Issue Category: Public Health Preparedness

TFAH Releases “The Truth about the Prevention Fund”

June 6, 2013

Washington, DC, June 6, 2013 – Trust for America’s Health (TFAH), today, released a new report of key facts about the Prevention and Public Health Fund, which was created by the Affordable Care Act (ACA).

The Truth about the Prevention Fund includes an overview of the Fund, which is the nation’s largest single investment in prevention, using evidence-based and innovative partnership approaches to improve the health of Americans.  The Fund provides more than $14.5 billion in mandatory appropriations over 10 years to improve health and prevent chronic illnesses by expanding preventive care and supporting proven community-based programs that reduce obesity, tobacco use and other preventable conditions.

Currently, more than half of Americans suffer from chronic diseases, such as type 2 diabetes and heart disease.  Two thirds of Americans are currently obese or overweight and nearly 20 percent of Americans smoke.  Obesity costs the country $147 billion and tobacco use $96 billion in direct healthcare costs each year.  A 2012 TFAH study found that if obesity rates continue on their current trajectory, half of Americans could be obese by 2030, and the rise in obesity-related healthcare costs could reach between $196 billion and $213 billion in direct medical costs.

“Today’s kids could become the first in American history to live shorter, less healthy lives than their parents,” said Jeffrey Levi, PhD, executive director of TFAH.  “We can resign our kids to that fate – or invest in proven, effective programs to reduce obesity, tobacco use and the prevalence of preventable chronic conditions.  The Prevention Fund is the best and most targeted effort the nation has made toward getting the health of this country back on track.”

The Prevention Fund invests in programs that are proven and effective.  Oversight and evaluation is a key component of every Fund-sponsored program, and strict performance measures ensure accountability before federal dollars are spent.   The Fund supports community-driven prevention efforts targeted at reducing tobacco use, increasing physical activity, improving nutrition, expanding mental health and injury prevention programs and improving prevention activities.

For instance, for one component of the Fund – the Community Transformation Grants (CTGs) – grantees are required within five years to reduce by 5 percent death and disability due to tobacco use; the rate of obesity (through nutrition and physical activity approaches); and death and disability due to heart disease and stroke.  States and local communities have the flexibility to decide what problems are most pressing for them to address and decide which approaches to use as long as they are evidence based.  All grantees are expressly forbidden from using any funds for lobbying.  U.S. Centers for Disease Control and Prevention (CDC) has initiated extra controls to ensure grantees are restricted from ever using funds on prohibited lobbying activities and has mechanisms in place to identify any violations.  No such violations have been confirmed.

“Obesity, tobacco-use and other preventable health problems are crippling this nation.  The Prevention Fund provides states and communities with the flexibility to address their most pressing health challenges. We will never be successful unless we invest in programs and approaches we know work,” said Levi.

The full report also profiles examples of how communities are effectively using Prevention Fund support – The Truth about the Prevention Fund is available on TFAH’s web site.

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

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Examples of CTG Efforts in Communities:

  • West Virginia is supporting local health departments to address top challenges facing their community and develop solutions.  The West Virginia Department of Health is using CTG support to help local health departments in every county in the state implement targeted initiatives including:  safe places in communities to work and play, Farm-to-School Initiatives to improve nutrition in school settings, Child and Day Care Center Nutrition Programs to educate and empower children to choose healthy lifestyles through physical activity and healthy food choices, and community coordinated care systems that link and build referral networks between the clinical system and community-based lifestyle programs so people can manage their health.

  • Oklahoma is using a CTG to work with a range of sectors to make healthier choices easier in the state.  Nearly 70 percent of Oklahoma County’s premature deaths are largely preventable, arising from an unhealthy lifestyle, poor diet or the use of tobacco, alcohol or other substances.  The county spends about $920 million every year to treat chronic disease. In September 2011, Oklahoma City was awarded a $3.5 million CTG.  Using a portion of those funds, the Oklahoma City-County Health Department (OCCHD) expanded the use of community health workers to ensure more people access the “My Heart, My Health, My Family” program, which provides prevention programs and services, specifically focused on cardiovascular disease.  The program includes lesson plans on healthy living (e.g. portion control and the benefits of substituting water for sugar sweetened beverages) and participants receive access to free regular clinical checkups four times a year and free medication. The CTG money will also support other obesity-specific initiatives, including expanded walking and biking trails, a push to help schools offer healthy menu options and a physical education coordinator for city schools.

  • An Accountable Care Community (ACC) in Akron, Ohio – a CTG recipient – has brought together 70 community partners to coordinate healthcare and support inside and outside the doctor’s office for patients with type 2 diabetes.  In just 18 months, the ACC has reduced the average cost per month of care for individuals with type 2 diabetes by more than 10 percent per month with an estimated program savings of $3,185 per person per year. This initiative also led to a decrease in diabetes-related emergency department visits.
  • The Iowa Department of Public Health (IDPH) is providing local communities with resources to better address obesity and other health risk factors.  Utilizing a $3 million/year CTG, one key element is the Iowa Community Referral Project. The project will help ensure Iowans follow through with healthy lifestyle behaviors as a result of referral system changes between health providers and community agencies. The two components of the project include 1) A partnership with the Iowa Primary Care Association (IPCA) and selected communities where intensive training and technical assistance are provided to promote a seamless referral system, and 2) Implementation of local referral projects in the Iowa CTG intervention counties.
  • A CTG awarded to Broward Regional Health Planning Council’s Transforming Our Community’s Health (TOUCH) initiative is serving 1.7 million residents of Broward County, Florida to improve health, including by working with a range of partners to alleviate childhood obesity.  TOUCH has brought together community-based organizations, multidisciplinary strategies and diverse communities to address the most recognizable factors contributing to childhood obesity.  It is anticipated that these system, environmental and policy enhancements will positively impact the health, well-being and longevity of children.
  • Additional highlights of CTG program efforts in 2011 are available at: http://www.cdc.gov/communitytransformation/accomplishments/index.htm.

New Report Provides High-Impact Recommendations to Improve Prevention Policies in America

January 29, 2013

Washington, D.C., January 29, 2013 – Today, Trust for America’s Health (TFAH) released A Healthier America 2013: Strategies to Move from Sick Care to Health Care in Four Years – which provides high-impact recommendations to prioritize prevention and improve the health of Americans.

The Healthier America report outlines top policy approaches to respond to studies that show 1) more than half of Americans are living with one or more serious, chronic diseases, a majority of which could have been prevented, and 2) that today’s children could be on track to be the first in U.S. history to live shorter, less healthy lives than their parents.

“America’s health faces two possible futures,” said Gail Christopher, DN, President of the Board of TFAH and Vice President – Program Strategy of the W.K. Kellogg Foundation.  “We can continue on the current path, resigning millions of Americans to health problems that could have been avoided or we invest in giving all Americans the opportunity to be healthier while saving billions in health care costs.  We owe it to our children to take the smarter way.”

The Healthier America report stresses the importance of taking innovative approaches and building partnerships with a wide range of sectors in order to be effective.  Some recommendations include:

  • Advance the nation’s public health system by adopting a set of foundational capabilities, restructuring federal public health programs and ensuring sufficient, sustained funding to meet these defined foundational capabilities;
  • Ensure insurance providers reimburse for effective prevention approaches both inside and outside the doctor’s office;
  • Integrate community-based strategies into new health care models, such as by expanding Accountable Care Organizations into Accountable Care Communities;
  • Work with nonprofit hospitals to identify the most effective ways they can expand support for prevention through community benefit programs;
  • Maintain the Prevention and Public Health Fund and expand the Community Transformation Grant program so all Americans can benefit;
  • Implement all of the recommendations for each of the 17 federal agency partners in the National Prevention Strategy; and
  • Encourage all employers, including federal, state and local governments, to provide effective, evidence-based workplace wellness programs.

“Prevention delivers real value as a cost-effective way to keep Americans healthy and improve their quality of life,” said Jeffrey Levi, PhD, executive director of TFAH.  “Everyone wins when we prevent disease rather than treating people after they get sick.  Health care costs go down, our local neighborhoods are healthier and provide more economic opportunity, and people live longer, healthier, happier lives.”

A Healthier America also features more than 15 case studies from across the country that show the report’s recommendations in action, such as:

  • The first-of-its-kind Accountable Care Community (ACC) launched by the Austen BioInnovation Institute in Akron, Ohio, which brings together more than 70 partners to coordinate health care inside and outside the doctor’s office for patients with type 2 diabetes.  By improving care and making healthier choices easier in people’s daily lives, the ACC reduced the average cost per month of care for individuals with type 2 diabetes by more than 10 percent per month within 18 months of starting the program – an estimated savings of $3,185 per person per year;
  • The Community Asthma Initiative (CAI), implemented by Boston Children’s Hospital, has provided support to improve the health of children with moderate to severe asthma in at-risk Boston neighborhoods.  The CAI has led to a return of $1.46 to insurers/society for every $1 invested; an 80 percent reduction in percentage of patients with one or more asthma-related hospital admission; and a 60 percent reduction in the percentage of patients with asthma-related emergency department visits; and
  • The Healthy Environments Collaborate (HEC) in North Carolina is an innovative partnership across four state agencies – Health and Human Services, Transportation, Environment and Natural Resources and Commerce. The partnership focuses on creating win-win policies and programs that improve health while also meeting other priority goals, such as improved transportation, increased commerce and stable housing programs.

In addition, the report includes recommendations for a series of 10 key public health issues: reversing the obesity epidemic; preventing tobacco use and exposure; encouraging healthy aging; improving the health of low-income and minority communities; strengthening healthy women, healthy babies; reducing environmental health threats; enhancing injury prevention; preventing and controlling infectious diseases; prioritizing health emergencies and bioterrorism preparedness; and fixing food safety.

The report was supported by grants from the Robert Wood Johnson Foundation, the W.K. Kellogg Foundation and The Kresge Foundation and is available on TFAH’s website at www.healthyamericans.org.

 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

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Ready or Not?

«state» Scored «number» out of Ten on Key Indicators in Report on Health Emergency Preparedness

Majority of States Score 6 or Lower Out of 10 Indicators in Ready or Not?

Washington, D.C., December 19, 2012 – In the 10th annual Ready or Not? Protecting the Public from Diseases, Disasters, and Bioterrorism report, «state» scored «total» out of 10 on key indicators of public health preparedness — 35 states and Washington, D.C. scored a six or lower.

The report, issued by the Trust for America’s Health (TFAH) and Robert Wood Johnson Foundation (RWJF), found that while there has been significant progress toward improving public health preparedness over the past 10 years, particularly in core capabilities, there continue to be persistent gaps in the country’s ability to respond to health emergencies, ranging from bioterrorist threats to serious disease outbreaks to extreme weather events.

In the report, Kansas and Montana scored the lowest – three out of 10 – and Maryland, Mississippi, North Carolina, Vermont and Wisconsin scored highest – eight out of 10.

“In the past decade, there have been a series of significant health emergencies, including extreme weather events, a flu pandemic and foodborne outbreaks,” said Jeffrey Levi, PhD, executive director of TFAH. “But, for some reason, as a country, we haven’t learned that we need to bolster and maintain a consistent level of health emergency preparedness. Investments made after September 11th, the anthrax attacks and Hurricane Katrina led to dramatic improvements, but now budget cuts and complacency are the biggest threats we face.”

The Ready or Not? report provides a snapshot of our nation’s public health emergency preparedness. Its indicators are developed in consultation with leading public health experts based on data from publicly available sources, or information provided by public officials. Some key findings from the report include:

No. Indicator «state» Number of States Receiving Points
A “Y” means the state received a point for that indicator
1 Funding Commitment – Did the state maintain or increase funding for public health programs from FY 2010-2011 to FY 2011-12. «q1» 21 + D.C.
2 Response Readiness – Was the state able to notify and immediately assemble (within the goal time of 60 minutes) public health staff to ensure a quick response to an incident in 2011. «q2» 47 + D.C.
3 Infectious Disease Control and Vaccinations – Did the state meet the HHS goal of vaccinating 90 percent of 19- to 35-month-olds against whooping cough. «q3» 2
4 Infectious Disease Control – Does the state require Medicaid to cover flu shots with no co-pays for beneficiaries under the age of 65. «q4» 38
5 Extreme Weather Event Preparedness – Does the state currently have a complete climate change adaptation plan. «q5» 15
6 Community Resiliency – Does the state mandate all licensed child-care facilities to have a multi-hazard written evacuation and relocation plan. «q6» 30 + D.C.
7 Emergency Management – Has the state been accredited by the Emergency Management Accreditation Program (EMAP). «q7» 29 + D.C.
8 Health System Preparedness – Does the state participate in a Nurse Licensure Compact. «q8» 24
9 Public Health Laboratories Staffing and Surge Capacity – Does the state public health laboratory report having enough staffing capacity to work five, 12-hour days for six to eight weeks in response to an infectious disease outbreak, such as a novel influenza A H1N1, from August 10, 2011 to August 9, 2012. «q9» 37 + D.C.
10 Public Health Laboratories – Chemical Threat Preparedness – Did the state public health laboratory report having increased or maintained their Laboratory Response Network for Chemical Threats (LRN-C) chemical capability from August 10, 2011 to August 9, 2012. «q10» 49
Total «total»

“Public health preparedness has improved leaps and bounds from where we were 10 years ago,” said Paul Kuehnert, MS RN Director of the Public Health Team at the Robert Wood Johnson Foundation. “But severe budget cuts at the federal, state and local levels threaten to undermine that progress. We must establish a baseline of ‘better safe than sorry’ preparedness that should not be crossed.”

The Ready or Not? report provides a series of recommendations that address many of the major gaps in emergency health preparedness, including:

  • Reauthorize the Pandemic and All-Hazards Preparedness Act (PAHPA);
  • Assure sufficient, dedicated funds for public health preparedness to ensure basic capabilities to respond to threats public health departments face every day and also to have the trained experts and systems in place to act quickly in the face of major, unexpected emergencies;
  • Provide ongoing support to communities so they better cope and recover from emergencies;
  • Modernize biosurveillance to a real-time, interoperable system to better detect and respond to problems;
  • Seriously address antibiotic resistance;
  • Improve research, development and manufacturing of medical countermeasures;
  • Increase readiness for extreme weather events; and
  • Update the nation’s food safety system.

The report was supported by a grant from RWJF and is available on TFAH’s website at www.healthyamericans.org and RWJF’s website at www.rwjf.org.

Score Summary:

A full list of all of the indicators and scores and the full report are available on TFAH’s website and RWJF’s website. 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 publicly available sources or were provided from public officials.

  • 8 out of 10: Maryland, Mississippi, North Carolina, Vermont and Wisconsin
  • 7 out of 10: Alabama, Arkansas, California, Delaware, Nebraska, New Hampshire, New Mexico, New York, North Dakota and Virginia
  • 6 out of 10: Connecticut, Idaho, Iowa, Kentucky, Louisiana, Maine, Massachusetts, Missouri, Ohio, Oklahoma, South Carolina, Tennessee, Utah, Washington and Wyoming
  • 5 out of 10: Alaska, Arizona, Washington, D.C., Florida, Hawaii, Illinois, Indiana, Michigan, Minnesota, Oregon, Pennsylvania, Rhode Island, South Dakota, Texas and West Virginia
  • 4 out of 10: Colorado, Georgia, Nevada and New Jersey
  • 3 out of 10: Kansas and Montana

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 health and health care, the Foundation works with a diverse group of organizations and individuals to identify solutions and achieve comprehensive, measurable, and timely change. For 40 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. When it comes to helping Americans lead healthier lives and get the care they need, the Foundation expects to make a difference in your lifetime. Follow the Foundation on Twitter or Facebook.