Prevention and Public Health Policy Archives - Page 15 of 19

Public Health Leaders Make Urgent Joint Call to Protect Prevention and Healthcare

Joint Statement from American Public Health Association, Prevention Institute, Public Health Institute and Trust for America’s Health

June 20, 2017

The fight to protect public health is more important than ever.

The Senate is moving quickly—and secretively—on their version of legislation to repeal the Affordable Care Act (ACA). While we don’t know the content of the bill, we do know that the House-passed repeal bill—the American Health Care Act—would cause over 23 million people to lose their healthcare, restructure Medicaid, pare down essential benefits like maternity and newborn care, result in the loss of over a million American jobs, and zero out the Prevention and Public Health Fund. As leaders of organizations dedicated to protecting and advancing the public’s health, we call on Congress now to protect federal investments in public health funding, the Prevention and Public Health Fund, and affordable, high-quality healthcare.

Public health is at the very core of keeping our country safe, healthy, resilient, and secure. It works behind the scenes to ensure we have clean water to drink, safe food to eat, and healthy air to breathe. It works to safeguard us from infectious diseases like measles or Ebola by preventing the onset or spread of disease. It builds on time tested strategies to reduce the toll of chronic diseases and injuries. Public health works to redress long-standing inequities in health and safety, by investing in communities of greatest need. Through prevention, evidence-based treatment of substance use, prescription drug monitoring, and improved opioid prescribing, public health can solve the opioid epidemic, which kills ninety-one Americans a day. From opioid overdoses to rising infant and maternal mortality rates, Americans are seeing both the length and quality of their lives decline—and we need more, not fewer, investments in public health to turn the tide.

Repealing the ACA and its investments in public health and prevention dismantles the capacity of public health to do its work. The pain will be felt in every state, every congressional district, and every neighborhood, and those who are most vulnerable will suffer the most. If the Prevention Fund is eliminated, over the next five years states stand to lose over $3 billion they rely on to prevent chronic disease, halt the spread of infections, and invest in the community resources that support health and safety. Repealing the ACA and the Prevention Fund ensures there is no progress to reduce healthcare spending or improve the health of our workforce. Repealing the ACA will result in an America where preventable suffering and death are more widespread, and an America where the poorest and sickest communities fall even farther behind.

A strong public health infrastructure is at the very core of making our country safe, healthy, and secure. We need to act now to protect it.

The President’s FY 2018 Budget Proposal Would be Perilous for the Nation’s Health

Washington, D.C., May 23, 2017 – The below is a statement from John Auerbach, president and CEO, of Trust for America’s Health (TFAH) on the President’s Fiscal Year (FY) 2018 proposed budget announcement.

“The proposed $1.2 billion cut to the Centers for Disease Control and Prevention (CDC) would be perilous for the health of the American people.

From Ebola to Zika to opioid misuse to diabetes to heart disease, the CDC is on the frontlines keeping Americans healthy. Cutting nearly 20 percent of the CDC’s Chronic Disease Prevention and Health Promotion center’s budget would be disastrous.

Enormous cuts are also proposed throughout the rest of the agency including to programs that protect the American people from infectious diseases, environmental contaminants, exposure to tobacco and much more. If these budget cuts were to occur, they would cripple CDC’s operations and result in increased illnesses, injuries and preventable deaths.

CDC has already lost more than $580 million in funding since 2010 – and the proposed American Healthcare Act would, in FY 2019, repeal the Prevention and Public Health Fund, which supplies 12 percent of CDC’s budget—of which more than $620 million goes yearly to states.

Even now, with a relatively stable FY 2017 budget, CDC is operating with nearly 700 vacancies and will function with diminished resources once the Zika emergency supplemental funding runs out.

As such, this unprecedented and dramatic cut would have unparalleled and drastic consequences for our nation’s health and would likely lead to staggering increases in our healthcare service costs. It would also create massive holes in state public health funding, as states and local communities rely on the hundreds of millions they receive from CDC every year.

In essence, the proposed budget would force CDC to fight epidemics and health threats with both hands tied behind their back while wearing a blindfold.

We urge the Administration and Congress to work together to ensure CDC is able to protect the American people and help Americans be healthy and thrive.”

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Trust for America’s Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority.

House ACA Replacement will Cripple the Nation’s Health, Trust for America’s Health Statement

Washington, D.C., May 4, 2017 – The below is a statement from John Auerbach, president and CEO, of Trust for America’s Health (TFAH).

“As historic as the passage of the Affordable Care Act was, any passage of the American Health Care Act will be just as infamous.

Tens of millions of American citizens will lose coverage. And millions of people on private insurance and Medicaid may lose access to life- and cost-saving clinical preventive services.

In particular, the Meadows-MacArthur Amendment would permit states to eliminate the requirement around essential health benefits (EHBs) and allow for the discrimination of people with pre-existing conditions.

Research tells us time and again two truths: Americans with coverage of preventive services are more likely to access these services and investing in preventive services improves health and reduces costs, yielding massive returns on investment.

Additionally, the agencies responsible for keeping us safe daily from ever-increasing public health threats will have their budgets slashed.

If the bill eventually becomes law, the Centers for Disease Control and Prevention (CDC) will lose 12 percent of its budget, of which a significant portion—$625 million a year—goes directly to state and local health departments.

This is a double whammy to the nation’s health.

Every day, the CDC and local public health departments are on the front lines in preventing disease outbreaks like Zika and Ebola, in protecting our children from lead poisoning, in lowering rates of heart disease, in stopping epidemics like prescription drug misuse and in helping people quit tobacco.

If the bill eventually passes, the results won’t be celebrated—they’ll be infamous.

We will likely see more overdoses and untreated STDs, rises in infant mortality and increases in innumerable other preventable health issues—not to mention mounting healthcare costs. All the while, our most vulnerable—the elderly, children, sick and less advantaged—will be at most risk.

That should not be the result of a health law.

We hope the United States Senate sees the many problems in the legislation.”

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Federal Funding for Public Health Has Declined by $580 Million Since 2010, According to New Analysis

Washington, D.C., April 13, 2017 – Today, Trust for America’s Health (TFAH) issued A Funding Crisis for Public Health and Safety: State-by-State Public Health Funding and Key Health Facts, 2017, which found that core funding for disease prevention and health promotion programs has declined by around $580 million federally and has remained flat in states since 2010 (adjusting for inflation).

The annual review demonstrates that cuts to federal funds have not been offset by increases to state and local funding. Adjusting for inflation:

The Centers for Disease Control and Prevention’s (CDC) core budget has decreased by more than $580 million since 2010. In fiscal year 2016, the agency’s budget was $7.17 billion ($22.26 per person).
State public health spending has remained relatively level since 2010 ($11.5 billion total in 2015-2016, median spending $31.62 per capita).

The President’s proposed FY 2018 budget blueprint would include a nearly 18 percent cut to the U.S. Department of Health and Human Services (HHS). The full budget detail is expected to be released later this Spring. Budget sequestration – which requires reductions in the rate of increase in federal spending – is scheduled to go back into effect in FY 2018 and would lead non-defense spending, including at CDC, to fall 16 percent below 2010 spending rates (adjusting for inflation).

“Major budgetary cuts have hampered the ability of public health agencies to protect and improve the nation’s health – impeding the response to pressing health concerns and the rising costs of treating preventable illnesses and injuries,” said John Auerbach, president and CEO, of TFAH. “It is painfully clear that the decrease in federal spending has not led to higher state spending for public health. Rather, the nation has doubled down on cuts at both levels, leaving us vulnerable to the next public health crisis. Cutting public health programs is shortsighted – and we will all pay the price over time.”

The Funding Crisis brief also found that:

Around 75 percent of CDC’s funds go to support state and local programs – but this support ranges from a low of $15.39 per person in Virginia to a high of $49.67 per person in Alaska – with differences due to competitive grant awards and some targeted-need programs;
Public Health Emergency Preparedness (PHEP) core funding for states and local communities – with the exception of the one-time, short-term funding for Ebola and Zika response needs – has been cut by more than one-third (from $940 million to $651 million) per year since the program was established in the wake of the 9/11 and anthrax attacks. CDC has responded to more than 750 emergencies in the past two years; and
Only $4 per person per year is spent on chronic disease prevention activities at CDC ($1.2 billion total). Nearly half of all Americans have one or more chronic disease – a majority of which are preventable – and more than 80 percent of healthcare spending is for chronic conditions.

TFAH also highlights how investing in proven public health strategies can improve health and yield positive returns. For instance:

Investing $1 in substance use prevention to realize as much as $34 in return. Deaths from prescription painkiller use have more than quadrupled in the past 15 years and deaths from heroin have tripled since 2010, contributing to higher death rates among middle-aged Whites. Five of the strongest school-based substance use prevention strategies have returns on investment ranging from $3.8:1 to $34:1.
Saving more than $16 billion through a more active and healthy population. One in three children will develop type 2 diabetes in their lifetime and one in four young adults are not healthy enough to join the military. An investment of $10 per person in proven, evidence-based community prevention programs to increase physical activity, improve nutrition and reduce tobacco use could save the country more than $16 billion annually – a $5.60:1 return.
Connecting health and social services to cut billions in costs. Health and social service coordinating systems that address gaps between medical care and effective social service programs – by connecting patients in need with programs ranging from supportive housing to food assistance – could yield between $15 billion and $72 billion in annual healthcare savings within 10 years, according to an analysis by TFAH and Healthsperien.
Reducing the $120 billion spent annually on preventable infectious diseases. Fifteen years after 9/11 and 11 years after Hurricane Katrina, when health crises such as new infectious diseases arise, the country often lacks sufficient funding and capabilities in place to effectively respond. Preventable infectious diseases cost the country more than $120 billion annually – and that cost is exponentially compounded when new diseases emerge.

Key recommendations for achieving a modern public health system highlighted in the paper include:

Increasing funding for public health – at the federal, state and local levels – to support basic capabilities to turn the tide on health epidemics and prevent disease;
Modernizing the public health system to address gaps in critical infrastructure and update outdated systems and technologies;
Creating a standing Public Health Emergency Fund for immediate use when new threats emerge – while still making sure to maintain ongoing preparedness and response funding. To be effective, this fund must provide a complimentary surge of resources for response to new crises and cannot replace the need to provide ongoing support for standing health security capabilities that must always be in place to deal with the regular cycle of emergencies and threats the country faces;
Supporting better health – and top local priorities – by providing communities with the flexibility to focus on their highest concerns, develop private-public partnerships to leverage resources and ensure accountability; and
Expanding the use of evidence-based, high-impact strategies to improve health in every community.

State	Total CDC Funding for State, Per Capita, FY 2016
Alaska	$49.67
Vermont	$41.57
Rhode Island	$39.59
South Dakota	$33.98
New Mexico	$32.66
Maryland	$31.93
Montana	$31.77
Hawaii	$31.76
Delaware	$30.15
North Dakota	$29.88
Wyoming	$29.69
Maine	$27.98
Louisiana	$27.59
New Hampshire	$27.53
Nebraska	$26.64
Georgia	$26.50
Mississippi	$25.48
Idaho	$24.57
Arkansas	$23.97
Massachusetts	$23.43
Oklahoma	$23.18
West Virginia	$22.96
South Carolina	$22.62
Utah	$22.19
Iowa	$21.70
Alabama	$21.60
Nevada	$21.55
Minnesota	$21.54
Oregon	$21.43
Texas	$21.28
Kentucky	$21.17
Colorado	$21.13
Arizona	$21.07
Tennessee	$20.87
Connecticut	$20.29
Kansas	$20.26
Washington	$20.06
California	$19.61
New York	$19.41
Florida	$19.09
Missouri	$18.98
North Carolina	$18.81
Michigan	$18.80
Ohio	$17.90
Indiana	$17.11
Wisconsin	$16.89
Illinois	$16.76
New Jersey	$16.59
Pennsylvania	$15.48
Virginia	$15.39

Includes CDC funds for organizations within the state.

The brief was supported by a grant from the Robert Wood Johnson Foundation (RWJF).

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Trust for America’s Health Releases Issue Brief on Preventive Services

Washington, D.C., March 30, 2017 –Impact of the 2017 Health Reform Proposals on Clinical Preventive Services, released today by Trust for America’s Health (TFAH), reviews the current status of public and private insurance coverage of preventive services, and what would be at stake if they were eliminated or reduced, either through legislation or administrative actions.

The Affordable Care Act (ACA) expanded coverage of a range of effective, targeted preventive services to make them accessible to millions of Americans.

As of 2015, around 137 million private insured Americans received guaranteed preventive services without cost sharing. Small and individual insurances plans are required to cover 10 Essential Health Benefits, such as blood pressure screenings and well care visits, and non-grandfathered individual, small and large plans are required to cover evidence-based services with top effectiveness ratings, recommended vaccines and preventive maternal and child health coverage (Section 2713 Preventive Services).
The 14 million Americans covered via Medicaid expansion qualify for no-cost coverage of Essential Health Benefits, other top rated preventive services and tobacco cessation services. States determine coverage of preventive services for enrollees in traditional Medicaid plans.

“For too long, America has propped up a sick care system. Instead of prioritizing keeping people healthy in the first place, we’ve waited until they get sick—often with chronic, debilitating and expensive conditions—and then paid the price,” said John Auerbach, president and CEO, TFAH. “Research tells us time and again two truths: Americans with coverage of preventive services are more likely to access these services and investing in preventive services improves health and reduces costs, yielding massive returns on investment.”

According to the brief, a range of proposals could potentially lead to millions of Americans losing access to preventive services – either through reductions or changes in requirements or as part of losing health insurance coverage. Studies have shown that expanding coverage for preventive services contributes to an uptick in routine exams; screenings for blood pressure, cholesterol and diabetes; use of flu shots; and annual dental exams. Examples of some outcomes of preventive services include:

Among the Medicaid population in Massachusetts, an evidence-based, Medicaid tobacco-cessation benefit was associated with a reduction in smoking rates and an estimated $3.12 in medical savings from averted cardiovascular hospitalizations alone for each dollar spent.
The Diabetes Prevention Program reduced risk for developing type-2 diabetes by 58 percent. Even after 10 years, people who completed the program were one-third less likely to develop type 2 diabetes.
Comprehensive prenatal maternal care helps reduce premature birth and infant mortality rates.
Vaccines prevented an estimated 322 million illnesses, 21 million hospitalizations and 732,000 deaths among children born in the U.S. between 1994 and 2013 – and yield a net savings of $295 billion in direct costs and $1.38 trillion in societal costs.

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Sign-on Letter to the President Supporting the Prevention and Public Health Fund (March 2017)

TFAH Statement: Budget Proposes Devastating Cuts for Public Health

Washington, D.C., March 16, 2017 – The below is a statement from John Auerbach, president and CEO, of Trust for America’s Health (TFAH).

“The President’s proposed budget – which includes nearly an 18 percent cut to the Department of Health and Human Services (HHS) – would be devastating to the public health and safety of Americans. This would constitute an unprecedented harmful blow to the nation’s health.

While there are not sufficient details in the budget blueprint about the impact to HHS agencies, including at the Centers for Disease Control and Prevention (CDC), it is clear that such a big decrease would undercut core health programs that are needed to address any and all health problems.

There is nothing more valuable than the health and vitality of the American people. To achieve that, we need to maintain a strong and stable public health system. Such significant cuts would hurt the country’s health system – which is essential for taking on the range of epidemics we face – from major disease outbreaks to diabetes to prescription painkiller misuse.

A few CDC-specific areas referenced in the budget blueprint include:

A proposal for a $500 million block grant program for states via CDC. The proposal does not provide specifics about the program or where the funds would come from, beyond encouraging flexibility for states to focus on their leading public health challenges. We would raise major concerns that in the past – when funding sources have been combined, they have also been reduced – leaving states with less funding and with less ability to address the health problems of their citizens. States then end up in a position of having to make tough trade-offs about which health problems they can address.
The creation of a Federal Emergency Response Fund. The document, however, does not provide sufficient information to evaluate what the fund would look like or if there would be new resources to support it, or if support would be diverted at the expense of funding for other programs. While creating such a fund is important – to allow for access to immediate funds during health emergencies – it is essential that such a fund be supplemental – and not come at the expense or instead of maintaining an ongoing public health security and defense programs. We need both steady ongoing capabilities – as well as the ability to quickly access emergency supplemental funds in times of crises.
500 million to address the opioid epidemic. A national commitment to this priority health crisis is important. However, the budget proposal was unclear as to whether these are new funds, funds that came from passage of the CURES bill or funds diverted from other programs. In addition to specific funding to address the crisis, it is also essential to maintain and sufficiently support the underlying public health system that any response would build upon.

Proposed cuts to other agencies and programs also threaten to adversely impact the health of Americans. For instance, the 31 percent proposed cut to the Environmental Protection Agency (EPA) could potentially roll back decades of progress protecting against the health impacts of air and water pollution. And, stable and secure housing is a major factor for maintaining good health – and the proposed 13 percent cut to the Department of Housing and Urban Development (HUD), including eliminating the Community Development Block Grant program, would contribute to harming the health and stability of numerous vulnerable families.

These cuts would be historically damaging to our nation’s health. The country is at a crossroads – where we have the knowledge and capability to help Americans have healthier, longer lives – but if we don’t invest and maintain these efforts, we will be taking a turn down the wrong path. The lives of our families are too valuable, and the stakes are too high to undercut our health and wellbeing.”

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TFAH Statement: Strongly Opposed to the House Obamacare Replacement Bill

Washington, D.C., March 7, 2017 – The below is a statement from John Auerbach, president and CEO, of Trust for America’s Health (TFAH).

“We are strongly opposed to the House Obamacare Replacement bill, which would repeal significant portions of the Affordable Care Act (ACA), including the Prevention and Public Health Fund.

Under this plan, millions of people could lose health insurance—a devastating blow to the health of many of our nation’s most vulnerable individuals and families. Without affordable insurance coverage we will see increased levels of preventable illnesses, injuries and deaths.

In addition, eliminating the Prevention Fund would erase 12 percent of the Centers for Disease Control and Prevention’s (CDC) budget. Of that investment, $625 million directly supports state and local public health efforts to fight preventable diseases such as diabetes, heart disease and cancer.

Losing this funding would wreak havoc on our efforts to reduce chronic disease rates, immunize our children, stop the prescription drug and opioid epidemic and prepare the public health system to prevent infectious disease outbreaks.

We know how to prevent many chronic and infectious illnesses—which make up a significant portion of the $3 trillion the nation spends yearly on healthcare. If we lose access to health care coverage and to the Prevention Fund, our children, families and communities will suffer and ultimately costs will rise.

The bottom line? This Bill would make untold numbers of the American people less healthy.”

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TFAH Statement on the Draft House Republican Obamacare Replacement Bill: Our Nation’s Health Will Suffer

Washington, D.C., February 24, 2017 – The below is a statement from John Auerbach, president and CEO, of Trust for America’s Health (TFAH).

“The draft House Republican Obamacare replacement bill—which would eliminate the Prevention and Public Health Fund—would threaten the health of American children, families and communities.

Thanks to the Prevention Fund, hundreds of thousands of Americans benefit from increased access to vaccines and other preventive health services. Quite simply, more people are getting and remaining healthy because of the Prevention Fund.

Yet, the proposed replacement bill would eliminate this important Fund and 12 percent of the U.S. Centers for Disease Control and Prevention’s (CDC) budget along with it.

And, without the Prevention Fund, states will lose substantial sums of money—totaling as much as $3 billion over the next 5 years—which fight growing epidemics and emerging diseases.

Every year, we spend $3 trillion on healthcare, yet millions suffer from chronic diseases and death rates among Blacks and other people of color remain too high. At the same time, death rates among white middle-aged Americans increased for the first time in decades, mainly due to preventable conditions.

Time and again research shows that the vast majority of these conditions—heart disease, diabetes and others—can be prevented by investing in addressing the root causes. Yet, the country has repeatedly failed to do so.

The nation cannot afford to trade away our single best investment in preventing disease, preparing for and responding to infectious disease outbreaks, reducing rates of chronic illness, and saving lives and money.

If this draft becomes law, our nation’s health will suffer—and it will be exponentially harder to fight growing epidemics, like the rise in prescription drug and heroin overdoses.”

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It Takes a Village: How Mancelona, Michigan Worked Together to Improve Health and Education

By Mike Swain, MPH, Community Health Coordinator, Health Department of Northwest Michigan

In the early 1990s, residents of Mancelona (a northern Michigan town) had limited access to healthcare, social services and higher education and there were sparse employment opportunities.

With the lowest per capita income in the immediate area, most families lived in poverty, and were underinsured, uninsured altogether or enrolled in Medicaid.

Some of the community’s youngest were hardest hit: the area had the state’s highest rates of youth physical and sexual abuse, teen pregnancies, drinking and drug use. And as could be expected, these health risks had a significant impact on academic performance – with behavior problems in the classroom, low grades, and high dropout rates. In the 1994-95 school year, 39 percent of Mancelona high schoolers dropped out and just 64 percent of the senior class graduated.

Terry McCleod, the Middle School Principal at the time, recognized the critical role of student health and wellness in academic success – and he led the charge for change in Mancelona.

First, he brought together a grassroots network of public and private service providers. Along with a three year grant from the W.K. Kellogg Foundation, they built Project S.H.A.R.E. (School Home Alliance for Restructured Education) to provide a comprehensive assessment and evaluation of the gaps and needs in Mancelona.

The results made it clear that any successful, lasting intervention would need to improve the environment and families by addressing the underlying, interconnected issues of poverty. The layout of the community’s schools—all three were essentially on the same campus—allowed for a unique solution: building a dedicated family resource center right next to school grounds. With thoughtful outreach, community advocates and the public health administration were engaged in the cause, and the land for this building was secured.

The group secured a grant from the Michigan Department of Health and Human Services (MDHHS) to fund the beginning of construction, with the Mancelona Family Resource Center (MFRC) officially opening in 1996.

MFRC housed health, social, daycare, educational, and economic services, offering a unique and comprehensive suite of services to support Mancelona’s students and their families. Staffing and programs were brought in with continued support from Project S.H.A.R.E., including the Michigan Works! Association – which resided in a dedicated wing of the MFRC.

Michigan Works! played a critical role in turning the tide of poverty by strengthening the employability of adults with workforce development services and mobilization of local businesses.

Still, quality healthcare was at the heart, with the local Health Department providing previously unattainable care, including a Dental Health Clinic, on site. Additionally, the MFRC team provided convenient and confidential, family planning, reproductive health services, and education. And working closely with the school, this innovative approach included the development of a dedicated class for pregnant mothers to help improve the health of future Mancelona generations.

Over time, partnerships and additional resources were added within the center, the school and the community. In 2001, Communities In Schools (CIS) began providing programs and services in Mancelona. Founded on the national CIS model, this non-profit organization provided new programs for before/after school activities, mentoring and tutoring.

The CIS team worked in collaboration with the MFRC, providing care coordination and referrals for students and their families. And, when the state of Michigan expanded school-linked health center qualification requirements to include areas with rural status, the MFRC leadership were among the first applicants in line. Mancelona was included with the first round of funded centers under this new qualification.

In 2006, with this additional funding, the Mancelona school-linked health center opened, called the Ironmen Health Center, was opened. The Center offered services to students aged 10-21 regardless of health insurance status. In addition, social work and behavioral health services were provided.

By blending and braiding different funding sources and bringing to bear all community resources to link families to important social services and interventions, the community is much improved.

In fact, rates of teen pregnancy, drug and tobacco use, and child abuse are all down. And, high school graduation is up—to 91 percent, a 42 percent increase from the inception of project.

The benefits of this innovative care model doesn’t stop there: 60 percent of the 2013 graduating class enrolled in college that fall. And nearly 100 percent of the 2015 seniors are making plans to pursue some form of higher education or technical skills training post-graduation. What was once and ending is now just the beginning of a story.

Here you can find a timeline and more information on the model, including details on the Women’s Resource Center, Communities in Schools and the Ironmen Health Center.