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].
Issue Category: Prevention and Public Health Policy
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.
Addressing the Social Determinants of Health Inequities Among Gay Men & Men Who Have Sex With Men
Prescription Drug Abuse: Strategies to Stop the Epidemic
«state» has the «rank_2010» Drug Overdose Mortality Rate in the United States
«state» Scored «total_score» out of 10 on New Policy Report Card of Promising Strategies to Help Curb Prescription Drug Abuse
Washington, D.C. October 7, 2013 – «state» has the «lrank_2010» drug overdose mortality rate in the United States, with «rate_2010» per 100,000 people suffering drug overdose fatalities, according to a new report, Prescription Drug Abuse: Strategies to Stop the Epidemic.
The number of drug overdose deaths – a majority of which are from prescription drugs – «od_death_change_desc» have doubled in 29 states since 1999, quadrupled in four of these states and tripled in 10 more.
The report also finds that «state» received «l_total_score» out of 10 possible indicators of promising strategies to help curb prescription drug abuse. Nationally, 28 states and Washington, D.C. scored six or less, with New Mexico and Vermont scoring the highest, with a 10, and South Dakota scoring the lowest with two out of 10.
According to the report by the Trust for America’s Health (TFAH), prescription drug abuse has quickly become a top public health concern, as prescription drug related deaths now outnumber those from heroin and cocaine combined, and drug overdose deaths exceed motor vehicle-related deaths in 29 states«do_gt_mv_2010» and Washington, D.C. Misuse and abuse of prescription painkillers alone costs the country an estimated $53.4 billion a year in lost productivity, medical costs and criminal justice costs. The report also notes that, currently, only one in 10 Americans with a substance abuse disorder receives treatment.
“Prescription drugs can be a miracle for many, but misuse can have dire consequences. The rapid rise of abuse requires nothing short of a full-scale response – starting with prevention and education all the way through to expanding and modernizing treatment,” said Jeffrey Levi, PhD, executive director of TFAH. “There are many promising signs that we can turn this around – but it requires urgent action.”
In the Prescription Drug Abuse report, TFAH – in consultation with a number of public health, clinical, injury prevention, law enforcement and community organization experts – reviewed a range of national recommendations and examined a set of 10 indicators of strategies being used in states to help curb the epidemic. There are indications that some of these efforts and strategies may be having a positive impact – the number of Americans abusing prescription drugs decreased from 7 million in 2010 to 6.1 in 2011, according to the National Survey on Drug Use and Health.
Some key «state» findings from the report include:
| No. | Indicator | Number of States Receiving Points | |
|---|---|---|---|
| A “Y” means the state received a point for that indicator | |||
| 1 | Existence of Prescription Drug Monitoring Program (PDMP): Has an active program |
«key_1» |
49 |
| 2 | PDMP: Requires mandatory utilization by prescribers |
«key_2» |
16 |
| 3 | Doctor Shopping Laws: Has a law specifying that patients are prohibited from withholding information about prior prescriptions from their healthcare provider |
«key_3» |
50 and Washington, D.C. |
| 4 | Support for Substance Abuse Treatment Services: Participating in Medicaid Expansion, which helps expand coverage of substance abuse services and treatment |
«key_4» |
24 and Washington, D.C. |
| 5 | Prescriber Education Required or Recommended |
«key_5» |
22 |
| 6 | Good Samaritan Laws: Has a law to provide a degree of immunity or mitigation of sentencing for individuals seeking to help themselves or others experiencing an overdose |
«key_6» |
17 and Washington, D.C. |
| 7 | Rescue Drug Laws: Has a law to expand access to, and use of naloxone, a prescription drug that can help counteract an overdose, by laypeople |
«key_7» |
17 and Washington, D.C. |
| 8 | Physical Exam Requirement: Has a law requiring healthcare providers to physically examine patients or have a bona fide patient-physician relationship before prescribing a controlled substance |
«key_8» |
44 and Washington, D.C. |
| 9 | ID Requirement: Has a law requiring or permitting a pharmacist to require an ID prior to dispensing a controlled substance |
«key_9» |
32 |
| 10 | Lock-In Programs: Has a pharmacy lock-in program under the state’s Medicaid plan where individuals suspected of misusing controlled substances must use a single prescriber and pharmacy |
«key_10» |
46 and Washington, D.C. |
| Total | «total_score» | ||
“Fifty Americans die a day from prescription drug overdoses, and more than 6 million suffer from prescription drug abuse disorders. This is a very real epidemic – and warrants a strong public health response,” said Andrea Gielen, ScD, Director of the Johns Hopkins Center for Injury Research and Policy. “We must use the best lessons we know from other public health and injury prevention success stories to work in partnership with clinical care, law enforcement, the business community, community-based organizations, and other partners to work together to curb this crisis.”
Key recommendations from the report include:
- Educate the public to understand the risks of prescription drug use to avoid misuse in the first place;
- Ensure responsible prescribing practices, including increasing education of healthcare providers and prescribers to better understand how medications can be misused and to identify patients in need of treatment;
- Increase understanding about safe storage of medication and proper disposal of unused medications, such as through “take back” programs;
- Make sure patients do receive the pain and other medications they need, and that patients have access to safe and effective drugs;
- Improve, modernize and fully-fund Prescription Drug Monitoring Programs, so they are real-time, interstate and incorporated into Electronic Health Records, to quickly identify patients in need of treatment and connect them with appropriate care and identify doctor shoppers and problem prescribers;
- Make rescue medications more widely available by increasing access for at-risk individuals to naloxone and provide immunity for individuals and others seeking help; and
- Expand access to and availability of effective treatment options as a key component of any strategy to combat prescription drug abuse.
According to the Centers for Disease Control and Prevention (CDC), nationally, sales of prescription painkillers per capita have quadrupled since 1999 – and the number of fatal poisonings due to prescription painkillers has also quadrupled. Enough prescription painkillers were prescribed in 2010 to medicate every American adult continually for a month.
“The release of the prescription drug abuse report by the Trust for America’s Health represents a significant step forward in elevating public awareness of the state of prescription drug abuse in the US”, according to Ginny Ehrlich, CEO of Clinton Health Matters Initiative (CHMI). “We are proud that the Trust has completed this important research as part of its CHMI Commitment to Action and congratulate the Trust on continuing to advocate for innovation and action towards addressing this public epidemic.”
The report was supported by a grant from the Robert Wood Johnson Foundation.
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 and RWJF’s web site at www.rwjf.org/RxReport. 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. Data for the indicators were drawn from a number of sources, including the National Alliance for Model State Drug Laws, NCIPC, Centers for Disease Control and Prevention, the Alliance of States with Prescription Drug Monitoring Programs, the National Conference of State Legislators, the Network for Public Health Law, the Kaiser Family Foundation and a review of current state legislation and regulations by TFAH. In August 2013, state health departments were provided with opportunity to review and revise their information.
10 out of 10: New Mexico and Vermont
9 out of 10: Kentucky, Massachusetts, New York and Washington
8 out of 10: California, Colorado, Connecticut, Delaware, Illinois, Minnesota, North Carolina, Oklahoma, Oregon, Rhode Island and West Virginia
7 out of 10: Florida, Nevada, New Jersey, Tennessee and Virginia
6 out of 10: Arkansas, District of Columbia, Georgia, Hawaii, Iowa, Louisiana, Maryland, Michigan, North Dakota, Ohio, Texas and Utah
5 out of 10: Alaska, Idaho, Indiana, Maine, Mississippi, Montana, New Hampshire and South Carolina
4 out of 10: Alabama, Arizona, Kansas, Pennsylvania, Wisconsin and Wyoming
3 out of 10: Missouri and Nebraska
2 out of 10: South Dakota
STATE-BY-STATE DRUG OVERDOSE MORTALITY RANKINGS
Note: Rates include total drug overdose mortality rates, the majority of which are from prescription drugs. 1 = Highest rate of drug overdose fatalities,51 = lowest rate of drug overdose fatalities. Rankings are based on data from CDC’s National Center for Health Statistics, WONDER Online Database, 2010.The numbers are based on the number of people per 100,000.
1. West Virginia**** (28.9); 2. New Mexico (23.8); 3. Kentucky**** (23.6); 4. Nevada (20.7); 5. Oklahoma*** (19.4); 6. Arizona (17.5); 7. Missouri*** (17); 8. (tie) Tennessee** and Utah (16.9); 10. Delaware** (16.6); 11. Florida** (16.4); 12. Ohio*** (16.1); 13. Rhode Island** (15.5); 14. Pennsylvania (15.3); 15. Wyoming*** (15); 16. South Carolina*** (14.6); 17. Indiana**** (14.4); 18. Michigan*** (13.9); 19. Louisiana*** (13.2); 20. Washington (13.1); 21. (tie) District of Columbia and Montana** and Oregon** (12.9); 24. Colorado (12.7); 25. Arkansas** (12.5); 26. (tie) Alabama*** and Idaho** and New Hampshire** (11.8); 29. Alaska (11.6); 30. (tie) Mississippi***and North Carolina** (11.4); 32. (tie) Maryland and Massachusetts (11); 34. (tie) Hawaii and Wisconsin** (10.9); 36. Georgia*** (10.7); 37. California (10.6); 38. Maine (10.4); 39. Connecticut (10.1); 40. Illinois (10); 41. New Jersey (9.8); 42. Vermont** (9.7); 43. (tie) Kansas** and Texas (9.6); 45. Iowa**** (8.6); 46. New York (7.8); 47. Minnesota** (7.3); 48. Virginia (6.8); 49. Nebraska** (6.7); 50. South Dakota (6.3); 51. North Dakota (3.4).
** Drug Overdose Mortality Rates doubled from 1999 to 2010
*** Drug Overdose Mortality Rates tripled from 1999 to 2010
**** Drug Overdose Mortality Rates quadrupled from 1999 to 2010
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. For more information, visit www.healthyamericans.org.
The Facts Hurt
«States» had the «capital_ranking» Rate of Injury Deaths in U.S.;
«States» scored a «capital_score» out of Ten on Key Indicators of Steps States can take to Prevent Injuries
Washington, D.C., May 22, 2012 (Scores were revised January 3, 2013 to reflect changes in seven state laws) – «States» had the «lower_ranking» rate of adult injury-related deaths for Americans with «rate» per 100,000 people suffering injury fatalities. Overall, the national rate is 57.9 per 100,000. The total lifetime medical costs due to fatal injury in «States» were «medical_costs».
The Facts Hurt report, released by the Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF), concludes that millions of injuries could be prevented each year if more states adopted additional research-based injury prevention policies, and if programs were fully implemented and enforced. TFAH and RWJF worked with a committee of top injury prevention experts from the Safe States Alliance and the Society for the Advancement of Violence and Injury Prevention (SAVIR) to develop a set of indicators of leading evidence-based strategies that have been shown to reduce injuries and save lives.
«States» scored «total_score» out of 10 on key indicators of steps states can take to prevent injuries – nationally, 21 states scored a five or lower. Two states, California and New York, received the highest score of nine out of a possible 10, while Montana scored the lowest with two out of 10.
| No. | Indicator | «States» | 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_blets» | 32 and Washington, D.C. |
| 2 | Drunk Driving: Mandatory ignition interlocks for all convicted drunk drivers, even first offenders. Sources: Governors Highway Safety Association |
«drunk_driving» | 17 |
| 3 | Motorcycle Helmets: Universal helmet law requiring helmets for all riders. Source: Governors Highway Safety Association |
«motorcycle» | 19 and Washington, D.C. |
| 4 | Booster Seats: Meet AAP standards — require booster seats to at least the age of eight. Source: AAP 2011 State Legislation Report |
«boost_seaters» | 33 and Washington, D.C. |
| 5 | Bicycle Helmet Use: Require bicycle helmets for all children. Source: American Academy of Pediatrics, 2011 State Legislation Report |
«bicycle_helmets» | 21 and Washington, D.C. |
| 6 | Intimate Partner Violence: Allow people in dating relationships to get protection orders. Source: Break the Cycle, 2010 Survey of Teen Dating Violence Laws |
«intimate_partner_violence» | 44 and Washington, D.C. |
| 7 | Teen Dating Violence: Receive an “A” in the Break the Cycle Report. Source: Break the Cycle, 2010 Survey of Teen Dating Violence Laws |
«teen_dating_violence» | 6 and Washington, D.C. |
| 8 | Concussions: Have a strong concussion law. Source: Momsteam.com and the Network for Public Health Law |
«concussions» | 43 and Washington, D.C. |
| 9 | Accidental Prescription Drug Overdose or Use: Have active prescription drug monitoring program. Source: Alliance of States with Prescription Monitoring Programs |
«prescription_drug» | 49 |
| 10 | Ecodes: More than 90 percent of injury discharges of patients of emergency departments received external cause of injury codes, which help researchers track trends and develop prevention strategies. Source: HCUP E Code Evaluation Addendum – Updated Information for 2009, Agency for Healthcare Research and Quality |
«ecodes» | 23 |
| Total | «score_numeric» | ||
Injuries – including those caused by accidents and violence – are the third leading cause of death nationally, and they are the leading cause of death for Americans between the ages of one and 44.
Approximately 50 million Americans are medically treated for injuries each year, and more than 2.8 million are hospitalized. Nearly 12,000 children and teens die from injuries resulting from accidents each year and around 9.2 million are treated in emergency rooms. Every year, injuries generate $406 billion in lifetime costs for medical care and lost productivity.
“There are proven, evidence-based strategies that can spare millions of Americans from injuries each year,” said Jeff Levi, PhD, Executive Director of TFAH. “This report focuses on specific, scientifically supported steps we can take to make it easier for Americans to keep themselves and their families safer.”
The report found that many injury prevention activities have been scientifically shown to reduce harm and deaths, for instance:
- Seat belts saved an estimated 69,000 lives from 2006 to 2010;
- Motorcycle helmets saved an estimated 8,000 lives from 2005 to 2009;
- Child safety seats saved around 1,800 lives from 2005 to 2009;
- The number of children and teens killed in motor vehicle crashes dropped 41 percent from 2000 to 2009; and
- School-based programs to prevent violence have cut violent behavior among high school students by 29 percent.
The report also identified a set of emerging new injury threats, including a dramatic, fast rise in prescription drug abuse, concussions in school sports, bullying, crashes from texting while driving and an expected increase in the number in falls as the Baby Boomer generation ages.
“Seat belts, helmets, drunk driving laws and a range of other strong prevention policies and initiatives are reducing injury rates around the country,” said Amber Williams, Executive Director of the Safe States Alliance. “However, we could dramatically bring down rates of injuries from motor vehicles, assaults, falls, fires and a range of other risks even more if more states adopted, enforced and implemented proven policies. Lack of national capacity and funding are major barriers to states adopting these and other policies.”
“While tremendous progress has been made in preventing and treating injury, it remains a leading cause of death for people of all ages and the number one cause of death for children,” said Dr. Andrea Gielen, ScD, Past President, SAVIR, and Director, Johns Hopkins Center for Injury Research and Policy. “Texting while driving, the increasing numbers of falls in older adults, domestic violence and the astonishing rise in misuse of prescription drugs mean we need to redouble our efforts to make safety research and policy a national priority.”
The report was supported by a grant from the Robert Wood Johnson Foundation and is available on TFAH’s website at www.healthyamericans.org.
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 and RWJF’s Web site at www.rwjf.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. The data for the indicators are from a number of sources, including: the Governors Highway Safety Association; the American Academy of Pediatrics; Break the Cycle; the Network for Public Health Law; momsTeam.com; the Alliance of States with Prescription Drug Monitoring Programs; and the Agency for Healthcare Research and Quality.
9 out of 10: California and New York
8 out of 10: Hawaii, Maryland, North Carolina, Oregon, Rhode Island and Washington
7 out of 10: Connecticut, Washington, D.C., Illinois, Kansas, Louisiana, Maine, Massachusetts, New Jersey, New Mexico and Tennessee
6 out of 10: Alabama, Alaska, Arizona, Delaware, Florida, Georgia, Missouri, Nebraska, New Hampshire, Vermont, Virginia and Wisconsin
5 out of 10: Arkansas, Colorado, Indiana, Iowa, Michigan, Minnesota, Oklahoma, Pennsylvania, Texas, Utah and West Virginia
4 out of 10: Mississippi and Nevada
3 out of 10: Idaho, Kentucky, North Dakota, Ohio, South Carolina, South Dakota and Wyoming
2 out of 10: Montana
STATE-BY-STATE INJURY DEATH RANKINGS
Note: Rates include all injury deaths for all ages, for injuries caused by accidents and violence (intentional and unintentional) 1 = Highest rate of injury fatalities, 51 = lowest rate of injury fatalities. Rankings are based on combining three years of data (2007-2009) from the U.S. Centers for Disease Control and Prevention’s Web-based Injury Statistics Query and Reporting System to “stabilize” data for comparison purposes. The data are age-adjusted using the year 2000 to standardize the data. This methodology, recommended by the CDC, compensates for any potential anomalies or usual changes due to the specific sample in any given year in any given state. The numbers are based on how many deaths per 100,000.
1. New Mexico (97.8); 2. Montana (86.5); 3. Alaska (85.8); 4. Wyoming (84.7); 5. Mississippi (84.3); 6. Oklahoma (83); 7. West Virginia (82.2); 8. Louisiana (80.1); 9. Arkansas (76.9) 10. (tie) Alabama and Kentucky (76.5); 12. Tennessee (75.6); 13. South Carolina (71.7); 14. Nevada (71.3); 15. Arizona (70.7); 16. Missouri (70.2); 17. Colorado (67.8); 18. Florida (66.8); 19. North Carolina (66); 20. Idaho (65.3); 21. Utah (64.8); 22. Georgia (61.4); 23. Vermont (61.3); 24. Oregon (61.2); 25. North Dakota (61.6); 26. South Dakota (60.7); 27. (tie) Indiana and Kansas (60.4); 29. Washington, D.C. (60.2); 30. Pennsylvania (59.4); 31. (tie) Maine and Wisconsin (58.7); 33. Texas (58.5); 34. Washington (58.1); 35. Delaware (56.9); 36. Michigan (56.8); 37. Maryland (56.1); 38. Ohio (55.9); 39. Virginia (53.4); 40. Iowa (52.5); 41. Nebraska (51.3); 42. Minnesota (51.2); 43. Rhode Island (50.4); 44. New Hampshire (50); 45. Illinois (48.7); 46. Hawaii (48.3); 47. Connecticut (47.9); 48. California (47.6); 49. Massachusetts (41.1); 50. New York (37.1); New Jersey (36.1).
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
The Robert Wood Johnson Foundation focuses on the pressing health and health care issues facing our country. As the nation’s largest philanthropy devoted exclusively to improving the health and health care of all Americans, the Foundation works with a diverse group of organizations and individuals to identify solutions and achieve comprehensive, meaningful and timely change. For more than 35 years the Foundation has brought experience, commitment, and a rigorous, balanced approach to the problems that affect the health and health care of those it serves. Helping Americans lead healthier lives and get the care they need – the Foundation expects to make a difference in our lifetime. For more information, visit www.rwjf.org.
The Safe States Alliance is a national, non-profit organization and professional association whose mission is to serve as the national voice in support of state and local injury and violence prevention professionals engaged in building a safer, healthier America.
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.