Earned Income Tax Credit Archives

What If Congress Adequately Funded Public Health?

You know the old adage, ‘those that don’t learn from history are doomed to repeat it.’ Coming off the COVID-19 public health emergency that has thus far claimed the lives of 1.2 million Americans, there are discussions in Congress to significantly cut funding for public health initiatives to dangerously low levels – again. And it doesn’t have to be like this.

Why do we go through these bleak cycles when anchoring public health in policymaking is a win-win decision for everyone – from elected officials to individual constituents.

Federal public health funding is facing challenges on multiple fronts right now. Congress continues to negotiate appropriations bills for the 2024 fiscal year, which will have major implications for the next fiscal year and beyond. The current short-term funding agreement for Health and Human Services expires on March 22. If Congress passes another continuing resolution rather than new appropriations, it could trigger extreme, across-the-board cuts to non-defense spending.

First, continuing resolutions, which are short-term measures to fund the government at the previous year’s levels, negatively impact the systems we need to protect the nation’s health. And severe cuts triggered by failing to pass a long-term spending bill would be even more dangerous. TFAH has joined more 1,000 other organizations in urging Congress to pass a full-year funding bill using the bipartisan framework laid out in the Senate as a starting point for negotiations.

Secondly, the FY2024 bills proposed by the House and Senate for Labor, Health and Human Services, Education and Related Agencies – the main funding source for public health programs – are vastly different and neither addresses the chronic underfunding of public health. Congress has already rescinded hundreds of millions of dollars intended to shore up the public health workforce and readiness and response efforts. The Senate’s bill proposes a small cut to the Centers for Disease Control and Prevention (CDC), and the House version would cut about $1.6 billion from CDC’s budget. TFAH and partners have called for a $2.5 billion increase for CDC.

Finally, we continue to see proposals to cut the Prevention and Public Health Fund, a critical investment in programs ranging from immunizations to tobacco use prevention. If these proposals were to move forward, this would again push public health funding into the “bust” phase of a decades long “boom and bust” funding pattern.

The health, safety, and well-being of individuals and communities should be at the foundation of U.S. policy and be funded accordingly.

Imagine if we fully invested in the prevention of adverse childhood experiences, suicide, and substance misuse. Many communities would see suicide and overdose rates fall.

Imagine if we prevented the root causes of death, injury, and excess healthcare costs instead of spending trillions of dollars to treat preventable chronic conditions. Workers would be healthier and more productive, employers would face fewer financial burdens, and the nation would be more resilient and thriving.

Imagine if CDC, state, local, tribal, and territorial health departments had modern data systems instead of rudimentary spreadsheets to track the spread of diseases. This country could contain potential outbreaks in their earliest stages and save lives.

Much of our health and well-being is determined by economic, environmental, and societal factors. In the midst of a recent and troubling decrease in life expectancy, TFAH believes that investing in the foundations of public health and effective prevention programs is a critical and indispensable path forward to protecting and promoting the health of the nation.

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

New Datasets Show Opportunities Exist for States to Bolster Fair Hiring Protections and Workers Rights with Earned Sick Leave and Ban the Box Laws

(Washington DC – January 28, 2021) — Two new datasets published to LawAtlas.org today offer a comprehensive look at state laws that address earned sick leave laws and Ban the Box policies. These datasets provide a snapshot of how earned sick leave, also known as paid sick leave, and ban the box policies differ between states, how such policies help promote the well-being of state residents, and opportunities for states to adopt or expand such regulations.

“States have a critical role to play in promoting the health and well-being of their residents. These data provide a clear picture that opportunities exist nationwide for states to foster equitable economies in which job seekers are evaluated on their merits and workers have access to paid leave benefits to care for themselves and loved ones,” Adam Lustig, MS, Senior Policy Development Manager and Co-Principal Investigator of the PHACCS initiative.

Earned Sick Leave

As of January 1, 2021, 15 states and the District of Columbia have an earned sick leave law that requires employers of varying sizes to provide paid time away to address medical needs for themselves or their families as a benefit to their employees. Across states, eligibility requirements, employer size, how and when an employee may use their time, and rate of leave accrual of the laws vary:

All 16 jurisdictions allow for earned sick leave to be used to care for a family member.
Geographically, earned sick leave laws are almost exclusively in place in the northeast and on the west coast, with Colorado, Arizona, and Michigan being exceptions.
Of the 16 jurisdictions that have earned sick leave laws, just six require employers of all sizes to provide this benefit.
Only two states, New York and Colorado, allow employees to use earned leave immediately upon accrual.
Eight states provide the most generous accrual of earned sick leave, enabling workers to earn one hour of sick leave for every 30 hours worked.
Washington is the only state that does not specify a limit on the amount of earned sick leave that can be accrued within one year.

Ban the Box

As of January 1, 2021, 36 states and the District of Columbia have a Ban the Box policy that prevents an employer from asking about a potential employee’s criminal history until after fairly considering the applicant’s relevant qualifications. These laws vary greatly in who they apply to, and their enforcement mechanisms:

Thirty-six jurisdictions have Ban the Box policies that regulate public employers. However, significant gaps remain, as only three of these jurisdictions apply this protection to government contractors.
Only 15 of the 37 jurisdictions with Ban the Box policies regulate private employers, leaving a significant portion of the workforce lacking access to this important fair hiring practice.
The most common private positions exempt from Ban the Box policies include: working with children, working with vulnerable adults, law enforcement, and positions where a criminal history check is required by law.

“We have seen a growing body of evidence supporting that earned sick leave laws and Ban the Box policies are important legal approaches to ensuring equity in hiring in the United States,” said Lindsay K. Cloud, JD, Director of the Center’s Policy Surveillance Program. “These datasets are an invaluable resource as we continue to seek to better understand the impact of employer-provided protections and fair chance hiring practices on health, and particularly on the social determinants of health amidst the Covid-19 pandemic.”

The Promoting Health and Cost Control in States initiative’s legal data resources are a collaboration of the Temple University Center for Public Health Law Research with Trust for America’s Health, and support from the Robert Wood Johnson Foundation. The earned sick leave and Ban the Box datasets are the fifth and sixth in a series of datasets on laws and policies that can support cost-savings for states and promote health and well-being.

Access the datasets on LawAtlas.org.

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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. Learn more at www.tfah.org

The Center for Public Health Law Research at the Temple University Beasley School of Law supports the widespread adoption of scientific tools and methods for mapping and evaluating the impact of law on health. Learn more at http://phlr.org.

Increases in Drug Overdose Death Rates Were Up Before COVID-19 and Are Continuing to Rise During the Pandemic

Trust for America’s Health and Well Being Trust Call for Renewed Focus on Preventing Deaths of Despair

DISTRICT OF COLUMBIA & OAKLAND, CA – Dec. 23, 2020 – According to data released this week by the National Center for Health Statistics, in 2019 age-adjusted drug overdose deaths increased slightly over the prior year. Coupled with data released last week by the CDC showing increases in drug overdose deaths in early 2020, these reports demonstrate the continuing upward trajectory of drug deaths in the U.S, a trend that is being compounded by the COVID-19 pandemic.

The age-adjusted rate of drug overdose during 2019 was 21.6 per 100,000 deaths, up from the 2018 rate of 20.7 per 100,000. In 2019, 70,630 people died due to drug overdose in the United States.

Between 1999 and 2019 the rate of drug overdose deaths increased for all groups aged 15 and older, with people aged 35-44 experiencing the highest single year increase in 2019. While rates of drug overdose deaths involving heroin, natural and semisynthetic opioids, and methadone decreased between 2018 and 2019 the rate of overdose deaths involving synthetic opioids other than methadone continued to increase.

2018 data showing only minor progress after decades of worsening trends, provisional drug overdose data showing an 18% increase over the last 12 months, and the recent CDC Health Alert Network notice on early 2020 increases in fatal drug overdoses driven by synthetic opioids all underscore the continued impact of the deaths of despair crisis and how the COVID-19 pandemic has further diminished the mental health and well-being of many Americans.

“These 2019 overdose rates and the outlook for 2020 are extremely alarming and the result of insufficient prioritization and investment in the well-being and health of Americans for decades,” said John Auerbach, President and CEO of the Trust for America’s Health. “As we work to recover from the COVID-19 pandemic, we must take a comprehensive approach that includes policies and programs that help Americans currently struggling and target upstream root causes, like childhood trauma, poverty and discrimination in order to help change the trajectory of alcohol, drug, and suicide deaths in the upcoming decades.”

Over the last five years, Trust for America’s Health (TFAH) and Well Being Trust (WBT) have released a series of reports on “deaths of despair” called Pain in the Nation: The Drug, Alcohol and Suicides Epidemics and the Need for a National Resilience Strategy, which include data analysis and recommendations for evidence-based policies and programs that federal, state, and local officials.

“If leaders don’t act now to stymie America’s mental health and addiction crises, next year’s data will easily surpass the astounding numbers we’re seeing today,” said Dr. Benjamin F. Miller, PsyD, Chief Strategy Officer at Well Being Trust. “Overdose deaths can be prevented if individuals who are struggling are able to access the appropriate services and supports – and with greater demonstrated success if the care individuals receive is rooted in their immediate communities.”

Drug Overdose Deaths, 1999-2019 (Rates age-adjusted)

Year	Deaths	Deaths per 100,000
1999	16,849	6.1
2000	17,415	6.2
2001	19,394	6.8
2002	23,518	8.2
2003	25,785	8.9
2004	27,424	9.4
2005	29,813	10.1
2006	34,425	11.5
2007	36,010	11.9
2008	36,450	11.9
2009	37,004	11.9
2010	38,329	12.3
2011	41,340	13.2
2012	41,502	13.1
2013	43,982	13.8
2014	47,055	14.7
2015	52,404	16.3
2016	63,632	19.8
2017	70,237	21.7
2018	67,367	20.7
2019	70,630	21.6

Sources:
CDC – NCHS – National Center for Health Statistics
https://emergency.cdc.gov/han/2020/han00438.asp
https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm

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About Trust for America’s Health
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

About Well Being Trust
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

Policymakers and Health Systems Must Earn Trust within Communities of Color and Tribal Nations to Ensure COVID-19 Vaccine Receptivity, Say Health and Public Health Leaders

Policy brief calls for building vaccine acceptance in communities of color and tribal communities through data transparency, tailored communications via trusted messengers, ensuring ease of vaccine access and no out-of-pocket costs

(Washington, DC – Dec. 21, 2020) – A woeful history of maltreatment of communities of color and tribal nations by government and the health sector, coupled with present day marginalization of these communities by the healthcare system, are the root of vaccine distrust among those groups, according to a policy brief, Building Trust in and Access to a COVID-19 Vaccine Among People of Color and Tribal Nations released today by Trust for America’s Health (TFAH) and co-authors the National Medical Association (NMA) and UnidosUS.

This historic maltreatment, coupled with current day structural racism, has played out in COVID-19’s disproportionate impact on communities of color and tribal communities. These factors also make ensuring vaccine receptivity and access within those communities challenging and of critical importance to protecting lives and ending the pandemic.

In October 2020, TFAH, NMA and UnidosUS hosted a policy convening with 40 leading health equity, healthcare, civil rights, and public health organizations. The purpose of the convening was to advise policymakers on the barriers to vaccine receptivity within communities of color and tribal communities and how to overcome those barriers.

“Earning trust within communities of color and tribal communities will be critical to the successful administration of the COVID-19 vaccine. Doing so will require prioritizing equity, ensuring that leaders from those communities have authentic opportunities to impact vaccine distribution and administration planning, and, the resources to fully participate in supporting vaccine outreach, education and delivery in their communities,” said Dr. J. Nadine Gracia, Executive Vice President and COO of Trust for America’s Health.

The convening created recommendations for policy actions that should be taken immediately within six key areas:

Ensure the scientific fidelity of the vaccine development process.

HHS and vaccine developers should release all available vaccine data at frequent and regular intervals to improve transparency and increase confidence in the vaccine evaluation process. Leadership at FDA and HHS must commit to advancing any vaccine only after it has been validated based on established federal and scientific protocols. Programs to monitor for adverse events must also be in place and transparent. Any perception of bypassing safety measures or withholding information could derail a successful vaccination effort.
FDA should engage health and public health professional societies, particularly those representing healthcare providers of color, local public health officials, as well as other stakeholders with a role in vaccination, and allow these groups to validate all available data, review the vaccine development and approval process, and issue regular updates on data to their patients, members, and the public.

Equip trusted community organizations and networks within communities of color and tribal nations to participate in vaccination planning, education, delivery and administration. Ensure their meaningful engagement and participation by providing funding.

Congress should fund CDC and its state, local, tribal, and territorial partners to provide training, support, and financial resources for community-based organizations to join in vaccination planning and implementation, including community outreach, training of providers, and participation in vaccination clinics. State, local, tribal, and territorial authorities should authentically engage and immediately begin vaccination planning with community-based organizations, community health workers/promotores de salud, faith leaders, educators, civic and tribal leaders, and other trusted organizations outside the clinical healthcare setting as key, funded partners.

Provide communities the information they need to understand the vaccine, make informed decisions, and deliver messages through trusted messengers and pathways.

Congress should provide at least $500 million to CDC for outreach, communication, and educational efforts to reach priority populations in order to increase vaccine confidence and combat misinformation. All communications must be culturally and linguistically appropriate and tailored as much as possible to reach diverse populations as well as generations within groups.
FDA and CDC should initiate early engagement with diverse national organizations and provide funding and guidance for state, local, tribal, and territorial planners to help shape messaging and engage locally with healthcare providers in communities of color and tribal communities, such as nurses, pharmacists, promotores de salud, community health workers, and others to ensure they have the information they need to feel comfortable recommending the vaccine to their patients. Congress and HHS should provide funding for training and engagement of trusted non-healthcare communicators to help shape messaging and to train informal networks, civic and lay leaders, and other trusted community leaders and community-based organizations to answer questions and encourage vaccination.
All messaging about the vaccine must be appropriate for all levels of health literacy. Communication should be realistic and clear about timelines and priority groups (and the rationale for these decisions), vaccine effectiveness, types of vaccines, the number of doses, costs, and the need for ongoing public health protections. Planners must provide information that meets people where they are (e.g., barber shops, bodegas, grocery stores, places of worship, etc.) and ensure that trusted messengers in those places have the information they need to be credible and authentic spokespeople.

Ensure that it is as easy as possible for people to be vaccinated. Vaccines must be delivered in community settings that are trusted, safe and accessible.

We urge the administration and Congress to appropriate the resources necessary to expand and strengthen federal, state, local, territorial, and tribal capacity for a timely, comprehensive, and equitable COVID-19 vaccination planning, communications, distribution, and administration campaign, including funding to support vaccine distribution at the local level and by community-based organizations.
Congress and HHS should allocate funding to increase access to vaccination services to ensure that people seeking to be vaccinated do not experience undue increased exposure to the virus as they travel to, move through, and return home from vaccination sites. Flexibility in funding is needed to enable transport of people to vaccination sites, increase accessibility to people without cars, and promote safety and minimize exposure at vaccination locations. Funding should also be provided to health and community-based agencies to assist those for whom transportation or childcare costs are an obstacle to receipt of the vaccine.
Planners should ensure that vaccination sites are located in areas that have borne a disproportionate burden of COVID-19, especially leveraging community-based organizations such as Federally Qualified Health Centers, community health centers, rural health centers, schools and places of worship. Mobile services will be particularly important in rural areas. Planners should prioritize congregate living facilities, such as long-term care, prisons, and homeless shelters. In addition, some families, displaced by the COVID economic fallout, may be living with relatives. Planners should ensure vaccination sites have services that meet the Americans with Disabilities Act (ADA) and HHS Office for Civil Rights (OCR) standards for disability and language access.
Federal state, local, tribal, and territorial officials must guarantee and communicate with the public that immigration status is not a factor in people’s ability to receive the vaccine and that immigration status is not collected or reported by vaccination sites/providers. Similarly, the presence of law enforcement officers or military personnel could be a deterrent for vaccination at locations, so planners should consider other means of securing sites.
In the initial phase, as communities vaccinate healthcare workers, planners must be sure to prioritize home health, long-term care, and other non-hospital-based healthcare workers, who are more likely to be people of color. Other essential workers that comprise large numbers of workers who are people of color and should be treated as within the vaccination priority groups are the food service industry, farmworkers and public transportation employees.

Ensure complete coverage of the costs associated with the vaccine incurred by individuals, providers of the vaccine, and state/local/tribal/territorial governments responsible for administering the vaccine and communicating with their communities about it.

Congress, the Centers for Medicare and Medicaid Services, and private payers must guarantee that people receiving the vaccine have zero out-of-pocket costs for the vaccine, related health care visits, or any adverse events related to the vaccine, regardless of their health insurance status.
HHS, with emergency funding from Congress, should provide funding so that state, local, tribal, and territorial governments do not bear any cost of vaccine communication efforts, working with their communities, organizing sites, training their staff, and providing personal protective equipment (PPE).

Congress must provide additional funding and require disaggregated data collection and reporting by age, race, ethnicity, gender identity, primary language, disability status, and other demographic factors on vaccine trust and acceptance, access, vaccination rates, adverse experiences, and ongoing health outcomes.

CDC, and state, local, tribal, and territorial authorities should include leaders from communities of color and tribal communities and to plan on-going data collection on vaccination efforts, interpret data, add cultural context, share data with communities, and determine implications and next steps.
CDC, and state, local, tribal, and territorial authorities should use these data to inform ongoing prioritization of vaccine distribution and rapidly address gaps in vaccination that may arise among subpopulations by race, ethnicity, neighborhood, or housing setting.

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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

New Data Show a Number of Opportunities Exist for States to Lift Working Families Out of Poverty with the Earned Income Tax Credit

(Washington DC – October 28, 2020)—The Earned Income Tax Credit (EITC), in place in over half of all US states, are estimated to help lift 5.6 million out of poverty, yet gaps remain, according to new data published today to LawAtlas.org.

As of August 1, 2020, 29 states and the District of Columbia have an EITC that supplements the federal EITC and provides tax relief on state taxes for working families and individuals. Across states, eligibility requirements, refundability, and notification of the policy vary:

Geographically, a majority of northeastern states have adopted a state EITC law. Fewer such state EITC policies exist among the southeast and great plains states.
Of the 30 jurisdictions that offer a state EITC, nine adopt the federal EITC eligibility requirements. The remaining 21 have implemented state-specific eligibility requirements.
If the state EITC exceeds a taxpayer’s liability, only four states provide a full refund; 21 states provide a partial refund, and six states offer a non-refundable credit to eligible taxpayers.
The federal EITC benefit is currently available to eligible taxpayers ages 25 to 65 years. Only four jurisdictions (three states and DC) have extended the EITC benefit beyond the required age to include taxpayers under the age of 25.
Fifteen jurisdictions require notification of the state EITC to tax filers. Of those, only 10 require the state to notify benefit recipients of the state EITC.

“These data offer a look into how the state Earned Income Tax Credit laws vary across the United States. They identify opportunities to expand state EITC laws to assist more working people and include younger workers currently not eligible for the Federal EITC,” said Adam Lustig, the manager of the Promoting Health & Cost Control in States initiative at Trust for America’s Health, which is the umbrella project for these data.

These data contribute to a growing body of research that has shown state EITCs may improve health outcomes, most significantly among single mothers and children.

“Although studies have highlighted the positive effects of state EITC for people with children, including better birth outcomes, as well as increased physical and mental health, there is still much to learn,” said Lindsay Cloud, JD, director of the Center for Public Health law Research Policy Surveillance Program, which created the data. “This dataset is a foundational resource for anyone interested in understanding the extent of these income security benefits on health, well-being, and equity.”

The Promoting Health and Cost Control in States initiative’s legal data resources are a collaboration of the Temple University Center for Public Health Law Research with Trust for America’s Health, and support from the Robert Wood Johnson Foundation. The Earned Income Tax Credit dataset is the fourth in a series of datasets on laws and policies that can support cost-savings for states and promote health and well-being.

Access the Earned Income Tax Credit dataset on LawAtlas.org.

The Center for Public Health Law Research at the Temple University Beasley School of law supports the widespread adoption of scientific tools and methods for mapping and evaluating the impact of law on health. Learn more at http://phlr.org.

COVID-19 School Closures Put 30 Million Children at Risk of Hunger

Many States with High COVID-19 Infection Rates Also Have Highest School-Meal Programs Participation Rates

(Washington, DC – July 16, 2020) – As COVID-19 infection rates continue to increase in states across the country, many of those jurisdictions are facing the complex dilemma of high infections rates complicating school re-openings and thereby limiting students’ access to school-based meal programs. Among the states with spiking infection rates and a high percentage of students participating in school-based meal programs are Arizona, Florida, Louisiana, Mississippi and South Carolina.

In March schools across the country began closing to stop the spread of the COVID-19 virus. In response, and recognizing the important source of nutrition school-based meals were to millions of American children, the U.S. Department of Agriculture’s Food and Nutrition Service began approving nationwide waivers to provide school systems flexibility in how meals were provided to students. For example, these waivers enable schools to serve meals in non-congregate settings and outside of standard mealtimes, serve afterschool snacks and meals outside of structured environments, and waive requirements that students be present when meals are picked up.

Over half of all students in elementary and secondary schools across the country depend on the National School Lunch Program, and 12.5 million of those students also participate in the School Breakfast Program. As the COVID-19 pandemic closed schools this spring, these students were placed at risk of not having enough to eat.

A new policy brief, Beyond School Walls: How Federal, State and Local Entities are Adapting Policies to Ensure Student Access to Healthy Meals During the COVID-19 Pandemic, released today by Trust for America’s Health, reviews steps the federal and state governments have taken to ensure students’ access to healthy meals when schools are closed and what needs to be done to ensure continued meal access as all school systems face uncertainties about how to safely reopen for the 2020-2021 school year.

“School meal programs are the most important source of nutritious food for millions of American children. To the degree possible, school systems, with financial and regulatory relief from the federal government, should continue to be innovative about how to deliver meals to students and should strive to meet or exceed federal nutrition standards for these meals despite product shortages created by the pandemic,” said Adam Lustig, Project Manager at Trust for America’s Health and the brief’s author.

Due to the economic impact the pandemic has had on millions of American families and the numerous uncertainties about how to safely re-open schools, the currently in place program waivers should be extended through the summer and may need to be kept in place during the 2020–2021 school year, the brief says.

Many of the states hardest hit by COVID also have highest school meal programs participation rates

States with some of the highest rates of COVID-19 infections also have high percentages of students who depend on school meals for much of their nutrition. States in which both COVID-19 infection rates are above national medians and school meals program enrollment is high include Arizona, Florida, Georgia, Louisiana, Mississippi, and South Carolina.

States in which more than half of students are enrolled in school-meals programs are:

Percentage of students enrolled in school meal programs

D.C. 76.4%

Mississippi 75.0%

New Mexico 71.4%

South Carolina 67.0%

Arkansas 63.6%

Louisiana 63.0%

Oklahoma 62.5%

Georgia 62.0%

Nevada 60.8%

Kentucky 58.7%

California 58.1%

Florida 58.1%

Arizona 57.0%

Missouri 52.7%

New York 52.6%

Illinois 50.2%

Alabama 51.6%

Oregon 50.5%

Hunger, poor nutrition and food insecurity can increase a child’s risk of developing a range of physical, mental, behavioral, emotional, and learning problems. Hungry children also get sick more often and are more likely to be hospitalized. Maintaining children’s access to nutritious meals despite school closures not only ensure they do not go hungry, but also promotes children’s health.

“State and federal guidelines waivers have allowed school systems to provide meals to students during the pandemic response, keeping them in place this summer and into the 2020-2021 school year will be the difference between kids who have enough to eat and kids who go hungry,” Lustig said.

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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

Sign-on Letter in Support of CDC Mission (July 2020)

New Maps Track Laws Related to Tobacco Pricing Strategies and Syringe Service Programs in US

(Philadelphia, Pa – Novermber 19, 2019) Two new maps published to LawAtlas.org today — syringe service programs (SSPs) and tobacco pricing strategies — offer a comprehensive look at US laws that address tobacco pricing strategies and access to clean syringes through syringe service programs.

“States have a vital role to play in promoting the health and well-being of their residents. These datasets, along with other resources produced under the Promoting Health and Cost Control (PHACCS) in States initiative, will provide decisionmakers, advocates, and other key stakeholders with the evidence and business case for the adoption of policies that have been shown to improve community health,” said Adam Lustig, MS, Manager and Co-Principal Investigator of the PHACCS initiative.

The maps are the first two legal data resources in a new series created and maintained by the Center for Public Health Law Research at Temple University’s Beasley School of Law (CPHLR) with the Trust for America’s Health (TFAH).

Researchers from the Center used the scientific policy surveillance process in collaboration with experts from TFAH to provide states with detailed information about the current state of US laws that could be used to improve community health through cost-saving policy changes.

“You must first measure a policy to understand its impact on health and cost. These maps give policymakers, advocates, practitioners and other stakeholders a comprehensive look into what these laws say and how the nuanced characteristics differ across the US,” said Lindsay Cloud, JD, Director of the Policy Surveillance Program at CPHLR. “The policy surveillance process we use is the gold standard for legal research because it creates objective, detailed legal data that can be used for evaluation and provides a clear visual to identifying gaps and areas for policy improvement.”

The project will include 13 datasets on a variety of public health topics through the end of 2020, ranging from universal pre-kindergarten and school nutrition standards, to housing and economic policies like the Earned Income Tax Credit and paid sick and family leave laws. The laws displayed were in effect as of August 1, 2019.

The two datasets released today, on syringe service programs and tobacco pricing strategies, represent two of the harm reduction-focused datasets in the series.

Syringe Service Programs

Syringe service program (SSP) policies authorize the legal sale and exchange of sterile syringes, and are one of the most effective and scientifically-based methods for reducing the spread of HIV and Hepatitis. This legal map identifies where SSPs have been explicitly authorized by the law, legal exemptions for individuals who access SSPs if they’re in possession of paraphernalia if stopped by law enforcement, and additional services an SSP must provide directly or through referrals.

Some key findings from this dataset include:

31 states have passed laws that explicitly authorize SSPs. This number has nearly doubled since 2014 (18 states as of August 1, 2014).
In four of the 31 states – Delaware, Florida, Hawaii, and Maine – the law requires a one-for-one exchange of syringes.
In three states – Colorado, Georgia and Ohio – SSPs are also required to provide HIV and Hepatitis screenings.

Tobacco Pricing Strategies

Tobacco use and exposure to second-hand smoke are leading causes of preventable death in the US. One strategy to decrease tobacco use and promote quitting is to increase the price of tobacco products. This legal map details US laws that apply taxes or set pricing limits for tobacco products, like traditional cigarettes, e-cigarettes, and others.

Some key findings from this dataset include:

All 50 states and the District of Columbia tax cigarettes.
All 50 states and the District of Columbia have taxes on non-cigarette tobacco products.
14 states and the District of Columbia also tax e-cigarettes, either by taxing the device, the liquid, or both.
31 states and the District of Columbia prohibit selling cigarettes, non-cigarette tobacco products, or both below cost.
32 states preempt local taxation of tobacco, either through explicit prohibitions on local tobacco taxation or through general limitations on the power of local governments to impose their own excise taxes.