Issue Category: Public Health Funding

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

Join a panel of experts on May 29, at 2 PM ET, to discuss the nation’s readiness for public health emergencies, examine the key findings of TFAH’s 2024 report, and discuss recommendations for policymakers.

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

TFAH Celebrates National Public Health Week

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

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

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

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

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

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

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

New Report Measures States’ Emergency Preparedness and Recommends Policy Actions to Strengthen the Nation’s Public Health System and Emergency Preparedness

Special Section Examines Health Impacts of Extreme Heat and the Disproportionate Risks for Certain Population Groups

(Washington, DC – March 14, 2024) – Ready or Not 2024: Protecting the Public’s Health from Diseases, Disasters, and Bioterrorism, released today by Trust for America’s Health, identifies key gaps in national and state preparedness to protect residents’ health during emergencies and makes recommendations to strengthen the nation’s public health system and improve emergency readiness.

As the nation experiences an increasing number of infectious disease outbreaks and extreme weather events, the report found that while emergency preparedness has improved in some areas, policymakers not heeding the lessons of past emergencies, funding cuts, and health misinformation are putting decades of progress in public health preparedness at risk.

Based on nine indicators, the report tiers states, and the District of Columbia, into three readiness levels: high, middle, and low. This year’s report placed 21 states and DC in the high-performance tier, 13 states in the middle-performance tier, and 16 states in the low-performance tier.

High Tier – 21 states & DC

AL, AZ, CO, CT, DC, FL, GA, KS, MA, ME, MS, NC, NE, NJ, OH, PA, RI, SC, TN, VA, VT, WA

Middle Tier – 13 states

AR, DE, IA, ID, IL, MD, MO, MT, NH, NM, OK, UT, WI

Low Tier – 16 states

AK, CA, HI, IN, KY, LA, MI, MN, ND, NV, NY, OR, SD, TX, WV, WY

The report is designed to give policymakers actionable data and benchmarks to improve their jurisdiction’s readiness through new and sustained investment in public health infrastructure, modern data systems, a larger and more diverse public health workforce, and collaboration between public health and healthcare systems, and both systems’ ability to surge capacity in response to emergencies. Additional areas of responsibility for the public health system are enhancing vaccine access and monitoring municipal water systems safety.

“This report underscores the need for comprehensive investment in public health infrastructure and preparedness and highlights the importance of addressing the disproportionate effects of underinvestment in public health on communities of color and other groups that have been underserved or marginalized,” said Dr. J. Nadine Gracia, President and CEO of Trust for America’s Health. “Recent public health emergencies, from wildfires to infectious disease outbreaks, not only reveal the imperative for a modernized public health system they also highlight the intrinsic link between the overall health of a community and its ability to be resilient during an emergency. Focusing on eliminating health disparities, advancing health equity, and stemming the rise in chronic diseases is essential for enhancing the nation’s emergency preparedness.”

The report’s special section discusses the increasing health risks from extreme heat, including for particular population groups: people who live in under-resourced communities, people living in urban heat islands or without air conditioning, people who work outdoors, people with chronic diseases, pregnant individuals, infants, children, and older adults. In 2022, more people died in the U.S. due to extreme heat than from any other single type of weather event.

The report’s findings showed both areas of strength in the nation’s health emergency preparedness and areas that need attention.

Areas of strong performance include:

  • A majority of states have made preparations to expand healthcare and public health laboratory capacity in an emergency. As of the end of 2023, 39 states participate in the Nurse Licensure Compact, which helps facilitate emergency response efforts by allowing nurses to work in multiple member states, both in person and via telehealth, without the need for additional state licenses. Additionally, 46 states and the District of Columbia have written plans for the expansion of public health laboratory services during health emergencies.
  • Most states (43) and the District of Columbia are accredited in the areas of public health or emergency management, with many accredited in both.
  • A majority of states (at least 37) and the District of Columbia either maintained or increased their public health funding during fiscal year 2023. State investment in public health is particularly important because most federal funding in response to the COVID-19 pandemic was temporary, one-time funding.

Areas that need attention include:

  • Too few people are vaccinated against seasonal flu. During the 2022-2023 flu season, only 49 percent of the population (ages 6 months and older) was vaccinated against the flu, well short of the 70 percent goal established by Healthy People 2030. There is concern among public health experts that misinformation about the COVID-19 vaccine could be impacting the uptake of other vaccines.
  • On average, only 25 percent of acute care hospitals in states earned a top-quality patient safety grade in fall 2023. Hospital safety scores measure performance on issues such as healthcare-associated infection rates, intensive-care capacity, and an overall culture of error prevention – all critical for performing at their best during health emergencies.
  • On average, only 55 percent of U.S. workers used paid time off during the period from March 2018 to March 2023. Access to paid time off is an important readiness measure because workers who go to work sick risk spreading infections in the workforce and throughout the community.

Policy action is needed:

The report contains recommendations for policy actions across both public and private sectors that would create stronger public health preparedness, including:

  • Congress should enhance and modernize public health infrastructure by investing $4.5 billion per year to support foundational public health capabilities at the federal, state, tribal, local, and territorial levels, including investments in data systems and the public health workforce.
  • Congress should empower CDC to collect public health data in a timely and coordinated manner, and the U.S. Department of Health and Human Services (HHS) and all jurisdictions should ensure timely, complete, and disaggregated data collection and reporting. Together, these will enable faster and more effective detection and response to health emergencies.
  • Policymakers should prioritize rebuilding trust in public health agencies and leaders. Public health policy decisions should always be based on the best available science and free from political considerations, and federal agencies should be equipped to provide timely and clear public health guidance.
  • Congress should provide at least $1.1 billion per year to support vaccine infrastructure and equitable delivery of vaccines. States should minimize vaccine exemptions for schoolchildren, and healthcare facilities should increase vaccination rates among healthcare workers.
  • Congress should significantly increase investments in public health initiatives to prevent, detect, and contain antimicrobial resistance.
  • Congress and states should provide job-protected paid leave to contain the spread of outbreaks and protect health.
  • Congress should provide significant funding for medical countermeasures and should work with the private sector to plan for their distribution and dispensing when needed.
  • Congress, HHS, and healthcare leaders should strengthen healthcare readiness and recovery, and state and local emergency planners should work with the healthcare sector to integrate healthcare delivery into emergency preparedness and response.
  • Congress should increase investments in programs that identify and mitigate the health impacts of climate change, environmental hazards, and extreme weather.

Read the report

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

 

What If Congress Adequately Funded Public Health?

You know the old adage, ‘those that don’t learn from history are doomed to repeat it.’ Coming off the COVID-19 public health emergency that has thus far claimed the lives of 1.2 million Americans, there are discussions in Congress to significantly cut funding for public health initiatives to dangerously low levels – again. And it doesn’t have to be like this.

Why do we go through these bleak cycles when anchoring public health in policymaking is a win-win decision for everyone – from elected officials to individual constituents.

Federal public health funding is facing challenges on multiple fronts right now. Congress continues to negotiate appropriations bills for the 2024 fiscal year, which will have major implications for the next fiscal year and beyond. The current short-term funding agreement for Health and Human Services expires on March 22. If Congress passes another continuing resolution rather than new appropriations, it could trigger extreme, across-the-board cuts to non-defense spending.

First, continuing resolutions, which are short-term measures to fund the government at the previous year’s levels, negatively impact the systems we need to protect the nation’s health. And severe cuts triggered by failing to pass a long-term spending bill would be even more dangerous. TFAH has joined more 1,000 other organizations in urging Congress to pass a full-year funding bill using the bipartisan framework laid out in the Senate as a starting point for negotiations.

Secondly, the FY2024 bills proposed by the House and Senate for Labor, Health and Human Services, Education and Related Agencies – the main funding source for public health programs – are vastly different and neither addresses the chronic underfunding of public health. Congress has already rescinded hundreds of millions of dollars intended to shore up the public health workforce and readiness and response efforts. The Senate’s bill proposes a small cut to the Centers for Disease Control and Prevention (CDC), and the House version would cut about $1.6 billion from CDC’s budget. TFAH and partners have called for a $2.5 billion increase for CDC.

Finally, we continue to see proposals to cut the Prevention and Public Health Fund, a critical investment in programs ranging from immunizations to tobacco use prevention. If these proposals were to move forward, this would again push public health funding into the “bust” phase of a decades long “boom and bust” funding pattern.

The health, safety, and well-being of individuals and communities should be at the foundation of U.S. policy and be funded accordingly.

Imagine if we fully invested in the prevention of adverse childhood experiences, suicide, and substance misuse. Many communities would see suicide and overdose rates fall.

Imagine if we prevented the root causes of death, injury, and excess healthcare costs instead of spending trillions of dollars to treat preventable chronic conditions. Workers would be healthier and more productive, employers would face fewer financial burdens, and the nation would be more resilient and thriving.

Imagine if CDC, state, local, tribal, and territorial health departments had modern data systems instead of rudimentary spreadsheets to track the spread of diseases. This country could contain potential outbreaks in their earliest stages and save lives.

Much of our health and well-being is determined by economic, environmental, and societal factors. In the midst of a recent and troubling decrease in life expectancy, TFAH believes that investing in the foundations of public health and effective prevention programs is a critical and indispensable path forward to protecting and promoting the health of the nation.

 

 

 

 

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

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

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

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

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

“Listen to the full conversation”