Issue Category: Environmental Health

Trust for America’s Health Statement on EPA’s Clean Power Plan: Essential for Safeguarding the Climate, Health and Wealth of the United States

Washington, D.C., August 3, 2015 – The following is a statement from Jeffrey Levi, PhD, executive director of the Trust for America’s Health (TFAH) on the final carbon pollution standards for new and existing source power plants, issued today by the Environmental Protection Agency (EPA).

“Today’s announcement finalizing the Clean Power Plan is an important step forward toward turning these proposals into reality and safeguarding our climate, health and wealth.

Climate change poses serious public health concerns — from natural disasters to reduced water resources to new insect-based infectious diseases associated with higher temperatures to worsening air quality to the effects of the extreme weather we’ve seen across the country this summer.

Issuing carbon pollutions standards for new and existing power plants is one essential piece of a strategy – but we cannot stop here.  The 2015 Lancet Commission on Health and Climate Change mapped out the impact of climate change and measures that could be taken to protect the health of humans and the planet – and how, if we work urgently and expeditiously, we can turn the tide and achieve promising results.”

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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.

TFAH Releases Issue Brief – The Clean Water Rule: Clearing up Confusion to Protect Public Health

Washington, D.C., July 23, 2015 – Today, the Trust for America’s Health (TFAH) released an issue brief examining the country’s Clean Water Rule and how it will improve and protect Americans’ health and restore guaranteed protections for a range of waters.

The brief, The Clean Water Rule: Clearing up Confusion to Protect Public Health, finds that, despite advances in water management, waterborne illnesses still pose a serious threat to Americans’ health.  Even though water-related illnesses are largely underreported, the United States annually experiences a significant number of waterborne illnesses. In fact, each year around 30 outbreaks and 1,000 reported drinking water-related cases and around 24 outbreaks and 1,300 recreational water-related cases occur.

According to the brief, water pollution affects Americans’ health on a regular basis. In the summer of 2014, the country witnessed a dramatic example of the effects of contaminated waterways when a toxic algal event in Lake Erie shut off the main drinking water supply for 400,000 people in Toledo, Ohio.

In another recent example, in Charleston, West Virginia, hundreds of thousands of people were unable to use their tap water because of toxic substances in the water supply. And, across the country, industrial pollution, animal and human waste, and waterborne pathogens are often found in these headwaters—from which 117 million Americans get their drinking water.

To help resolve these issues, the Environmental Protection Agency (EPA) and the Army Corps of Engineers — which implement the Clean Water Act—held more than 400 stakeholder meetings, sifted through  more than a million public comments (of which 87 percent favored the action), and developed a detailed scientific report, Connectivity of Streams and Wetlands to Downstream Waters, that examined more than 1,200 peer-reviewed publications on the connections between upstream and downstream bodies of water.

These actions resulted in the creation of the Clean Water Rule, which clarifies the scope of the headwaters that are protected under the Clean Water Act. According to the brief, by providing protection for these waters, the Clean Water Rule will safeguard headwaters, better hold industrial polluters of headwaters accountable and greatly improve the nation’s health.

“We want to un-muddy the waters – the Clean Water Act’s legacy has been to ensure Americans have sustainable access to a healthy water supply,” said Jeffrey Levi, PhD, executive director of TFAH. “Moving forward, the Clean Water Rule will further the Act’s great successes by strengthening protections for our nation’s water supply and reducing instances of waterborne illness. The Rule should be administered—without delay or further changes—to avoid putting the public’s health at further risk.”

The brief also notes that protecting America’s headwaters is popular across political lines. A recent poll found that 80 percent of American voters favor the Rule, with half of voters saying they strongly favor it. Support for the rule cuts across party lines, with large majorities of Democrats, Independents and Republicans in favor.

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.

TFAH Statement: Lancet Commission and White House Summit Highlight Urgent Need to Address Climate Change Health Threats

Washington, DC, June 23, 2015 – The following is a statement from Jeffrey Levi, PhD, executive director of the Trust for America’s Health (TFAH) on the White House Climate and Health Summit and release of the 2015 Lancet Commission on Health and Climate change report this morning.

“For too long, the country has buried its head in the sand when it comes to the threats climate change poses to our health.

The new Lancet Commission on Health and Climate Change report raises the stakes, clearing defining the consequences of inaction – but also presents a silver lining of how action now can help mitigate the problems of tomorrow.

That is why the White House Climate and Health Summit on Tuesday is so critical – bringing together U.S. Surgeon General Dr. Vivek Murthy, Environmental Protection Agency Administrator Gina McCarthy and leading experts to help build a path forward. But, to have a real ongoing impact, we need more than a one day forum. We need a sustained approach—across agencies—that strategically aligns programs and policies to address climate change and health.

This sustained approach should include the U.S. Department of Health and Human Services committing to ensuring that all its programs address the impact of climate change on health and the White House mobilizing every federal agency to consider the health implications of climate change when performing their duties.

We know that, as climate and weather patterns shift, they contribute to the emergence of new diseases and the reemergence or spread of diseases that were nearly eradicated or thought to be under control. As changes in temperature and weather patterns allow pathogens to expand into different geographic regions, some vector- and zoonotic-borne diseases may increase along with foodborne and waterborne diseases. Excessively high temperatures, heavy downpours, wildfires, severe droughts, permafrost thawing, ocean acidification, sea-level rise and other extreme weather events all have implications for public health.

In the Trust for America’s Health annual Outbreaks: Protecting Americans from Infectious Diseases report, we found that only 15 states have complete climate change adaptation plans – including planning for the impact of climate change on human health.

We know that climate change is affecting every sector of American society, making addressing this issue the urgent responsibility of every government program and agency. There’s no time like the present to safeguard the future health and wealth of the country.”

 

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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.

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. 

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.