Issue Category: Substance Misuse and Mental Health

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

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

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

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

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

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

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

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

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

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

 

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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.

Survey Finds 73 Percent Support Investments to Improve Health; Obesity, Future Health of Children Top Concerns

Washington, D.C., January 19, 2017 —A new national survey of registered voters has found that nearly three-quarters (73 percent) of Americans support increasing investments to improve the health of communities.  Support spans across party lines (57 percent of Republicans, 87 percent of Democrats and 70 percent of Independents) and regionally across the country (75 percent in the Northeast, 71 percent in the Central U.S., 72 percent in the South, and 75 percent in the West).  Women are the strongest proponents of supporting health improvement efforts (62 percent of Republican women, 87 percent of Democratic women and 80 percent of Independent women).

The survey, released today by the Robert Wood Johnson Foundation and the Trust for America’s Health, was conducted by Greenberg Quinlan Rosner Research, in consultation with Bellweather Research, on September 8-9, 2016 of a nationwide sample of 1302 registered voters across the country.

A majority (51 percent) believe that today’s children will be less healthy than previous generations when they reach adulthood.  The groups who hold this belief most strongly include: Republicans (55 percent); rural residents (60 percent); Southerners (57 percent); Independent women (62 percent); and Black women (68 percent).  Most registered voters with children under age 18, however, believe their own children are very healthy (92 percent give an 8-10 rating on a 10-point scale); this is the case for parents of all ideologies, incomes, education levels, and ethnicities.

Additionally, 64 percent believe that the number of health issues facing the country has grown in recent years. Obesity is the top health concern (41 percent), cancer ranked second (33 percent), followed by heart disease and stroke (14 percent) and diabetes and substance misuse (both at 11 percent).

Americans also rate their own health better than the health of the community where they live (66 percent rate their own health as 8-10 (very good) on a 10 point scale, but only 36 percent rank their community’s health as very good).  There are differences based on income, age, education and area of the country on how people rank their health.  For instance:

  • 73 percent of college-educated Whites rank their health as very good compared to 57 percent of Whites without college degrees; and
  • 72 percent of individuals with a household income above $50,000 per year rank their health as very good compared to 59 percent of those with incomes below $50,000.

A majority of American registered voters also strongly support (rating 8-10 out of a 10 point scale) a range of priorities and strategies for improving health, including:

  • 74 percent of people highly support providing enough time — during the school day and afterschool – for kids’ physical education, physical activity or community sports;
  • 74 percent also highly support creating partnerships among farmers, food suppliers and community health groups to bring fresh produce trucks or mobile markets to communities that lack access to grocery stores;
  • 65 percent highly support providing kids with more information on making healthy food choices and being physically active;
  • 63 percent highly support investing more in preventing obesity and chronic diseases like heart disease, diabetes and stroke;
  • 62 percent highly support increasing early childhood health programs, including home visit programs, mobile health screenings and treatment for diseases like asthma;
  • 61 percent highly support investing more in preventing the spread of infectious diseases like the Zika virus, bird flu and hepatitis;
  • 60 percent highly support treating substance use, including addiction to prescription painkillers and heroin, like a disease, not a crime;
  • 60 percent highly support planning for building more parks, walking and biking trails and other recreation areas for people to be physically active in all communities;
  • 60 percent highly support increasing access to safe and affordable housing and routinely testing for things that create health problems in homes, like lead in water and paint, carbon monoxide, and harmful chemicals in the air;
  • 59 percent highly support increasing incentives that encourage business owners to open grocery stores in communities that lack access to healthy food options; and
  • 58 percent highly support building local partnerships across businesses, health systems, schools and community organizations to address specific health problems in communities.

Methodology:  On behalf of the Robert Wood Johnson Foundation and the Trust for America’s Health, Greenberg Quinlan Rosner Research, in consultation with Bellwether Research, conducted a survey among 1,320 registered voters nationwide (1,019 weighted). The survey was conducted between September 8th and 19th, 2016. Voters were randomly selected from a list of registered voters and reached on a landline or cell phone depending on the number they designated on their voter registration. Interviews were conducted by live telephone interviewers; 50 percent were reached on a cell phone. Included in the sample were three oversamples: 100 Black voters, 100 Hispanic voters, and 100 White non-college voters. Upon completion of the survey, the results were weighted to bring the three oversamples into line with the racial and ethnic composition of registered voters nationwide. The data was weighted to reflect the total population of registered voters, taking into account regional and demographic characteristics according to known census estimates and voter file projections. The data are subject to a margin of error of +/- 3.1 percentage points.  Full survey and topline results are available upon request.

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 atwww.rwjf.org/twitter or on Facebook at www.rwjf.org/facebook. 

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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: Deeply Disappointed Congress Utilized the Prevention Fund as a 21st Century Cures Offset

Washington, D.C., December 7, 2016 – The below is a statement from Rich Hamburg, interim president and CEO, of Trust for America’s Health (TFAH) on the 21st Century Cures legislative package.

“TFAH is deeply disappointed Congress will utilize the Prevention and Public Health Fund as an offset for the legislative package known as 21st Century Cures. Cutting the Prevention Fund will limit the nation’s ability to improve health and quality of life and prevent disease.

While TFAH supports aspects of this legislative package, including the much-needed funds to address the opioid epidemic, we remain opposed to using the Prevention Fund to offset the cost of this legislation.

The Prevention Fund is inextricably tied to the nation’s future ability to reign in healthcare costs. This is the nation’s first and only substantial investment in moving from our current “sick care” system to a true preventive health system. The Prevention Fund should be dedicated to its intended purpose: helping all Americans stay healthy.

Despite the exponentially growing burden of largely preventable diseases, federal disease prevention and public health programs remain critically underfunded. Public health spending is still below pre-recession levels, having remained relatively flat for years. Today, more than 12 percent of the CDC budget is supplied through Prevention Fund investments, including the 317 immunization program, epidemiology and laboratory capacity grants and the entire Preventive Health and Health Services Block Grant program—all critical to preparing for and responding to public health emergencies.

The United States spends $3 trillion annually on healthcare without much to show for it: Millions of Americans suffer from chronic diseases, which are responsible for seven out of 10 deaths and $1.3 trillion in treatment costs and lost productivity every year.

And, two-thirds of Americans are overweight or obese and nearly 20 percent of Americans smoke. Obesity costs the country $147 billion and tobacco use leads to another $130 billion in healthcare spending each year.

Time and again research shows that the vast majority of these chronic diseases can be prevented by investing in addressing the root causes. Yet, the country has repeatedly failed to do so.

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

 

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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 “Blueprint for a Healthier America” Report Featuring High-Impact Policies for the Next Administration and Congress

Washington, D.C., October 19, 2016 – Today, the Trust for America’s Health (TFAH) released Blueprint for a Healthier America 2016: Policy Priorities for the Next Administration and Congress which calls for a new approach to health – prioritizing improving health and addressing major epidemics in the United States.

“It’s time for a sea change from our current sick care system to a true health system, where we focus on preventing disease and improving quality of life,” said Richard Hamburg, Interim CEO and President of TFAH.  “In the Blueprint, we highlight high-impact policies that could help spare millions of Americans from preventable health problems and save billions in avoidable healthcare costs – if we make them a priority.” 

The report highlights pressing crises and how investments could yield positive returns on investment by adopting proven health strategies.  For instance:

  • Investing $1 in substance use prevention to realize as much as $34 in return.  Deaths from prescription painkiller use have more than quadrupled in the last 15 years and deaths from heroin have tripled since 2010, contributing to higher death rates among middle-aged Whites.  Five of the strongest school-based substance use prevention strategies have returns on investment ranging from $3.8:1 to $34:1.
  • Saving more than $16 billion through a more active and healthy population. One in three children will develop type 2 diabetes in their lifetime and one in four young adults are not healthy enough to join the military.  An investment of $10 per person in proven, evidence-based community prevention programs to increase physical activity, improve nutrition and reduce tobacco use could save the country more than $16 billion annually – a $5.60:1 return.
  • Connecting health and social services to cut billions in costs.  Health and social service coordinating systems that address gaps between medical care and effective social service programs – by connecting patients in need with programs ranging from supportive housing to food assistance – could yield between $15 billion and $72 billion in healthcare savings a year within 10 years, according to a new analysis by TFAH and Healthsperien.
  • Reducing the $120 billion spent annually on preventable infectious diseases.  Fifteen years after 9/11 and 11 years after Hurricane Katrina, when health crises such as new infectious diseases arise, the country still scrambles to implement emergency plans and secure funding.  Preventable infectious diseases cost the country more than $120 billion annually – and that cost is exponentially compounded when new diseases emerge.
  • Realizing a 7-10 percent annual return by investing in early childhood education. More than half of U.S. children – across the economic spectrum – experience adverse experiences, such as physical or sexual abuse, and more than 20 percent live below the poverty line, which increases their risk for “toxic stress” – living under a constant state of stressful conditions – that can contribute to a range of physical, mental and behavioral health issues.  Investments in early childhood education can help mitigate against impact of these risks and increase resilience, while also providing an annual return of 7 to 10 percent per year, and supportive nurse-family home visits for high-risk families show a return of $5.70:1. 

The Blueprint highlights leading evidence-based strategies for improving health and policy – and models to help bring them to scale across the country. These include:

  • Supporting Better Health in Every Community:  Federal, state and local public health programs and policies should support place-based health improvement partnerships. Doing so will help identify and elevate a local community’s top priorities and bring key partners and assets together – from public health, healthcare, social services, philanthropies, education, businesses and faith and community groups – for a greater collective impact.  A network of expert institutes in each state should provide technical assistance to these multisector collaborative partnerships.  In addition, the Prevention and Public Health Fund and other community-based health improvement programs should be protected and fully funded.
  • Modernizing the Public Health System to Be Prepared for Emergencies:  The public health system must be modernized – and sufficiently funded – so that it can handle ongoing threats and new emergencies. Too often the country has been caught off guard when a new crisis emerges, diverting attention and resources.  There should be 1) greater investment to improve baseline foundational capabilities in communities around the country; 2) a standing Public Health Emergency Fund to provide additional surge funds when needed; 3) improved federal leadership, such as through a Special Assistant to the President for Health Security; and 4) upgrades to out-of-date technology and surveillance systems.
  • Incentivizing Health Care vs. Sick Care:  There should be increased incentives and mechanisms for healthcare insurers, nonprofit hospital community benefit programs and social investment funds to support health improvement strategies.  Efforts such as healthcare investment in community-wide health improvement programs, “navigator plus support” health and social service integration (such as Accountable Health Communities), Community Development Financial Institutions for Health (strategic planning and financing intermediaries) and pay-for-outcome approaches should be expanded.

The report also includes a set of policy recommendations to address priority health problems that require urgent action, some highlight areas include:

  • Stopping the Prescription Painkiller and Heroin Epidemics
  • Renewing Efforts to Prevent Obesity, Diabetes and Tobacco Use
  • Highlighting Prevention in the National Cancer Moonshot Initiative
  • Ending the HIV/AIDS Epidemic
  • Stopping Superbugs and Antibiotic Resistance
  • Lowering the Rising Death Rates Among Middle-Aged Whites
  • Achieving Health Equity

The Blueprint was supported by grants from the Robert Wood Johnson Foundation, the W.K. Kellogg Foundation, The California Endowment and The Kresge Foundation.

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.

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Trust for America’s Health Announces New President and CEO, John Auerbach

Washington, D.C., October 7, 2016–Today, Trust for America’s Health (TFAH) announced the selection of John Auerbach, MBA, as its new President and CEO.

Auerbach brings more than 35 years of experience as a leader in the public health field – including serving as the Commissioner of the Massachusetts Department of Health, Executive Director of the Boston Public Health Commission, and, most recently, Associate Director for Policy and Acting Director of the Office for State, Tribal, Local and Territorial Support at the Centers for Disease Control and Prevention (CDC).

“John is a true innovator in public health and we cannot be more pleased to have him as the new head of TFAH,” said Gail Christopher, board chair of TFAH and vice president for policy and senior advisor at the W.K. Kellogg Foundation. “His work embodies a transformative approach to improving health – thinking beyond medical care to support opportunities for better health in our daily lives. We share a vision where every American has the chance to be as healthy as they can be.”

At CDC, Auerbach has focused on promotion of public health and prevention as components of healthcare and payment reform and health system transformation. He also oversees key activities and technical assistance that support the nation’s health departments and the public health system.

Previously, he was, from 2012 to 2014, a distinguished professor of practice in health sciences and director of the Institute on Urban Health Research and Practice at Northeastern University.  From 2007 to 2012, he was the commissioner of public health for the Commonwealth of Massachusetts. Under his leadership, the department developed innovative programs to address racial and ethnic disparities, promote wellness, combat chronic disease, and support the successful implementation of the state’s early healthcare reform initiative.  He served as the President of the Association of State and Territorial Health Officials (ASTHO) in 2010-2011.

Prior to that, Auerbach was the executive director of the Boston Public Health Commission for nine years during which health equity, emergency preparedness, and tobacco prevention became priorities. In addition to Boston’s public health programs, he oversaw its emergency medical, homeless, and substance abuse services.  Throughout his tenure as the city commissioner, Auerbach served as a member of the Board of Directors at the National Association of County and City Health Officials (NACCHO).

Earlier in his career Auerbach worked at the state health department for a decade, first as chief of staff and later as an assistant commissioner overseeing the HIV/AIDS Bureau during the early years of the epidemic.  He was a founding member and the second president of the National Association of State and Territorial AIDS Directors (NASTAD).

“I’ve had a lifelong commitment to health and social justice, from the start of my career as a community health worker in one of the earliest community health centers to having the privilege of managing city, state and federal efforts,” said Auerbach.  “We’re in a unique moment to define the next generation of health and healthcare – and I am excited to be joining TFAH and being at the leading edge of efforts to advance the mission of creating a healthier America.”

Auerbach will start in his role January 1, 2017.  TFAH’s previous executive director, Jeffrey Levi, PhD, is now serving as Professor of Health Policy and Management at the Milken Institute School of Public Health at the George Washington University.

Richard Hamburg, who has been Interim President and CEO at TFAH, will be assuming the position of Executive Vice President and Chief Operating Officer.

 

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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.

Molina Healthcare Community Connectors

Molina Healthcare serves Medicaid, Medicare, CHIP, Marketplace, and dual-eligible plans in multiple states. In 2004, Molina Healthcare began leveraging community health care workers known as Community Connectors to engage and empower Molina members to achieve better health outcomes. By partnering with state Medicaid organizations and other community partners, Community Connectors serve as liaisons between patients and clinicians, assessing needs and assisting the treatment team with coordinating members’ care. They coach members to self-manage their chronic conditions, connect them to basic community resources (e.g., food, shelter and safety) and more traditional health-related social services, and advocate on their behalf. Community Connectors are familiar with the community and the available resources that can help members improve their health. In New Mexico, the program has demonstrated a savings of $4,564 per enrollee through reduced emergency department use, days of inpatient care, and substance abuse. The program is funded by Molina Healthcare. To read more about this innovative program, see this brief summary [link].

Get Healthy Philly

“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].