Issue Category: Paid Leave

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

 

TFAH and Other Leaders Launch Public Health Communications Collaborative to Support and Advance Public Health During COVID-19 Pandemic

(Washington, DC, September 2, 2020) – The Public Health Communications Collaborative (PHCC), launched today, will promote the value of public health to protect Americans’ health and safety as well as the nation’s economy. The collaborative will coordinate and amplify public health messaging on COVID-19 issues to increase Americans’ confidence in health guidance by communicating the best available science, by positioning public health leaders as expert spokespersons, and by quickly correcting misinformation.

“Unfortunately, misinformation and conflicting messages about COVID-19 have confused the American public at a time when clear guidance about how to protect their health is critical,” said John Auerbach, President, and CEO of Trust for America’s Health. “This collaborative will share information that will advance science-based decision making during the pandemic and in doing so will help save lives.”

Founding members of the PHCC are Trust for America’s Health, the CDC Foundation, and the de Beaumont Foundation. Partner organizations are the American Public Health Association, the Association of State and Territorial Health Officials, the Big Cities Health Coalition, the National Association of County and City Health Officials, PATH, and Resolve to Save Lives.

The Public Health Communications Collaborative website will be a hub repository of information and messaging products designed to help state and local public health officials share information with their constituents and navigate the current media landscape. The site will be updated regularly with real-time messaging and resources.

To sign up for email updates from PHCC, visit the website.

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

Nuevo informe muestra que la respuesta de COVID-19 fue años de fabricación

El financiamiento para los programas de preparación y respuesta de salud pública perdió terreno en el año fiscal 2020 y durante la última década

(Washington, DC – 16 de abril de 2020) – La falta de fondos crónica de los sistemas de preparación para emergencias y salud pública del país ha hecho que el país sea vulnerable a los riesgos de seguridad de la salud, incluida la nueva pandemia de coronavirus, según un nuevo informe publicado hoy por Trust for America’s Health.

El informe, El impacto de la falta de fondos crónica en el sistema de salud pública de Estados Unidos: Tendencias, riesgos y recomendaciones, 2020, examina las tendencias federales, estatales y locales de financiamiento de salud pública y recomienda inversiones y acciones políticas para construir un sistema más sólido, priorizar la prevención y efectivamente abordar los riesgos para la salud del siglo XXI.

“COVID-19 ha puesto de relieve la dura falta de preparación del país para hacer frente a las amenazas al bienestar de los estadounidenses”, dijo John Auerbach, presidente y CEO de Trust for America’s Health. “Años de recortar fondos para programas de salud pública y preparación para emergencias han dejado a la nación con una fuerza laboral de salud pública más pequeña de lo necesario, capacidad de prueba limitada, una reserva nacional insuficiente y sistemas de seguimiento de enfermedades arcaicas – en resumen, herramientas del siglo XX para lidiando con los desafíos del siglo XXI “.

Imagen mixta para la financiación de los CDC para el año fiscal 2020

Los Centros para el Control y la Prevención de Enfermedades (CDC) de los Estados Unidos. Son la agencia de salud pública líder del país. El presupuesto general de los CDC para el año fiscal 2020 es de $ 7.92 mil millones: un aumento de $ 645 millones, 9 por ciento sobre el financiamiento de los CDC para el año fiscal 2019, 7 por ciento en dólares ajustados por inflación. El mayor aumento del año fiscal 2020 fue una inversión única en edificios e instalaciones (+ $ 225 millones). Otros aumentos incluyeron fondos para la iniciativa Ending HIV (+ $ 140 millones) y pequeños aumentos para programas de prevención de suicidio y enfermedades crónicas.

Financiamiento de preparación para emergencias este año y por más de una década

Los fondos para los programas de preparación y respuesta de salud pública de los CDC disminuyeron entre los presupuestos del año fiscal 2019 y el año fiscal 2020, de $ 858 millones en el año fiscal 2019 a $ 850 millones en el año fiscal 2020. Los fondos del programa de los CDC para la preparación para emergencias en el año fiscal 2020 ($ 7.92 mil millones) son menores que fue en el año fiscal 2011 ($ 7.99 mil millones en dólares del año fiscal 2020), después de ajustar por inflación.

Los fondos para los programas de preparación y respuesta ante emergencias de salud pública estatales y locales también se han reducido, en aproximadamente un tercio desde 2003. Y, de gran preocupación ahora, los fondos para el Programa de Preparación Hospitalaria, la única fuente federal de fondos para ayudar a la prestación de atención médica. El sistema de preparación y respuesta ante emergencias se ha reducido a la mitad desde 2003.

La acción federal para promulgar tres paquetes de fondos suplementarios para apoyar la respuesta a la pandemia COVID-19 fue crítica. Pero son ajustes a corto plazo que no fortalecen la capacidad central a largo plazo del sistema de salud pública, según los autores del informe. Se necesitan incrementos sostenidos de fondos anuales para garantizar que nuestros sistemas de seguridad de salud e infraestructura de salud pública estén a la altura de la tarea de proteger a todas las comunidades.

El descuido habitual de la salud pública en la nación, excepto durante emergencias, es un problema de larga data. “Las emergencias que amenazan la salud y el bienestar de los estadounidenses son cada vez más frecuentes y más graves. Estos incluyen incendios forestales e inundaciones, la crisis de opioides, el aumento de la obesidad y las enfermedades crónicas, y este año un brote de sarampión, lesiones pulmonares graves debido al vapeo y la peor pandemia en un siglo. Debemos comenzar a hacer inversiones año tras año en salud pública”, dijo Auerbach.

Además de apoyar las actividades federales, los fondos federales también son la fuente principal de financiamiento para la mayoría de los programas de salud pública locales y estatales. Durante el año fiscal 2018, el 55 por ciento de los gastos de salud pública de los estados, en promedio, fueron financiados por fuentes federales. Por lo tanto, los recortes en el gasto federal tienen un grave efecto de goteo en los programas estatales y locales. Entre el año fiscal 2016 y el año fiscal 2018, los gastos estatales de dinero federal para actividades de salud pública disminuyeron de $ 16.3 mil millones a $ 12.8 mil millones. Además de los recortes federales, algunos estados también han reducido los fondos de salud pública. Más del 20 por ciento de los estados (once) recortaron sus fondos de salud pública entre 2018 y 2019.

Estos recortes de fondos han llevado a reducciones significativas de la fuerza laboral en los departamentos de salud pública estatales y locales. En el 2017, el 51 por ciento de los grandes departamentos locales de salud pública informaron pérdidas de empleos. Algunas de las posiciones pérdidas fueron en el personal de salud pública de primera línea que habría sido movilizado para combatir la pandemia de COVID-19.

El informe incluye 28 recomendaciones de políticas para mejorar la preparación para emergencias del país en cuatro áreas prioritarias:

  • mayor financiamiento para fortalecer la infraestructura de salud pública y la fuerza laboral, incluida la modernización de los sistemas de datos y las capacidades de vigilancia.
  • mejorar la preparación para emergencias, incluida la preparación para eventos relacionados con el clima y brotes de enfermedades infecciosas.
  • salvaguardar y mejorar la salud de los estadounidenses invirtiendo en la prevención de enfermedades crónicas y la prevención del abuso de sustancias y el suicidio.
  • abordar los determinantes sociales de la salud y avanzar en la equidad en salud.

El informe también respalda el llamado de más de 100 organizaciones de salud pública para que el Congreso aumente el presupuesto de los CDC en un 22 por ciento para el año fiscal 2022.

 

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

New Report Shows Hamstrung COVID-19 Response was Years in the Making

Funding for public health preparedness and response programs lost ground in FY 2020 and over the past decade.

(Washington, DC – April 16, 2020) – Chronic underfunding of the nation’s public health and emergency preparedness systems has made the nation vulnerable to health security risks, including the novel coronavirus pandemic, according to a new report released today by Trust for America’s Health.

The report, The Impact of Chronic Underfunding on America’s Public Health System: Trends, Risks, and Recommendations, 2020, examines federal, state, and local public health funding trends and recommends investments and policy actions to build a stronger system, prioritize prevention, and effectively address twenty-first-century health risks.

“COVID-19 has shined a harsh spotlight on the country’s lack of preparedness for dealing with threats to Americans’ well-being,” said John Auerbach, President and CEO of Trust for America’s Health. “Years of cutting funding for public health and emergency preparedness programs has left the nation with a smaller-than-necessary public health workforce, limited testing capacity, an insufficient national stockpile, and archaic disease tracking systems – in summary, twentieth-century tools for dealing with twenty-first-century challenges.”

Mixed Picture for CDC FY 2020 Funding

The U.S. Centers for Disease Control and Prevention (CDC) is the nation’s leading public health agency. The CDC’s overall budget for FY 2020 is $7.92 billion – a $645 million increase, 9 percent over FY 2019 CDC funding, 7 percent in inflation-adjusted dollars. The largest FY 2020 increase was a onetime investment in buildings and facilities (+$225 million). Other increases included funding for the Ending HIV initiative (+$140 million) and small increases for suicide and chronic disease prevention programs.

Emergency Preparedness Funding Down This Year and For Over a Decade

Funding for CDC’s public health preparedness and response programs decreased between the FY 2019 and FY 2020 budgets – down from $858 million in FY 2019 to $850 million in FY 2020.  CDC’s program funding for emergency preparedness in FY 2020 ($7.92 billion) is less than it was in FY 2011 ($7.99 billion in FY 2020 dollars), after adjusting for inflation.

Funding for state and local public health emergency preparedness and response programs has also been reduced, by approximately one-third since 2003. And, of critical concern now, funding for the Hospital Preparedness Program, the only federal source of funding to help the healthcare delivery system prepare for and respond to emergencies, has been cut by half since 2003.

Federal action to enact three supplemental funding packages to support the COVID-19 pandemic response was critical. But they are short-term adjustments that do not strengthen the core, long-term capacity of the public health system, according to the report’s authors.  Sustained annual funding increases are needed to ensure that our health security systems and public health infrastructure are up to the task of protecting all communities.

The nation’s habitual neglect of public health, except during emergencies, is a longstanding problem. “Emergencies that threaten Americans’ health and well-being are becoming more frequent and more severe. These include wildfires and flooding, the opioid crisis, the increase in obesity and chronic illness, and this year a measles outbreak, serious lung injuries due to vaping, and the worst pandemic in a century. We must begin making year-in and year-out investments in public health,” Auerbach said.

In addition to supporting federal activities, federal monies are also the primary source of funding for most state and local public health programs. During FY 2018, 55 percent of states’ public health expenditures, on average, were funded from federal sources. Therefore, federal spending cuts have a serious trickle-down effect on state and local programs. Between FY 2016 and FY 2018, state expenditures of federal monies for public health activities decreased from $16.3 billion to $12.8 billion.   On top of federal cuts, some states have also reduced public health funding.  More than 20 percent of states (eleven) cut their public health funding between 2018 and 2019.

These funding cuts have led to significant workforce reductions in state and local public health departments. In 2017, 51 percent of large local public health departments reported job losses.  Some of the positions lost were frontline public health staff who would have been mobilized to combat the COVID-19 pandemic.

The report includes 28 policy recommendations to improve the country’s emergency preparedness in four priority areas:

  • increased funding to strengthen the public health infrastructure and workforce, including modernizing data systems and surveillance capacities.
  • improving emergency preparedness, including preparation for weather-related events and infectious disease outbreaks.
  • safeguarding and improving Americans’ health by investing in chronic disease prevention and the prevention of substance misuse and suicide.
  • addressing the social determinants of health and advancing health equity.

The report also endorses the call by more than 100 public health organizations for Congress to increase CDC’s budget by 22 percent by FY 2022.

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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

Combating COVID-19: Why Paid Sick Leave Matters to Controlling its Spread

This webinar highlights recommendations made in TFAH’s Ready or Not and Promoting Health and Cost Control in States (PHACCS) reports on the important role of paid sick leave in combating infectious diseases, as well as other complementary evidence-based policies that can be adopted by federal, state and local governments and by employers.

Presenters focused on pending federal legislation, states that have adopted laws regarding paid leave, and businesses that are expanding these benefits. In addition, they discussed the potential short-term uses of the recently approved supplemental budget to assist individuals without paid leave when confined to their homes.

Recommended for anyone working in public health, advocacy, school health, community-based organizations, businesses, labor unions, hospitals, health systems, insurers, policy staff, and local and state health officials.