The Nation’s Public Health System is at an Inflection Point

New Report Provides the Next Administration and Congress a Policy Roadmap for Improving the Nation’s Health, Economy, and National Security

(October 8, 2024 – Washington, DC) – The public health system—responsible for protecting and promoting health in every community— needs sustained investment, policy support, and protection from political interference, according to a new report released today by Trust for America’s Health.

The report, Pathway to a Healthier America: A Blueprint for Strengthening Public Health for the Next Administration and Congress, identifies six priority areas and includes policy recommendations that, if adopted, will improve health outcomes and bolster the nation’s economic and national security.

Americans are living longer, thanks in part to public health. Public health interventions, such as improved sanitation, enhanced vaccination access and stronger infectious disease control, improved nutrition, tobacco use prevention, and addressing preventable injury, were the largest contributing factors to life expectancy increases over the last century.

However, too many Americans are still suffering from preventable health problems. Over the last few decades, increasing rates of chronic diseases and alarming levels of substance use disorder and suicides threaten the public’s health. Furthermore, weather-related emergencies are occurring more frequently, and population-level health disparities persist.

Public health is at risk on several fronts. Underfunding has weakened the public health infrastructure and its workforce. Mis- and disinformation and politicization have contributed to distrust of public health officials and guidance. Public health’s ability to protect communities is also at risk due to proposed or enacted policies that undermine the role of public health officials or access to preventive healthcare.

“This Blueprint Report provides a roadmap for the Administration and Congress taking office in January to improve the health and well-being of the nation. We know what works in public health and that when Congress and the Administration act in support of public health, the return is improved preparedness and individual and community health and safety,” said J. Nadine Gracia, M.D. MSCE, President and CEO, Trust for America’s Health. “The next Administration and Congress will have an important opportunity to enable all Americans to enjoy optimal health.”

2024 Blueprint Priority Areas and Highlighted Recommendations

This report includes recommendations across six priority areas to protect and strengthen public health, prevention, and our nation’s health security. The following are highlighted recommendations from the report. See the report for the inclusive set of recommendations.

Priority 1: Invest in Infrastructure and Workforce to Ensure Our Public Health System Can Meet the Challenges and Opportunities of the 21st Century.

  • Congress should protect and increase overall funding for the Centers for Disease Control and Prevention (CDC).
  • Congress should ensure continuous improvement of public health infrastructure.
  • Congress should invest in public health data modernization and enact the Improving DATA in Public Health Act to better detect and contain health threats.
  • Congress and HHS agencies should support efforts to bolster recruitment, retention, and resilience of the public health workforce.

Priority 2: Strengthen Prevention, Readiness, and Response to Health Security Threats.

  • The White House should maintain coordination and leadership around public health emergencies and biodefense, and the White House and Congress should renew the nation’s Global Health Security Commitment.
  • Congress should expand public health emergency preparedness funding for state, tribal, local, and territorial jurisdictions.
  • Congress and the Administration for Strategic Preparedness and Response should strengthen the emergency readiness of the healthcare delivery system.
  • Congress should enact legislation to ensure access to vaccines for uninsured and underinsured adults.
  • Congress should support nationwide efforts to protect against environmental and climate-related health threats, including extreme heat.

Priority 3: Promote the Health and Well-being of Individuals, Families, and Communities Across the Lifespan.

  • Congress should increase funding to CDC’s National Center for Chronic Disease Prevention and Health Promotion.
  • Congress should enhance benefits in and protect access to the Supplemental Nutrition Assistance Program and should make healthy school meals for all permanent.
  • Congress should create a national standard requiring employers to provide job-protected paid sick, family, and medical leave for all employees.
  • Congress and HHS should address Adverse Childhood Experiences (ACEs) by passing the Preventing Adverse Childhood Experiences Act and increasing the investment in the CDC ACEs program.
  • Congress should fund the nationwide implementation of CDC’s Comprehensive Suicide Prevention Program and support Substance Abuse and Mental Health Services Administration’s efforts to bolster the continuum of crisis care.
  • Congress and the Administration should fund CDC’s internal capacity for healthy aging efforts and its support to build and sustain age-friendly public health systems in state, local, tribal, and territorial public health departments.

Priority 4: Advance Health Equity by Addressing Structural Discrimination.

  • Federal agencies should regularly update and report progress on agency equity plans, ensuring metrics are inclusive of and extend beyond tracking disparities.
  • Congress and the Administration should ensure accurate and complete data collection to report health-related information by race/ethnicity, age, sex, disability, language, sexual orientation, gender identity, and geography.
  • Federal health agencies should focus funding on populations at elevated risk for chronic disease and poor health outcomes due to the impact of structural discrimination and disinvestment.

Priority 5: Address the Non-Medical Drivers of Health to Improve the Nation’s Health Outcomes.

  • Congress should increase funding to $150 million for the Social Determinants of Health program at CDC and pass the Improving Social Determinants of Health Act.
  • The Administration should continue to build on the Centers for Medicare & Medicaid Services’ (CMS) efforts to support Medicaid, Medicare, and Children’s Health Insurance Program coverage of patients’ health-related social needs.
  • CMS and Congress should explore opportunities to expand the capacity of healthcare providers and payers to screen and refer individuals to social services.
  • Congress should amend tax laws to increase economic opportunity for families by expanding access to the Child Tax Credit and Earned Income Tax Credit.

Priority 6: Enhance and Protect the Scientific Integrity, Effectiveness, and Accountability of the Agencies Charged with Protecting the Health of all Americans.

  • The Administration and Congress should maintain the existing structure of federal health agencies, which have specific roles and expertise in protecting the nation’s health.
  • The Administration should protect the scientific integrity of public health agencies and leaders.
  • Congress and HHS should invest in and prioritize effective public health communications and reducing the spread of misinformation and disinformation.
  • Lawmakers and courts should reject laws that weaken or preempt public health authorities, which could threaten basic public health protections such as outbreak detection, vaccination, and response.

 

Read the full report

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

 

 

National Immunization Month Highlights Lifesaving Benefits of Vaccines

August 2024

National Immunization Awareness Month sponsored by the National Public Health Information Coalition (NPHIC) and observed every August, highlights the lifesaving benefits of vaccines. During the month, activities will raise awareness of the importance of vaccinating people of all ages against serious and sometimes deadly diseases. The awareness month also celebrates the successes of immunizations and educates Americans about vaccine safety and effectiveness.

According to a study by the Commonwealth Fund, from December 2020 through November 2022, COVID-19 vaccines prevented approximately 18.5 million hospitalizations and 3.2 million deaths in the U.S., but the lifesaving impact of vaccines extends far beyond COVID-19. Vaccines have dramatically reduced the spread of diseases like measles, polio, and whooping cough, protecting countless individuals and communities.

According to new data published this month by the CDC, among children born during 1994-2023, routine childhood vaccinations will have prevented about 508 million cases of illness, 32 million hospitalizations, and 1,129,000 deaths over the course of their lifetimes.

Unfortunately, numerous factors have led to a decline in vaccination rates in recent years including healthcare disruptions during the COVID-19 pandemic and the spread of misinformation about vaccine safety and effectiveness. In some cases, this has resulted in outbreaks of once-controlled diseases, including measles and to a lesser degree polio, jeopardizing the progress we have made.

According to the American Association of Immunologists, getting vaccinated protects against the spread of infectious diseases by helping our immune systems fight infection. Vaccines work by introducing a weakened or inactive form of a virus or bacteria to the body. This triggers the immune system to develop antibodies, creating a kind of shield against future infection. When a large portion of the population is vaccinated, it creates “herd” or community-level immunity, making it difficult for diseases to spread, even protecting those who haven’t been vaccinated themselves.

The public health benefits of vaccines include:

Disease Prevention: Vaccines are highly effective at preventing serious illnesses like measles, mumps, rubella, polio, diphtheria, tetanus, whooping cough, chickenpox, shingles, influenza, and pneumonia. These diseases can cause severe complications, hospitalization, and even death.

Reduced Healthcare Costs: Vaccines are a cost-effective way to prevent illness and its associated medical expenses. Vaccination programs save billions of dollars in healthcare costs each year.

Protection for Populations at Higher Risk: Vaccines are especially important for protecting those with developing immune systems (infants) or weakened immune systems, such as older adults and people with certain chronic illnesses.

Global Health Impact: Vaccination programs have had a significant impact on global health. They have helped to virtually eliminate smallpox and dramatically reduced the burden of other diseases worldwide.

To build on and sustain the health benefits of vaccines, TFAH’s 2024 Ready or Not: Protecting the Public’s Health from Diseases, Disasters, and Bioterrorism report includes a number of important recommended policy actions to strengthen the nation’s vaccine infrastructure:

  • Increased Funding: Congress should provide at least $1.1 billion per year to support vaccine infrastructure and delivery, including programs promoting equitable vaccine distribution.
  • Insurance Coverage: Congress and states should ensure first-dollar coverage for recommended vaccines under commercial insurance and for uninsured populations.
  • Minimizing Exemptions: States should minimize vaccine exemptions for schoolchildren, and healthcare facilities should increase vaccination rates of healthcare workers.
  • New Vaccine Development: Congress should create incentives for new-product discovery to prevent and fight resistant infections including therapeutics, diagnostics, and prevention products such as vaccines.
  • Strengthening Influenza Defenses: Congress should strengthen the pipeline of influenza vaccines, diagnostics, and therapeutics.
  • Countering Vaccine Misinformation:The spread of misinformation about vaccines can lead to vaccine hesitancy and lower vaccination rates. TFAH calls for promoting accurate information from trusted sources to increase vaccine confidence.

According to research published in The Lancet, since 1974, vaccination has prevented 154 million deaths worldwide. By ensuring equitable access to vaccines, promoting accurate information, and investing in research and education, we can continue to harness the power of vaccines and build a healthier future for all.

 

Ready or Not 2024: Protecting the Public’s Health from Diseases, Disasters, and Bioterrorism

The Ready or Not 2024: Protecting the Public’s Health from Diseases, Disasters, and Bioterrorism report identifies gaps in national and state preparedness to protect residents’ health during emergencies and makes recommendations to strengthen the nation’s public health system and improve emergency readiness. As the nation experiences an increasing number of infectious disease outbreaks and extreme weather events, the report found that while emergency preparedness has improved in some areas, policymakers not heeding the lessons of past emergencies, funding cuts, and health misinformation put decades of progress at risk.

 

Resource:

Ready or Not 2024: State-by-State Factsheets

TFAH Celebrates National Public Health Week

April 1-7, 2024 is National Public Health Week. This year’s theme is Protecting, Connecting and Thriving: We Are All Public Health and TFAH is proud to celebrate and recognize all of the individuals, organizations, and agencies that work to protect health, advance equity, and promote well-being in communities nationwide.

Public health workers are on the front lines helping communities prevent chronic diseases and substance misuse, defending against disease outbreaks, protecting our water supply, and preparing for and responding to natural and human-caused disasters. Their work is constant and critically important to improving and protecting the health and safety of all communities.

Examples of the contributions of the public health system to advancing Americans’ health are many, including:

  • Increasing life expectancy – Americans’ life expectancy steadily increased during the 20th century and through 2009 the first decade of the 21st century, was flat between 2010 and 2018 the next decade, and declined during the COVID-19 pandemic. The latest available data, for 2022, showed a slight rebound in the life expectancy trendline.
  • Delivering vaccines – the 20th and beginning of the 21st centuries saw substantial decreases in vaccine preventable diseases such as measles and polio thanks in part to public health programs to ensure vaccine access, particularly in underserved communities.
  • Promoting maternal and infant health – programs to support pregnant people have created improved access to prenatal, post-partum, and infant healthcare, but more work needs to be done to address racial and ethnic disparities in maternal and postpartum health outcomes.
  • Helping people who smoke quit – the initial phase of the Centers for Disease Control’s Tips from Former Smokers campaign (2012 – 2018) helped more than one million people successfully stop smoking, which has prevented an estimated 129,000 early deaths and saved approximately $7.3 billion in smoking-related healthcare costs.
  • Protecting health during extreme heat – extreme heat threatens the public’s health. Several U.S. jurisdictions have heat response plans, and others are working on creating such plans. Heat response plans outline actions to mitigate the impact of the increasing number and intensity of heatwaves.

“Public health practitioners work tirelessly to prevent disease, prepare for and respond to disasters, address health disparities, and create healthy communities. This vital work deserves support and requires investment to fully fund the public health infrastructure and its workforce,” said Dr. J. Nadine Gracia, M.D. MSCE, President and CEO of Trust for America’s Health.

Most of the money spent on healthcare in the U.S. goes toward preventable illnesses and injuries. Increased and sustained funding for public health would be an investment in prevention and would help to reduce healthcare spending over time. TFAH has called for $4.5 billion annually to adequately fund public health infrastructure across the country.  As the White House and Congress work on FY 2025 appropriations, lawmakers should support the full range of work the CDC and health departments do every day to keep communities safe and healthy.

A different public health theme is highlighted each day during National Public Health Week. Visit the American Public Health Association and to access information and resources on each topic.

TFAH’s President and CEO Dr. Gracia Discusses the Significance of Dr. Martin Luther King Jr. Day & National Day of Racial Healing

(Washington, DC – January 15, 2024) – This week TFAH’s President and CEO, Dr. J. Nadine Gracia and Director of Strategic Communications and Policy Research Rhea Farberman discussed the significance of two important observances, Dr. Martin Luther King Jr. Day and the National Day of Racial Healing. The conversation focused on the intersections between Dr. King’s mission to advance social justice and TFAH’s work to promote optimal health. Also discussed were the ways in which structural racism creates barriers to good health for many people of color and the policy actions needed to dismantle those barriers.

“What we know, especially in thinking about this in terms of Dr. Martin Luther King, Jr. Day and the National Day of Racial Healing, is that for too many people of color and communities of color there has been, over many decades, a disadvantage in terms of access to health promoting resources.”

“We have to act with a sense of urgency because the health, well-being and prosperity of our nation depends on it.  That’s the call that I believe Dr. King would challenge us to continue, to strive for and not relent.  That’s his legacy to us, to ensure that everyone us the opportunity to reach their full potential for health.”

Dr. J. Nadine Gracia
President and CEO
Trust for America’s Health

“Listen to the full conversation”

 

Over 110 Organizations Call on Senate to Oppose Cuts to Prevention Fund

(Washington, DC – September 20, 2023) – Trust for America’s Health, American Public Health Association, Association of Public Health Laboratories, Big Cities Health Coalition, Campaign for Tobacco-free Kids, Council of State and Territorial Epidemiologists, National Association of County and City Health Officials, and more than 100 other organizations representing public health, healthcare, research, social services, and other sectors, today released a letter to the Senate Health, Education, Labor, and Pensions (HELP) Committee opposing a committee proposal to cut $980 million from the Prevention & Public Health Fund (“the Prevention Fund”) to pay for other health legislation.

The Prevention Fund is a critical source of funding for the Centers for Disease Control and Prevention and other agencies across Health and Human Services. The Prevention Fund invests in states and communities across the nation to strengthen systems and the workforce that allow us to provide immunizations, detect and control outbreaks, and prevent illness and early deaths from tobacco and chronic diseases. It supports activities outside one’s doctor’s office – separate and distinct from individual health concerns and treatments.

In an already challenging budget environment, this would further endanger the health of Americans. These cuts would impact not only health programs, but also labor and education, as it will leave a significant gap in base appropriations for the Labor-HHS-Education spending bill that will need to be backfilled. This pay-for has far reaching consequences for all ofthe  programs that fall under the spending bill’s purview.

The letter in part reads:

“The nation can no longer afford to underfund public health…. Despite spending more than any other high-income nation on treating disease, the U.S. has substantially worse health outcomes, with life expectancy declining in recent years. Now is the time to invest in public health and prevention…

Cuts to the Prevention Fund will translate into funding shortfalls in programs that states have long relied upon to keep their residents healthy and safe. In its first 14 years (FY2010–23), the Prevention Fund has invested more than $12.3 billion in resources to states, localities, and tribal and community organizations in support of critical prevention and public health programs. These investments include the 317 immunization program that enables prevention of outbreaks, epidemiologists and public health laboratory grants in every state and territory to detect and investigate outbreaks and prevent further infections, the Preventive Health and Health Services (Prevent) Block Grant that enables states and localities to address their most pressing health concerns, supporting cancer screenings, and other critically important programs. Across the U.S. Department of Health and Human Services, the Prevention Fund supports programs such as suicide prevention, Alzheimer’s disease prevention, and chronic disease self-management.

Funding prevention not only saves lives, but it also saves money. The Prevention Fund’s Tips from Former Smokers Campaign alone saved an estimated $7.3 billion in smoking-related healthcare costs from 2012 to 2018 and helped more than one million Americans quit smoking for good. Public health funding has not kept up with the range of threats that public health must address. For many of these conditions, we know what works, but public health does not have the resources to address these growing health threats.”

The full text of the letter is linked here.

Information about the Prevention and Public Health Fund can be found here.

Organizations Joining the Letter:

ADAP Advocacy

American Academy of Pediatrics

American Association on Health and Disability

American College of Clinical Pharmacy

American College of Obstetricians and Gynecologists

American College of Physicians

American College of Preventive Medicine

American College of Sports Medicine

American Heart Association

American Lung Association

American Public Health Association

American Society for Microbiology

American Society on Aging

American Statistical Association

Association for Prevention Teaching and Research

Association for Professionals in Infection Control and Epidemiology

Association of American Medical Colleges

Association of Immunization Managers

Association of Maternal & Child Health Programs

Association of Pathology Chairs

Association of Public Health Laboratories

Association of Schools and Programs of Public Health

Association of State and Territorial Health Officials

Asthma and Allergy Foundation of America

Big Cities Health Coalition

CAEAR Coalition

Campaign for Tobacco-Free Kids

Center for Advocacy for the Rights and Interests of Elders (CARIE)

Children’s Environmental Health Network

Christian Council of Delmarva

City-County Health District

Colorado Public Health Association

Community Access National Network

Connecticut Public Health Association

Cook County Department of Public Health

Council of State and Territorial Epidemiologists

Dorchester County Health Department

Early Impact Virginia

Endocrine Society

Eta Sigma Gamma

Foundation for Healthy Generations

Futures Without Violence

GLMA: Health Professionals Advancing LGBTQ+ Equality

GO2 for Lung Cancer

Green & Healthy Homes Initiative, Inc

Health Promotion Consultants

Healthy Weight Partnership Inc.

HIV Medicine Association

HLN Consulting, LLC

Illinois Society for the Prevention of Blindness

Immunize.org

Institute for Public Health Innovation

International WELL Building Institute

Johns Hopkins Center for Health Security

Kansas Breastfeeding Coalition

Kentucky Voices for Health

Kids and Car Safety

Lakeshore Foundation

Linn County Public Health

Maine Public Health Association

March of Dimes

Marked By Covid

MaryCatherine Jones Consulting, LLC

Mel Leaman Free Clinic

Mental Health America

Minnesota Public Health Association

NASTAD

National Alliance of Public Health Students and Alums

National Association of Chronic Disease Directors

National Association of County and City Health Officials

National Association of Social Workers

National Center for Healthy Housing

National Center on Domestic and Sexual Violence

National Network of Public Health Institutes

National Nurse-Led Care Consortium

National Prevention Science Coalition

Nemours Children’s Health

New Jersey Public Health Association

New York State Public Health Association

Oregon Coalition of Local Health Officials

Peggy Lillis Foundation

Pennsylvania Public Health Association

Population Association of America

Prevent Blindness

Prevent Blindness Georgia

Prevent Blindness Ohio

Prevent Blindness Wisconsin

Prevent Child Abuse America

Prevention Institute

Public Health Foundation

Public Health Institute

Redstone Global Center for Prevention and Wellness

Resolve to Save Lives

RiverStone Health

Safe States Alliance

Society for Healthcare Epidemiology of America

Society for Maternal-Fetal Medicine

Society for Public Health Education

Society for Women’s Health Research

Sound Generations

Sound Generations – Project Enhance

Spina Bifida Association

Task Force for Global Health

The 317 Coalition

The Foundation for Sustainable Communities

The Gerontological Society of America

Trust for America’s Health

USAging

Vaccinate Your Family

Voices for Vaccines

Washington State Association of Local Public Health Officials

Washington State Public Health Association

Well-Being and Equity in the World

Wisconsin Public Health Association

YMCA of the USA