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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

 

 

 

 

 

The State of Obesity 2018

«state_headline»

Report emphasizes urgent need to increase evidence-based obesity prevention programs to prevent disease and potentially save billions in healthcare spending

«lead_graph»

Findings include:

  • Adult obesity rates vary considerably from state to state, with a high of 38.1 percent in West Virginia and a low of 22.6 percent in Colorado. No state had a statistically significant improvement in its obesity rate over the past year.
  • Adult obesity rates are at or above 35 percent in seven states; for the first time in Iowa and Oklahoma, and at least the second time in Alabama, Arkansas, Louisiana, Mississippi, and West Virginia.
  • Six states — Iowa, Massachusetts, Ohio, Oklahoma, Rhode Island, and South Carolina — saw their adult obesity rates increase significantly between 2016 and 2017.
  • Adult obesity rates are between 30 and 35 percent in 22 states and 19 states have adult obesity rates between 25 and 30 percent.
  • Over the past five years (2012 – 2017), 31 states had statistically significant increases in their obesity rate and no state had a statistically significant decrease in its obesity rate.
  • There continue to be striking racial and ethnic disparities in obesity rates. In 31 states, the adult obesity rate among Blacks is at or above 35 percent.  Latino adults have obesity at a rate at or above 35 percent in eight states.  White adults have obesity rates at or above 35 percent in one state. Nationally, the adult obesity rates for Latinos, Blacks and Whites are 47.0 percent, 46.8 percent and 37.9 percent respectively.

State by State rates of obesity among adults: 1 = highest rate of obesity, 51 = lowest rate

  1. West Virginia (38.1%), 2. Mississippi (37.3%), 3. Oklahoma (36.5%), 4. Iowa (36.4%), 5. Alabama (36.3%), 6. Louisiana (36.2%), 7. Arkansas (35.0%), 8. Kentucky (34.3%), 9. Alaska (34.2 %), 10. South Carolina (34.1%), 11. Ohio (33.8%), 12. Indiana (33.6%), 13. North Dakota (33.2%), 14. Texas (33.0%), 15. Tie Tennessee and Nebraska (32.8%), 17. Missouri (32.5%), 18. Kansas (32.4%), 19. Michigan (32.3%), 20. North Carolina (32.1%), 21. Wisconsin (32.0%), 22. South Dakota (31.9%), 23. Delaware (31.8%), 24. Tie Pennsylvania and Georgia (31.6%), 26. Maryland (31.3%), 27. Illinois (31.1%), 28. Virginia (30.1%), 29. Rhode Island (30.0%), 30. Arizona (29.5%), 31. Oregon (29.4%), 32. Idaho (29.3%), 33. Maine (29.1%), 34. Wyoming (28.8%), 35. Tie Minnesota, Florida and New Mexico (28.4%), 38. New Hampshire (28.1%), 39. Washington (27.7%), 40. Vermont (27.6%), 41. New Jersey (27.3%), 42. Connecticut (26.9%), 43. Nevada (26.7%), 44. Massachusetts (25.9%), 45. New York (25.7%), 46. Tie Montana and Utah (25.3%), 48. California (25.1%), 49. Hawaii (23.8 %), 50. District of Columbia (23.0%), 51. Colorado (22.6 %).

NOTE to reporters: See full report at TFAH.org/ObesityReport2018 and StateofObesity.org for state-by-state obesity rates, data interactives, priority policy summaries, and briefs for all 50 states.

“Obesity is a complex and often intractable problem and America’s obesity epidemic continues to have serious health and cost consequences for individuals, their families and our nation,” said John Auerbach, president and CEO of Trust for America’s Health. “The good news is that there is growing evidence that certain prevention programs can reverse these trends.  But we won’t see meaningful declines in state and national obesity rates until they are implemented throughout the nation and receive sustained support.”

Obesity is a problem in virtually every city and town, and every income and social sector.  But its impact is most serious in communities where conditions make access to healthy foods and regular physical activity more difficult, such as lower income and rural areas, including many communities of color.

The national costs of obesity are enormous.  Obesity drives an estimated $149 billion annually in directly related healthcare spending, and an additional $66 billion annually in lowered economic productivity. Also, one in three young adults is ineligible for military service, owing to being overweight, posing a national security vulnerability.

Evidence-based programs, policies and practices to reverse the obesity trend are known but need widespread implementation.

“Obesity is a major challenge in nearly every state and our role as public health leaders is to ensure we’re doing everything we can to address it,” said John Wiesman, president of the Association of State and Territorial Health Officials (ASTHO) and secretary of health at the Washington State Department of Health. “Our goal at the state level is to work across sectors to advocate for and implement evidence-based policies that encourage active healthy living and support healthy and safe communities that provide access to healthy foods, physical activity, and clinical preventive services.”

Recommendations

The report offers 40 recommendations for federal, state and local policymakers; the restaurant and food industries; and the healthcare system, including:

  • Support and expand policies and programs aimed at addressing obesity at the federal, state and community levels, including programs in the Centers for Disease Control and Prevention’s (CDC) Division of Nutrition, Physical Activity and Obesity, and community health programs like the Racial and Ethnic Approaches for Community Health program (REACH), and programs that focus on school health in CDC’s Division of Population Health.
  • Maintain and strengthen essential nutrition supports for low-income children, families and individuals through programs — like the Supplemental Nutrition Assistance Program (SNAP) and the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) in the U.S. Department of Agriculture (USDA) and expand programs and pilots to make healthy food more available and affordable through the program.
  • Maintain nutrition standards for school meals that were in effect prior to USDA’s interim final rule from November 2017, as well as current nutrition standards for school snacks.
  • States should ensure that all students receive at least 60 minutes of physical education or activity during each school day.
  • Medicare should encourage eligible beneficiaries to enroll in obesity counseling as a covered benefit, and, evaluate its use and effectiveness. Health plans, medical schools, continuing medical education, and public health departments should raise awareness about the need and availability of these services.
  • Food and beverage companies should eliminate children’s exposure to advertising and marketing of unhealthy products.
  • Hospitals should no longer sell or serve sugary drinks on their campuses; they should also improve the nutritional quality of meals and promote breastfeeding.

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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

Pain in the Nation

New Report: «state»’s Drug, Alcohol and Suicide Death Rate Could Increase «inc_percent» in Next Decade; «state» Would have «rank_25_upper» Rate in Country

Study Highlights Solutions, Calls for National Resilience Strategy

Washington, D.C., November 21, 2017 – «state»’s drug, alcohol and suicide death rate could increase by «inc_percent» in the next 10 years, according to a new report, Pain in the Nation: The Drug, Alcohol and Suicide Epidemics and the Need for a National Resilience Strategy, released today by the Trust for America’s Health (TFAH) and Well Being Trust (WBT).

«state»’s rate could rise to «rate_25» per 100,000 people from these three causes by 2025 – which would be the «rank_25_lower» – compared to the state’s current rate of «rate_15» per 100,000 (as of 2015), which is the «rank_15_lower».

Nationally, deaths from drugs, alcohol and suicide could account for 1.6 million fatalities over the coming decade (2016 to 2025). This would represent a 60 percent increase compared to the past decade, if recent trends hold, based on an analysis conducted by the Berkeley Research Group (BRG) for this report. From 2006 to 2015, there were 1 million deaths from these three causes.

  • Nationally, in 2015, there were 127,500 deaths from drugs, alcohol and suicide. The epidemics currently are responsible for 350 deaths per day, 14 per hour and one every four minutes.
  • According to the report’s projections, this could reach 192,000 per year by 2025 (39.7 deaths per 100,000 in 2015 compared to 55.9 per 100,000 in 2025).
  • At a state level, in 2005, 21 states and Washington, D.C. had death rates from these three causes above 30 per 100,000, and only six states had death rates above 40 per 100,000.
  • As of 2015, 48 states and Washington, D.C. had rates above 30 per 100,000, 30 were above 40 per 100,000 and five states had rates above 60 per 100,000, including New Mexico which had the highest rate of 77.4 per 100,000.
  • By 2025, 26 states could reach 60 deaths per 100,000 – and two states (New Mexico and West Virginia) could reach rates of 100 deaths per 100,000.

The study found, however, that these numbers may be conservative, especially with the rapid rise of heroin, fentanyl and carfentanil use. If the nation continues along recent trajectories, death rates would actually double to 2 million by 2025.

“These numbers are staggering, tragic – and preventable,” said John Auerbach, president and CEO of TFAH. “There is a serious crisis across the nation and solutions must go way beyond reducing the supply of opioids, other drugs and alcohol. Greater steps – that promote prevention, resiliency and opportunity – must be taken to address the underlying issues of pain, hopelessness and despair.

Current Nationwide Trends

  • Drug overdose deaths tripled between 2000 and 2015 (with a total of 52,400 deaths in 2015), with rural community opioid-related death rates increasing seven-fold. Provisional data shows drug overdoses could exceed 64,000 in 2016, with fentanyl deaths alone accounting for 21,000 of these deaths (and fentanyl-related deaths doubling between 2015 and 2016).«state»’s drug overdose death rate was «deaths_drug» per 100,000 in 2015, which ranked «rank_drug».
  • Alcohol-induced deaths increased 37 percent between 2000 and 2015, reaching a 35-year high at 33,200 deaths in 2015. This excludes alcohol-attributable deaths related to injury and violence.«state»’s alcohol-induced death rate was «deaths_alcohol» per 100,000 in 2015, which ranked «rank_alcohol».
  • Suicide deaths increased by 28 percent between 2000 and 2015 to more than 44,000 deaths (as of 2015). Rural suicide rates are 40 percent higher than in metro areas.«state»’s suicide death rate was «deaths_suicide» per 100,000 in 2015, which ranked «rank_suicide».
  • As of 2015, more than 43 million Americans experienced a mental health issue, more than 20 million had a substance use disorder and more than 8 million experienced both – and these numbers are likely to be underestimates due to stigma and lack of available treatment; and
  • Only around one in 10 people with substance use disorders receive recommended treatment.

Report Calls for a National Resilience Strategy

“We’re facing a generational crisis. And it calls for bigger and bolder action. Simply creating new programs to address one piece of the problem is insufficient – we need more robust and systematic change. The good news is: we know a lot about what works and can make a difference,” said Benjamin F. Miller, PsyD, Chief Policy Officer, Well Being Trust. “This report highlights the need for investments that take a whole-person approach to wellbeing – encompassing the physical, mental, emotional and spiritual aspects of wellbeing – to truly address the drivers of pain, ultimately saving lives.”

Pain in the Nation calls for the creation of a National Resilience Strategy that takes a comprehensive approach by focusing on prevention, early identification of issues and effective treatment. The report highlights more than 60 research-based policies, practices and programs to reduce substance misuse and suicide and improve well-being.

Example State Policies and Rates: The report features more than 60 policies – the following are some example policies where state activity can be tracked «state» National Trends
A “Y” means the state has a particular policy
State Law Requires Prescribers to Query the Prescription Drug Monitoring Program (PDMP) Before Submitting an Opioid Prescription (as of 2017)

«policy_pdmp»

37 States
State Law Allows Laypersons to Possess Naloxone Without a Prescription (as of 2017)

«policy_possession»

14 States + D.C.
State Has a Good Samaritan Law Protecting People from Reporting/Experiencing an Overdose from Liability (as of 2017)

«policy_samaritan»

40 States + D.C.
State Has a Law Supporting Sterile Syringe Access Programs (as of 2016)

«policy_syringe»

24 States + D.C.
State Has a Commercial Host Liability Law (also known as dram shop laws, which hold a seller responsible for providing alcohol to minors or intoxicated individuals, laws vary in terms of levels and types of allowed liability) (as of 2016)

«policy_commercial_host»

37 States + D.C.
State Has a Comprehensive Anti-Bullying Laws (all states have some form of law, American Academy of Pediatrics reviewed laws for comprehensiveness) (as of July 2017)

«policy_anti_bullying»

22 States
State Requires Annual Suicide Prevention Training for School Personnel (as of 2016)

«policy_suicide_prevention»

9 States
Number of Physicians in the State Certified to Provide Buprenorphine (Medication-Assisted) Treatment to 100 or more patients (as of October 2017)

«policy_buprenorphine»

1,297 Physicians Nationwide
Children Confirmed as Victims of Maltreatment by Child Welfare Services – Rate Per 1,000 Children. (as of 2015)

«policy_maltreatment_rate»

9 per 1,000
State Has an Earned Income Tax Credit (which supports better outcomes for low-income families, including boosting millions of families out of poverty) (as of 2016)

«policy_eitc»

26 States + D.C.

Some key recommendations from the report include to:

  • Improve Pain Management and Treatment by helping people heal physically, mentally and emotionally. Approaches must acknowledge that there are different types of pain and experts from mental health, medical care and other disciplines must develop team-based solutions that focus on proactively addressing pain before it gets worse.
  • Stem the Opioid Crisis with a full-scale approach – including promoting responsible opioid prescribing practices (such as provider education and best practices for Prescription Drug Monitoring Programs); public education about misuse and safe disposal of unused drugs; “hotspot” intervention strategies; anti-trafficking to stop the flow of heroin, fentanyl and other illicit drugs; and expanding the use and availability of rescue drugs, sterile syringes and diversion programs.
  • Address the Impact of the Opioid Epidemic on Children – and the Need for a Multi-Generational Response that includes substance use disorder treatment for parents and wrap-around services for children and families, including grandparents and other relatives who help care for children, and expand support for the foster care system.Model programs for families struggling with opioid and other substance misuse disorders have been twice as effective in helping mothers achieve sobriety, reduced state custody placement of children by half and had a return on investment of $2.22 for every $1 spent on child welfare programs.
  • Lower Excessive Alcohol Use through evidence-based policies, such as by increasing pricing, limiting hours and density of alcohol sales, enforcing underage drinking laws and holding sellers and hosts liable for serving minors.For example, a 10 percent increase in the price of alcoholic beverages is shown to reduce consumption by 7.7 percent.
  • Prevent Suicides by expanding crisis intervention services; anti-bullying and social-emotional learning in schools; and support systems for Veterans; and better integrating mental health into primary care.For instance, the Zero Suicide model program has shown 80 percent reductions in suicides.
  • Expand and Modernize Mental Health and Substance Use Disorder Treatment Services – Toward a Goal of Focusing on the “Whole Health” of Individuals by prioritizing innovative integrated delivery models for rural and underserved urban areas and expanding the provider workforce, including those who can deliver medication-assisted treatment.Some effective substance use treatment programs have a return of $3.77 per $1 invested.
  • Prioritize Prevention, Reduce Risk Factors and Promote Resilience in Children, Families and Communities by limiting trauma and adverse experiences, which have the biggest long-term impact on later substance misuse, and promoting better mental health.For instance, nurse family home visiting programs have a return of $5.70 for every $1 invested, and early childhood education programs have a $4 to $12 return for every $1 invested.
  • Reboot Substance Misuse Prevention and Mental Health in Schools by scaling up evidence-based life- and coping-skills programs and inclusive school environments and increasing the availability of mental health and other services.Top school substance misuse prevention programs have a $3.80 to $34 return for every $1 invested; social-emotional learning programs have an $11 for $1 return; and school violence prevention (including suicide) programs have a $15 to $81 for $1 return.

The report was supported by grants from WBT and the Robert Wood Johnson Foundation (RWJF). Data analysis and projections were provided by the Berkeley Research Group. The full report is available on TFAH’s website at www.healthyamericans.org.

2015 STATE-BY-STATE DRUG, ALCOHOL AND SUICIDE DEATH RATES AND 2025 PROJECTIONS

Based on an analysis of new state-by-state data from the Centers for Disease Control and Prevention’s Wide-ranging ONline Data for Epidemiologic Research (CDC WONDER), current (2015) and projected (2025) rates of deaths per 100,000 people from drugs, alcohol and suicide from highest to lowest were:

Note: 1 = Highest rate, 51 = lowest.

2025 PROJECTIONS, STATE-BY-STATE DRUG, ALCOHOL AND SUICIDE DEATH RATES

1. New Mexico (105.7); 2. West Virginia (99.6); 3. Wyoming (88.8); 4. New Hampshire (88.1); 5. Alaska (84.4); 6. Kentucky (81.3); 7. Rhode Island (79.7); 8. Arizona (75.8); 9. Montana (75.6); 10. Nevada (75.0); 11. Ohio (74.6); 12. Oregon (72.8); 13. Maine (71.5); 14. (tie) Oklahoma (70.0) and Utah (70.0); (tie) 16. Colorado (67.8) and Tennessee (67.8); 18. Pennsylvania (67.7); 19. Massachusetts (66.6); 20. Michigan (65.9); 21. Vermont (65.8); 22. Idaho (63.4); 23. Washington (63.3); 24. Connecticut (61.2); 25. Indiana (61.0); 26. Delaware (60.4); 27. Florida (59.6); 28. (tie) Louisiana (58.5) and Missouri (58.5); 30. South Dakota (57.4); 31. Wisconsin (55.5); 32. South Carolina (55.4); 33. Arkansas (54.2); 34. North Carolina (53.1); 35. (tie) District of Columbia (52.2) and Maryland (52.2); 37. Alabama (51.9); 38. Kansas (49); 39. California (48.9); 40. North Dakota (47.4); 41. Minnesota (47.3); 42. Iowa (46); 43. Virginia (44.9); 44. Georgia (44.6); 45. (tie) Illinois (44.4) and 45. New Jersey (44.4); 47. (tie) Hawaii (43.3) and New York (43.3); 49. Mississippi (42.8); 50. Texas (38.9); 51. Nebraska (37.7).

2015 STATE-BY-STATE DRUG, ALCOHOL AND SUICIDE DEATH RATES

1. New Mexico (77.4); 2. West Virginia (67.4); 3. Wyoming (66.4); 4. Alaska (63); 5. New Hampshire (60.6); 6. Montana (56.7); 7. Kentucky (56.1); 8. Arizona (55); 9. Rhode Island (54.5); 10. Oregon (54); 11. Nevada (53.8); 12. Maine (51.1); 13. Ohio (50.8); 14. Oklahoma (50.5); 15. (tie) Colorado (49.7) and Utah (49.7); 17. Vermont (47.6); 18. Tennessee (47.3); 19. Idaho (47.1); 20. Pennsylvania (46.3); 21. Washington (45.9); 22. Michigan (45.8); 23. Massachusetts (44.9); 24. South Dakota (43.8); 25. Indiana (43); 26. Florida (42.9); 27. (tie) Connecticut (41.9) and Delaware (41.9); 29. Missouri (41.7); 30. Louisiana (41.2); 31. Wisconsin (39.9); 32. South Carolina (39.7); 33. Arkansas (39.5); 34. North Carolina (37.7); 35. Alabama (36.8); 36. Kansas (36); 37. (tie) District of Columbia (35.7) and North Dakota (35.7); 39. California (35.4); 40. Maryland (35.1); 41. Minnesota (34.5); 42. Iowa (33.9); 43. Virginia (32.3); 44. Georgia (31.9); 45. Illinois (31.3); 46. Hawaii (31.2); 47. Mississippi (30.9); 48. New Jersey (30.5); 49. New York (30); 50. Texas (28.4); 51. Nebraska (28.2).

Trust for America’s Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority. For more information, visit www.healthyamericans.org. Twitter: @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 wellness. www.wellbeingtrust.org. Twitter: @WellBeingTrust

Ready or Not? 2017

«state» Achieved «score_num» of 10 Indicators in Report on Health Emergency Preparedness

«state»’s Flu Vaccination Rate is «fvr_num» Percent, «flu_rank_upper»

Washington, D.C., December 19, 2017 – In Ready or Not? Protecting the Public’s Health from Diseases, Disasters and Bioterrorism, «state» achieved «score_lower» of 10 key indicators of public health preparedness.

In total, 25 states scored a 5 or lower—Alaska scored lowest at 2 out of 10, and Massachusetts and Rhode Island scored the highest at 9 out of 10.

The report, issued today by the Trust for America’s Health (TFAH), found the country does not invest enough to maintain strong, basic core capabilities for health security readiness and, instead, is in a continued state of inefficiently reacting with federal emergency supplemental funding packages each time a disaster strikes.

According to Ready or Not?, federal funding to support the base level of preparedness has been cut by more than half since 2002, which has eroded advancements and reduced the country’s capabilities.

“While we’ve seen great public health preparedness advances, often at the state and community level, progress is continually stilted, halted and uneven,” said John Auerbach, president and CEO of TFAH.  “As a nation, we—year after year—fail to fully support public health and preparedness. If we don’t improve our baseline funding and capabilities, we’ll continue to be caught completely off-guard when hurricanes, wildfires and infectious disease outbreaks hit.”

No. Indicator «state» Number of States Receiving Points
A “Y” means the state received a point for that indicator
1 Public Health Funding Commitment: State increased or maintained funding for public health from FY 2015 to FY 2016 and FY 2016 to FY 2017. «phfc» 19 + D.C.
2 National Health Security Preparedness Index: State increased their overall preparedness scores based on the National Health Security Preparedness Index™ between 2015 and 2016. «nhspi» 33
3 Public Health Accreditation: The state public health department is accredited. «pha» 30 + D.C.
4 Antibiotic Stewardship Program for Hospitals:  State has 70 percent or more of hospitals reporting meeting Antibiotic Stewardship Program core elements in 2016. «asp» 20 + D.C.
5 Flu Vaccination Rate: State vaccinated at least half of their population (ages 6 months and older) for the seasonal flu from Fall 2016 to Spring 2017.* «fvr» 20
6 Enhanced Nurse Licensure Compact (eNLC): State participates in an eNLC. «enlc» 26
7 United States Climate Alliance: State has joined the U.S. Climate Alliance to reduce greenhouse gas emissions consistent with the goals of the Paris Agreement. «usca» 14
8 Public Health Laboratories: State laboratory provided biosafety training and/or provided information about biosafety training courses (July 1, 2016 to June 30, 2017). «lab_safety» 47 + D.C.
9 Public Health Laboratories: State laboratory has a Biosafety Professional (July 1, 2016 to June 30, 2017). «phl_staff» 47 + D.C.
10 Paid Sick Leave: State has paid sick leave law. «sick_leave» 8 + D.C.
Total «score_num»

Ready or Not? features six expert commentaries from public health officials who share perspectives on and experiences from the historic hurricanes, wildfires and other events of 2017, including from California, Florida, Louisiana and Texas.

The report also examines the nation’s ability to respond to public health emergencies, tracks progress and vulnerabilities, and includes a review of state and federal public health preparedness policies. Some key findings include:

  • Just 19 states and Washington, D.C. increased or maintained funding for public health from Fiscal Year (FY) 2015-2016 to FY 2016-2017.
  • The primary source for state and local preparedness for health emergencies has been cut by about one-third (from $940 million in FY 2002 to $667 million in FY 2017) and hospital emergency preparedness funds have been cut in half ($514 million in FY 2003 to $254 million in FY 2017).
  • In 20 states and Washington, D.C. 70 percent or more of hospitals reported meeting Antibiotic Stewardship Program core elements in 2016.
  • Just 20 states vaccinated at least half of their population (ages 6 months and older) for the seasonal flu from Fall 2016 to Spring 2017—and no state was above 56 percent.
  • 47 state labs and Washington, D.C. provided biosafety training and/or provided information about biosafety training courses (July 1, 2016 to June 30, 2017).

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

  • Communities should maintain a key set of foundational capabilities and focus on performance outcomes in exchange for increased flexibility and reduced bureaucracy.
  • Ensuring stable, sufficient health emergency preparedness funding to maintain a standing set of core capabilities so they are ready when needed. In addition, a complementary Public Health Emergency Fund is needed to provide immediate surge funding for specific action for major emerging threats.
  • Strengthening and maintaining consistent support for global health security as an effective strategy for preventing and controlling health crises. Germs know no borders.
  • Innovating and modernizing infrastructure needs – including a more focused investment strategy to support science and technology upgrades that leverage recent breakthroughs and hold the promise of transforming the nation’s ability to promptly detect and contain disease outbreaks and respond to other health emergencies.
  • Recruiting and training a next generation public health workforce with expert scientific abilities to harness and use technological advances along with critical thinking and management skills to serve as Chief Health Strategist for a community.
  • Reconsidering health system preparedness for new threats and mass outbreaks.  Develop stronger coalitions and partnerships among providers, hospitals and healthcare facilities, insurance providers, pharmaceutical and health equipment businesses, emergency management and public health agencies.
  • Preventing the negative health consequences of climate change and weather-related threats. It is essential to build the capacity to anticipate, plan for and respond to climate-related events.
  • Prioritizing efforts to address one of the most serious threats to human health by expanding efforts to stop superbugs and antibiotic resistance.
  • Improving rates of vaccinations for children and adults – which are one of the most effective public health tools against many infectious diseases.
  • Supporting a culture of resilience so all communities are better prepared to cope with and recover from emergencies, particularly focusing on those who are most vulnerable.   Sometimes the aftermath of an emergency situation may be more harmful than the initial event.  This must also include support for local organizations and small businesses to prepare for and to respond to emergencies.

The report was supported by a grant from the Robert Wood Johnson Foundation (RWJF) and is available on TFAH’s website at www.healthyamericans.org.

Score Summary:

A full list of all of the indicators and scores and the full report are available on TFAH’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.

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

 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

Ready or Not?

«state» Scored «score_upper» out of 10 on Key Indicators Related to Preventing, Detecting, Diagnosing and Responding to Outbreaks

Report Finds the Nation Often Caught Off Guard when a New Threat Emerges

Washington, D.C., December 20, 2016 – A report released today by Trust for America’s Health (TFAH) finds «state» scored «score_lower» out of 10 on key indicators of public health preparedness.

In Ready or Not? Protecting the Public from Diseases, Disasters and Bioterrorism, 26 states and Washington, D.C. scored a six or lower on 10. Alaska and Idaho scored lowest at 3 out of 10, and Massachusetts scored the highest at 10 out of 10, with North Carolina and Washington State scoring 9’s.

The report found that the nation is often caught off guard when a new threat arises, such a Zika or the Ebola outbreak or bioterrorist threat, which then requires diverting attention and resources away from other priorities.

“Health emergencies can quickly disrupt, derail and divert resources from other ongoing priorities and efforts from across the government,” said Rich Hamburg, interim president and CEO, TFAH.  “Many areas of progress that were made after 9/11 and the anthrax attacks to improve health security have been undercut.  We aren’t adequately maintaining a strong and steady defense, leaving us unnecessarily vulnerable when new threats arise.”

Ready or Not? examines the nation’s ability to respond to public health emergencies, tracks progress and vulnerabilities, and includes a review of state and federal public health preparedness policies.  Some key «state» findings include:

No. Indicator «state» Number of States Receiving Points
A “Y” means the state received a point for that indicator
1 Public Health Funding Commitment: State increased or maintained funding for public health from FY 2014 to FY 2015 and
FY 2015 to FY 2016.		 «phfc» 26
2 National Health Security Preparedness Index: State met or exceeded the overall national average score (6.7) of the National Health Security Preparedness IndexTM, as of 2016. «nhspi» 30 + D.C.
3 Public Health Accreditation: State had at least one accredited public health department. «pha» 43 + D.C.
4 Flu Vaccination Rate: State vaccinated at least half of their population (ages 6 months and older) for the seasonal flu from Fall 2015 to Spring 2016. «fvr» 10
5 Climate Change Readiness: State received a grade of C or above in States at Risk: America’s Preparedness Report Card. «ccr» 32 + D.C.
6 Food Safety: State increased the speed of DNA fingerprinting using pulsed-field gel electrophoresis (PFGE) testing for all reported cases of E. coli. «fs» 45 + D.C.
7 Reducing Healthcare-Associated Infections (HAIs): State implemented all four recommended activities to build capacity for HAI prevention. «rhai» 35 + D.C.
8 Public Health Laboratories: State public health laboratory provided biosafety training and/or provided information about biosafety training courses for sentinel clinical labs (from July 1, 2015 to June 30, 2016). «phl_train» 44
9 Public Health Laboratories: State public health laboratories reported having a biosafety professional on staff (from July 1, 2015 to June 30, 2016). «phl_staff» 47 + D.C.
10 Emergency Healthcare Access: State has a formal access program or a program in progress for getting private sector healthcare staff and supplies into restricted areas during a disaster. «eha» 10
Total «score_num»

In addition, the report examined trends in public health preparedness over the last 15 years, finding successes and ongoing concerns.

  • One-third of funds for health security and half of funds for healthcare system preparedness have been cut: Health emergency preparedness funding for states has been cut from $940 million in fiscal year (FY) 2002 to $660 million in FY 2016; and healthcare system preparedness funding for states has been cut by more than half since FY 2005 – down to $255 million.
  • Some major areas of accomplishment: Improved emergency operations, communication and coordination; support for the Strategic National Stockpile and the ability to distribute medicines and vaccines during crises; major upgrades in public health labs and foodborne illness detection capabilities; and improvements in legal and liability protections during emergencies.
  • Some major ongoing gaps: Lack of a coordinated, interoperable, near real-time biosurveillance system; insufficient support for research and development of new medicines, vaccines and medical equipment to keep pace with modern threats; gaps in the ability of the healthcare system to care for a mass influx of patients during a major outbreak or attack; and cuts to the public health workforce across states.

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

  • Requiring strong, consistent baseline public health Foundational Capabilities in regions, states and communities-so that everyone is protected.
  • Ensuring stable, sufficient health emergency preparedness funding to maintain a standing set of foundational capabilities alongside a complementary Public Health Emergency Fund which would provide immediate surge funding during an emergency.
  • Improving federal leadership before, during and after disasters – including at the White House level.
  • Recruiting and training a next generation public health workforce with expert scientific abilities to harness and use technological advances along with critical thinking and management skills to serve as the Chief Health Strategist for a community.
  • Reconsidering health system preparedness for new threats and mass outbreaks by developing stronger coalitions and partnerships among providers, hospitals, insurance providers, pharmaceutical and health equipment businesses, emergency management, and public health agencies.
  • Prioritizing efforts to address one of the most serious threats to human health by expanding efforts to stop Superbugs and antibiotic resistance.
  • Improving rates of vaccinations for children and adults – which are one of the most effective public health tools against many infectious diseases.

Ready or Not? was released annually from 2003-2012, and more recently, TFAH has released Outbreaks: Protecting Americans from Infectious Diseases, from 2013-2015. The report was supported by a grant from the Robert Wood Johnson Foundation (RWJF) and is available on TFAH’s website at www.healthyamericans.org.

Score Summary:

A full list of all of the indicators and scores and the full report are available on TFAH’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.

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

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

Special Issue Brief: Obesity Rates Among WIC Children

«state»’s Obesity Rate Among Young Children from Low-Income Families «delta_upper», is «rate_2014» Percent

Robert Wood Johnson Foundation and Trust for America’s Health Highlight Signs of Progress Among WIC Participants, but Emphasize Obesity Rates Remain Too High

Washington, D.C., November 17, 2016 —«state»’s obesity rate among young children from low-income families «delta_lower» and is «rate_2014» percent, according to a study published today in Morbidity and Mortality Weekly Report (MMWR) by the Centers for Disease Control and Prevention (CDC) and U.S. Department of Agriculture (USDA). «state»’s rate is «rank_upper».

Overall, obesity showed a statistically significant decrease in 31 states and three territories and increased significantly in four states (Nebraska, North Carolina, Ohio and West Virginia) among 2- to 4-year-olds enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) from 2010 to 2014.

Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF) released a new data visualization showing how state-by-state obesity rates have changed among 2- to 4-year-old WIC participants since 2000 and a series of maps highlighting states’ efforts to help promote nutrition and physical activity in early child care settings.

Utah had the lowest rate of 2- to 4-year-old WIC participants who were obese at 8.2 percent, while Virginia had the highest rate at 20.0 percent, according to today’s findings.

Additional data on obesity rates among young children:

WIC

  • 18 states have obesity rates at or above 15 percent among 2- to 4-year-old WIC participants (in 2014). In 2010, 26 states had a rate at or above 15 percent.
  • While obesity rates among this population have declined in recent years, they remain high – with a national average of 14.5 percent. The national average was 8.4 percent in 1992.

NHANES

  • These new data for young children from low-income families reflect the significant inequity in obesity and health related to income-the national obesity rate among 2- to 5-year-olds across all economic levels is 8.9 percent (from the National Health and Nutrition Examination Survey, 2014).

“These data are encouraging because kids from lower-income families are especially vulnerable and often face higher risk for obesity,” said Donald F. Schwarz, MD, MPH, MBA, vice president, RWJF. “We must continue to track and analyze child obesity and the programs that aim to reduce rates, especially among our nation’s youngest kids. This is critical for informing efforts to address disparities and ensuring that all children-no matter who they are or where they live-have a healthy start from their very first days.”

“It is heartening to see evidence of progress after decades of work,” said Rich Hamburg, interim president and CEO, TFAH. “However, this doesn’t mean we’ve accomplished our goal. We need to keep the momentum going to ensure young children and families have the support they need — through programs like WIC — that help improve access to healthy, affordable food, quality healthcare, home visiting programs and health and nutrition education programs.”

Last month, CDC released a new Early Care and Education State Indicator Report, tracking state policies that aim to prevent obesity in child care settings. Some key findings include:

  • 38 states and Washington, D.C. have Quality Rating and Improvement Systems (QRIS) for child care programs, and, of those, 29 have included obesity prevention in their state standards;
  • 41 states and Washington, D.C. offer online professional development training for early childhood education (ECE) providers that cover obesity prevention topics;
  • 42 states and Washington, D.C. include ECE settings in their comprehensive plans for addressing chronic disease or nutrition and physical activity; and
  • 28 states and Washington, D.C. encouraged enhanced nutrition standards in their Child and Adult Care Food Programs (CACFP) as of 2015.

In September 2016, RWJF and TFAH released State of Obesity 2016: Better Policies for a Healthier America, which included a detailed policy analysis of WIC and other related childhood nutrition and obesity prevention initiatives, noting that:

  • WIC provides benefits – direct food assistance as well as counseling and education support – to approximately 8 million low-income individuals, including around 2 million pregnant and post-partum women, 2 million infants and 4 million children under age 5;
  • For every dollar spent on pregnant women enrolled in the WIC program, up to $4.21 is saved in Medicaid spending;
  • Around 15 million U.S. children live in “food-insecure” households, where they have limited access to adequate food and nutrition due to cost, proximity and/or other resources; and
  • Food insecurity among families is particularly concentrated in different areas around the country – in 321 counties, the average food insecurity rate is 23 percent, while in the other 2,821 counties, the average rate is 15 percent. Fifty percent of the high food-insecurity counties are in rural areas, 26 percent are metropolitan and 90 percent are in the South.

The State of Obesity report includes recommended strategies and policies to help ensure all young children have the opportunity to maintain a healthy weight. Some key areas of emphasis include:

  • Ensuring access to quality healthcare and family home visiting programs for at-risk families, which includes supporting early screening for health, nutrition and social service needs and connecting families directly to programs and resources;
  • Nutrition assistance and education programs and healthy food financing initiatives to make healthy choices affordable and available for all families in all neighborhoods;
  • Active living initiatives in communities that support places that are convenient and safe to be physically active;
  • Supporting healthy nutrition and physical activity in all child care settings, including limiting screen time, eliminating sugar-sweetened beverages and implementing the updated standards from the Child and Adult Care Food Program and Child Care and Development Block Grant; and
  • Prioritizing early childhood education opportunities under the Every Student Succeeds Act (ESSA).

Data released today are from the WIC Participant and Program Characteristics Study (WIC PC) as reported in an analysis of the Morbidity and Mortality Weekly Review. WIC PC summarizes the demographic information of WIC participants and is based on measured height and weight data. Women, infants and children in families with incomes at or below 185 percent of the federal poverty level (FPL) who are at nutritional risk are eligible for the WIC program (FPL is $24,250 for a family of four); some participants become income eligible for WIC through participation in other programs based on income or other economic variables programs. Further analysis of the WIC program and changes in participation levels could provide additional evidence on the factors that helped contribute to the decline in obesity rates.

Follow the conversation at #StateofObesity.

Trust for America‘s Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority. For more information, visit www.healthyamericans.org.

For more than 40 years the Robert Wood Johnson Foundation has worked to improve health and health care. We are striving to build a national Culture of Health that will enable all to live longer, healthier lives now and for generations to come. For more information, visit www.rwjf.org. Follow the Foundation on Twitter at www.rwjf.org/twitter or on Facebook at www.rwjf.org/facebook.

2014 «state»-BY-«state» OBESITY RATES OF WIC PARTICIPANTS AGES 2-4

Based on an analysis of new state-by-state data from the WIC Participant and Program Characteristics Study (WIC PC), obesity rates for children ages 2-4 by state from highest to lowest were:

1. Virginia (20.0); 2. Alaska (19.1); 3. Delaware (17.2); 4. South Dakota (17.1); 5. Nebraska (16.9); 6. (tie) California (16.6) and Massachusetts (16.6); 8. Maryland (16.5); 9. West Virginia (16.4); 10. (tie) Alabama (16.3) and Rhode Island (16.3); 12. (tie) Connecticut (15.3) and 12. New Jersey (15.3); 14. Illinois (15.2); 15. (tie) Maine (15.1) and 15. New Hampshire (15.1); 17. (tie) North Carolina (15.0) and Oregon (15.0); 19. (tie) Tennessee (14.9) and Texas (14.9); 21. (tie) Iowa (14.7) and 21. Wisconsin (14.7); 23. Mississippi (14.5); 24. (tie) Arkansas (14.4) and North Dakota (14.4); 26. (tie) Indiana (14.3) and New York (14.3); 28. Vermont (14.1); 29. Oklahoma (13.8); 30. Washington (13.6); 31. Michigan (13.4); 32. (tie) Arizona (13.3) and Kentucky (13.3); 34. Louisiana (13.2); 35. Ohio (13.1); 36. (tie) District of Columbia (13.0) and Georgia (13.0) and Missouri (13.0); 39. Pennsylvania (12.9); 40. Kansas (12.8); 41. Florida (12.7); 42. (tie) Montana (12.5) and New Mexico (12.5); 44. Minnesota (12.3); 45. (tie) Nevada (12.0) and South Carolina (12.0); 47. Idaho (11.6); 48. Hawaii (10.3); 49. Wyoming (9.9); 50. Colorado (8.5); 51. Utah (8.2).

Note: 1 = Highest rate, 51 = lowest rate.

The State of Obesity 2016

New Report Finds «state»’s Obesity Rate is «rate» Percent, «rank_upper»

Rates Decreased in Four States: Minnesota, Montana, New York and Ohio

Washington, D.C., September 1, 2016 — The adult obesity rate in «state» is «rate» percent, giving them the «rank_lower» rate, according to The State of Obesity: Better Policies for a Healthier America, a report from the Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF).

U.S. adult obesity rates decreased in four states (Minnesota, Montana, New York and Ohio), increased in two (Kansas and Kentucky) and remained stable in the rest, between 2014 and 2015. This marks the first time in the past decade that any states have experienced decreases – aside from a decline in Washington, D.C. in 2010.

Despite these modest gains, obesity continued to put millions of Americans at increased risk for a range of chronic diseases, such as diabetes and heart disease, and costs the country between $147 billion and $210 billion each year.

In 2015, Louisiana has the highest adult obesity rate at 36.2 percent and Colorado has the lowest at 20.2 percent. While rates remained steady for most states, they are still high across the board. The 13th annual report found that rates of obesity now exceed 35 percent in four states, are at or above 30 percent in 25 states and are above 20 percent in all states. In 1991, no state had a rate above 20 percent.  The analyses are based on the U.S. Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System (BRFSS).

The State of Obesity also found that:

  • 9 of the 11 states with the highest obesity rates are in the South and 22 of the 25 states with the highest rates of obesity are in the South and Midwest.
  • 10 of the 12 states with the highest rates of diabetes are in the South-and rates of diabetes increased in three states (Louisiana, Mississippi and Oregon). «state»’s diabetes rate is «diabetes_rate» percent, «diabetes_rank».
  • American Indian/Alaska Natives have an adult obesity rate of 42.3 percent.
  • Adult obesity rates for Blacks are «black_rate» in «state»«black_rank» and at or above 40 percent for Blacks in 14 states.
  • Adult obesity rates for Latinos are «latino_rate» percent in «state», the «latino_rank» rate.
  • Adult obesity rates for Whites are «white_rate» percent in «state», the «white_rank» rate, and at or above 25 percent for Whites in 39 states.
  • Nationally, adult obesity rates are at or above 30 percent in: 40 states and Washington, D.C. for Blacks; 29 states for Latinos; and 16 states for Whites.

There is some evidence that the rate of increase has been slowing over the past decade.  For instance, in 2005, 49 states experienced an increase; in 2008, 37 states did; in 2010, 28 states did; in 2011, 16 states did; in 2012, only one state did; and in 2014, only two states did. (Note: the methodology for BRFSS changed in 2011).

“Obesity remains one of the most significant epidemics our country has faced, contributing to millions of preventable illnesses and billions of dollars in avoidable healthcare costs,” said Richard Hamburg, interim president and CEO, TFAH. “These new data suggest that we are making some progress but there’s more yet to do. Across the country, we need to fully adopt the high-impact strategies recommended by numerous experts. Improving nutrition and increasing activity in early childhood, making healthy choices easier in people’s daily lives and targeting the startling inequities are all key approaches we need to ramp up.”

Some other key findings from the report include:

  • The number of high school students who drink one or more soda a day has dropped by nearly 40 percent since 2007, to around one in five (20.4 percent) in 2015 (note: does not include sport/energy drinks, diet sodas, or water with added sugars). «soda_text»
  • The number of high school students who report playing video or computer games three or more hours a day has increased more than 88 percent since 2003 (from 22.1 to 41.7 percent). «video_games_tv»
  • More than 29 million children live in “food deserts,” and more than 15 million U.S. children-including «food_insecure_rate» in «state»-live in “food-insecure” households – having limited access to adequate food and nutrition due to cost, proximity and/or other reasons.
  • The federal government has awarded more than $90 million via 44 Healthy Food Financing Initiative financial assistance awards in 29 states«hffi» since 2011 – helping leverage more than $1 billion and create 2,500 jobs.
  • 18 states«elem_pe» and Washington, D.C. set a minimum amount of time that elementary students must participate in physical education; 14 states«ms_pe» and Washington, D.C. set a minimum amount for middle schools; and six states«hs_pe» set a minimum amount for high schools.

The report also includes a set of priority policy recommendations to accelerate progress in addressing obesity:

  • Invest in Obesity Prevention: Providing adequate funding for the Prevention and Public Health Fund and for the Centers for Disease Control and Prevention’s National Center for Chronic Disease Prevention and Health Promotion/Division of Nutrition, Physical Activity, and Obesity would increase support to state and local health departments.
  • Focus on Early Childhood Policies and Programs: Supporting better health among young children through healthier meals, physical activity, limiting screen time and connecting families to community services through Head Start; prioritizing early childhood education opportunities under the Every Student Succeeds Act (ESSA); and implementing the updated nutrition standards covering the Child and Adult Care Food Program.
  • School-Based Policies and Programs: Continuing implementation of the final “Smart Snacks” rule for improved nutrition for snacks and beverages sold in schools; eliminating in-school marketing of foods that do not meet Smart Snacks nutrition standards; and leveraging opportunities to support health, physical education and activity under ESSA.
  • Community-Based Policies and Programs: Prioritizing health in transportation planning to help communities ensure residents have access to walking, biking, and other forms of active transportation and promoting innovative strategies, such as tax credits, zoning incentives, grants, low-interest loans and public-private partnerships to increase access to healthy, affordable foods.
  • Health, Healthcare and Obesity: Covering the full range of obesity prevention, treatment and management services under all public and private health plans, including nutrition counseling, medications and behavioral health consultation, along with encouraging an uptake in services for all eligible beneficiaries.

“This year’s State of Obesity report is an urgent call to action for government, industry, healthcare, schools, child care and families around the country to join in the effort to provide a brighter, healthier future for our children. It focuses on important lessons and signs of progress, but those efforts must be significantly scaled to see a bigger turn around,” said Risa Lavizzo-Mourey, president and CEO of RWJF. “Together, we can build an inclusive Culture of Health and ensure that all children and families live healthy lives.”

The State of Obesity report (formerly known as F as in Fat), with state rankings and interactive maps, charts and graphs, is available at http://stateofobesity.org. Follow the conversation at #StateofObesity.

2015 STATE-BY-STATE ADULT OBESITY RATES

Based on an analysis of new state-by-state data from the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System, adult obesity rates by state from highest to lowest were:

Note: 1 = Highest rate of adult obesity, 51 = lowest rate of adult obesity.

1. Louisiana (36.2); 2. (tie) Alabama (35.6), Mississippi (35.6) and West Virginia (35.6); 5. Kentucky (34.6); 6. Arkansas (34.5); 7. Kansas (34.2); 8. Oklahoma (33.9); 9. Tennessee (33.8); 10. (tie) Missouri (32.4) and Texas (32.4); 12. Iowa (32.1); 13. South Carolina (31.7); 14. Nebraska (31.4); 15. Indiana (31.3); 16. Michigan (31.2); 17. North Dakota (31.0); 18. Illinois (30.8); 19. (tie) Georgia (30.7) and Wisconsin (30.7); 21. South Dakota (30.4); 22. (tie) North Carolina (30.1) and Oregon (30.1); 24. (tie) Maine (30.0) and Pennsylvania (30.0); 26. (tie) Alaska (29.8) and Ohio (29.8); 28. Delaware (29.7); 29. Virginia (29.2); 30. Wyoming (29.0); 31. Maryland (28.9); 32. New Mexico (28.8); 33. Idaho (28.6); 34. Arizona (28.4); 35. Florida (26.8); 36. Nevada (26.7); 37. Washington (26.4); 38. New Hampshire (26.3); 39. Minnesota (26.1); 40. Rhode Island (26.0); 41. New Jersey (25.6); 42. Connecticut (25.3); 43. Vermont (25.1); 44. New York (25.0); 45. Utah (24.5); 46. Massachusetts (24.3); 47. California (24.2); 48. Montana (23.6); 49. Hawaii (22.7); 50. District of Columbia (22.1); 51. Colorado (20.2).

Trust for America’s Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority. For more information, visit www.healthyamericans.org.

For more than 40 years the Robert Wood Johnson Foundation has worked to improve health and health care. We are striving to build a national Culture of Health that will enable all to live longer, healthier lives now and for generations to come. For more information, visit www.rwjf.org. Follow the Foundation on Twitter at www.rwjf.org/twitter or on Facebook at www.rwjf.org/facebook.

Outbreaks

«state» Scored «score_upper» Out of 10 on Key Indicators Related to Preventing, Detecting, Diagnosing and Responding to Outbreaks

Report Finds Major Gaps in Country’s Ability to Prevent and Control Infectious Disease Outbreaks

Washington, D.C., December 17, 2015 – A new report released today by Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF) finds «state» scored «score_lower» out of 10 on key indicators related to preventing, detecting, diagnosing and responding to outbreaks.

Twenty-eight states and Washington, D.C. scored 5 or lower out of 10 key indicators. Five states—Delaware, Kentucky, Maine, New York and Virginia—tied for the top score, achieving eight out of 10 indicators. Seven states — Idaho, Kansas, Michigan, Ohio, Oklahoma, Oregon and Utah — tied for the lowest score at three out of 10.

The report, Outbreaks: Protecting Americans from Infectious Diseases, concluded that the United States must redouble efforts to better protect Americans from new infectious disease threats such as MERS-CoV and antibiotic-resistant Superbugs and resurging illnesses like whooping cough, tuberculosis and gonorrhea.

“The overuse of antibiotics and underuse of vaccinations along with unstable and insufficient funding have left major gaps in our country’s ability to prepare for infectious disease threats,” said Jeffrey Levi, PhD, executive director of TFAH. “We cannot afford to continue to be complacent. Infectious diseases – which are largely preventable – disrupt the lives of millions of Americans and contribute to billions of dollars in unnecessary healthcare costs each year.”

Some key «state» findings include:

No. Indicator «state» Number of States Receiving Points
A “Y” means the state received a point for that indicator
1 Public Health Funding: State increased or maintained funding for public health between FY 2013 to 2014 and FY 2014 to 2015. «metric1» 34 and Washington, D.C.
2 Flu Vaccination Rates: State vaccinated at least half of their population (ages 6 months and older) for the seasonal flu from Fall 2014 to Spring 2015. The rate was «flu_vaccine_rate» in «state», the national average is 47.1 percent. «metric2» 18
3 Childhood Immunization School Requirement Policies: State law either excludes philosophical exemptions entirely or requires a parental notarization or affidavit to achieve a religious or philosophical exemption for school attendance. In 2014, there were more than 600 cases of measles and nearly 33,000 cases of whooping cough reported. While more than 90 percent of U.S. kindergarteners receive all recommended vaccinations, rates are lower in a number of communities and states. More than 28 percent of preschoolers do not receive all recommended vaccinations. «metric3» 20
4 HIV/AIDS Surveillance: State requires reporting of all (detectable and undetectable) CD4 cell count (a type of white blood cell) and HIV viral load data to their state HIV surveillance program. Of the more than 1.2 million Americans are living with HIV, almost one in eight do not know they are infected. (As of July 2013.) «metric4» 43 and Washington, D.C.
5 Syringe Exchange Programs: State explicitly authorizes syringe exchange programs (SEP). Hepatitis C infections—related to a rise in heroin and injection drug use from people transitioning from prescription painkillers—increased by more than 150 percent nationally from 2010 to 2013. «metric5» 16 and Washington, D.C.
6 Climate Change and Infectious Disease: State currently has climate change adaptation plans completed. «metric6» 15
7 Central Line-Associated Bloodstream Infections (CLABSI): State reduced the standard infection rate (SIR) for CLABSI between 2012 and 2013. «state» has a CLABSI SIR of «clabsi_2013_sir». The national CLABSI SIR is 0.5. Around one out of every 25 people who are hospitalized each year contracts some form of healthcare-associated infection leading to around 75,000 deaths a year. «metric7» 9
8 Public Health Laboratories: State laboratories reported having a biosafety professional from July 1, 2014 to June 30, 2015. «metric8» 36
9 Public Health Laboratories: State laboratories provided biosafety training and/or information about courses for sentinel clinical labs in their jurisdiction from July 1, 2014 to June 30, 2015. «metric9» 35
10 Food Safety: State met the national performance target of testing 90 percent of reported E.coli O157 cases within four days (in 2013). Around 48 million Americans get sick from a foodborne illness each year. «metric10» 39 and Washington, D.C.
Total «score_upper»

“America’s investments in infectious disease prevention ebb and flow leaving our nation challenged to sufficiently address persistent problems,” said Paul Kuehnert, a Robert Wood Johnson Foundation director. “We need to reboot our approach so we support the health of every community by being ready when new infectious threats emerge.”

The Outbreaks report features priority recommendations, including:

  • Increase resources to ensure every state can maintain and modernize basic capabilities – such as epidemiology and laboratory abilities – that are needed to respond to new and ongoing outbreaks;
  • Update disease surveillance to be real-time and interoperable across communities and health systems to better detect, track and contain disease threats;
  • Incentivize the development of new medicines and vaccines, and ensure systems are in place to effectively distribute them when needed;
  • Decrease antibiotic overuse and increase vaccination rates;
  • Improve and maintain the ability of the health system to be prepared for a range of potential threats – such as an influx of patients during a widespread outbreak or the containment of a novel, highly infectious organism that requires specialty care;
  • Strengthen efforts and policies to reduce healthcare-associated infections;
  • Take strong measures to contain the rising hepatitis C epidemic and other sexually transmitted infections, particularly among young adults; and
  • Adopt modern strategies to end AIDS in every state and city.

The indicators represent examples of important capabilities, policies and trends, and were selected in consultation with leading public health and healthcare officials. The report and state-by-state materials are available on TFAH’s website at www.healthyamericans.org.

Score Summary:

A full list of all of the indicators and scores and the full report are available on TFAH’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, with zero the lowest possible overall score and 10 the highest. The data for the indicators are from publicly available sources or were provided from public officials.

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

Trust for America’s Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority. www.healthyamericans.org

For more than 40 years the Robert Wood Johnson Foundation has worked to improve health and health care. We are striving to build a national Culture of Health that will enable all to live longer, healthier lives now and for generations to come. For more information, visit www.rwjf.org. Follow the Foundation on Twitter at www.rwjf.org/twitter or on Facebook at www.rwjf.org/facebook.

Reducing Teen Substance Misuse: What Really Works

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Washington, D.C., November 19, 2015– In a new report, Reducing Teen Substance Misuse: What Really Works, «intro_text»

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The report’s analysis of the most recent drug overdose death rates among 12- to 25-year-olds found:

  • Current rates were highest in West Virginia (12.6 per 100,000 youth) – which were more than five times higher than the lowest rates in North Dakota (2.2 per 100,000).
  • Males are 2.5 times as likely to overdose as females (10.4 vs. 4.1 per 100,000). The rate in «state» for males was «male» «per_label» and «female» for females.
  • In 1999-2001, no state had a youth drug overdose death rate above 6.1 per 100,000. By 2011-13, 33 states were above 6.1 per 100,000. In the past 12 years:
    • Rates have more than doubled in 18 states (Alabama, Arizona, California, Colorado, Connecticut, Georgia, Hawaii, Idaho, Illinois, Kentucky, Nebraska, Nevada, New Jersey, New Mexico, North Carolina, Oregon, South Carolina and Tennessee);
    • Rates have more than tripled in twelve states (Arkansas, Delaware, Indiana, Iowa, Michigan, Minnesota, Missouri, New Hampshire, New York, Oklahoma, Utah and West Virginia); and
    • Rates have more than quadrupled in five states (Kansas, Montana, Ohio, Wisconsin and Wyoming).

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No. Indicator «state» Number of States Receiving Points
A “Y” means the state received a point for that indicator
1 Support Academic Achievement: State has at least an 80 percent high school graduation rate (2012-2013).
Source: U.S. Department of Education, ED Data Express, Regulatory Adjusted Cohort Graduation Rates, 2013-2014.		 «metric1» 35
2 Preventing Bullying: State has comprehensive bullying prevention laws.
Source: American Academy of Pediatrics.		 «metric2» 21
3 Preventing Smoking: State has smoke-free laws that prohibit smoking in public places, including restaurants and bars.
Source: Campaign for Tobacco-Free Kids.		 «metric3» 30 and Washington, D.C.
4 Preventing Underage Alcohol Sales: State has liability (dram shop) laws holding establishments accountable for selling alcohol to underage or obviously intoxicated individuals.
Source: National Conference of State Legislatures and NOLO.		 «metric4» 37 and Washington, D.C.
5 Screening, Brief Intervention and Referral to Treatment Support: State has billing codes for Screening, Brief Intervention and Referral for Treatment (SBIRT) in their medical health (Medicaid or private insurance) programs.
Source: Institute for Research Education & Training in Addictions and Community Catalyst.		 «metric5» 32 and Washington, D.C.
6 Mental Health Funding: State increased funding for mental health services for Fiscal Year 2015.
Source: National Alliance on Mental Illness.		 «metric6» 29 and Washington, D.C.
7 Depression Treatment: State has rates of treatment for teens with major depressive episodes above the National percentage of 38.1 percent (2009-2013).
Source: SAMHSA, Behavioral Health Barometer: United States, 2014. 		«metric7» 30 and Washington, D.C.
8 Good Samaritan Laws: State has laws in place to provide some immunity from criminal charges or mitigation of sentencing of seeking help for an overdose.
Source: Network for Public Health Law.		 «metric8» 31 and Washington, D.C.
9 Treatment and Recovery Support for Prescription Drug Misuse: State provides Medicaid coverage for all three FDA-approved medications for the treatment of painkiller dependence.
Source: American Society of Addiction Medicine.		 «metric9» 30 and Washington, D.C.
10 Sentencing Reform: State has taken action to roll back “one-size-fits-all” sentences for nonviolent drug offenses.
Sources: The Vera Institute of Justice for 2000-2013 laws. For 2014 updates, The Sentencing Project, National Conference of State Legislatures and additional legislative scans for states meeting the thresholds set by the Vera Institute review.		 «metric10» 31 and Washington, D.C.
Total «score_upper»

“More than 90 percent of adults who develop a substance use disorder began using before they were 18,” said Jeffrey Levi, PhD, executive director of TFAH. “Achieving any major reduction in substance misuse will require a reboot in our approach – starting with a greater emphasis on preventing use before it starts, intervening and providing support earlier and viewing treatment and recovery as a long-term commitment.”

The increase in youth drug overdose deaths is largely tied to increases in prescription drug misuse and the related doubling in heroin use by 18- to 25-year-olds in the past 10 years – 45 percent of people who use heroin are also addicted to prescription painkillers.

In addition, youth marijuana rates have increased by nearly 6 percent since 2008 and more than 13 percent of high school students report using e-cigarettes. Youth from affluent families and/or neighborhoods report more frequent substance and alcohol use than lower-income teens – often related to having more resources available to access alcohol and drugs.

“The case for a prevention-first and continuum-of-care approach is supported by more than 40 years of research, but the science hasn’t been implemented on a wide scale in the real world,” said Alexa Eggleston, senior program officer, domestic programs, Conrad N. Hilton Foundation. “It’s time to bring innovations to scale and invest in more proactive and sustained approaches that promote positive protective factors, like safe, stable families, homes, schools and communities and intervene early to address youth substance use before addiction develops.”

Reducing Teen Substance Misuse identified a set of research-based approaches and recommendations to modernize the nation’s strategy to prevent and reduce substance use and support a full continuum-of-care, including:

  • Putting prevention first, using evidence-based approaches across communities and in schools. Each state should have an end-to-end network of experts and resources to support the effective community-based selection, adoption, implementation and evaluation of evidence-based programs;
  • Strategically investing in evidence-based programs that show the strongest results in reducing risk factors for substance misuse, poor academic performance, bullying, depression, violence, suicide, unsafe sexual behaviors and other problems that often emerge during teen years and young adulthood;
  • Integrating school-based and wider community efforts, via multisector collaboration – and effectively collecting data to assess community needs, better select programs that match with those needs and improve accountability. Schools cannot and should not be expected to solve the problem on their own;
  • Renewing efforts to gain support for the adoption and implementation of evidence-based and sustained school-based programs – moving beyond decades of ineffective approaches;
  • Incorporating SBIRT as a routine practice in middle and high schools and healthcare settings – along with other regular health screenings – even brief counseling and interventions can have a positive impact; and
  • Increasing funding support for sustained and ongoing mental health and substance use treatment and recovery.

The report provides additional research-based recommendations for preventing and reducing youth substance misuse. It was supported by a grant from the Conrad N. Hilton Foundation and is available on TFAH’s website at www.healthyamericans.org.

Score Summary:

A full list of all of the indicators and scores, listed below, is available along with the full report on TFAH’s web site at www.healthyamericans.org.  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.

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

State-by-state Youth Drug Overdose Death Rankings:

Note: Rates include drug overdose deaths, for 2011-2013, a three-year average, for 12- to 25-year-olds. 1 = Highest rate of drug overdose fatalities, 51 = lowest rate of drug overdose fatalities. States with statistically significant (p<0.05) increases since 2005-2007 are noted with an asterisk (*), while states with a statistically significant decrease are noted with two asterisks (**).

1. West Virginia (12.6); 2. New Mexico (12.5); 3. Utah (12.1); 4. Pennsylvania (11.8); 5. Nevada (11.6); 6. New Jersey (10.7*); 7. Kentucky (10.5); 8. (tie) Arizona (10.2*) and Colorado (10.2*) and Delaware (10.2*); 11. Wyoming (9.8*); 12. Indiana (9.6); 13. Missouri (9.5*); 14. Oklahoma (9.4); 15. New Hampshire (9.3); 16. Ohio (9.1*); 17. Wisconsin (8.8*); 18. Maryland (8.5); 19. Arkansas (8.4); 20. Connecticut (8.3); 21. Illinois (8.2*); 22. Michigan (8.1*); 23. Massachusetts (7.8); 24. Alaska (7.2); 25. North Carolina (7.1); 26. (tie) Montana (7.0) and Tennessee (7.0**) and Vermont (7.0); 29. (tie) New York (6.9*) and Washington (6.9); 31. Oregon (6.5); 32. (tie) Alabama (6.2) and Louisiana (6.2**); 34. (tie) Rhode Island (6.0) and Texas (6.0); 36. (tie) Kansas (5.9) and Virginia (5.9); 38. (tie) Idaho (5.8) and South Carolina (5.8); 40. (tie) Florida (5.7**) and Minnesota (5.7*); 42. Georgia (5.2); 43. California (4.9*); 44. Maine (4.7**); 45. Hawaii (4.6); 46. Iowa (4.3); 47. (tie) Mississippi (3.7**) and Nebraska (3.7); 49. South Dakota (3.3); 50. North Dakota (2.2).

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