Issue Category: Issues

Black History Month Spotlight: National Council of Negro Women and Good Health WINs Initiative

February marks Black History Month, and the theme for this year celebrates Black artists as ‘agents of change.’

The National Council of Negro Women’s Good Health Women’s Immunizations Networks (Good Health WINS) initiative, of which Trust for America’s Health (TFAH) is a founding member, has certainly been an agent of change in the art of public health. The historic national organization’s efforts to bolster vaccinations among African Americans and counter misinformation during the COVID-19 pandemic were important to reaching and educating Black families and communities across the country.

The National Council of Negro Women (NCNW) was founded in 1935 by legendary philanthropist, civil rights activist, and suffragist Dr. Mary McLeod Bethune as a vehicle to empower African American women, their families, and communities. It has historically served as an umbrella organization for a network of chapters and groups advancing Black women civically, politically, and economically. The organization and its revered leaders have provided housing and education for women, particularly in the South, and been recognized for its influence and measured approach to policy advocacy.

At the height of the COVID-19 pandemic, the organization furthered its leadership on the front lines of promoting and protecting the health of communities of color, particularly as the first COVID-19 vaccines began to rollout. Fears, mistrust, inequitable distribution, barriers to access and misinformation led to African Americans initially having much lower vaccination rates than other populations.

In 2021, NCNW partnered with TFAH, Vaccinate Your Family (VYF) – a collaborative that drew on its partners’ expertise and reach to provide culturally-specific educational and messaging resources to its communities.

The initiative elevated voices trusted in Black communities to provide crucial information about vaccines at a time when past racial medical injustices, such as the Tuskegee experiments, were being used against the new vaccines. Good Health WINs produced how-to videos for social media and fact sheets. In its first year alone, the nationwide network hosted nearly 1,500 vaccination events, reaching 750,000 people.

COVID-19 vaccination rates are now higher for African American adults than their white counterparts, according to the Centers for Disease Control and Prevention (CDC), largely due to Good Health WINs and efforts like it. At the end 2023, nearly 83 percent of African Americans received at least one dose of the COVID-19 vaccine, compared to 80 percent of white Americans who received at least one dose.

NCNW’s ability to build and facilitate this coalition has been instrumental to its wide reach. NCNW itself is a collaborative of 36 national organizations that serve the Black community. Many chapters of historically Black Greek-letter fraternities and sororities are part of the NCNW/Good Health WINs network. Lifelong community service is an integral part of membership for these Pan-Hellenic organizations. The network also includes many faith-based organizations with sophisticated external marketing capabilities, such as the Alfred Street Baptist Church.

“We were facing a pandemic unprecedented in our lifetimes that, because of longstanding social determinants of health, posed an existential threat to African Americans,” said NCNW President and CEO Reverend Shavon Arline-Bradley. “Fortunately, our network and experience, including with HIV/AIDS education, equipped us to act quickly and decisively.  We appreciate the support of Trust for America’s Health, Vaccinate Your Family, the Centers for Disease Control, Moss Consulting, our dedicated employees and tens of thousands of volunteers who support Good Health WINs.”

To date, more than 600,000 people have attended Good Health WINs events, and it has reached over 1.4 million people on social media with its science-based information about the safety and effectiveness of COVID-19 vaccines, according to the organization.

Good Health WINs provides communications toolkits for its members and circulates success stories from local chapters with the rest of the network.

The community engagement expertise of the NCNW, combined with the public health expertise of TFAH, CDC, and VYF, has been a fruitful recipe for raising awareness on other critical health needs in Black communities. The work now includes efforts to provide immunization resources for seasonal viruses and other diseases, as well as publicizing other health and wellness events, particularly around preventing heart disease.

“Outreach efforts that authentically and meaningfully seek to empower its constituents is an artform that the National Council of Negro Women has long mastered and that the country needs to achieve health equity,” said TFAH President and CEO Dr. J. Nadine Gracia. “Partnerships with community-based organizations that are trusted in their communities, supported by funding and resources to implement effective programs, are essential to promote optimal health, reduce health disparities, and advance health equity.”

Nutrition Support Programs are Vital to Preventing Food and Nutrition Insecurity and Reducing Chronic Disease – Congress Must Act to Support Them

As of early November 2023, draft appropriation bills by both the House of Representatives and the Senate do not adequately fund the WIC nutrition support program, threatening to break a nearly 30-year, bipartisan commitment to ensure all participants can access the program without waitlists.

(Washington, DC – 11/20/23) – Access to nutritious food is critical to preventing many chronic diseases and is particularly important to keep young children on track with their growth and developmental needs. In 2022, an estimated 12.8 percent of U.S. households experienced food and or nutrition insecurity sometime during the year.
As Trust for America’s Health’s (TFAH) State of Obesity report series has demonstrated, food insecurity is a risk factor for obesity and other nutrition-related chronic diseases. Progress on addressing these critical public health issues is in jeopardy if Congress does not provide funding for federal nutrition support programs during the current fiscal year.
One of the key federal nutrition programs supporting the specific nutritional needs of young children, infants, and birthing people is the Special Supplemental Nutrition Program for Women, Infants, and Children, or WIC. Created in 1972, the WIC program is a short-term, public health intervention program designed to strengthen lifetime nutrition and health behaviors within households with low-incomes. The WIC program provides nutrition benefits tailored to support a young child’s development. Over time, the program, including its food packages, has aligned with new science about the key nutrients infants and children need. These changes have had a significant impact. Studies show that the 2007 benefit update helped improve beneficiaries’ diets and decreased rates of obesity among enrolled toddlers ages 2-4.

The WIC program also adapted to challenges created by the COVID-19 pandemic by implementing new flexibilities, such as allowing WIC agencies to remotely load benefits cards. In 2021, Congress also increased the monthly benefit available to families to purchase more fruits and vegetables from $9 to $26 for children, and from $11 to $47 for pregnant and postpartum participants. These changes modernized the program and in turn increased participation; important because WIC has long had lower participation rates in comparison to the number of eligible families.

Today, nearly seven million parents and children under five years old depend on the WIC program, and participation is expected to grow due to increased program flexibilities. To keep up with increased demand, additional program funding is needed. As of early November 2023, draft appropriation bills by both the House of Representatives and the Senate do not adequately fund the WIC program, which threatens to break a nearly 30-year, bipartisan commitment to ensure all participants can access WIC without waitlists. Increasing food costs, make action to grow the WIC program critically important as families are struggling to afford healthy meals and may be forced to turn to cheaper but less nutritious alternatives.

Critical public health programs like WIC not only provide nutritious foods to families in the short term, but also help prevent diet-related diseases. Trust for America’s Health urges Congress to increase funding in the Fiscal Year (FY) 2024 budget for the WIC program to ensure pregnant and postpartum birthing people and their young children have the nutrition they need to enjoy good

TFAH Announces Board Chair Transition

Distinguished Board Chair Dr. Gail C. Christopher to Step Down, Board Member Dr. Stephanie Mayfield Gibson elected Incoming Chair

(Washington, DC – December 19, 2022) — Trust for America’s Health (TFAH) announced today that the chairperson of its Board of Directors, Gail C. Christopher, DN, will be stepping down after 10 years of visionary leadership.  The Board of Directors has unanimously elected Board member Stephanie Mayfield Gibson, MD, as the incoming Board Chair, effective January 1, 2023.

Dr. Christopher has a noteworthy 15 years of service on the TFAH Board, becoming a member of the Board in 2007, and serving as chair for a decade.  She informed the Board of her intention to step down as chair at last year’s annual Board meeting, and the Board subsequently underwent a thoughtful succession planning process.  Dr. Mayfield, who joined the TFAH Board in 2017, and is currently a member of the Board’s Finance Committee, was nominated and elected as the next chair.

“Drs. Christopher and Mayfield are nationally renowned and visionary leaders in public health and health equity,” said TFAH’s President and CEO Dr. J. Nadine Gracia.  “TFAH is extremely fortunate to have benefited from Dr. Christopher’s brilliant leadership and will continue to be guided by Dr. Mayfield’s passion and vast experience in our next chapter as an organization.”

While stepping down from the TFAH Board, Dr. Christopher will continue in her roles as the Executive Director of the National Collaborative for Health Equity and as a Senior Scholar at George Mason University’s Center for Well-Being. In addition, Dr. Christopher is president and founder of Ntianu Center for Healing and Nature. Prior to her Ntianu Center tenure, Dr. Christopher was senior adviser and vice president at the W.K. Kellogg Foundation where she was the architect of the Foundation’s Truth, Racial Healing, and Transformation Initiative, an adaptation of the globally recognized Truth and Reconciliation Commission model.

“It has been my honor to serve TFAH and to follow the leadership of former statesman, and Connecticut senator, Lowell Weicker in this vital role as President, then Chair of the TFAH board,” Dr. Christopher said. “I am particularly proud of TFAH’s legacy as a bipartisan convener and problem-solver during challenging and polarized times. I will continue to cherish the meaningful relationships with all my fellow board members and the outstanding staff, stakeholders, funders, and partners of this amazing organization. TFAH is a strong organization and I’m sure that we’ll continue to do great things lead by our incoming board chair, Dr. Stephanie Mayfield, our outstanding organizational president, Dr. Nadine Gracia, and all of the dedicated members of the TFAH Board.”

During Dr. Christopher’s tenure, TFAH experienced tremendous growth and notable achievement in addressing our nation’s most pressing public health issues, such as public health funding, emergency preparedness, obesity, substance misuse and suicide, healthy aging, healthy schools, the health impacts of climate change, and the social determinants of health.  Her exemplary leadership strengthened TFAH’s focus on health equity as foundational to policymaking at all levels.  And, along with her fellow Board members, Dr. Christopher provided steady and sage counsel to the organization in navigating the unprecedented COVID-19 pandemic.

“TFAH owes Dr. Christopher a large debt of gratitude for her service to the organization. Her vision, mentorship, and expertise in racial healing and equity have been an inspiration to her fellow Board members and to the TFAH staff,” said Dr. Gracia.  “We look forward to working with her in the future as she continues to be a leader in the nation’s journey toward health equity.”

VIDEO: Drs. Gracia and Christopher discuss TFAH’s work

Dr. Stephanie Mayfield is a board-certified anatomic and clinical pathologist and an experienced health executive in both the public and private sectors.  As the incoming TFAH Board Chair, she brings critical frontline public health, healthcare system, and academic experience to the position.  Furthermore, she is a longtime advocate of promoting population health and advancing health equity.

“It’s a privilege to be the incoming board chair for Trust for America’s Health, a well-established and meaningful organization,” said Dr. Mayfield. “As a former state public health commissioner and former state laboratory director, we utilized TFAH’s reports for their rich data and policy recommendations to shape an informed systems approach to advance health equity. It’s an exciting time to support the organization in this new role in furtherance of our mission – to promote optimal health for every person and community and make the prevention of illness and injury a national priority. Thank you to our funders for enabling TFAH to pursue its mission and to our outgoing board chair, Dr. Gail Christopher, for her keen stewardship and visionary leadership.”

From 2020 to 2022, Dr. Mayfield served as the Director of the U.S. COVID-19 Response Initiative and Senior Advisor for U.S. Partnerships for Resolve to Save Lives.  The initiative provided COVID-19 response guidance and technical support to local and state health departments, other community partners, and to agencies of the Federal government. In her role as senior advisor, Dr. Mayfield additionally advised on a multi-sector, community-driven, best practices hypertension control initiative focused on optimizing patient empowerment and addressing social determinants of health.

In 2012, Dr. Mayfield was appointed commissioner of public health for the Commonwealth of Kentucky. She was the first African American and first woman to serve in that role. Prior to her tenure as state public health commissioner, she was the state’s director of laboratory services under the Cabinet of Health and Family Services. In 2016, Dr. Mayfield joined KentuckyOne Health and KentuckyOne Health Partners, as the senior vice president and chief medical officer for population health and led the transformation of the state’s largest healthcare system by addressing basic human needs across the continuum of health. Dr. Mayfield has also held faculty positions at the Louisville School of Medicine and served as the Associate Chief of Staff and Staff Pathologist at the Louisville Veteran’s Administration Medical Center. Dr. Mayfield’s research includes early evaluation of what is now the gold-standard heart disease marker, Troponin.

 

 

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

 

Annual Deaths Due to Alcohol, Drugs or Suicide Exceeded 150,000According to the Most Recent Data – And Could Get Worse Due to COVID-19

Despite decreases in overall opioid overdose deaths, deaths involving synthetic opioids, cocaine and other psychostimulants increased sharply and alcohol and suicide deaths are also up.

(Washington, DC and Oakland, CA – May 21, 2020) – Newly released data show that 151,964 Americans died due to alcohol, drugs or suicide in 2018. This national death rate for alcohol, drug and suicide deaths was only very slightly lower than what it had been in 2017 despite progress in reducing some types of opioid overdose, according to a new study by Trust for America’s Health (TFAH) and Well Being Trust (WBT).

For the year, alcohol deaths were up 4 percent and suicide deaths were up 2 percent. The new data also show a continuing shift within the opioid crisis with reductions in deaths due to prescription opioid overdose but increases in deaths involving synthetic opioids, including fentanyl.

Death rates for all opioids were down 2 percent, but the death rate for synthetic opioids was up 10 percent. Additionally, heroin involved overdose deaths were lower but deaths involving cocaine and other psychostimulants, such as methamphetamine, ecstasy, amphetamine and prescription stimulants, were higher.

While still disturbingly high, the s2018 data is the first time since 1999, when the current data collection began, that there has not been a sizable increase in the alcohol, drugs and suicide deaths per 100,000 rate. However, this stabilization in the deaths rate was not uniform. Some places and population groups are experiencing stable or decreasing deaths rates while rates among other groups or in other places continue to rise.

“These data are a clarion call to action,” said John Auerbach, President and CEO of Trust for America’s Health. “We know what works to address deaths of despair but progress has been uneven and death rates continue to climb, with communities of color experiencing higher rates of increases in drug-induced and alcohol deaths. And there’s another immediate concern: the COVID-19 crisis has increased the health burdens and economic pressures on many communities of color.”

American Indians, Asians, Blacks, Latinos and older adults all experienced increases in drug-induced deaths between 2017 and 2018. Blacks and American Indians had the largest absolute increase. Black now have higher synthetic opioid overdose rates (10.7 per 100,000), cocaine overdose rates (8.8 percent per 100,000) and nearly the same overall drug-induced rate (21.8 per 100,000) as Whites, after decades of having substantially lower rates.

Population groups that experienced lower drug-induced death rates in 2018 included adults ages 18-54 and Whites.

“Quite simply, too many Americans are dying from preventable causes. The profound racial health disparities seen in these data show that many ethnic minority groups are being left behind in our response efforts,” said Benjamin F. Miller, PsyD, chief strategy officer, Well Being Trust. “The nation needs a comprehensive framework for excellence in mental health and well-being, one that intentionally provides solutions for American Indians, Blacks, Asians and Latinos. With all the other COVID-19 related investments, it’s time for the federal government to fully invest in mental health now and for all states to take action.”

The reduction in certain opioid deaths suggests that the policies and programs targeting the opioid epidemic may be taking hold in some populations – but many racial and ethnic groups are not seeing the same progress as Whites. The nation should build on the small degree of success and bring the same focus to populations who are at increasing risk, especially Blacks, Latinos and American Indians.

Policy recommendations outlined in the report include:

  • Investing in prevention by addressing the upstream factors that create the conditions that improve outcomes. Numerous factors contribute to well-being or the lack of it including Intergenerational poverty, systemic racism, ethnic discrimination, and homophobia/transphobia are among the social, economic, and environmental factors that elevate risk. Government agencies at all levels should take steps to promote racial equity and combat racism and discrimination.
  • Reducing risk factors and promoting resilience in children, families, and communities. Support equitable policies and programs that reduce traumatic and adverse experiences—such as exposure to violence, unstable housing, racial and ethnic discrimination, and implicit bias—which have profound long-term impacts on later substance use and mental health.
  • Integrating, increasing access to, and improving healthcare by engaging all sectors of society in addressing mental health and substance use disorders. Schools, workplaces, community centers, libraries, and public-facing programs should all incorporate ways to address mental health and addictions issues, from boosting awareness and reducing stigma, to providing crisis intervention training and facilitating referrals, and even integrating healthcare into their programming where possible.
  • Limiting access to lethal means of suicide. Promote safe storage of medications and firearms by providing public education; restricting access to firearms for children and individuals in crisis or at risk of suicide; and creating protocols for health care providers, counselors, and first responders on how to interact with and counsel patients and families to create safe environments. Implement universal background checks for gun purchases and extreme-risk protection orders nationwide, and expand programs to engage stakeholders—like the Gun Shop Project, which educates gun store staffs on suicide prevention.

2018 Data Summary

Deaths by Drug Type

Synthetic Opioids Overdose Deaths – in 2018, 31,355 Americans died from synthetic opioid-involved overdose; up 10 percent since 2017. In total, the synthetic-opioid-involved overdose death rate has increased nearly 10-fold since 2013.

Cocaine Overdose Deaths – In 2018, 14,666 Americans died from cocaine-involved overdoses; up 5 percent since 2017. The overall cocaine overdose death rate has increased by 187 percent since 2013.

Other psychostimulants Overdose Deaths – In 2018, 12,676 Americans died from overdoses involving psychostimulants and 52,279 have died over the past decade due to psychostimulants abuse.  The 2018 psychostimulants overdose death rate was 22 percent higher than it was in 2017.

Alcohol-induced Deaths

In 2018, 37,329 Americans died due to alcohol-induced causes; the rate of alcohol-induced deaths in 2018 was 4 percent higher than the prior year.

Alcohol induced deaths are highest among American Indians (30.0 per 100,000) and adults ages 55 to 74 (27.6 per 100,000). All population groups had higher rates of alcohol deaths in 2018 as compared to the prior year except youths ages 0-17, whose rate held steady.

Suicide Deaths

In 2018, 48,344 Americans died as a result of suicide. Nationally, the 2018 suicide rate was two percent higher than the prior year (after a four percent increase in 2017). Suicide rates increased across all demographics, except for adults ages 18-54 whose rate remained stable. In addition, all racial and ethnic minority groups experienced larger proportional changes in suicide rates than did Whites.

Death by suicide in 2018 was highest among males (23.4 percent per 100,000), those living in rural areas (19.7 per 100,000), Whites (16.8 per 100,000) and American Indian/Alaska Natives (14.1 per 100,000).

State Trends

Between 2017 and 2018, 27 states experienced higher rates (above 0.04%) of alcohol, drug and suicide deaths. Twenty-three states and the District of Columbia had lower alcohol, drug and suicide deaths during the same period.

States with the highest alcohol, drugs and suicide death rates in 2018 were: West Virginia (84.9 per 100,000), New Mexico (82.8 per 100,000), New Hampshire (68.2 per 100,000) and Alaska (67.8 per 100,000).

States with the lowest alcohol, drug and suicide rates in 2018 were: Texas (31.7 per 100,000), Mississippi (31.7 per 100,000) and Hawaii (34.6 per 100,000).

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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.  www.tfah.org. Twitter:@HealthyAmerica1

 

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