infection control and emergency preparedness; risk communications capabilities that inform the public without creating unnecessary fear; and maintaining a strong research capacity to develop new vaccines and medical treatments;
  • Healthcare and Public Health Integration:  Systems must be improved so the healthcare system, hospitals and public health agencies work better together toward the common goals of protecting patients, healthcare workers and the public; and
  • Leadership and Accountability:  Stronger leadership is needed for a government-wide approach to health threats at the federal, state and local levels, and there must be increased support for integration and flexibility of programs in exchange for demonstration of capabilities and accountability.

The report and state-by-state materials was supported by a grant from RWJF.

Score Summary: 

A full list of all of the indicators and scores and the full report are available on TFAH’s website.  For the state-by-state scoring, states received one point for achieving an indicator or zero points if they did not achieve the indicator.  Zero is the lowest possible overall score, 10 is the highest.  The data for the indicators are from publicly available sources or were provided from public officials.

8 out of 10: Maryland, Massachusetts, Tennessee, Vermont and Virginia

7 out of 10: California, Delaware, Nebraska, New Hampshire, North Dakota, Pennsylvania and Wisconsin

6 out of 10: Colorado, Connecticut, Florida, Hawaii, Illinois, Iowa, Minnesota, New York, North Carolina, Rhode Island, South Carolina, South Dakota and Texas

5 out of 10: Alabama, D.C., Georgia, Indiana, Michigan, New Mexico, Oklahoma, Oregon, Utah and West Virginia

4 out of 10: Alaska, Arizona, Maine, Mississippi, Missouri, Montana, Nevada and Washington

3 out of 10: Idaho, Kansas, Kentucky, Louisiana, New Jersey, Ohio and Wyoming

2 out of 10: Arkansas

 

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.

For more than 40 years the Robert Wood Johnson Foundation has worked to improve health and health care. We are striving to build a national Culture of Health that will enable all to live longer, healthier lives now and for generations to come. For more information, visit www.rwjf.org. Follow the Foundation on Twitter at www.rwjf.org/twitter or on Facebook at www.rwjf.org/facebook.

New Report Finds Adult Obesity Rates Increased in Six States

Rates Higher in South, and Among Blacks, Latinos and Low-Income Americans

September 4, 2014

Washington, D.C., September 4, 2014 –  Adult obesity rates remained high overall, increased in six states in the past year, and did not decrease in any, according to The State of Obesity: Better Policies for a Healthier America, a report from the Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF).

The annual report found that adult obesity rates increased in Alaska, Delaware, Idaho, New Jersey, Tennessee and Wyoming.  Rates of obesity now exceed 35 percent for the first time in two states, are at or above 30 percent in 20 states and are not below 21 percent in any.  Mississippi and West Virginia tied for having the highest adult obesity rate in the United States at 35.1 percent, while Colorado had the lowest at 21.3 percent.

Findings reveal that significant geographic, income, racial, and ethnic disparities persist, with obesity rates highest in the South and among Blacks, Latinos and lower-income, less-educated Americans. The report also found that more than one in ten children become obese as early as ages 2 to 5.

“Obesity in America is at a critical juncture. Obesity rates are unacceptably high, and the disparities in rates are profoundly troubling,” said Jeffrey Levi, PhD, executive director of TFAH.  “We need to intensify prevention efforts starting in early childhood, and do a better job of implementing effective policies and programs in all communities – so every American has the greatest opportunity to have a healthy weight and live a healthy life.”

Other key findings from The State of Obesity include:

After decades of rising obesity rates among adults, the rate of increase is beginning to slow, but rates remain far too high and disparities persist.   

In 2005, the obesity rate increased in every state but one; this past year, only six states experienced an increase. In last year’s report, only one state, Arkansas, experienced an increase in its adult obesity rate.

Obesity rates remain higher among Black and Latino communities than among Whites:

  • Adult obesity rates for Blacks are at or above 40 percent in 11 states, 35 percent in 29 states and 30 percent in 41 states.
  • Rates of adult obesity among Latinos exceeded 35 percent in five states and 30 percent in 23 states.
  • Among Whites, adult obesity rates topped 30 percent in 10 states.

Nine out of the 10 states with the highest obesity rates are in the South.

Baby Boomers (45-to 64-year-olds)* have the highest obesity rates of any age group – topping 35 percent in 17 states and 30 percent in 41 states.

More than 33 percent of adults 18 and older who earn less than $15,000 per year are obese, compared with 25.4 percent who earn at least $50,000 per year.

More than 6 percent of adults are severely** obese; the number of severely obese adults has quadrupled in the past 30 years.

The national childhood obesity rate has leveled off, and rates have declined in some places and among some groups, but disparities persist and severe obesity may be on the rise.

As of 2011-2012:

  • Nearly one out of three children and teens ages 2 to 19 is overweight or obese, and national obesity rates among this age group have remained stable for 10 years.
  • More than 1 in 10 children become obese between the ages of 2 to 5; and 5 percent of 6- to 11-year-olds are severely obese.
  • Racial and ethnic disparities emerge in childhood (ages 2-19):  The obesity rates are 22.4 percent among Hispanics, 20.2 percent among Blacks and 14.1 percent among Whites.

Between 2008 and 2011, 18 states and one U.S. territory experienced a decline in obesity rates among preschoolers from low-income families.

“While adult rates are stabilizing in many states, these data suggest that our overall progress in reversing America’s obesity epidemic is uneven and fragile,” said Risa Lavizzo-Mourey, MD, RWJF president and CEO. “A growing number of cities and states have reported decreases in obesity among children, showing that when we make comprehensive changes to policies and community environments, we can build a Culture of Health that makes healthy choices the easy and obvious choices for kids and adults alike. Going forward, we must spread what works to prevent obesity to every state and region, with special focus on those communities where rates remain the highest.”

The State of Obesity reviews existing policies and issues high-priority recommendations for making affordable healthy foods and safe places for physical activity available to all Americans, such as focusing on healthy food financing, improving nutrition and activity in schools and child care settings, limiting the marketing of unhealthy foods to kids, and improving the built environment to support increased physical activity.  In addition, for this year’s report, TFAH and RWJF partnered with the NAACP, Salud America! The RWJF Research Network to Prevent Obesity Among Latino Children, and Greenberg Quinlan Rosner Research to identify more effective strategies for implementing obesity-prevention policies in Black and Latino communities.

Recommendations, which were based on a series of in-depth interviews with public health experts in Black and Latino communities around the country, included:

  • Expanding access to affordable healthy foods and opportunities for physical activity by increasing resources for programs, connecting obesity-prevention initiatives with other ongoing community programs, and other approaches;
  • Providing education and addressing cultural differences to both improve people’s knowledge about nutrition and physical activity and make initiatives more relevant to their daily lives; and
  • Making sustainability, community input, involvement and shared leadership top priorities of obesity-prevention initiatives from the outset.

The State of Obesity (formerly known as the F as in Fat report series) is the 11th annual report produced by TFAH and RWJF, with support by a grant from RWJF. The full report, with state rankings in all categories and new interactive maps, is available at http://stateofobesity.org. Follow the conversation at #StateofObesity.

* (45-64 Year Olds, includes most Baby Boomers, who range from 49-67 year olds)

Adult obesity = Body Mass Index of 30 or more; **Severe obesity in adults = BMI of 40 or more. 

Childhood obesity = BMI at or above the 95th percentile for children of same age/sex; Severe obesity in children = BMI greater than 120 percent of 95th percentile for children of same age/sex

2013 STATE-BY-STATE ADULT OBESITY RATES

Based on an analysis of new state-by-state data from the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance Survey, adult obesity rates by state from highest to lowest were:

Note: 1 = Highest rate of adult obesity, 51 = lowest rate of adult obesity.

1. (tie) Mississippi and West Virginia (35.1%); 3. Arkansas (34.6%); 4. Tennessee (33.7%); 5. Kentucky (33.2%); 6. Louisiana (33.1%); 7. Oklahoma (32.5%); 8. Alabama (32.4%); 9. Indiana (31.8%); 10. South Carolina (31.7%); 11. Michigan (31.5%); 12. Iowa (31.3%); 13. Delaware (31.1%); 14. North Dakota (31%); 15. Texas (30.9%); 16. (tie) Missouri and Ohio (30.4%); 18. Georgia (30.3%); 19. (tie) Kansas and Pennsylvania (30%); 21. South Dakota (29.9%); 22. Wisconsin (29.8%); 23. (tie) Idaho and Nebraska (29.6%); 25. (tie) Illinois and North Carolina (29.4%); 27. Maine (28.9%); 28. Alaska (28.4%); 29. Maryland (28.3%); 30. Wyoming (27.8%); 31. Rhode Island (27.3%); 32. (tie) Virginia and Washington (27.2%); 34. Arizona (26.8%); 35. New Hampshire (26.7%); 36. Oregon (26.5%); 37. (tie) Florida and New Mexico (26.4%); 39. New Jersey (26.3%); 40. Nevada (26.2%); 41. Minnesota (25.5%); 42. New York (25.4%); 43. Connecticut (25.0%); 44. Vermont (24.7%); 45. Montana (24.6%); 46. (tie) California and Utah (24.1%); 48. Massachusetts (23.6%); 49. Washington, D.C. (22.9%) 50. Hawaii (21.8%); 51. Colorado (21.3%).

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. For more information, visit www.healthyamericans.org.

For more than 40 years the Robert Wood Johnson Foundation has worked to improve the health and health care of all Americans. We are striving to build a national Culture of Health that will enable all Americans to live longer, healthier lives now and for generations to come. For more information, visit www.rwjf.org. Follow the Foundation on Twitter at www.rwjf.org/twitter or on Facebook at www.rwjf.org/facebook.

TFAH Releases “The Truth about the Prevention Fund”

June 6, 2013

Washington, DC, June 6, 2013 – Trust for America’s Health (TFAH), today, released a new report of key facts about the Prevention and Public Health Fund, which was created by the Affordable Care Act (ACA).

The Truth about the Prevention Fund includes an overview of the Fund, which is the nation’s largest single investment in prevention, using evidence-based and innovative partnership approaches to improve the health of Americans.  The Fund provides more than $14.5 billion in mandatory appropriations over 10 years to improve health and prevent chronic illnesses by expanding preventive care and supporting proven community-based programs that reduce obesity, tobacco use and other preventable conditions.

Currently, more than half of Americans suffer from chronic diseases, such as type 2 diabetes and heart disease.  Two thirds of Americans are currently obese or overweight and nearly 20 percent of Americans smoke.  Obesity costs the country $147 billion and tobacco use $96 billion in direct healthcare costs each year.  A 2012 TFAH study found that if obesity rates continue on their current trajectory, half of Americans could be obese by 2030, and the rise in obesity-related healthcare costs could reach between $196 billion and $213 billion in direct medical costs.

“Today’s kids could become the first in American history to live shorter, less healthy lives than their parents,” said Jeffrey Levi, PhD, executive director of TFAH.  “We can resign our kids to that fate – or invest in proven, effective programs to reduce obesity, tobacco use and the prevalence of preventable chronic conditions.  The Prevention Fund is the best and most targeted effort the nation has made toward getting the health of this country back on track.”

The Prevention Fund invests in programs that are proven and effective.  Oversight and evaluation is a key component of every Fund-sponsored program, and strict performance measures ensure accountability before federal dollars are spent.   The Fund supports community-driven prevention efforts targeted at reducing tobacco use, increasing physical activity, improving nutrition, expanding mental health and injury prevention programs and improving prevention activities.

For instance, for one component of the Fund – the Community Transformation Grants (CTGs) – grantees are required within five years to reduce by 5 percent death and disability due to tobacco use; the rate of obesity (through nutrition and physical activity approaches); and death and disability due to heart disease and stroke.  States and local communities have the flexibility to decide what problems are most pressing for them to address and decide which approaches to use as long as they are evidence based.  All grantees are expressly forbidden from using any funds for lobbying.  U.S. Centers for Disease Control and Prevention (CDC) has initiated extra controls to ensure grantees are restricted from ever using funds on prohibited lobbying activities and has mechanisms in place to identify any violations.  No such violations have been confirmed.

“Obesity, tobacco-use and other preventable health problems are crippling this nation.  The Prevention Fund provides states and communities with the flexibility to address their most pressing health challenges. We will never be successful unless we invest in programs and approaches we know work,” said Levi.

The full report also profiles examples of how communities are effectively using Prevention Fund support – The Truth about the Prevention Fund is available on TFAH’s web site.

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. www.healthyamericans.org

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Examples of CTG Efforts in Communities:

  • West Virginia is supporting local health departments to address top challenges facing their community and develop solutions.  The West Virginia Department of Health is using CTG support to help local health departments in every county in the state implement targeted initiatives including:  safe places in communities to work and play, Farm-to-School Initiatives to improve nutrition in school settings, Child and Day Care Center Nutrition Programs to educate and empower children to choose healthy lifestyles through physical activity and healthy food choices, and community coordinated care systems that link and build referral networks between the clinical system and community-based lifestyle programs so people can manage their health.

  • Oklahoma is using a CTG to work with a range of sectors to make healthier choices easier in the state.  Nearly 70 percent of Oklahoma County’s premature deaths are largely preventable, arising from an unhealthy lifestyle, poor diet or the use of tobacco, alcohol or other substances.  The county spends about $920 million every year to treat chronic disease. In September 2011, Oklahoma City was awarded a $3.5 million CTG.  Using a portion of those funds, the Oklahoma City-County Health Department (OCCHD) expanded the use of community health workers to ensure more people access the “My Heart, My Health, My Family” program, which provides prevention programs and services, specifically focused on cardiovascular disease.  The program includes lesson plans on healthy living (e.g. portion control and the benefits of substituting water for sugar sweetened beverages) and participants receive access to free regular clinical checkups four times a year and free medication. The CTG money will also support other obesity-specific initiatives, including expanded walking and biking trails, a push to help schools offer healthy menu options and a physical education coordinator for city schools.

  • An Accountable Care Community (ACC) in Akron, Ohio – a CTG recipient – has brought together 70 community partners to coordinate healthcare and support inside and outside the doctor’s office for patients with type 2 diabetes.  In just 18 months, the ACC has reduced the average cost per month of care for individuals with type 2 diabetes by more than 10 percent per month with an estimated program savings of $3,185 per person per year. This initiative also led to a decrease in diabetes-related emergency department visits.
  • The Iowa Department of Public Health (IDPH) is providing local communities with resources to better address obesity and other health risk factors.  Utilizing a $3 million/year CTG, one key element is the Iowa Community Referral Project. The project will help ensure Iowans follow through with healthy lifestyle behaviors as a result of referral system changes between health providers and community agencies. The two components of the project include 1) A partnership with the Iowa Primary Care Association (IPCA) and selected communities where intensive training and technical assistance are provided to promote a seamless referral system, and 2) Implementation of local referral projects in the Iowa CTG intervention counties.
  • A CTG awarded to Broward Regional Health Planning Council’s Transforming Our Community’s Health (TOUCH) initiative is serving 1.7 million residents of Broward County, Florida to improve health, including by working with a range of partners to alleviate childhood obesity.  TOUCH has brought together community-based organizations, multidisciplinary strategies and diverse communities to address the most recognizable factors contributing to childhood obesity.  It is anticipated that these system, environmental and policy enhancements will positively impact the health, well-being and longevity of children.
  • Additional highlights of CTG program efforts in 2011 are available at: http://www.cdc.gov/communitytransformation/accomplishments/index.htm.

New Report Provides High-Impact Recommendations to Improve Prevention Policies in America

January 29, 2013

Washington, D.C., January 29, 2013 – Today, Trust for America’s Health (TFAH) released A Healthier America 2013: Strategies to Move from Sick Care to Health Care in Four Years – which provides high-impact recommendations to prioritize prevention and improve the health of Americans.

The Healthier America report outlines top policy approaches to respond to studies that show 1) more than half of Americans are living with one or more serious, chronic diseases, a majority of which could have been prevented, and 2) that today’s children could be on track to be the first in U.S. history to live shorter, less healthy lives than their parents.

“America’s health faces two possible futures,” said Gail Christopher, DN, President of the Board of TFAH and Vice President – Program Strategy of the W.K. Kellogg Foundation.  “We can continue on the current path, resigning millions of Americans to health problems that could have been avoided or we invest in giving all Americans the opportunity to be healthier while saving billions in health care costs.  We owe it to our children to take the smarter way.”

The Healthier America report stresses the importance of taking innovative approaches and building partnerships with a wide range of sectors in order to be effective.  Some recommendations include:

  • Advance the nation’s public health system by adopting a set of foundational capabilities, restructuring federal public health programs and ensuring sufficient, sustained funding to meet these defined foundational capabilities;
  • Ensure insurance providers reimburse for effective prevention approaches both inside and outside the doctor’s office;
  • Integrate community-based strategies into new health care models, such as by expanding Accountable Care Organizations into Accountable Care Communities;
  • Work with nonprofit hospitals to identify the most effective ways they can expand support for prevention through community benefit programs;
  • Maintain the Prevention and Public Health Fund and expand the Community Transformation Grant program so all Americans can benefit;
  • Implement all of the recommendations for each of the 17 federal agency partners in the National Prevention Strategy; and
  • Encourage all employers, including federal, state and local governments, to provide effective, evidence-based workplace wellness programs.

“Prevention delivers real value as a cost-effective way to keep Americans healthy and improve their quality of life,” said Jeffrey Levi, PhD, executive director of TFAH.  “Everyone wins when we prevent disease rather than treating people after they get sick.  Health care costs go down, our local neighborhoods are healthier and provide more economic opportunity, and people live longer, healthier, happier lives.”

A Healthier America also features more than 15 case studies from across the country that show the report’s recommendations in action, such as:

  • The first-of-its-kind Accountable Care Community (ACC) launched by the Austen BioInnovation Institute in Akron, Ohio, which brings together more than 70 partners to coordinate health care inside and outside the doctor’s office for patients with type 2 diabetes.  By improving care and making healthier choices easier in people’s daily lives, the ACC reduced the average cost per month of care for individuals with type 2 diabetes by more than 10 percent per month within 18 months of starting the program – an estimated savings of $3,185 per person per year;
  • The Community Asthma Initiative (CAI), implemented by Boston Children’s Hospital, has provided support to improve the health of children with moderate to severe asthma in at-risk Boston neighborhoods.  The CAI has led to a return of $1.46 to insurers/society for every $1 invested; an 80 percent reduction in percentage of patients with one or more asthma-related hospital admission; and a 60 percent reduction in the percentage of patients with asthma-related emergency department visits; and
  • The Healthy Environments Collaborate (HEC) in North Carolina is an innovative partnership across four state agencies – Health and Human Services, Transportation, Environment and Natural Resources and Commerce. The partnership focuses on creating win-win policies and programs that improve health while also meeting other priority goals, such as improved transportation, increased commerce and stable housing programs.

In addition, the report includes recommendations for a series of 10 key public health issues: reversing the obesity epidemic; preventing tobacco use and exposure; encouraging healthy aging; improving the health of low-income and minority communities; strengthening healthy women, healthy babies; reducing environmental health threats; enhancing injury prevention; preventing and controlling infectious diseases; prioritizing health emergencies and bioterrorism preparedness; and fixing food safety.

The report was supported by grants from the Robert Wood Johnson Foundation, the W.K. Kellogg Foundation and The Kresge Foundation and is available on TFAH’s website at www.healthyamericans.org.

 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. www.healthyamericans.org

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New Report Calls for Federal Action to Close Achievement Gap by Addressing School Health

Health in Mind Features Solutions to Public Education and Health Challenges

January 24, 2013

Washington, D.C., January 24, 2013 – Health in Mind, a new report from Healthy Schools Campaign (HSC) and Trust for America’s Health (TFAH), details immediate solutions that can help close the achievement gap and create a healthy future for all children.

American children are struggling academically and the nation faces a growing achievement gap that is increasingly tied to health disparities—today’s children could become the first generation to live shorter and less healthy lives than their parents, notes the report.

Health in Mind offers a strong framework for addressing the nation’s most urgent health and education challenges by outlining strategies within the current regulatory and budget framework of the Department of Education and Department of Health and Human Services that the administration can utilize to better the conditions for health and learning in schools. The report also examines the research connecting health disparities with educational outcomes and presents case studies of innovative on-the-ground practices across the nation.

“We’ve never met a parent, teacher or school leader who didn’t recognize that healthy students are better prepared to learn,” said Rochelle Davis, President and CEO of HSC, a national advocacy organization that focuses much of its work on improving the food and fitness environment in Chicago schools. “But the truth is that vast health disparities exist in our nation and far too many children attend school in environments that do not support their health. Unless we address these challenges, our efforts to close the achievement gap will be compromised. The consequences are enormous for children’s learning and for their lifetime health.”

Health in Mind presents research, policy analysis and immediate recommendations focused on:

  • Preparing teachers and principals to promote student health and wellness;
  • Engaging parents in school health;
  • Incorporating health and wellness into school metrics, accountability and recognition programs;
  • Building the Department of Education’s capacity to address student health and wellness; and
  • Placing a school nurse in every school.

“We are beginning to see an important shift in the way the nation addresses health and wellness,” said Jeffrey Levi, PhD, executive director of TFAH. “With Health in Mind and the National Prevention Strategy, we’ve begun to move toward integrating and thinking about health in all of the contexts—education, transportation, housing and other areas—that impact health. Specifically focusing on the connection between health and school will ensure students can do as well as possible academically and are healthier.”

“We know that health and education are inextricably linked; with that knowledge, we must shift how we approach both wellness and the school day,” said Dr. Gail Christopher, vice president for program strategy at the W.K. Kellogg Foundation. “The Health in Mind report points us forward. Our communities truly can develop children who are healthy, smart and strong. Doing so will take creativity and commitment from leaders at all levels. I am confident we can rise to that challenge.”

The report follows a May 2012 event at which HSC and TFAH, with the support of the nation’s largest education unions, presented a set of recommendations to U.S. Secretary of Education Arne Duncan and U.S. Secretary of Health and Human Services Kathleen Sebelius. At the event, both Sec. Duncan and Sec. Sebelius publicly expressed their support for the goals that would form the basis for Health in Mind.

In December 2012, 10 members of Congress signed on to a letter to Sec. Duncan and Sec. Sebelius expressing their support for the recommendations. More than 70 organizations representing the nation’s health and education advocates have signed on to the Health in Mind vision statement.

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About Healthy Schools Campaign
Healthy Schools Campaign, an independent not-for-profit organization, is a leading authority on healthy school environments and a voice for people who care about our environment, our children, and education. HSC advocates for policies and practices that allow all students, teachers and staff to learn and work in a healthy school environment.  www.healthyschoolscampaign.org.

About Trust for America’s Health
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. www.healthyamericans.org.