Substance Misuse and Mental Health Archives - Page 5 of 12

Policymakers and Health Systems Must Earn Trust within Communities of Color and Tribal Nations to Ensure COVID-19 Vaccine Receptivity, Say Health and Public Health Leaders

Policy brief calls for building vaccine acceptance in communities of color and tribal communities through data transparency, tailored communications via trusted messengers, ensuring ease of vaccine access and no out-of-pocket costs

(Washington, DC – Dec. 21, 2020) – A woeful history of maltreatment of communities of color and tribal nations by government and the health sector, coupled with present day marginalization of these communities by the healthcare system, are the root of vaccine distrust among those groups, according to a policy brief, Building Trust in and Access to a COVID-19 Vaccine Among People of Color and Tribal Nations released today by Trust for America’s Health (TFAH) and co-authors the National Medical Association (NMA) and UnidosUS.

This historic maltreatment, coupled with current day structural racism, has played out in COVID-19’s disproportionate impact on communities of color and tribal communities. These factors also make ensuring vaccine receptivity and access within those communities challenging and of critical importance to protecting lives and ending the pandemic.

In October 2020, TFAH, NMA and UnidosUS hosted a policy convening with 40 leading health equity, healthcare, civil rights, and public health organizations. The purpose of the convening was to advise policymakers on the barriers to vaccine receptivity within communities of color and tribal communities and how to overcome those barriers.

“Earning trust within communities of color and tribal communities will be critical to the successful administration of the COVID-19 vaccine. Doing so will require prioritizing equity, ensuring that leaders from those communities have authentic opportunities to impact vaccine distribution and administration planning, and, the resources to fully participate in supporting vaccine outreach, education and delivery in their communities,” said Dr. J. Nadine Gracia, Executive Vice President and COO of Trust for America’s Health.

The convening created recommendations for policy actions that should be taken immediately within six key areas:

Ensure the scientific fidelity of the vaccine development process.

HHS and vaccine developers should release all available vaccine data at frequent and regular intervals to improve transparency and increase confidence in the vaccine evaluation process. Leadership at FDA and HHS must commit to advancing any vaccine only after it has been validated based on established federal and scientific protocols. Programs to monitor for adverse events must also be in place and transparent. Any perception of bypassing safety measures or withholding information could derail a successful vaccination effort.
FDA should engage health and public health professional societies, particularly those representing healthcare providers of color, local public health officials, as well as other stakeholders with a role in vaccination, and allow these groups to validate all available data, review the vaccine development and approval process, and issue regular updates on data to their patients, members, and the public.

Equip trusted community organizations and networks within communities of color and tribal nations to participate in vaccination planning, education, delivery and administration. Ensure their meaningful engagement and participation by providing funding.

Congress should fund CDC and its state, local, tribal, and territorial partners to provide training, support, and financial resources for community-based organizations to join in vaccination planning and implementation, including community outreach, training of providers, and participation in vaccination clinics. State, local, tribal, and territorial authorities should authentically engage and immediately begin vaccination planning with community-based organizations, community health workers/promotores de salud, faith leaders, educators, civic and tribal leaders, and other trusted organizations outside the clinical healthcare setting as key, funded partners.

Provide communities the information they need to understand the vaccine, make informed decisions, and deliver messages through trusted messengers and pathways.

Congress should provide at least $500 million to CDC for outreach, communication, and educational efforts to reach priority populations in order to increase vaccine confidence and combat misinformation. All communications must be culturally and linguistically appropriate and tailored as much as possible to reach diverse populations as well as generations within groups.
FDA and CDC should initiate early engagement with diverse national organizations and provide funding and guidance for state, local, tribal, and territorial planners to help shape messaging and engage locally with healthcare providers in communities of color and tribal communities, such as nurses, pharmacists, promotores de salud, community health workers, and others to ensure they have the information they need to feel comfortable recommending the vaccine to their patients. Congress and HHS should provide funding for training and engagement of trusted non-healthcare communicators to help shape messaging and to train informal networks, civic and lay leaders, and other trusted community leaders and community-based organizations to answer questions and encourage vaccination.
All messaging about the vaccine must be appropriate for all levels of health literacy. Communication should be realistic and clear about timelines and priority groups (and the rationale for these decisions), vaccine effectiveness, types of vaccines, the number of doses, costs, and the need for ongoing public health protections. Planners must provide information that meets people where they are (e.g., barber shops, bodegas, grocery stores, places of worship, etc.) and ensure that trusted messengers in those places have the information they need to be credible and authentic spokespeople.

Ensure that it is as easy as possible for people to be vaccinated. Vaccines must be delivered in community settings that are trusted, safe and accessible.

We urge the administration and Congress to appropriate the resources necessary to expand and strengthen federal, state, local, territorial, and tribal capacity for a timely, comprehensive, and equitable COVID-19 vaccination planning, communications, distribution, and administration campaign, including funding to support vaccine distribution at the local level and by community-based organizations.
Congress and HHS should allocate funding to increase access to vaccination services to ensure that people seeking to be vaccinated do not experience undue increased exposure to the virus as they travel to, move through, and return home from vaccination sites. Flexibility in funding is needed to enable transport of people to vaccination sites, increase accessibility to people without cars, and promote safety and minimize exposure at vaccination locations. Funding should also be provided to health and community-based agencies to assist those for whom transportation or childcare costs are an obstacle to receipt of the vaccine.
Planners should ensure that vaccination sites are located in areas that have borne a disproportionate burden of COVID-19, especially leveraging community-based organizations such as Federally Qualified Health Centers, community health centers, rural health centers, schools and places of worship. Mobile services will be particularly important in rural areas. Planners should prioritize congregate living facilities, such as long-term care, prisons, and homeless shelters. In addition, some families, displaced by the COVID economic fallout, may be living with relatives. Planners should ensure vaccination sites have services that meet the Americans with Disabilities Act (ADA) and HHS Office for Civil Rights (OCR) standards for disability and language access.
Federal state, local, tribal, and territorial officials must guarantee and communicate with the public that immigration status is not a factor in people’s ability to receive the vaccine and that immigration status is not collected or reported by vaccination sites/providers. Similarly, the presence of law enforcement officers or military personnel could be a deterrent for vaccination at locations, so planners should consider other means of securing sites.
In the initial phase, as communities vaccinate healthcare workers, planners must be sure to prioritize home health, long-term care, and other non-hospital-based healthcare workers, who are more likely to be people of color. Other essential workers that comprise large numbers of workers who are people of color and should be treated as within the vaccination priority groups are the food service industry, farmworkers and public transportation employees.

Ensure complete coverage of the costs associated with the vaccine incurred by individuals, providers of the vaccine, and state/local/tribal/territorial governments responsible for administering the vaccine and communicating with their communities about it.

Congress, the Centers for Medicare and Medicaid Services, and private payers must guarantee that people receiving the vaccine have zero out-of-pocket costs for the vaccine, related health care visits, or any adverse events related to the vaccine, regardless of their health insurance status.
HHS, with emergency funding from Congress, should provide funding so that state, local, tribal, and territorial governments do not bear any cost of vaccine communication efforts, working with their communities, organizing sites, training their staff, and providing personal protective equipment (PPE).

Congress must provide additional funding and require disaggregated data collection and reporting by age, race, ethnicity, gender identity, primary language, disability status, and other demographic factors on vaccine trust and acceptance, access, vaccination rates, adverse experiences, and ongoing health outcomes.

CDC, and state, local, tribal, and territorial authorities should include leaders from communities of color and tribal communities and to plan on-going data collection on vaccination efforts, interpret data, add cultural context, share data with communities, and determine implications and next steps.
CDC, and state, local, tribal, and territorial authorities should use these data to inform ongoing prioritization of vaccine distribution and rapidly address gaps in vaccination that may arise among subpopulations by race, ethnicity, neighborhood, or housing setting.

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Trust for America’s Health is a nonprofit, nonpartisan organization that promotes optimal health for every person and community and makes the prevention of illness and injury a national priority. Twitter: @healthyamerica1

A Blueprint for the 2021 Administration and Congress

New Data: Overdose Deaths Up Nearly 5 Percent; COVID-19 Creates Additional Stressors for Both Patient and Provider Community

(Washington, DC and Oakland, CA – July 20, 2020) – Last week, the Centers for Disease Control and Prevention (CDC) released preliminary data showing an increase in drug overdose deaths in 2019. These provisional data showed an estimated 71,999 Americans died from overdoses last year, a nearly five percent increase in numbers of deaths as compared to 2018 and a reversal of the prior year’s small decrease in such deaths.

The 2019 increase was largely driven by a rise in deaths from synthetic opioids, like fentanyl, as well as methamphetamine, and cocaine.

“These new data are a stark reminder that we must fight the dual public health threats of COVID-19 and substance misuse at the same time,” said John Auerbach, President and CEO of Trust for America’s Health. “While understandably focusing attention on the pandemic response, we can’t neglect the devastation caused by substance misuse and overdoses.”

An area of concern is that the COVID-19 pandemic could contribute to more substance misuse and overdose deaths. Preliminary data from the Office of National Drug Control Policy has found a substantial increase in suspected overdoses since the start of stay-at-home orders on March 19^th, 2020. And a new study, out this week by RTI International, found that alcohol sales have surged nationally during the pandemic.

In response to the pandemic, policymakers have eased certain regulations on the delivery of mental health and substance use services. Telehealth requirements have been altered to allow for increased access through audio-only services and federal authorities have allowed for prescribing of buprenorphine and methadone, drugs t treat opioid use disorder, without an initial in-person examination.

Despite these changes, challenges remain. COVID-19 has made access to substance misuse treatment more difficult for many. Millions have lost or will soon lose health insurance coverage as unemployment rises. Some are fearful of seeking care because of the threat of infection. And relatively little is being done to address the upstream factors that elevate the risk of substance misuse, such as lack of educational and economic opportunities and racial injustice.

“How many more lives must we lose before we take seriously the need for a comprehensive call to action? We are going in the wrong direction and need to prioritize this larger epidemic within the COVID-19 pandemic,” says Benjamin F. Miller, Chief Strategy Officer for Well Being Trust. “We must begin by investing in solutions that work – those solutions that more seamlessly integrate mental health and substance use disorder treatment into all the places people show up for help.”

Trust for America’s Health and Well Being Trust co-produce the Pain in the Nation series which has tracked alcohol, drug, and suicide deaths nationally since 2017. For more information visit: http://www.pitn.org/

COVID-19 School Closures Put 30 Million Children at Risk of Hunger

Many States with High COVID-19 Infection Rates Also Have Highest School-Meal Programs Participation Rates

(Washington, DC – July 16, 2020) – As COVID-19 infection rates continue to increase in states across the country, many of those jurisdictions are facing the complex dilemma of high infections rates complicating school re-openings and thereby limiting students’ access to school-based meal programs. Among the states with spiking infection rates and a high percentage of students participating in school-based meal programs are Arizona, Florida, Louisiana, Mississippi and South Carolina.

In March schools across the country began closing to stop the spread of the COVID-19 virus. In response, and recognizing the important source of nutrition school-based meals were to millions of American children, the U.S. Department of Agriculture’s Food and Nutrition Service began approving nationwide waivers to provide school systems flexibility in how meals were provided to students. For example, these waivers enable schools to serve meals in non-congregate settings and outside of standard mealtimes, serve afterschool snacks and meals outside of structured environments, and waive requirements that students be present when meals are picked up.

Over half of all students in elementary and secondary schools across the country depend on the National School Lunch Program, and 12.5 million of those students also participate in the School Breakfast Program. As the COVID-19 pandemic closed schools this spring, these students were placed at risk of not having enough to eat.

A new policy brief, Beyond School Walls: How Federal, State and Local Entities are Adapting Policies to Ensure Student Access to Healthy Meals During the COVID-19 Pandemic, released today by Trust for America’s Health, reviews steps the federal and state governments have taken to ensure students’ access to healthy meals when schools are closed and what needs to be done to ensure continued meal access as all school systems face uncertainties about how to safely reopen for the 2020-2021 school year.

“School meal programs are the most important source of nutritious food for millions of American children. To the degree possible, school systems, with financial and regulatory relief from the federal government, should continue to be innovative about how to deliver meals to students and should strive to meet or exceed federal nutrition standards for these meals despite product shortages created by the pandemic,” said Adam Lustig, Project Manager at Trust for America’s Health and the brief’s author.

Due to the economic impact the pandemic has had on millions of American families and the numerous uncertainties about how to safely re-open schools, the currently in place program waivers should be extended through the summer and may need to be kept in place during the 2020–2021 school year, the brief says.

Many of the states hardest hit by COVID also have highest school meal programs participation rates

States with some of the highest rates of COVID-19 infections also have high percentages of students who depend on school meals for much of their nutrition. States in which both COVID-19 infection rates are above national medians and school meals program enrollment is high include Arizona, Florida, Georgia, Louisiana, Mississippi, and South Carolina.

States in which more than half of students are enrolled in school-meals programs are:

Percentage of students enrolled in school meal programs

D.C. 76.4%

Mississippi 75.0%

New Mexico 71.4%

South Carolina 67.0%

Arkansas 63.6%

Louisiana 63.0%

Oklahoma 62.5%

Georgia 62.0%

Nevada 60.8%

Kentucky 58.7%

California 58.1%

Florida 58.1%

Arizona 57.0%

Missouri 52.7%

New York 52.6%

Illinois 50.2%

Alabama 51.6%

Oregon 50.5%

Hunger, poor nutrition and food insecurity can increase a child’s risk of developing a range of physical, mental, behavioral, emotional, and learning problems. Hungry children also get sick more often and are more likely to be hospitalized. Maintaining children’s access to nutritious meals despite school closures not only ensure they do not go hungry, but also promotes children’s health.

“State and federal guidelines waivers have allowed school systems to provide meals to students during the pandemic response, keeping them in place this summer and into the 2020-2021 school year will be the difference between kids who have enough to eat and kids who go hungry,” Lustig said.

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Trust for America’s Health is a nonprofit, nonpartisan organization that promotes optimal health for every person and community and makes the prevention of illness and injury a national priority. Twitter:@HealthyAmerica1

Sign-on Letter in Support of CDC Mission (July 2020)

Addressing the Crisis of Black Youth Suicide: Interview with Dr. Michael A. Lindsey

Dr. Lindsey is the executive director of the McSilver Institute for Poverty Policy and Research at New York University. He also leads the working group of experts supporting the Congressional Black Caucus Emergency Task Force on Black Youth Suicide and Mental Health. The Task Force report, Ring the Alarm: The Crisis of Black Youth Suicide, released in December 2019, is a comprehensive examination of the alarming rise in suicide rates for Black youth over the past generation; a survey of available data and evidence; and a call for policymakers and communities to take action to better understand and to reverse this emergent trend.[1]

TFAH: Please describe your work at the McSilver Institute.

Dr. Lindsey: We focus on the social determinants of mental health, as well as trauma and treatment disparities, all of which intersect with intergenerational poverty. If you are experiencing inequality related to, for example, food insecurity or underemployment, that has a psychological impact. We are looking for ways to break that cycle. We are committed to studying intergenerational poverty, not only to understand its consequences, but to also do something about it.

TFAH: Where does your passion for your work come from?

Dr. Lindsey: I’ve always been interested in mental health treatment disparities, particularly the lack of treatment access for serious mental health issues among Black people. I know the consequences of lack of mental health treatment. My passion derives from growing up in the Southeast section of Washington, D.C., where I saw the effects of drug use and undiagnosed, untreated addiction and mental health issues. I want to bridge that gap to make sure kids and families are connected to treatment in meaningful ways.

TFAH: If you could recommend to policymakers one or two actions that would make a real difference on the social determinants of mental health, what would they be?

Dr. Lindsey: Let’s focus that a bit. And that’s a key point. Whatever we design as an intervention has to speak to the unique issues that are experienced by a specific group. For example, looking at the rising rates of suicide among Black youth. We need to have mental health professionals in schools, proportionate to the number of kids in that school. We can’t have one provider trying to serve 500 kids or even 100 kids; that’s too many. We also need to see more federal research dollars, specifically, for studying the increasing rate of Black youth suicide. The data are clearly telling us that Black youth are at high risk.

TFAH: Does the research you are calling for need to be population-focused?

Dr. Lindsey: No question, it does. The research also needs to be gender-sensitive and culturally appropriate. We need to understand how families of color, in this case, Black families, resolve mental health challenges. For example, do we need to involve clergy in the intervention programs? Do we need services in non-traditional settings? Do we need to provide services in places other than those that the community believes are where “crazy people” go? Setting up services from the consumer perspective will help us establish services that are going to be meaningful.

TFAH: What’s the impact of the school environment on the lives of Black children? Are you concerned about school disciplinary policies that have unintended consequences for students who end up in trouble with the juvenile justice system?

Dr. Lindsey: This is something I’m particularly concerned about. For students of color, there’s implicit bias in how their behaviors are interpreted. If you have a White kid and a Black kid and a Latino kid—if the Black or Latino kid aggresses toward someone, the reaction is that kid is a bad kid, one who should be removed from school. But if a White kid acts up, he is perceived as having emotional challenges. The White kid is not suspended, he’s offered mental health services. It happens a lot.

When Black kids are suspended from school, they can be wayward in the community, they’re not engaged, their behavior comes to the attention of law enforcement—it’s a vicious cycle. It’s also tough for those same kids who are suspended from school to return to school because those school communities often don’t want them back. The largest number of students who have this lack of school engagement tend to be Black and Brown.

If we had intervened on those behaviors early on and gotten those kids to mental health treatment and associated services, we could have averted that later suspension from school. It’s a matter of how we interpret the behavioral presentations of kids. It happens to be that Black and Brown students are the ones who are not getting the requisite services surrounding their mental health.

TFAH: What has been the impact of zero-tolerance policies in schools on students of color?

Dr. Lindsey: Zero-tolerance has had a big impact on what I would call school persistence and staying connected to school among Black and Brown kids. Zero-tolerance policies do not work, and they disadvantage low-income kids and kids of color.

TFAH: McSilver’s Step Up program is established in two New York City high schools. Can you tell us more about it?

Dr. Lindsey: Step Up is focused on positive youth development. What we do is take students who are at risk for truancy or school dropout, and we wrap-around services to support them. It includes peer support—so a lot of peer-based mentoring—as well as professionally led activities to help kids stay on a positive course. The program has an 85 percent graduation rate; that’s about 10 percent higher than the general graduation rate in New York City. Programs like Step Up or school mental health services that can be offered to kids who are struggling can be very important to ensure that these kids stay connected.

TFAH: You led the expert working group that helped inform the work of the Congressional Black Caucus Emergency Task Force on Black Youth Suicide and Mental Health. What did the task force find and what did it recommend?

Dr. Lindsey: Black youth suicide and suicidal behaviors are rising. Black boys (ages 5 to 12 years old) are twice as likely to die by suicide as compared with their White peers. We led a study at the McSilver Institute that found that the self-reported suicide attempt rate for Black youth increased by 73 percent between 1991 and 2017; meanwhile, self-reported suicide attempt rates fell for White and Latino kids and for Asian and American Indian/Alaska Native kids during the same period.

What needs to be done is many of things we’ve talked about. We’re calling for mental health professionals in every school and for more National Institutes of Health funding. We’re calling for Mental Health First Aid to be widely implemented in schools. All the professionals in schools should be well-versed in the presentation of mental health issues, the signs that a student may be having trouble and how to get that student connected to supportive treatment.

We are also calling for more demonstration projects, programs that would implement evidence-based and best practices for clinicians and teachers and anyone who interacts with Black youth. We are calling for investment in demonstration projects to identify exemplars and then implement those programs at scale.

TFAH: What is required to scale up promising programs?

Dr. Lindsey: We have a program called Making Connections. In this program, we are targeting kids who have depression. The program works to reduce stigma. It is designed to help families understand what mental health treatment is all about and to address any concerns they might have about it. It’s a promising program I’d like to see delivered at scale. In order to do that, we are going to have to invest dollars in understanding how this program works. We are currently funded by NIMH [National Institute of Mental Health], but we are going to need increased funding to be able to do this in other places. If we are going to deliver these programs at scale, we are going to have to engage in the research to take them to scale. That means establishing the efficacy of programs like Making Connections, but also determining how best to implement programs like it at scale.

TFAH: Anything else you want to share?

Dr. Lindsey: I’m reminded of the power of storytelling. We need to demonstrate how implicit bias is impacting Black and Brown kids, bias that is potentially an underlying feature of why we are seeing the rising suicide trends. We need to tell the story of implicit bias in compelling ways. I believe that will challenge folks to action. It’s also important to recognize the role that stigma and mistrust play in the disconnection from services. They play a huge role in terms of the disconnection from mental health treatment. We need to work on bridging those gaps between need and use of treatment.

[1] Watson Coleman B. Ring the Alarm: The Crisis of Black Youth Suicide in America. Washington, D.C.: Congressional Black Caucus Emergency TaskForce on Black Youth Suicide and Mental Health, December 2019. https://watsoncoleman.house.gov/uploadedfiles/full_taskforce_report.pdf (accessed April 30, 2020).

TFAH’s Statement on Racism and Health and Well Being in America

Trust for America’s Health (TFAH) stands in solidarity with those opposing racism and seeking racial justice. The recent horrific deaths of George Floyd, Breonna Taylor, and Ahmaud Arbery further expose the persistence of racism and racial violence in American society. We must remember the lives of so many Black people taken by such violence. We keep the families in our minds and hearts.

Systemic racism undermines equity and opportunity and is far-reaching – in health, education, economic opportunity, employment, housing, transportation, and criminal justice, only to name a few examples. The toll from racism on the lives and health of Black people and other people of color is vast. It is seen in the impact of the disinvestment in and marginalization of communities of color, the unhealthy social, economic, and environmental conditions, and the lack of opportunities within community, work and school settings, which result in deaths at earlier ages and high rates of chronic and infectious diseases. It is seen in the impact of racial violence as well as daily instances of prejudice and racial discrimination that result in adverse mental and physical health effects such as stress, trauma, and elevated blood pressure. The recent cases of violence against Black people and the disproportionate impact of the COVID-19 pandemic on people of color have highlighted once again the importance of combating racism as a public health imperative.

At Trust for America’s Health, we envision a nation that values the health and well-being of all, where equity is foundational to policymaking at all levels of society. Together with all justice-seeking people in America, we remain steadfast in advocating for policy solutions to achieve equity so that everyone has a fair and just opportunity for optimal health.

Las muertes anuales debidas al alcohol, las drogas o el suicidio superaron los 150,000 según los datos más recientes, y podrían empeorar debido a COVID-19

Las muertes por alcohol, drogas y suicidios aumentan en 27 estados

(Washington, DC – 21 de mayo de 2020) – Datos recientemente publicados muestran que 151,964 estadounidenses murieron debido al alcohol, las drogas o el suicidio en el 2018. Esta tasa nacional de mortalidad por muertes por alcohol, drogas y suicidio en el 2018 fue muy ligeramente inferior a la que hubo en el 2017 a pesar del progreso en la reducción de muertes debido a algunos tipos de sobredosis de opioides, según un nuevo estudio realizado por Trust for America’s Health (TFAH) y Well Being Trust (WBT).

Entre 2017 y 2018, 27 estados experimentaron tasas más altas (incrementos superiores al 0.04 por ciento) de muertes por alcohol, drogas y suicidio. Dos estados, Vermont y Delaware, experimentaron aumentos de la tasa de mortalidad de dos dígitos: 13 por ciento y 10 por ciento, respectivamente. Veintitrés estados y el Distrito de Columbia tuvieron menos muertes por alcohol, drogas y suicidio durante el mismo período.

Los estados con las tasas más altas de mortalidad por alcohol, drogas y suicidio en el 2018 fueron:

West Virginia (84.9 por 100,000)
Nuevo México (82.8 por 100,000)
New Hampshire (68.2 por 100,000)
Alaska (67.8 por 100,000)
Delaware (62.9 por 100,00)

Los estados con las tasas más bajas de alcohol, drogas y suicidio en el 2018 fueron:

Texas (31.7 por 100,000)
Mississippi (31.7 por 100,000)
Hawaii (34.6 por 100,000)
Nebraska (35.5 por 100,000)
Iowa (35.7 por 100,000)

Por el año, las muertes por alcohol aumentaron un 4 por ciento y las muertes por suicidio aumentaron un 2 por ciento en todo el país. Los nuevos datos también muestran un cambio continuo dentro de la crisis de los opioides con reducciones en las muertes por abuso de opioides recetados, pero aumentan las muertes relacionadas con opioides sintéticos, incluido el fentanilo. Las tasas de mortalidad de todos los opioides disminuyeron un 2 por ciento, pero la tasa de mortalidad de los opioides sintéticos aumentó un 10 por ciento. Además, las muertes por heroína fueron menores, pero las muertes por abuso de cocaína y psicoestimulantes fueron mayores.

Aunque todavía es inquietantemente alto, los datos del 2018 son la primera vez desde 1999, cuando comenzó la recopilación de datos actual, que no ha habido un aumento considerable en el índice nacional de muertes por alcohol, drogas y suicidios por cada tasa de 100,000. Sin embargo, esta estabilización en la tasa de mortalidad no fue uniforme. Algunos lugares y grupos de población están experimentando tasas de mortalidad estables o decrecientes, mientras que las tasas entre otros grupos o en otros lugares continúan aumentando.

“Estos datos son un llamado a la acción”, dijo John Auerbach, presidente y CEO de Trust for America’s Health. “Sabemos lo que funciona para abordar las muertes por desesperación, pero el progreso ha sido desigual y las tasas de mortalidad continúan aumentando, con comunidades de color que experimentan tasas más altas de aumento en las muertes por drogas y alcohol. Y hay otra preocupación inmediata: la crisis de COVID-19 ha aumentado las cargas sanitarias y las presiones económicas en muchas comunidades de color “.

Los indios americanos, asiáticos, negros, latinos y adultos mayores experimentaron aumentos en las muertes inducidas por drogas entre 2017 y 2018. Los negros y los indios estadounidenses tuvieron el mayor aumento. Los negros ahora tienen tasas más altas de sobredosis de opioides sintéticos (10.7 por 100,000), tasas de sobredosis de cocaína (8.8 por 100,000) y casi la misma tasa general de mortalidad inducida por drogas (21.8 por 100,000) que los blancos, después de décadas de tener tasas de sobredosis sustancialmente más bajas. Los grupos de población que experimentaron tasas de mortalidad más bajas inducidas por drogas en el 2018 incluyeron adultos de 18 a 54 años y blancos.

“Simplemente, muchos estadounidenses están muriendo por causas prevenibles. Las profundas disparidades raciales de salud observadas en estos datos muestran que muchos grupos de minorías étnicas se están quedando atrás en nuestros esfuerzos de respuesta “, dijo Benjamin F. Miller, PsyD, director de estrategia de Well Being Trust. “La nación necesita un marco integral para la excelencia en la salud mental y el bienestar, uno que intencionalmente brinde soluciones para los indios americanos, negros, asiáticos y latinos. Con todas las demás inversiones relacionadas con COVID-19, es hora de que el gobierno federal invierta completamente en salud mental ahora y que todos los estados tomen medidas “.

Muertes por tipo de droga

Opioides sintéticos: en el 2018, 31,355 estadounidenses murieron por sobredosis de opioides sintéticos; un aumento del 10 por ciento desde el 2017. En total, la tasa de mortalidad por sobredosis con opioides sintéticos ha aumentado 10 veces desde el 2013.

Cocaína: en el 2018, 14,666 estadounidenses murieron por sobredosis de cocaína; hasta un 5 por ciento desde el 2017. La tasa general de mortalidad por sobredosis de cocaína ha aumentado en un 187 por ciento desde el 2013.

Otros psicoestimulantes: en el 2018, 12,676 estadounidenses murieron por sobredosis de psicoestimulantes y 52,279 murieron en la última década debido al abuso de psicoestimulantes. La tasa de mortalidad por sobredosis de psicoestimulantes en el 2018 fue un 22 por ciento más alta que en el 2017.

Muertes inducidas por alcohol
En el 2018, 37,329 estadounidenses murieron debido a causas inducidas por el alcohol; La tasa de muertes inducidas por el alcohol en el 2018 fue un 4 por ciento más alta que el año anterior.

Las muertes inducidas por el alcohol son más altas entre los indios americanos (30.0 por 100,000) y adultos de 55 a 74 años (27.6 por 100,000). Todos los grupos de población tuvieron tasas más altas de muertes por alcohol en 2018 en comparación con el año anterior, excepto los jóvenes de 0 a 17 años, cuya tasa se mantuvo estable.

Muertes por suicidios
En el 2018, 48,344 estadounidenses murieron como resultado del suicidio. A nivel nacional, la tasa de suicidios de 2018 fue dos por ciento más alta que el año anterior (es decir, después de un aumento de cuatro por ciento en 2017). Las tasas de suicidio aumentaron en todos los datos demográficos, excepto en adultos de 18 a 54 años cuya tasa se mantuvo estable. Además, todos los grupos minoritarios raciales y étnicos experimentaron cambios proporcionales mayores en las tasas de suicidio que los blancos.

La muerte por suicidio en el 2018 fue más alta entre los hombres (23.4 por ciento por 100,000), aquellos que viven en áreas rurales (19.7 por 100,000), blancos (16.8 por 100,000) y nativos de los indios americanos / Alaska (14.1 por 100,000).

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Trust for America’s Health es una organización sin fines de lucro y no partidista que promueve la salud óptima para cada persona y comunidad y hace de la prevención de enfermedades y lesiones una prioridad nacional. www.tfah.org. Twitter: @HealthyAmerica1

Well Being Trust es una fundación nacional dedicada a promover la salud mental, social y espiritual de la nación. Creado para incluir la participación de organizaciones de todos los sectores y perspectivas, Well Being Trust se compromete a innovar y abordar los desafíos de salud mental más críticos que enfrenta Estados Unidos, y a transformar el bienestar individual y comunitario. www.wellbeingtrust.org. Twitter: @WellBeingTrust

Annual Deaths Due to Alcohol, Drugs or Suicide Exceeded 150,000 According to the Most Recent Data – And Could Get Worse Due to COVID-19

Alcohol, drug and suicide deaths up in 27 states

(Washington, DC – May 21, 2020) – Newly released data show that 151,964 Americans died due to alcohol, drugs or suicide in 2018. This 2018 national death rate for alcohol, drug and suicide deaths was only very slightly lower than what it had been in 2017 despite progress in reducing deaths due to some types of opioid overdose, according to a new study by Trust for America’s Health (TFAH) and Well Being Trust (WBT).

Between 2017 and 2018, 27 states experienced higher rates (increases above 0.04 percent) of alcohol, drug and suicide deaths. Two states, Vermont and Delaware, experienced double-digit death rate increases – 13 percent and 10 percent respectively. Twenty-three states and the District of Columbia had lower alcohol, drug and suicide deaths during the same period.

States with the highest alcohol, drugs and suicide death rates in 2018 were:

West Virginia (84.9 per 100,000)
New Mexico (82.8 per 100,000)
New Hampshire (68.2 per 100,000)
Alaska (67.8 per 100,000)
Delaware (62.9 per 100,00)

States with the lowest alcohol, drug and suicide rates in 2018 were:

Texas (31.7 per 100,000)
Mississippi (31.7 per 100,000)
Hawaii (34.6 per 100,000)
Nebraska (35.5 per 100,000)
Iowa (35.7 per 100,000)

For the year, alcohol deaths were up 4 percent and suicide deaths were up 2 percent across the country. The new data also show a continuing shift within the opioid crisis with reductions in deaths due to prescription opioid abuse but increases in deaths involving synthetic opioids including fentanyl. Death rates for all opioids were down 2 percent, but the death rate for synthetic opioids was up 10 percent. Additionally, heroin deaths were lower but deaths due to cocaine and psychostimulants abuse were higher.

While still disturbingly high, the 2018 data is the first time since 1999, when the current data collection began, that there hasn’t been a sizable increase in the national alcohol, drugs and suicide deaths per 100,000 rate. However, this stabilization in the deaths rate was not uniform. Some places and populations groups are experiencing stable or decreasing deaths rates while rates among other groups or in other places are continuing to rise.

“These data are a clarion call to action,” said John Auerbach, President and CEO of Trust for America’s Health. “We know what works to address deaths of despair but progress has been uneven and death rates continue to climb, with communities of color experiencing higher rates of increases in drug and alcohol deaths. And there’s another immediate concern: the COVID-19 crisis has increased the health burdens and economic pressures on many communities of color.”

American Indians, Asians, Blacks, Latinos and older adults all experienced increases in drug-induced deaths between 2017 and 2018. Blacks and American Indians had the largest increase. Blacks now have higher synthetic opioid overdose rates (10.7 per 100,000), cocaine overdose rates (8.8 per 100,000) and nearly the same overall drug-induced death rate (21.8 per 100,000) as Whites, after decades of having substantially lower overdose rates. Population groups that experienced lower drug-induced death rates in 2018 included adults ages 18-54 and Whites.

“Quite simply, too many Americans are dying from preventable causes. The profound racial health disparities seen in these data show that many ethnic minority groups are being left behind in our response efforts,” said Benjamin F. Miller, PsyD, chief strategy officer, Well Being Trust. “The nation needs a comprehensive framework for excellence in mental health and well-being, one that intentionally provides solutions for American Indians, Blacks, Asians and Latinos. With all the other COVID-19 related investments, it’s time for the federal government to fully invest in mental health now and for all states to take action.”

Deaths by Drug Type

Synthetic Opioids – in 2018, 31,355 Americans died from synthetic opioid overdose; up 10 percent since 2017. In total, the synthetic-opioid-involved overdose death rate has increased 10-fold since 2013.

Cocaine – In 2018, 14,666 Americans died from cocaine-involved overdoses; up 5 percent since 2017. The overall cocaine overdose death rate has increased by 187 percent since 2013.

Other psychostimulants – In 2018, 12,676 Americans died from overdoses involving psychostimulants and 52,279 have died over the past decade due to psychostimulants abuse. The 2018 psychostimulants overdose death rate was 22 percent higher than it was in 2017.

Alcohol-induced Deaths

In 2018, 37,329 Americans died due to alcohol-induced causes; the rate of alcohol-induced deaths in 2018 was 4 percent higher than the prior year.

Alcohol induced deaths are highest among American Indians (30.0 per 100,000) and adults ages 55 to 74 (27.6 per 100,000). All population groups had higher rates of alcohol deaths in 2018 as compared to the prior year except youths ages 0-17, whose rate held steady.

Suicide Deaths

In 2018, 48,344 Americans died as a result of suicide. Nationally, the 2018 suicide rate was two percent higher than the prior year (that is after a four percent increase in 2017). Suicide rates increased across all demographics, except for adults ages 18-54 whose rate remained stable. In addition, all racial and ethnic minority groups experienced larger proportional changes in suicide rates than did Whites.

Death by suicide in 2018 was highest among males (23.4 percent per 100,000), those living in rural areas (19.7 per 100,000), Whites (16.8 per 100,000) and American Indian/Alaska Natives (14.1 per 100,000).

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Trust for America’s Health is a nonprofit, nonpartisan organization that promotes optimal health for every person and community and makes the prevention of illness and injury a national priority. www.tfah.org. Twittwe: @HealthyAmerica1

Well Being Trust is a national foundation dedicated to advancing the mental, social, and spiritual health of the nation. Created to include participation from organizations across sectors and perspectives, Well Being Trust is committed to innovating and addressing the most critical mental health challenges facing America, and to transforming individual and community well-being. www.wellbeingtrust.org. Twitter: @WellBeingTrust

Las muertes anuales debidas al alcohol, las drogas o el suicidio excedieron los 150,000 según los datos más recientes, y podrían empeorar debido a COVID-19

A pesar de las disminuciones en las muertes por sobredosis de opioides en general, las muertes por opioides sintéticos, cocaína y otros psicoestimulantes aumentaron bruscamente y las muertes por alcohol y suicidio también aumentaron

(Washington, DC y Oakland, CA – 21 de mayo de 2020) – Los datos recientemente publicados muestran que 151,964 estadounidenses murieron debido al alcohol, las drogas o el suicidio en el 2018. Esta tasa nacional de mortalidad por alcohol, drogas y muertes por suicidio fue solo muy ligeramente inferior a lo que había sido en el 2017 a pesar del progreso en la reducción de algunos tipos de sobredosis de opioides, según un nuevo estudio realizado por Trust for America’s Health (TFAH) y Well Being Trust (WBT).

Por el año, las muertes por alcohol aumentaron un 4 por ciento y las muertes por suicidio aumentaron un 2 por ciento. Los nuevos datos también muestran un cambio continuo dentro de la crisis de opioides con reducciones en las muertes por sobredosis de opioides recetados, pero aumentan las muertes que involucran opioides sintéticos, incluido el fentanilo.

Las tasas de mortalidad de todos los opioides disminuyeron un 2 por ciento, pero la tasa de mortalidad de los opioides sintéticos aumentó un 10 por ciento. Además, las muertes por sobredosis con heroína fueron menores, pero las muertes por cocaína y otros psicoestimulantes, como la metanfetamina, el éxtasis, la anfetamina y los estimulantes recetados, fueron mayores.

Aunque todavía es inquietantemente alto, los datos del 2018 son la primera vez desde 1999, cuando comenzó la recopilación de datos actual, que no ha habido un aumento considerable en el alcohol, las drogas y las muertes por suicidio por una tasa de 100,000. Sin embargo, esta estabilización en la tasa de mortalidad no fue uniforme. Algunos lugares y grupos de población están experimentando tasas de mortalidad estables o decrecientes, mientras que las tasas entre otros grupos o en otros lugares continúan aumentando.

“Estos datos son un llamado a la acción”, dijo John Auerbach, presidente y CEO de Trust for America’s Health. “Sabemos lo que funciona para abordar las muertes por desesperación, pero el progreso ha sido desigual y las tasas de mortalidad continúan aumentando, con comunidades de color que experimentan tasas más altas de aumentos en las muertes inducidas por drogas y alcohol. Y hay otra preocupación inmediata: la crisis de COVID-19 ha aumentado las cargas sanitarias y las presiones económicas en muchas comunidades de color “.

Los indios americanos, asiáticos, negros, latinos y adultos mayores experimentaron aumentos en las muertes inducidas por drogas entre 2017 y 2018. Los negros y los indios estadounidenses tuvieron el mayor aumento absoluto. Los negros ahora tienen tasas más altas de sobredosis de opioides sintéticos (10.7 por 100,000), tasas de sobredosis de cocaína (8.8 por 100,000) y casi la misma tasa general de mortalidad inducida por drogas (21.8 por 100,000) que los blancos, después de décadas de tener tasas sustancialmente más bajas.

Los grupos de población que experimentaron tasas de mortalidad más bajas inducidas por drogas en el 2018 incluyeron adultos de 18 a 54 años y blancos.

La reducción de ciertas muertes por opioides sugiere que las políticas y los programas dirigidos a la epidemia de opioides pueden estar afianzándose en algunas poblaciones, pero muchos grupos raciales y étnicos no están viendo el mismo progreso que los blancos. La nación debe basarse en el pequeño grado de éxito y llevar el mismo enfoque a las poblaciones que están en mayor riesgo, especialmente los negros, los latinos y los indios estadounidenses.

Las recomendaciones de política descritas en el informe incluyen:

o Invertir en prevención abordando los factores importantes que crean las condiciones que mejoran los resultados. Numerosos factores contribuyen al bienestar o la falta de este, incluida la pobreza intergeneracional, el racismo sistémico, la discriminación étnica y la homofobia / transfobia se encuentran entre los factores sociales, económicos y ambientales que elevan el riesgo. Las agencias gubernamentales a todos los niveles deben tomar medidas para promover la equidad racial y combatir el racismo y la discriminación.

o Reducir los factores de riesgo y promover la resiliencia en niños, familias y comunidades. Apoyo de políticas y programas equitativos que reduzcan las experiencias traumáticas y adversas, como la exposición a la violencia, la vivienda inestable, la discriminación racial y étnica y el sesgo implícito, que tienen profundos impactos a largo plazo en el uso posterior de sustancias y la salud mental.

o Integrar, aumentar el acceso y mejorar la atención médica al involucrar a todos los sectores de la sociedad para abordar los trastornos de salud mental y uso de sustancias. Las escuelas, los lugares de trabajo, los centros comunitarios, las bibliotecas y los programas públicos deben incorporar formas de abordar los problemas de salud mental y adicciones, desde aumentar la conciencia y reducir el estigma, hasta proporcionar capacitación en intervenciones de crisis y facilitar referencias, e incluso integrar la atención médica en su programación donde sea posible.

o Limitar el acceso a medios letales de suicidio. Promover el almacenamiento seguro de medicamentos y armas de fuego proporcionando educación pública; restringir el acceso a armas de fuego a niños y personas en crisis o en riesgo de suicidio; y la creación de protocolos para proveedores de atención médica, consejeros y personal de primera respuesta sobre cómo interactuar y aconsejar a los pacientes y sus familias para crear entornos seguros. Implementar verificaciones de antecedentes universales para la compra de armas y órdenes de protección de riesgo extremo en todo el país, y ampliar los programas para involucrar a las partes interesadas, como el Proyecto Gun Shop, que educa al personal de las tiendas de armas sobre la prevención del suicidio.

Resumen de datos de 2018

Muertes por tipos de drogas

Muertes por sobredosis de opioides sintéticos: en el 2018, 31,355 estadounidenses murieron por sobredosis de opioides sintéticos; un aumento del 10 por ciento desde el 2017. En total, la tasa de mortalidad por sobredosis con opioides sintéticos ha aumentado casi 10 veces desde el 2013.

Muertes por sobredosis de cocaína: en el 2018, 14,666 estadounidenses murieron por sobredosis relacionadas con la cocaína; hasta un 5 por ciento desde el 2017. La tasa general de mortalidad por sobredosis de cocaína ha aumentado en un 187 por ciento desde el 2013.

Otras muertes por sobredosis de psicoestimulantes: en el 2018, 12,676 estadounidenses murieron por sobredosis de psicoestimulantes y 52,279 murieron en la última década debido al abuso de psicoestimulantes. La tasa de mortalidad por sobredosis de psicoestimulantes en el 2018 fue un 22 por ciento más alta que en el 2017.

Muertes inducidas por alcohol

En el 2018, 37,329 estadounidenses murieron debido a causas inducidas por el alcohol; La tasa de muertes inducidas por el alcohol en el 2018 fue un 4 por ciento más alta que el año anterior.

Muertes por suicidios

En el 2018, 48,344 estadounidenses murieron como resultado del suicidio. A nivel nacional, la tasa de suicidios de 2018 fue dos por ciento más alta que el año anterior (después de un aumento de cuatro por ciento en 2017). Las tasas de suicidio aumentaron en todos los datos demográficos, excepto en adultos de 18 a 54 años cuya tasa se mantuvo estable. Además, todos los grupos minoritarios raciales y étnicos experimentaron cambios proporcionales mayores en las tasas de suicidio que los blancos.

Tendencias estatales

Entre 2017 y 2018, 27 estados experimentaron tasas más altas (por encima del 0,04%) de muertes por alcohol, drogas y suicidio. Veintitrés estados y el Distrito de Columbia tuvieron menos muertes por alcohol, drogas y suicidio durante el mismo período.

Los estados con las tasas más altas de mortalidad por alcohol, drogas y suicidio en el 2018 fueron: West Virginia (84.9 por 100,000), Nuevo México (82.8 por 100,000), New Hampshire (68.2 por 100,000) y Alaska (67.8 por 100,000).

Los estados con las tasas más bajas de alcohol, drogas y suicidio en 2018 fueron: Texas (31.7 por 100,000), Mississippi (31.7 por 100,000) y Hawaii (34.6 por 100,000).

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