“Get Healthy Philly” is an initiative of the Philadelphia Department of Public Health that brings together government agencies, community-based organizations, academia, and the private sector to address obesity and smoking in Philadelphia. The organization is making great strides toward a healthy Philly through actions including: designating nearly 12,000 acres of new smoke-free spaces; passing a $2 per pack tax increase on cigarettes; establishing school nutrition standards; menu labeling; and working with food retailers to promote healthy food sales. Accomplishments over the past four years include a 15 percent reduction in smoking among adults, a 30 percent reduction in smoking among youth, and a 5 percent reduction in childhood obesity. The initiative is supported by local, state, and federal funding, including the Centers for Disease Control and Prevention through the Prevention and Public Health Fund and the Pennsylvania Department of Health. To read more about this innovative program, see this brief summary [link].
Issue Category: Prevention and Public Health Policy
District of Columbia Healthy Communities Collaborative
DC Healthy Communities Collaborative—a collaborative of community health leaders and organizations—formed in 2012 to assess and address the community health needs in the Washington, D.C. area. The Collaborative works in four key areas identified as community health needs in the D.C. area: asthma, obesity, sexual health, and substance abuse/mental health. To date, the Collaborative has conducted a community health assessment identifying health needs within the D.C. area and produced a community health improvement plan with strategies to address the aforementioned health needs. D.C. Healthy Communities Collaborative is funded by member contributions. To read more about this innovative program, see this brief summary [link].
Dignity Health’s Community Health Investments
For more than 20 years, Dignity Health, a health care provider in multiple states, has been investing in the health of the communities it serves through community benefit programs and community economic initiatives, including grants and low-interest loans to nonprofits addressing community needs. Investments are targeted to populations with disproportionate unmet health needs as identified through the community health needs assessment and a Community Need Index developed by Dignity Health. Since 1990, Dignity Health has awarded more than $51 million in areas such as prevention, HIV/AIDS services, behavioral health services, and improving access to care. The Dignity Health Community Investment Program has had a total loan volume of $143 million, benefiting the community-based health programs of California, Nevada, and Arizona including: providing affordable housing for seniors; access to shelters for the homeless discharged from community hospitals; and healthy food projects. To read more about this innovative program, see this brief summary [link].
Dallas Information Exchange Portal
The Dallas Information Exchange Portal (IEP) is an electronic platform which enables health care providers, community based organizations, and social service agencies to share medical and social information via a secure network. Through patient-authorized, secure two-way exchange of information, IEP is improving care transitions and increasing coordination of care around both clinical and social issues like homelessness, hunger, and substance abuse. The ultimate goal of the program is not only to improve clinical outcomes and measures, but also generate significant cost savings to health systems. The initiative began in 2014 with a $12 million grant from the W.W. Caruth, Jr. Foundation at Communities Foundation of Texas. To read more about this innovative program, see this brief summary [link].
Cultivating Health for Success
Cultivating Health for Success (CHS) established in 2010, focuses on the inclusion of safe, affordable, and supportive housing to reduce unplanned care, improve adherence to recommended treatment, and improve health care cost and outcomes as well as quality of life for participants in greater Pittsburgh. CHS serves adults with one or more chronic illnesses and those with a history of at least one year of above average use of unplanned care, such as crisis services, Emergency Department visits, and the homeless. To deliver services, CHS partners with the Allegheny County Department of Human Services, Metro Family Practice, Community Human Services, UPMC for You, and the Community Care Behavioral Health Organization. Since CHS’s inception, per-member per-month (PMPM) medical costs have decreased 11.5 percent, the average PMPM for unplanned care has decreased by 19.2 percent, and the average prescription PMPM increased by 5.2 percent for participants with a meaningful tenure in the program. CHS is funded by UMPC for You contributions. To read more about this innovative program, see this brief summary [link].
Community Assessment Project
The Community Assessment Project (CAP) is a broad-based collaborative of the United Way of Santa Cruz County, California that jointly conducts community health needs assessments and publishes an annual countywide community indicators report. The report, first introduced 20 years ago, serves as the community health needs assessment for local nonprofit hospitals and includes indicators in six domains: economy, education, health, public safety, natural environment, and social environment. The CAP also conducts a bi-annual quality-of-life survey of the County’s households. A sampling of the goals in 2015 include: improvement in access to primary care; comprehensive health care coverage for children; and a decrease in the prevalence of childhood obesity. Annually, CAP measures and reports progress toward its goals. For example, in 2007, the Healthy Kids Insurance Program achieved 98 percent insurance coverage for children in Santa Cruz County. CAP is funded by local hospitals, city and county governments, utility companies, colleges, and non-profit organizations. To read more about this innovative program, see this brief summary [link].
Changing the Narrative About What Creates Health—Essential Steps in Improving Population Health in Minnesota
The goal of Changing the Narrative about What Creates Health— Essential Steps in Improving Population Health is to bring about critical change to effectively address the social determinants of health and achieve health equity. Launched in 2011 by the Minnesota Health Department, this initiative shifts the responsibility for health to a community level to address the conditions in which all people can be healthy through policy, systems, and environmental changes. Key strategies include: the creation of a Healthy Minnesota 2020 framework that engages partners in all sectors; community engagement via the Healthy Minnesota Partnership, establishment of cabinet-level committee on Health in All Policies; a State Health Improvement Program that outlines policy, systems, and environmental changes; and creation of Accountable Communities for Health. By focusing the narrative on what creates health (beyond the health system), community agencies and groups have become involved in health policies contributing to policy changes including: anti-bullying law; minimum wage increase; smoke-free campuses and apartments; and complete street ordinances. Minnesota has also shown decreasing rates of childhood obesity and youth tobacco use, and increasing rates of breastfeeding. This initiative is funded by State Health Department grants. To read more about this innovative program, see this brief summary [link].
TFAH Commends President Obama and Congressional Leadership for Securing the Bipartisan Budget Act of 2015
Washington, D.C., October 28, 2015 – The Trust for America’s Health (TFAH) commends President Obama and Congressional leadership for the Bipartisan Budget Act of 2015, and is pleased to announce its support for this legislation. The following is a statement from Jeffrey Levi, PhD, executive director of TFAH.
“This agreement is an important step toward ensuring the nation has adequate resources to help people be healthy, happy and productive. TFAH calls on Congress to pass the Bipartisan Budget Act.
By largely replacing sequestration’s harmful cuts—which forced historically low and grossly inadequate funding for critical public health programs—Congress is now able to increase investments in vital public health and other domestic programs that keep Americans healthy, safe, and secure.
TFAH recommends Congress use this funding to invest in programs that build a public health system that focuses on preventing disease in the first place by restoring funding to chronic disease programs—such as Partnerships to Improve Community Health, Racial and Ethnic Approaches to Community Health and Tips From Former Smokers—at the Centers for Disease Control and Prevention. These programs support proven strategies that prevent and control the development of numerous chronic diseases.
We also urge Congress to pass appropriations bills that do not include ideologically driven, partisan policy riders that could threaten the implementation of this historic deal.
Every American deserves to be healthy. By maintaining funding for the Prevention and Public Health Fund and passing this Act, the nation’s leaders will have finally signaled that they are serious about providing the support needed to keep Americans healthy and happy.”
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Trust for America’s Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority.
Trust for America’s Health Releases Letter Detailing Strong Opposition to the Reconciliation Instructions Proposed by the House Energy and Commerce Committee
Eliminating the Prevention and Public Health Fund—which has the support of more than 900 organizations—would set Public Health back by a Decade
Washington, D.C., September 29, 2015 – Trust for America’s Health (TFAH) released a letter detailing strong opposition to the Reconciliation Instructions proposed for consideration by the House Energy and Commerce Committee, stating that eliminating funding for the Prevention and Public Health Fund would set public health back by a decade.
The letter also notes that more than 900 state and national organizations have already pledged their support for the Prevention Fund and details the successes of the Fund.
The letter, in part, reads:
“In the first six years since its inception, the Prevention Fund has invested nearly $5.25 billion in resources to states, communities, tribal and community organizations in support of community-based prevention, including tobacco use prevention, healthy eating and active living, as well as childhood immunizations and clinical prevention. Decimating the Prevention Fund in this manner would dramatically impede efforts underway to improve health, including:
- The Preventive Health and Health Services Block Grant, which was doubled under the Prevention Fund and provides all 50 states, the District of Columbia, two American Indian tribes, and eight U.S. territories with flexible funding to address their unique public health issues at the state and community level.
- Expanding Access to Cancer Screenings: In FY 2015, the Fund provided $104 million for the National Breast and Cervical Cancer Early Detection Program, which is helping states across the country provide cancer screenings to high risk women who are uninsured or underinsured.
- The successful Tips from Former Smokers campaign, which in just its first three months inspired more than 1.6 million people to try to quit smoking, and more than 100,000 smokers have quit for good.
- Funding for the section 317 childhood immunization program, which has been vital to preventing and responding to measles outbreaks, and epidemiology and laboratory capacity in all states, which are key to preventing and containing infectious disease outbreaks.
“These are just a few examples of the work underway thanks to the Prevention Fund. Massively reducing the Fund would set back public health by a decade, and would slash life-saving investments in every state that are desperately needed. For example, chronic diseases such as cancer, diabetes, lung disease, heart disease, and stroke are now responsible for seven out of 10 deaths and account for 86 percent of health care spending in America. An approach to deficit reconciliation that cuts prevention may in fact have the opposite effect – less prevention of illness and disease and increased future health care spending.”
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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.
The Facts Hurt: A State-By-State Injury Prevention Policy Report
«state» had the «injury_rank_uc» Rate of Injury Deaths in U.S.
«state» scored «score_uc» out of 10 on Key Indicators of Steps States can take to Prevent Injuries
Washington, D.C., June 17, 2015 – In a new report, The Facts Hurt: A State-By-State Injury Prevention Policy Report, «state» ranked «injury_rank_lc» for the number of injury-related deaths in the state, with a rate of «injury_rate» per 100,000 people. Overall, the national rate is 58.4 per 100,000.
Rates in «state» «injury_delta» over the past four years for injury deaths, which includes drug overdoses, motor vehicle crashes, homicides and others. Overall, 17 states increased, 24 remained stable and 9 decreased. Injuries are the leading cause of death for Americans ages 1 to 44 – and are responsible for nearly 193,000 deaths per year.
Drug overdoses have become the leading cause of injury death in 36 states, «overdose_vehicle» «state», surpassing motor vehicle-related deaths.
Nationally, drug overdose deaths have more than doubled in the past 14 years – resulting in 44,000 deaths per year, and half of those deaths (22,000) are related to prescription drugs. «state» ranked «overdose_rank» for drug overdose deaths – at a rate of «overdose_rate» per 100,000 people.
«state» scored «score_lc» out of 10 on key indicators of steps states can take to prevent injuries – nationally, 29 states and Washington, D.C. scored a five or lower. New York received the highest score of nine out of a possible 10 points, while four states scored the lowest, Florida, Iowa, Missouri and Montana, with two out of 10 points.
| No. | Indicator | «state» | Number of States Receiving Points |
|---|---|---|---|
| A “Y” means the state received a point for that indicator | |||
| 1 | Seat Belts: Have primary seat belt laws Source: Governors Highway Safety Association |
«seat_belts» | 34 and Washington, D.C. |
| 2 | Drunk Driving: Mandatory ignition interlocks for all convicted drunk drivers, even first offenders Source: Governors Highway Safety Association |
«drunk_driving» | 21 |
| 3 | Booster Seats: Require booster seats up to at least the age of eight–Meeting American Academy of Pediatrics standards Source: Governors Highway Safety Association |
«booster_seats» | 35 and Washington, D.C. |
| 4 | Driver Licensing for Teens: Restricts teens from nighttime driving after 10 p.m. (Most states have a Graduated Drivers License with some time and passenger restrictions, but this indicator requires a10 pm restriction) Source: Governors Highway Safety Association |
«teen_license» | 11 |
| 5 | Bicycle Helmet Use: Requires bicycle helmets for all children Source: American Academy of Pediatrics |
«bicycle_helmets» | 21 and Washington, D.C. |
| 6 | Preventing Homicide: Homicide rate at or below national goal of 5.5 per 100,000 people (2011-2013 data) Source: Healthy People 2020 |
«low_homicide» | 31 |
| 7 | Child Abuse and Neglect: Rates at or below the National Rate of 9.1 per 1,000 Children (in 2013) Source: Administration of Children, Youth and Families Children’s Bureau |
«low_child_abuse» | 25 |
| 8 | Preventing Falls: Deaths from unintentional falls below national goal of 7.2 per 100,000 People (2011-2013 data) Source: Healthy People 2020 |
«low_falls» | 13 |
| 9 | Prescription Drug Monitoring Program (PDMP): State requires mandatory use of PDMP – to monitor for overprescribing or doctor shopping — by healthcare providers in at least some circumstances Source: PDMP Center for Excellence at Brandeis University |
«rx_monitoring» | 25 |
| 10 | Rescue Drug Laws: State law allows prescribing and access to naloxone – a drug used to counteract overdoses – for use by laypersons Source: Network for Public Health Law |
«naloxone_ed» | 34 and Washington, D.C. |
| Total | «score_uc» | ||
“Injuries are not just acts of fate. Research shows they are pretty predictable and preventable,” said Jeffrey Levi, PhD, executive director of TFAH. “This report illustrates how evidence-based strategies can actually help prevent and reduce motor vehicle crashes, head injuries, fires, falls, homicide, suicide, assaults, sexual violence, child abuse, drug misuse, overdoses and more. It’s not rocket science, but it does require common sense and investment in good public health practice.”
Some key findings include:
- Drug abuse: More than 2 million Americans misuse prescription drugs. The prescription drug epidemic is also contributing to an increase in heroin use; the number of new heroin users has doubled in the past seven years.
- Motor vehicle deaths: Rates have declined 25 percent in the past decade (to 33,000 per year).
- Homicides: Rates have dropped 42 percent in the past 20 years (to 16,000 per year). The rate of Black male youth (ages 10 to 24) homicide victims is 10 times higher than for the overall population. One in three female homicide victims is killed by an intimate partner.
- Suicides: Rates have remained stable for the past 20 years (41,000 per year). More than one million adults attempt suicide and 17 percent of teens seriously consider suicide each year. Seventy percent of suicides deaths are among White males.
- Falls: One in three Americans over the age of 64 experiences a serious fall each year, falls are the most common nonfatal injuries, and the number of fall injuries and deaths are expected to increase as the Baby Boomer cohort ages.
- Traumatic brain injuries (TBIs): from sports/recreation among children and youths have increased by 60 percent in the past decade.
Score Summary:
A full list of all of the indicators and scores, listed below, is available along with the full report on TFAH’s web site at www.healthyamericans.org. For the state-by-state scoring, states received one point for achieving an indicator or zero points if they did not achieve the indicator. Zero is the lowest possible overall score, 10 is the highest.
9 out of 10: New York
8 out of 10: Delaware
7 out of 10: California, New Jersey, North Carolina, Tennessee, Washington and West Virginia
6 out of 10: Alaska, Colorado, Hawaii, Indiana, Kentucky, Louisiana, Maine, Minnesota, Nevada, New Mexico, Oregon, Rhode Island and Virginia
5 out of 10: Alabama, Arkansas, Connecticut, Georgia, Illinois, Kansas, Massachusetts, Oklahoma, Utah, Vermont and Wisconsin
4 out of 10: Arizona, District of Columbia, Idaho, Maryland, Michigan, Mississippi, New Hampshire, North Dakota and Pennsylvania
3 out of 10: Nebraska, Ohio, South Carolina, South Dakota, Texas and Wyoming
2 out of 10: Florida, Iowa, Missouri and Montana
The 10 indicators include:
- Does the state have a primary seat belt law? (34 states and Washington, D.C. meet the indicator and 16 states do not.)
- Does the state require mandatory ignition interlocks for all convicted drunk drivers, even first-time offenders? (21 states meet the indicator and 29 states and Washington, D.C. do not.)
- Does the state require car seats or booster seats for children up to at least the age of 8? (35 states and Washington, D.C. meet the indicator and 15 do not.)
- Does the state have Graduated Driver Licensing laws – restricting driving for teens starting at 10 pm? (11 states meet the indicator and 39 states and Washington, D.C. do not. Note a number of other states have restrictions starting at 11 pm or 12 pm.)
- Does the state require bicycle helmets for all children? (21 states and Washington, D.C. meet the indicator and 29 states do not.)
- Does the state have fewer homicides than the national goal of 5.5 per 100,000 people established by the U.S. Department of Health and Human Services (HHS) (2011-2013 data)? (31 states meet the indicator and 19 states and Washington, D.C. do not.)
- Does the state have a child abuse and neglect victimization rate at or below the national rate of 9.1 per 1,000 children (2013 data)? (25 states meet the indicator and 25 states and Washington, D.C. do not.)
- Does the state have fewer deaths from unintentional falls than the national goal of 7.2 per 100,000 people established by HHS (2011-2013 data)? (13 states meet the indicator and 37 states and Washington, D.C. do not.)
- Does the state require mandatory use of data from the prescription drug monitoring program by at least some healthcare providers? (25 states meet the indicator and 25 states and Washington, D.C. do not.)
- Does the state have laws in place to expand access to, and use of, naloxone, an overdose rescue drug by laypersons? (34 states and D.C. meet the indicator and 16 states do not.)
State-by-State Injury Death Rankings
Note: Rates include all injury deaths for all ages for injuries caused by injuries and violence (intentional and unintentional). They are based on a methodology used to compare rates across all states – including using three-year averages of the most recent data (2011-2013). National data sources may differ from how some states calculate their data (because of use of different time frames, inclusion/exclusions, etc.). 1 = Highest rate of injury fatalities, 51 = lowest rate of injury fatalities. The 2011-2013 data are from the U.S. Centers for Disease Control and Prevention‘s Web-based Injury Statistics Query and Reporting System — age-adjusted using the year 2000 to standardize the data. This methodology, recommended by the CDC, compensates for any potential anomalies or unusual changes due to the specific sample in any given year in any given state. States with statistically significant (p<0.05) increases since 2007-2009 are noted with an asterisk (*), while states with a statistically significant decrease are noted with two asterisks (**).
1. West Virginia (97.9*); 2. New Mexico (92.7**); 3. Oklahoma (88.4*); 4. Montana (85.1); 5. Wyoming (84.6); 6. Alaska (83.5); 7. Kentucky (81.7*); 8. Mississippi (81.0); 9. Tennessee (76.7); 10. Arkansas (75.3); 11. Louisiana (75.3**); 12. Arizona (73.4); 13. Alabama (73.3); 14. Utah (72.8*); 15. Missouri (72.4); 16. Colorado (70.7); 17. South Carolina (69.9); 18. Idaho (69.1); 19. (tie) Nevada (67.1**) and South Dakota (67.1*); 21. Vermont (66.0); 22. Kansas (65.0*); 23. Pennsylvania (64.3*); 24. Ohio (63.9*); 25. Indiana (63.7*); 26. North Carolina (62.1**); 27. Wisconsin (62.0*); 28. Oregon (61.8); 29. Florida (61.3**); 30. Michigan (60.6*); 31. Maine (60.1); 32. Delaware (60.0); 33. North Dakota (59.3); 34. Rhode Island (58.6*); 35. Georgia (58.1**); 36. Washington (57.1); 37. New Hampshire (56.6*); 38. Iowa (56.4*); 39. Texas (55.3**); 40. Minnesota (54.9*); 41. District of Columbia (53.7); 42. Maryland (53.4**); 43. Nebraska (52.5); 44. Virginia (52.0); 45. Illinois (50.0); 46. Connecticut (49.6); 47. Hawaii (48.8); 48. California (44.6**); 49. New Jersey (44.0*); 50. Massachusetts (42.9); 51. New York (40.3*).
State-by-State Drug Overdose Death Rankings
Note: Rates include drug overdose deaths, for 2011-2013, a three-year average. 1 = Highest rate of drug overdose fatalities, 51 = lowest rate of drug overdose fatalities. States with statistically significant (p<0.05) increases since 2007-2009 are noted with an asterisk (*), while states with a statistically significant decrease are noted with two asterisks (**). States with a § have an overdose death rate higher than the state‘s overall motor vehicle mortality rate for 2011 to 2013.
1. West Virginia (33.5*§); 2. (tie) Kentucky (24.6*§) and New Mexico (24.6§); 4. Nevada (21.6*§); 5. Utah (21.5§); 6. Oklahoma (20.0§); 7. Rhode Island (19.4*§); 8. Ohio (19.2*§); 9. Pennsylvania (18.9§); 10. Arizona (17.8*§); 11. Tennessee (17.7*§); 12. Delaware (17.1*§); 13. Wyoming (16.4*); 14. Missouri (16.2*§); 15. Indiana (16.0*§); 16. Colorado (15.5§); 17. Alaska (15.3§); 18. (tie) Michigan (14.6§) and New Hampshire (14.6§); 20. Louisiana (14.5§); 21. (tie) District of Columbia (13.8*§) and Massachusetts (13.8§); 23. (tie) Florida (13.7**§) and Washington (13.7**§); 25. Montana (13.6); 26. Maryland (13.3*§); 27. (tie) New Jersey (13.2*§) and North Carolina (13.2*§); 29. (tie) Connecticut (13.1*§) and Wisconsin (13.1*§); 31. Vermont (13.0§); 32. South Carolina (12.9§); 33. Idaho (12.7*); 34. Oregon (12.4§); 35. Arkansas (12.3**); 36. (tie) Alabama (12.2**) and Maine (12.2**§); 38. Illinois (11.8*§); 39. Hawaii (11.4*§); 40. Kansas (11.2); 41. (tie) California (10.7*§) and Georgia (10.7*) and Mississippi (10.7); 44. New York (10.4*§); 45. (tie) Texas (9.6) and Virginia (9.6*); 47. Minnesota (9.3*§); 48. Iowa (8.8*); 49. Nebraska (7.2*); 50. South Dakota (6.5); 51. North Dakota (2.6**).
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. www.healthyamericans.org
For more than 40 years the Robert Wood Johnson Foundation has worked to improve health and health care. We are striving to build a national Culture of Health that will enable all to live longer, healthier lives now and for generations to come. For more information, visit www.rwjf.org. Follow the Foundation on Twitter at www.rwjf.org/twitter or on Facebook at www.rwjf.org/facebook.
The Safe States Alliance is a national, non-profit organization and professional association whose mission is to strengthen the practice of injury and violence prevention.
SAVIR is a national professional organization dedicated to fostering excellence in the science of preventing and treating violence and injury. Our vision is a safer world through violence and injury research and its application to practice.