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Press Release on health-related topics.

On the 20th Anniversary of the September 11th Terror Attacks the Nation is Better Prepared but Still not Fully Prepared for Public Health Emergencies

(Washington, DC – September 6, 2021) – On the 20th anniversary of the September 11th attacks on the World Trade Center and the Pentagon, Trust for America’s Health (TFAH) reflects on the nation’s strong progress in preparedness for public health emergencies, as well as the major challenges that still exist, including those illuminated by the COVID-19 pandemic.

In 2002, following the first anniversary of this tragedy and the subsequent anthrax attacks, TFAH released its first analysis of the response and limitations of the public health system, Public Health Preparedness: Progress and Challenges Since September 11, 2001. From this report, TFAH’s Ready or Not: Protecting the Public’s Health from Diseases, Disasters and Bioterrorism report series was developed.  The 2021 Ready or Not report highlights the urgent need for federal, state, and local policymakers to prioritize the nation’s health security as we work toward ending the COVID-19 pandemic and preparing for extreme weather, the health impacts of climate change, future pandemics, and other emerging threats.

“The COVID-19 pandemic, the devastating wildfires, and the unfolding impacts of Hurricane Ida are only the most recent reminders of the need to strengthen our nation’s health security,” said J. Nadine Gracia, MD, MSCE, TFAH President and CEO. “The 20th anniversary of September 11th is an important milestone to mark the progress we have made in the past two decades: we have built a public health preparedness enterprise from the ground up, including a dedicated public health emergency workforce. But we must make additional and sustained investments in public health infrastructure and workforce, and we must ensure equity is at the center of preparedness, response, and recovery efforts.”

TFAH recommends the following policy actions to strengthen the nation’s emergency response capacity:

  • Federal, state, and local governments should bolster public health infrastructure investments. Congress should enact the Public Health Infrastructure Saves Lives Act and make annual investments in public health infrastructure to build the workforce and systems that have been chronically neglected for decades.
  • Congress should invest in modernizing public health data systems. Modern and sustainable public health data systems and the collection of complete and disaggregated demographic data will facilitate a more effective and equitable public health response during future emergencies.
  • Public health and government leaders must be equipped to deliver effective public communications and counter misinformation. Misinformation, such as inaccurate social media messaging, has been a significant barrier to developing a proactive public health response during the COVID-19 pandemic and has increased vaccine hesitancy. Congress must fund research and implementation of public health communications and messaging, grounded in the best available science, to counter misinformation.
  • Equity should be an explicit and foundational component of preparedness and response at all levels of public health. The COVID-19 pandemic has highlighted that health inequities are exacerbated during emergencies. Health departments and policymakers should build the health equity workforce, partner with, and provide resources to trusted community organizations, and incorporate equity leadership into all emergency planning and response.
  • Federal and state lawmakers should invest in policies and capacity to improve social and economic conditions in communities and advance equity and resilience. People at highest risk during disasters and those who have the hardest time recovering are often those with unstable or unhealthy housing, limited access to transportation, and people who live in low-income communities – circumstances often rooted in longstanding systemic inequities. Congress should invest in the Center for Disease Control and Prevention (CDC) efforts to address the social determinants of health. Lawmakers and employers should advance policies and promote multisector efforts to ensure access to healthy, affordable housing; promote economic mobility through living wage and paid sick and family leave policies; eliminate poverty; address food security; and improve transportation.

This month, the nation commemorates the thousands of lives lost during the 9/11 attacks, continues to mourn the hundreds of thousands of lives lost to COVID-19, and honors the heroic efforts of first responders, the public health workforce, and healthcare workers. As we reflect and move forward, we must commit to preventing and preparing for public health emergencies in ways that ensure that everyone’s health and well-being are protected during times of crisis.

 

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Trust for America’s Health is a nonprofit, nonpartisan organization that promotes optimal health for every person and community and makes the prevention of illness and injury a national priority.

New Report Outlines Role of Social Determinants in Americans’ Health

Calls for Adoption of Policies Shown to Improve Health Outcomes, Control Healthcare Spending, and Create Health Equity

(Washington, DC – July 29, 2021) – America’s chronic disease and health disparities crisis require policy interventions targeting structural racism and the social determinants of health, concludes a report released today by Trust for America’s Health.

The report, Leveraging Evidence-Based Policies to Improve Health, Control Costs, and Create Health Equity, reviews five policy areas: access to healthcare, economic mobility, affordable housing, safe and healthy learning environments for children, and health-promoting excise taxes. Based on an extensive review of the evidence, the report recommends federal and state-level policies in each issue area to improve health outcomes, advance health equity and reduce healthcare spending.

Today, nearly half of all Americans have at least one chronic disease, and that number is growing. In addition, the COVID-19 pandemic starkly illuminated the ways in which social and economic conditions and inequities– often deeply rooted in communities due to historical and current day structural racism and discrimination – greatly increase health risks and burdens for certain populations groups, including many communities of color. According to the CDC, hospitalization rates during the height of the COVID-19 pandemic were 3.3 times higher for American Indian/Alaska Natives and approximately 3 times higher for Blacks and Latinos as compared to the hospitalization rate for whites.

“The COVID-19 pandemic put a spotlight on the role that social and economic conditions play in health and gives policymakers an opportunity to build an improved social supports and public health system,” said J. Nadine Gracia, MD, MSCE, President and CEO of Trust for America’s Health. “Focusing solely on individual behavior will not solve America’s health crisis. Building healthy and thriving communities and advancing health equity require improving the social and economic conditions that shape health. Only then will everyone have a fair and just opportunity to enjoy optimal health.”

The social determinants of health are factors beyond traditional healthcare that significantly impact health including where you are born, live, work, play, go to school, and age. Data show that these factors impact a wide range of quality-of-life outcomes and health risks. For example, where you live, has a measurable impact on overall health status and longevity.  Furthermore, inequities limit access to health resources and educational and economic opportunities that can lead to poor health.

Policy decisions can drive improvements in the social conditions in communities or they can perpetuate inequities. Policies do not need to be deliberately discriminatory to exacerbate inequities. For example, tying school funding to local property taxes leaves schools in lower income communities with fewer resources than higher income neighborhoods.

The report identifies policies that, if implemented, can create the conditions in people’s lives that support optimal health.  Recommended policy actions in each category includes:

Goal: Supporting Access to High-Quality Healthcare Services

Recommendation: Adopt Medicaid Expansion.  States that have adopted Medicaid expansion experienced the largest reductions in the number of uninsured persons. In 2018, the uninsured rate among low-income, non-elderly adults in states that expanded Medicaid eligibility was about half that of the uninsured rate in states that did not expand the program. Increased access to healthcare saved lives and was associated with a reduction in total state spending on traditional Medicaid.

Goal: Promoting Economic Mobility

Recommendation: Expand the Earned Income Tax Credit. The earned income tax credit (EITC) is a tax credit offered to eligible low-income workers to enhance their economic security. EITC policies, both federal and state, help lift millions of working families out of poverty and reduces the severity of poverty for millions more.

Goal: Ensuring Access to Affordable Housing

Recommendation: Expand the Low-income Housing Tax Credit Program. Decades of research has demonstrated a connection between safe and secure housing and good health.  The low-income housing tax credit (LIHTC) provides tax incentives to encourage developers to build affordable housing. Since the LIHTC program was created approximately 3 million quality homes have been developed to serve working families, older adults, people with disabilities and those at risk of homelessness. Despite this success, the need for affordable housing remains high across the country.

Goal: Promoting Safe and Healthy Learning Environments for Children

Recommendation: Increase access to high-quality early childhood education programs. Research demonstrates the many ways in which safe and supportive school environments put children on healthy developmental pathways. High-quality early childhood education programming, such as Head Start and pre-K can have long-lasting positive impacts on children throughout their lives. Early childhood education centers and schools are also critical sources of nutrition for millions of children through the National School Lunch and School Breakfast Programs and provide access to healthcare for millions of students via school-based health centers.

Goal: Using tax policy to encourage healthy choices

Recommendation: Tax unhealthy products, like tobacco and sugar-sweeten beverages. Such taxes can be a win-win for localities, encouraging healthy choices and raising local revenue that can be reinvested in health-promoting and prevention programs.

Report:  Leveraging Evidence-Based Policies to Improve Health, Control Costs, and Create Health Equity

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Trust for America’s Health is a nonprofit, nonpartisan organization that promotes optimal health for every person and community and makes the prevention of illness and injury a national priority. Twitter: @healthyamerica1

 

Nuevo informe describe el papel de los determinantes sociales en la salud de los estadounidenses

Pide la adopción de políticas eficientes para mejorar los resultados de salud, controlar el gasto en atención médica y crear equidad en la salud

(Washington, DC – 29 de julio de 2021) – La crisis de las enfermedades crónicas y las disparidades de salud en Estados Unidos requiere intervenciones de políticas dirigidas al racismo estructural y los determinantes sociales de la salud, concluye un informe publicado hoy por Trust for America’s Health.

El informe, Leveraging Evidence-Based Policies to Improve Health, Control Costs, and Create Health Equity, analiza cinco áreas de políticas: acceso a la atención médica, movilidad económica, vivienda asequible, entornos de aprendizaje seguros y saludables para los niños e impuestos especiales que promueven la salud. Basado en una extensa revisión de la evidencia, el informe recomienda políticas a nivel federal y estatal en cada área temática para mejorar los resultados de salud, promover la equidad en la salud y reducir el gasto en atención médica.

Hoy en día, casi la mitad de todos los estadounidenses tienen al menos una enfermedad crónica, y ese número está aumentando. Además, la pandemia de COVID-19 iluminó claramente las formas en que las condiciones sociales y económicas y las desigualdades, a menudo profundamente arraigadas en las comunidades debido al racismo y la discriminación estructural históricos y actuales, aumentan en gran medida los riesgos y las cargas para la salud de ciertos grupos de población, incluidos muchas comunidades de color. Según los CDC, las tasas de hospitalización durante el apogeo de la pandemia COVID-19 fueron 3.3 veces más altas para los indios americanos / nativos de Alaska y aproximadamente 3 veces más altas para los afroamericanos y latinos en comparación con la tasa de hospitalización de los blancos.

“La pandemia de COVID-19 puso en relieve el papel que juegan las condiciones sociales y económicas en la salud y brinda a los responsables de la formulación de políticas la oportunidad de construir un mejor apoyo social y un sistema de salud pública”, dijo J. Nadine Gracia, MD, MSCE, Presidente y CEO de Trust for America’s Health. “Centrarse únicamente en el comportamiento individual no resolverá la crisis de salud de Estados Unidos. La construcción de comunidades saludables y prósperas y el avance de la equidad en salud requieren mejorar las condiciones sociales y económicas que dan forma a la salud. Solo entonces todos tendrán una oportunidad justa y equitativa de disfrutar de una salud óptima “.

Los determinantes sociales de la salud son factores más allá de la atención médica tradicional que tienen un impacto significativo en la salud, incluido el lugar de nacimiento, el hogar, el trabajo, el juego, la escuela y la edad. Los datos muestran que estos factores afectan una amplia gama de resultados de calidad de vida y riesgos para la salud. Por ejemplo, el lugar donde vive tiene un impacto medible en el estado de salud general y la longevidad. Además, las inequidades limitan el acceso a los recursos de salud y las oportunidades educativas y económicas que pueden conducir a una mala salud.

Las decisiones de política pueden impulsar mejoras en las condiciones sociales en las comunidades o pueden perpetuar las inequidades. No es necesario que las políticas sean deliberadamente discriminatorias para exacerbar las desigualdades. Por ejemplo, vincular los fondos escolares a los impuestos locales a la propiedad deja a las escuelas en comunidades de menores ingresos con menos recursos que los vecindarios de mayores ingresos.

El informe identifica políticas que, si se implementan, pueden crear las condiciones en la vida de las personas que respaldan una salud óptima. Las acciones de política recomendadas en cada categoría incluyen:

Objetivo: Respaldar el acceso a servicios de atención médica de alta calidad

Recomendación: Adopte la expansión de Medicaid. Los estados que han adoptado la expansión de Medicaid experimentaron las mayores reducciones en el número de personas sin seguro. En el 2018, la tasa de personas sin seguro médico entre los adultos no ancianos de bajos ingresos en los estados que expandieron la elegibilidad para Medicaid fue aproximadamente la mitad de la tasa de personas sin seguro en los estados que no expandieron el programa. El mayor acceso a la atención médica salvó vidas y se asoció con una reducción en el gasto estatal total en Medicaid tradicional.

Objetivo: Promover la movilidad económica

Recomendación: Ampliar el Crédito Tributario por Ingreso del Trabajo. El crédito tributario por ingreso del trabajo (EITC) es un crédito tributario que se ofrece a los trabajadores elegibles de bajos ingresos para mejorar su seguridad económica. Las políticas del EITC, tanto federales como estatales, ayudan a sacar de la pobreza a millones de familias trabajadoras y reducen la gravedad de la pobreza para millones más.

Objetivo: Garantizar el acceso a viviendas asequibles

Recomendación: Ampliar el programa de crédito fiscal para viviendas de bajos ingresos. Décadas de investigación han demostrado una conexión entre viviendas seguras y protegidas y buena salud. El crédito fiscal para viviendas para personas de bajos ingresos (LIHTC) ofrece incentivos fiscales para alentar a los desarrolladores a construir viviendas asequibles. Desde que se creó el programa LIHTC, se han desarrollado aproximadamente 3 millones de hogares de calidad para atender a familias trabajadoras, adultos mayores, personas con discapacidades y personas en riesgo de quedarse sin hogar. A pesar de este éxito, la necesidad de viviendas asequibles sigue siendo alta en todo el país.

Objetivo: Promover entornos de aprendizaje seguros y saludables para los niños

Recomendación: Incrementar el acceso a programas de educación infantil de alta calidad.

Las investigaciones demuestran las muchas formas en que los entornos escolares seguros y de apoyo colocan a los niños en vías de desarrollo saludables. Los programas de educación de la primera infancia de alta calidad, como Head Start y prekínder, pueden tener impactos positivos duraderos en los niños a lo largo de sus vidas. Los centros de educación infantil y las escuelas también son fuentes críticas de nutrición para millones de niños a través de los Programas Nacionales de Almuerzos y Desayunos Escolares y brindan acceso a la atención médica para millones de estudiantes a través de los centros de salud escolares.

Objetivo: utilizar la política fiscal para fomentar opciones saludables

Recomendación: Impuestos los productos no saludables, como el tabaco y las bebidas azucaradas. Dichos impuestos pueden ser beneficiosos para las localidades, fomentando opciones saludables y recaudando ingresos locales que pueden reinvertirse en programas de prevención y promoción de la salud.

 

Reporte:  Leveraging Evidence-Based Policies to Improve Health, Control Costs, and Create Health Equity

 

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Trust for America’s Health es una organización no partidista sin fines de lucro que promueve la salud óptima para cada persona y comunidad y hace de la prevención de enfermedades y lesiones una prioridad nacional. Twitter: @ healthyamerica1

TFAH Applauds Surgeon General’s Call for Whole-of-Society Approach to Correcting the Problem of Health Misinformation

(Washington, DC – July 15, 2021) – Trust for America’s Health (TFAH) applauds the Surgeon General’s Advisory on Building a Healthy Information Environment and his call for a whole-of-society approach to correcting the problem of health misinformation.

“As the COVID-19 pandemic has illustrated, access to accurate health information empowers people and protects their health, while health misinformation risks lives.  TFAH is committed to working with all partners and allies to combat health misinformation,” said J. Nadine Gracia, MD, MSCE, TFAH President and CEO.

 

 

 

TFAH Applauds Court’s Decision Preserving the Affordable Care Act

Decision strengthens the nation’s healthcare system, protects healthcare access for 31 million Americans and will help address health disparities

(Washington, DC — June 17, 2021) – Trust for America’s Health applauds today’s Supreme Court’s decision in California v. Texas for the ways in which it protects healthcare access for 31 million Americans and will help address the nation’s health disparities.

“Access to affordable healthcare is fundamental to individual health. It is also fundamental to achieving health equity. While as a nation we still have a lot of work to do to achieve good health for every individual, today’s court decision keeps us moving in the right direction – it will save lives,” says John Auerbach, President and CEO of Trust for America’s Health.

According to the U.S. Department of Health and Human Services, 31 million people have gained health insurance through the Affordable Care Act (ACA) including many who lost employment and health coverage during the COVID-19 pandemic.[i]  Since the ACA, rates of people without health insurance have decreased in every state, with states that expanded Medicaid experiencing the largest reductions.[ii]

The ACA is transformative legislation in at least three ways: the number of Americans who can now access medical care when they are ill or to deal with chronic conditions (78 percent of U.S. adults 55 and older have at least one chronic condition);[iii] the illness it prevented as millions of Americans gained access to preventive care and screenings and other life-saving services previously inaccessible to them;[iv] and the ways in which it resulted in improved access to healthcare for people of color, reducing – although not eliminating – longstanding healthcare access disparities.

Prior to the ACA, non-Hispanic Black Americans were 70 percent more likely to be uninsured than were whites and the uninsured rate for Hispanics was nearly three times the uninsured rate for whites.[v] Once the ACA was in place, Hispanics had the largest decrease in uninsurance rates, falling from 32.6 percent to 19.1 percent between 2010 and 2016. Uninsurance rates also fell for Asian and Black Americans by 8 percent during the same period.[vi]

Medicaid expansion states experienced significant coverage gains and reductions in uninsured rates among the low-income population broadly and within specific vulnerable populations.[vii] According to the Center on Budget and Policy Priorities, expanding Medicaid coverage to low-income adults led to significant benefits to those individuals and families including improved access to care, improved health outcomes and increased financial stability – including a reduction in medical debt per person gaining coverage via the expansion.[viii] A study by the National Bureau of Economic Research found states that expanded Medicaid had an estimated 19,200 fewer adult deaths (ages 55 to 64) between 2014 and 2017 than did states that did not expand Medicaid.[ix]

The decision also has major implications for public health by protecting over $16 billion in funding over the next 10 years (FY 2022-FY 2031) for the Centers for Disease Control and Prevention (CDC) and other public health agencies. The Prevention and Public Health Fund, a dedicated funding stream created by the ACA and specifically designated for public health and prevention, funds approximately 11 percent of the CDC’s budget. These funds are put to work in every state to expand immunizations, prevent suicide, modernize laboratory and epidemiology services to detect and contain disease outbreaks, prevent childhood lead poisoning, and help smokers quit.

Also preserved are the requirement that insurers not refuse coverage due to preexisting conditions, the provision disallowing annual or lifetime limits on essential care, and the requirement that insurers cover recommended clinical preventive services without cost-sharing: all essential to Americans’ health.

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[i] HHS, HHS Press Office. New HHS Data Show More Americans Than Ever Have Health Coverage Through the Affordable Care Act. June 5, 2021. New HHS Data Show More Americans than Ever Have Health Coverage through the Affordable Care Act | HHS.gov

[ii] ibid

[iii] CDC, National Center for Health Statistics. Percentage of U.S. Adults over 55 with Chronic Conditions. https://www.cdc.gov/nchs/health_policy/adult_chronic_conditions.htm

[iv] Garfield R, Orgera K, Damico A. The uninsured and the ACA: a primer—key facts about health insurance and the uninsured amidst changes to the Affordable Care Act [Internet]. San Francisco (CA): Henry J. Kaiser Family Foundation; 2019 Jan 25.  https://www.kff.org/uninsured/report/the-uninsured-and-the-aca-a-primer-key-facts-about-health-insurance-and-the-uninsured-amidst-changes-to-the-affordable-care-act/ Google Scholar

[v] Buchmueller TC, Levinson ZM, Levy HG, Wolfe BL. Effect of the Affordable Care Act on racial and ethnic disparities in health insurance coverage. Am J Public Health. 2016;106(8):1416–21

[vi] Garfield R, Orgera K, Damico A. The uninsured and the ACA: a primer—key facts about health insurance and the uninsured amidst changes to the Affordable Care Act [Internet]. San Francisco (CA): Henry J. Kaiser Family Foundation; 2019 Jan 25.  https://www.kff.org/uninsured/report/the-uninsured-and-the-aca-a-primer-key-facts-about-health-insurance-and-the-uninsured-amidst-changes-to-the-affordable-care-act/ Google Scholar

[vii] Madeline Guth, et al. The Effects of Medicaid Expansion Under the ACA: Updated Findings from a Literature Review. March 17, 2020.

[viii] Center on Budget and Policy Priorities. The Far-Reaching Benefits of the Affordable Care Act’s Medicaid Expansion. October 21, 2020. The Far-Reaching Benefits of the Affordable Care Act’s Medicaid Expansion | Center on Budget and Policy Priorities (cbpp.org)

[ix] Madeline Guth, et al. The Effects of Medicaid Expansion Under the ACA: Updated Findings from a Literature Review. March 17, 2020.

Trust for America’s Health Statement in Remembrance of George Floyd and the Call for Racial Justice and Health Equity

(Washington, DC – May 25, 2021) – On this first anniversary of the murder of George P. Floyd, Jr. by a former Minneapolis police officer, Trust for America’s Health reaffirms its commitment to honoring Mr. Floyd’s memory, and to advocating for policies that end racism and advance justice and equity for all people, regardless of their race or ethnicity.

Racism undermines equity and has far-reaching impacts on health, education, economic opportunity, employment, housing, transportation, and criminal justice.

The recent cases of racial violence against people of color and the disproportionate impact of the COVID-19 pandemic on communities of color have highlighted once again the importance of combating racism as a public health imperative.  Racism is at the root of disinvestment in and marginalization of communities of color, leading to unhealthy social, economic, and environmental conditions, and the lack of opportunities within many communities of color.

The best and most lasting tribute to Mr. Floyd would be to correct the structural disadvantages that exist due to the enduring legacy of historic and current day racism in all forms.

Specifically, TFAH recommends the following policy actions to combat racism and advance health equity:

  • Federal, state and local governments should act to eliminate racially motivated violence so that people of color do not have to fear for their health and safety as they go about their daily lives.
  • Policymakers should make advancing health equity and eliminating health disparities a national priority. Such a priority requires ending systemic barriers and advancing policies and programs that create equitable opportunity for health and well-being.
  • Increase federal funding for programs that will advance health equity particularly in historically underserved communities, e.g., for affordable housing including home ownership, access to quality childcare, schools, education and career development including access to jobs with better wages and full benefits, higher education, transportation, and high-quality healthcare.
  • Increase funding for programs that support the whole child and family and schools and that promote long-term security, coping skills, and good health.
  • Funding agencies should collaborate with historically underserved communities to best understand their needs and create space for community leaders to co-create program and policy design and implementation.
  • Federal and state governments should act to protect voting rights for all persons.

We should remember and honor Mr. Floyd and countless others whose lives have been taken by racial violence – and the hundreds of thousands of people of color who have died from COVID-19.  We must remain committed to making America a place where no person’s health and safety is limited by race or ethnicity, but rather valued and respected.

 

Annual Deaths Due to Alcohol, Drugs or Suicide Exceeded 156,000 According to the Most Recent Data

Preliminary data shows COVID-19 crisis created higher rates of mental distress, substance use, and drug overdose; 2019 alcohol deaths were higher for every adult age group

(Washington, DC and Oakland, Ca) – May 18, 2021 – Newly released data show that 156,242 Americans died due to alcohol, drugs or suicide in 2019, a record number of such deaths in a single year.  Furthermore, the COVID-19 pandemic increased stress and related substance use for many Americans.

During 2019, alcohol and drug-induced deaths increased, while suicide rates were slightly lower. Over the last decade, 2009 – 2019, the number of alcohol and drug related and suicide deaths increased by 52 percent.  These data are part of a report releasing today, Pain in the Nation: Alcohol, Drug and Suicide Deaths, the latest in a series of reports tracking the nation’s deaths of despair crisis produced by Trust for America’s Health and Well Being Trust.

Americans dying due to drug-induced causes was five percent higher in 2019 than the previous year, for a total of 74,511 deaths. The data are also beginning to show changes in the most affected population groups.  For many years, the death rate for drug overdoses among whites was substantially higher than other racial groups, data are now showing dramatic increases in drug related deaths for certain populations of color. For the year, drug-induced deaths were up by 15 percent among Latinos and Blacks, 11 percent for American Indians and 10 percent for people of Asian descent. Among whites’ drug-induced deaths rose by 2 percent for the year.

For the first time since 2005, 2019 deaths rates from drugs for Black people was higher than that of whites.

Synthetic opioids, such as fentanyl, (up 16%), cocaine (up 8%) and other psychostimulants (e.g., methamphetamine and ecstasy) (up 28%) continue to drive drug-induced deaths higher. Natural/semisynthetic opioids (e.g., Prescription opioids) and heroin overdoses declined for the year.

In 2019, 39,043 Americans died from alcohol-related causes, up 4 percent over 2018.  It was the tenth year in a row that the alcohol death rate increased.  Alcohol deaths were highest among American Indians (31.9 deaths per 100,000 people), adults over 55 (28.3 deaths per 100,000 people) and males (15.2 deaths per 100,000 people). All groups, except children, had a higher rate of alcohol deaths in 2019 compared with 2018 and early 2020 data show that rates of consumption are continuing to increase.

One bright spot in the data is that for the year (2019), the age-adjusted suicide rate declined from 14.2 to 13.9 deaths per 100,000 deaths, a 2 percent decrease. Americans who died by suicide in 2019 totaled 47,511. This decline in suicide deaths was the first since 2005 and is statistically significant. Preliminary 2020 data show a further small decrease in suicides despite the COVID crisis.

States with the highest age-adjusted death rates from alcohol, drugs and suicide combined in 2019 were New Mexico (88 deaths per 100,000 people) and West Virginia (85.1 deaths per 100,000 people).

“These data underscore, yet again, the massive problem we have had on our hands in this country,” said Benjamin Miller, PsyD, Chief Strategy Officer, Well Being Trust. “The trends are clear we are going in the wrong direction. If we are serious about addressing mental health and addiction, we must invest in strategies that are comprehensive and integrated. Incremental tinkering will not change the course or direction sufficiently enough – it’s time for bold leadership to demand more.”

The Impact of the COVID-19 Pandemic

The COVID-19 pandemic impacted Americans in almost inconceivable ways including illness, the loss of loved ones, job loss, financial stress, food insecurity, social isolation, and learning loss and the interruption of school-based services for millions of children. These stressors are impacting rates of alcohol and drug use and drug overdose deaths as more people turn to substances to help them cope.

From March 2019 to March 2020, the number of calls to the Substance Abuse and Mental Health Services Administration Disaster Distress Helpline increased by 891 percent.  The U.S. Household Pulse Survey found that the number of adults reporting symptoms of anxiety or depression from April 2020 through March 2021 was triple the number who reported such symptoms in 2019. A June 2020 CDC study found that 13 percent of adults “started or increased substance use to cope with pandemic-related stress or emotions.”

“The drug, alcohol and suicide crisis has been growing for a decade and growing in uneven ways. The COVID crisis has increased stress on all Americans and has worsened the differential impact of health inequities on communities of color. While all Americans need support coping with the pandemic, people who are currently struggling with addiction or a mental health issue need urgent attention,” said John Auerbach, President and CEO Trust for America’s Health.

The report includes policy solutions and recommendations including:

  • Expand programs that support families and communities and reduce traumatic experiences, particularly in childhood.
  • Expand access to substance use prevention programs and mental health and resiliency programs in schools.
  • Tailor prevention and intervention programs for communities of color.
  • Strengthen crisis intervention programs and supports.
  • Increase access to mental health and substance use healthcare through full enforcement of the Mental Health Parity and Addiction Equity Act.
  • Reduce availability of illicit opioids and psychostimulants.
  • Limit access to lethal means of suicide.
  • Expand efforts to combat stigma about mental health issues.
  • Improve mental health data accuracy, completeness and timeliness.
  • Expand the mental health and substance use treatment workforce; promote diversity and culturally informed practices within the workforce.
  • Build community capacity for early identification and intervention with individuals who need mental health care.

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 Trust for America’s Health is a nonprofit, nonpartisan organization that promotes optimal health for every person and community and makes the prevention of illness and injury a national priority.

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 well-being. www.wellbeingtrust.org. Twitter: @WellBeingTrust

 

 

 

 

 

 

 

 

Las muertes anuales por alcohol, drogas o suicidio superaron las 156.000 Según los datos más recientes

Los datos preliminares muestran que la crisis de COVID-19 creó tasas más altas de angustia mental, uso de sustancias y sobredosis de drogas; Las muertes por alcohol en 2019 fueron más altas para cada grupo de edad adulta

(Washington, DC y Oakland, CA) – 18 de mayo de 2021 – Los datos publicados recientemente muestran que 156,242 estadounidenses murieron debido al alcohol, las drogas o el suicidio en el 2019, un número récord en muertes en un solo año. Además, la pandemia de COVID-19 aumentó el estrés y el uso de sustancias relacionadas para muchos estadounidenses.

Durante el 2019, las muertes inducidas por alcohol y drogas aumentaron, mientras que las tasas de suicidio fueron ligeramente más bajas. Durante la última década, 2009-2019, la cantidad de muertes por suicidio y relacionadas con el alcohol y las drogas aumentó en un 52 por ciento. Estos datos son parte de un informe que se publica hoy, Pain in the Nation: Alcohol, Drug and Suicide Deaths, el último de una serie de informes que rastrean las muertes de la nación por crisis de desesperación producidas por Trust for America’s Health and Well Being Trust.

Los estadounidenses que murieron por causas inducidas por drogas fue un cinco por ciento más alto en el 2019 que el año anterior, para un total de 74,511 muertes. Los datos también comienzan a mostrar cambios en los grupos de población más afectados. Durante muchos años, la tasa de mortalidad por sobredosis de drogas entre los blancos fue sustancialmente más alta que la de otros grupos raciales, los datos ahora muestran aumentos dramáticos en las muertes relacionadas con las drogas para ciertas poblaciones de color. Durante el año, las muertes inducidas por drogas aumentaron en un 15 por ciento entre los latinos y negros, el 11 por ciento entre los indígenas estadounidenses y el 10 por ciento entre las personas de ascendencia asiática. Entre las muertes de blancos inducidas por drogas aumentaron un 2 por ciento durante el año.

Por primera vez desde 2005, las tasas de muerte por drogas en 2019 para las personas negras fueron más altas que las de los blancos.

Los opioides sintéticos, como el fentanol (hasta el 16%), la cocaína (hasta el 8%) y otros psicoestimulantes (por ejemplo, la metanfetamina y el éxtasis) (hasta el 28%) continúan aumentando las muertes inducidas por drogas. Los opioides naturales / semisintéticos (por ejemplo, opioides recetados) y las sobredosis de heroína disminuyeron durante el año.

En el 2019, 39,043 estadounidenses murieron por causas relacionadas con el alcohol, un 4 por ciento más que en el  2018. Fue el décimo año consecutivo en que aumentó la tasa de mortalidad por alcohol. Las muertes por alcohol fueron más altas entre los indios americanos (31,9 muertes por cada 100.000 personas), los adultos mayores de 55 años (28,3 muertes por cada 100.000 personas) y los hombres (15,2 muertes por cada 100.000 personas). Todos los grupos, excepto los niños, tuvieron una tasa más alta de muertes por alcohol en 2019 en comparación con 2018 y los datos de principios de 2020 muestran que las tasas de consumo continúan aumentando.

Un punto brillante en los datos es que para el año (2019), la tasa de suicidio ajustada por edad disminuyó de 14.2 a 13.9 muertes por cada 100,000 muertes, una disminución del 2 por ciento. Los estadounidenses que murieron por suicidio en el 2019 sumaron 47,511. Esta disminución en las muertes por suicidio fue la primera desde 2005 y es estadísticamente significativa. Los datos preliminares del 2020 muestran una pequeña disminución adicional en los suicidios a pesar de la crisis del COVID.

Los estados con las tasas de mortalidad ajustadas por edad más altas por alcohol, drogas y suicidio combinados en el 2019 fueron Nuevo México (88 muertes por cada 100.000 personas) y Virginia Occidental (85,1 muertes por cada 100.000 personas).

“Estos datos subrayan, una vez más, el enorme problema que hemos tenido en nuestras manos en este país”, dijo Benjamin Miller, PsyD, director de estrategia de Well Being Trust. “Las tendencias son claras: vamos en la dirección equivocada. Si nos tomamos en serio el tratamiento de la salud mental y la adicción, debemos invertir en estrategias que sean completas e integradas. Los retoques incrementales no cambiarán el curso o la dirección lo suficiente; es hora de que un liderazgo audaz exija más “.

El impacto de la pandemia COVID-19

La pandemia de COVID-19 afectó a los estadounidenses de formas casi inconcebibles, incluidas la enfermedad, la pérdida de seres queridos, la pérdida del trabajo, el estrés financiero, la inseguridad alimentaria, el aislamiento social y la pérdida del aprendizaje y la interrupción de los servicios escolares para millones de niños. Estos factores estresantes están afectando las tasas de consumo de alcohol y drogas y las muertes por sobredosis de drogas a medida que más personas recurren a sustancias para ayudarlas a sobrellevar la situación.

Desde marzo del 2019 hasta marzo del 2020, la cantidad de llamadas a la línea de ayuda para casos de desastre de la Administración de Servicios de Salud Mental y Abuso de Sustancias aumentó en un 891 por ciento. La Encuesta de pulso de los hogares de EE. UU. Encontró que la cantidad de adultos que informaron síntomas de ansiedad o depresión desde abril de 2020 hasta marzo de 2021 fue el triple que la cantidad de quienes informaron dichos síntomas en el 2019. Un estudio de los CDC de junio del 2020 encontró que el 13 por ciento de los adultos “comenzaron o aumentaron el consumo de sustancias utilizar para hacer frente al estrés o las emociones relacionadas con la pandemia “.

“La crisis de las drogas, el alcohol y el suicidio ha ido en aumento durante una década y de manera desigual. La crisis de COVID ha aumentado el estrés en todos los estadounidenses y ha empeorado el impacto diferencial de las desigualdades en salud en las comunidades de color. Si bien todos los estadounidenses necesitan apoyo para hacer frente a la pandemia, las personas que actualmente luchan contra la adicción o un problema de salud mental necesitan atención urgente “, dijo John Auerbach, presidente y director ejecutivo de Trust for America’s Health.

El informe incluye soluciones y recomendaciones de políticas que incluyen:

  • Ampliar los programas que apoyan a las familias y comunidades y reducir las experiencias traumáticas, particularmente en la niñez.
  • Ampliar el acceso a los programas de prevención del uso de sustancias y los programas de salud mental y resiliencia en las escuelas.
  • Adaptar los programas de prevención e intervención para las comunidades de color.
  • Fortalecer los programas y apoyos de intervención en crisis.
  • Aumentar el acceso a la atención médica para la salud mental y el uso de sustancias a través de la plena aplicación de la Ley de igualdad en la salud mental y las adicciones.
  • Reducir la disponibilidad de opioides y psicoestimulantes ilícitos.
  • Limitar el acceso a medios letales de suicidio.
  • Ampliar los esfuerzos para combatir el estigma sobre los problemas de salud mental.
  • Mejorar la precisión, integridad y puntualidad de los datos de salud mental.
  • Expandir la fuerza laboral de tratamiento de salud mental y abuso de sustancias; promover la diversidad y las prácticas culturalmente informadas dentro de la fuerza laboral.
  • Desarrollar la capacidad de la comunidad para la identificación e intervención tempranas con las personas que necesitan atención de salud mental.

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Trust for America’s Health es una organización no partidista sin fines de lucro que promueve la salud óptima para cada persona y comunidad y hace de la prevención de enfermedades y lesiones una prioridad nacional. www.tfah.org

Well Being Trust es una fundación nacional dedicada a promover la salud mental, social y espiritual de la nación. Creada para incluir la participación de organizaciones de todos los sectores y perspectivas, Well Being Trust se compromete a innovar y abordar los desafíos de salud mental más críticos que enfrenta Estados Unidos y a transformar el bienestar individual y comunitario. www.wellbeingtrust.org. Gorjeo: @WellBeingTrust

John Auerbach Stepping Down from TFAH President & CEO Position to Return to CDC; TFAH Executive Vice President & COO Dr. J. Nadine Gracia Named New President & CEO

Statement by Dr. Gail Christopher, Chair

TFAH Board of Directors

May 12, 2021

 It is with mixed feelings that I announce that as of June 18th John Auerbach will be leaving Trust for America’s Health (TFAH) to return to the Centers for Disease Control and Prevention (CDC).  I am also delighted to announce that the Board of Directors has selected J. Nadine Gracia, MD, MSCE, as the new President and CEO of TFAH.

During Mr. Auerbach’s four and a half years as TFAH’s President and CEO he has led the transformation of the organization, doubling the number of philanthropic funders, increasing the budget by 50 percent, and growing its staff by 33 percent.  During this time, we have elevated our work on equity and on the social determinants of health and made them central to who we are as an organization.  TFAH has continued many of its signature activities while also taking on new projects from Promoting Health and Cost Control in States to the Public Health Communications Collaborative, from Pain in the Nation to Age-Friendly Public Health and much more. There is so much that John can be proud of during his tenure at TFAH.

In his new position, John will serve as the Director of Intergovernmental and Strategic Affairs, in which he will oversee external affairs and help guide the development of agency-wide priority initiatives.

Dr. Gracia is a national health equity leader with significant experience in federal government, the nonprofit sector, and professional associations. She is recognized for her work at TFAH and previously in federal government service in the Obama Administration as the Deputy Assistant Secretary for Minority Health and Director of the Office of Minority Health at the U.S. Department of Health and Human Services (HHS).  In that capacity, she directed departmental policies and programs to end health disparities and advance health equity and provided executive leadership on administration priorities including the Affordable Care Act and My Brother’s Keeper.

Previously, she served as Chief Medical Officer in the Office of the Assistant Secretary for Health at HHS, where her portfolio included adolescent health, emergency preparedness, environmental health and climate change, global health, and the White House Council on Women and Girls.  Prior to that role, she was appointed as a White House Fellow at the U.S. Department of Health and Human Services and worked in the Office of the First Lady on the development of the Let’s Move! initiative to solve childhood obesity.

Dr. Gracia earned her undergraduate degree from Stanford University, a medical degree from the University of Pittsburgh School of Medicine, and a Master of Science in Clinical Epidemiology from the University of Pennsylvania.  She is active in many civic and professional organizations.

Nadine and John worked as a team in every aspect of TFAH’s mission for the past three and a half years.   During that time, Nadine successfully managed many roles as she handled TFAH’s operational responsibilities, provided policy leadership and strengthened and broadened partnership relations while also often serving as the face of TFAH at national conferences and convenings.  Her expertise in and commitment to the promotion of equity ensured that TFAH walks the walk as well as talks the talk.  The Board of Directors unanimously agreed that had we done a national search, we would not have found a more ideal person to lead the organization.  We enthusiastically anticipate the achievements that will result from her being at the helm.

During this transition, let me offer my thanks to the wonderful and talented staff at TFAH who day in and day out display skill, and dedication in the service of our mission.  And let me thank my fellow Board members as well, for their commitment and wisdom in supporting TFAH during the last several years under John’s leadership and in choosing Nadine as the new President and CEO.  Your selfless commitment to promoting optimal health and well-being for all is inspiring.

COVID-19 Pandemic Proved that Underinvesting in Public Health Puts Lives and Livelihoods at Risk

Chronic underfunding of public health system weakened the country’s COVID-19 response

(Washington, DC – May 7, 2021) – Chronic underfunding of the public health system was a key contributing factor in the nation’s flatfooted response to the COVID-19 pandemic, according to a new report, The Impact of Chronic Underfunding on America’s Public Health System: Trends, Risks, and Recommendations, 2021, released today by Trust for America’s Health.

The report discusses how the underfunding of core public health programs impeded the pandemic response and exacerbated its impacts.  According to the report’s authors, the missteps of the 2020 COVID-19 response were rooted in a public health system weakened by years of underfunding, the federal government’s failure to communicate and follow the best available science, and, health inequities that put communities of color and Tribal Nations at particular risk.

This annual report examines federal, state and local public health funding trends and recommends investments and policy actions to build a stronger public health system, prioritize prevention, and address the ways in which social and economic inequities create barriers to good health. Also highlighted is the need for the public health system to be ready to prevent and respond to a spectrum of risks, from weather-related emergencies to the rising numbers of drug overdoses, to increasing rates of obesity and resulting chronic diseases.

Response funding critical but not a long-term solution

Congress passed numerous COVID relief bills since March 2020, funding that has been critical to managing the immediate crisis.  But this one-time funding is not a solution to years of underfunding which hollowed out the system, thereby making it less able to spend emergency funds quickly and efficiently.

“What the system urgently needs is sustained, predictable funding that allows it to grow and maintain its workforce and invest in modern data systems and all-hazards preparedness planning on a year-in, year-out basis,” said John Auerbach, President and CEO of Trust for America’s Health.

CDC funding down for the year and decade

The Centers for Disease Control and Prevention (CDC) is the primary federal provider of public health funding to states. For FY 2021, CDC’s budget (aside from supplemental COVID response funding) was $7.8 billion, down 1 percent from the previous year, and continues to be insufficient to meet the country’s public health needs.  Over the last decade (FY 2012 – 21) the CDC’s core budget fell by 2 percent when adjusted for inflation. That decrease in spending happened over a 10-year period in which the U.S. population grew, the number and severity of weather-related emergencies increased, and the number of Americans grappling with substance abuse, suicide and chronic diseases also grew.  Anemic funding for CDC has meant that effective programs fail to reach all 50 states, and there has been little investment in cross-cutting infrastructure and capabilities.

CDC’s annual funding for Public Health Emergency Preparedness (PHEP) cooperative agreements, which support core emergency readiness capacity in states, territories and local areas, increased by $20 million in FY 2021.  But funding for PHEP shrank by approximating one-quarter (about half when adjusting for inflation) over the last two decades from $939 million in FY 2003 to $695 million in FY 2021.

In addition, the Hospital Preparedness Program, the main source of federal funding to help healthcare systems prepare for emergencies, has experienced a nearly 50 percent funding cut (nearly two-thirds when adjusted for inflation) over the last two decades – from $515 million in FY 2003 to $280 million in FY 2021.

At the state level, 43 states and the District of Columbia maintained or increased their public health funding in FY 2020.  In some instances, state-supported COVID response funding increased the state’s public health funding for the year but this emergency response funding is unlikely to translate into sustained funding growth.

Public health workforce is smaller than it was a decade ago

The state and local public health workforce is a critical part of the nation’ public health infrastructure.  From 2008 to 2019 the estimated number of full-time local public health agency staff decreased by 16 percent, while state health agencies lost almost 10 percent of their collective workforce between 2012 and 2019. These personnel cuts translated into fewer trained professionals available to do critical work as the COVID-19 pandemic was spreading across the country.

“For decades, public health leaders have sounded the alarm about the ways in which underfunding the public health system makes us less prepared and puts lives at risk. The COVID-19 pandemic is a stark illustration of how serious those risks are as public health departments were forced to fight the virus with antiquated tools and a depleted workforce,” said John Auerbach. “We must learn from the COVID tragedy and dramatically increase annual support of the public health workforce, programs and infrastructure.  If we fail to learn the lessons from the pandemic, we will be doomed to repeat them.”

The report calls for a $4.5 billion annual investment in the nation’s core public health capabilities.  Other recommendations speak to the need to:

  • Substantially increase core funding to strengthen the public health system, including by building and supporting the workforce, modernizing the system’s data tools and increasing its surveillance capacities.
  • Strengthen public health emergency preparedness, including within the healthcare system.
  • Safeguard and improve Americans’ health by investing in chronic disease prevention and the prevention of substance misuse and suicide.
  • Take steps to advance health equity by combating the impacts of racism and addressing the social determinants that lead to poor health.