State Category: Arkansas

New Report: Nation’s Chronic Lack of Investment in Public Health Puts Americans’ Lives and Livelihoods at Risk

COVID-19 emergency funding was critical to initial pandemic response but did not address nation’s long-standing underinvestment in public health; $4.5 billion in annual infrastructure funding is needed

(Washington, DC – July 28, 2022) – Chronic underfunding has created a public health system that cannot address the nation’s health security needs, its persistent health inequities, as well as emerging threats, and, was a contributing factor in the inadequate response to the COVID-19 pandemic, according to a report, The Impact of Chronic Underfunding on America’s Public Health System: Trends, Risks, and Recommendations, 2022, released today by Trust for America’s Health.

Lack of funding in core public health programs slowed the response to the COVID-19 pandemic and exacerbated its impact, particularly in low-income communities, communities of color, and for older Americans – populations that experience higher rates of chronic disease and have fewer resources to recover from an emergency. TFAH is one of numerous organizations within the public health community calling for an annual $4.5 billion investment in public health infrastructure at the state, local, tribal, and territorial levels.

This annual report examines federal, state, and local public health funding trends and recommends investments and policy actions to build a stronger public health system, prioritize prevention, and address the ways in which social and economic inequities create barriers to good health in many communities.

“As we navigate the next stages of the pandemic and beyond, it is critical that we modernize public health data infrastructure, grow and diversify the public health workforce, invest in health promotion and prevention programs, and reduce health inequities. Investments in public health are needed in every community but should particularly be directed to those communities, which due to the impacts of structural racism, poverty, systemic discrimination, and disinvestment are placed at greatest risk during a health emergency,” said Dr. Gracia.

Emergency funding is not sufficient to address system weaknesses created by chronic underfunding

State and local public health agencies managed two divergent realities during 2021. Short-term funding was up significantly as the federal government provided funding to states and localities in an effort to control the pandemic.  But this funding was one-time money and often specifically tied to COVID-19. Most of it could not be used to address longstanding deficits in the public health system, including ensuring the provision of basic public health services, replacing antiquated data systems, and growing the public health workforce. An October 2021 analysis conducted by the de Beaumont Foundation and the Public Health National Center for Innovations, found that state and local health departments need an 80 percent increase in the size of their workforce to be able to provide comprehensive public health services to their communities.

Another challenge for state and local health departments is that emergency response funding, while critical during the emergency, is too late to build prevention and preparedness programs, programs that must be in place before an emergency if they are going to protect lives. To be adequately prepared for the next public health emergency, the nation needs to sustain higher levels of public health funding and provide more flexible funding.

“Emergency funding is important but not sufficient to fill the longstanding gaps in public health investments. The ‘boom-and-bust’ cycle of public health funding has meant that the system does not have the tools or workforce to modernize and respond to the range of threats impacting our communities,” said J. Nadine Gracia, M.D., MSCE, President and CEO of Trust for America’s Health.

Funding for two key emergency preparedness and response programs are down sharply over the past two decades:

  • The U.S. Centers for Disease Control and Prevention (CDC) is the country’s leading public health agency and the primary source of funding for state, local, tribal, and territorial health departments. CDC’s annual funding for Public Health Emergency Preparedness (PHEP) programs increased slightly between FY 2021 and FY 2022, from $840 million to $862 million, but has been reduced by just over one-fifth since FY 2002, or approximately in half when adjusted for inflation.
  • The Hospital Preparedness Program, administered by the U.S. Department of Health and Human Services’ Office of the Assistant Secretary for Preparedness and Response, is the primary source of federal funding to help healthcare systems prepare for emergencies. It has experienced a nearly two-thirds reduction over the last two decades when adjusted for inflation.

Funding for health promotion, prevention, and equity also need sustained growth

As a nation, we spent $4.1 trillion on health in 2020 but only 5.4 percent of that spending targeted public health and prevention. Notably, this share nearly doubled last year as compared to 2019 – due to short-term COVID-19 response funding – but is still grossly inadequate and likely to return to pre-pandemic levels if the historic pattern of surging funding for public health during an emergency but neglecting it at other times resumes.  Inadequate funding means that effective public health programs, such as those to prevent suicide, obesity, and environmental health threats, only reach a fraction of states. This longstanding neglect contributes to high rates of chronic disease and persistent health inequities.

Recommendations for policy actions

The report calls for policy action by the administration, Congress, and state and local officials within four areas:

Substantially increase core funding to strengthen public health infrastructure and grow the public health workforce, including increasing CDC’s base appropriation and modernizing the nation’s public health data and disease tracking systems.

Invest in the nation’s health security by increasing funding for public health emergency preparedness, including within the healthcare system, improving immunization infrastructure, and addressing the impacts of climate change.

Address health inequities and their impact on root causes of disease by addressing the social determinants of health that have an outsized impact on health outcomes.

Safeguard and improve health across the lifespan. Many programs that promote health and prevent the leading causes of disease, disability, and death have been long neglected and do not reach all states or the populations most at risk. Reinvigorating programs that stem chronic disease, support children and families, and prevent substance misuse and suicide should be a top priority.

Read the full report

 

 

Nuevo Reporte: La Falta Reiterada de inversión en Salud Pública Por Parte de la Nación, Pone en Riesgo La Vida y Los Medios De Subsistencia De Los Estadounidenses

Los Fondos de Emergencia del COVID-19 fue una respuesta fundamental desde un principio, pero no lo suficiente efectiva para atender el problema que viene acarreando el país debido a la falta de inversión en la salud pública; Se necesitan $ 4.5 mil millones en fondos anuales

(Washington, DC – 28 de julio del 2022) – La insuficiencia crónica de fondos ha creado un sistema de salud pública que no logra cubrir las necesidades de seguridad de salud de la nación, las persistentes desigualdades en la salud, así como las amenazas emergentes, y fue uno de los factores que contribuyó a la respuesta inadecuada a la pandemia de COVID-19, según un informe, The Impact of Chronic Underfunding on America’s Public Health System: Trends, Risks, and Recommendations, 2022, publicado hoy por Trust for America’s Health.

“El financiamiento de emergencia es importante pero no suficiente para llenar los vacíos de larga data en las inversiones en salud pública. El ciclo de ‘auge y caída’ de la financiación de la salud pública demuestra que el sistema no tiene las herramientas o la fuerza laboral para modernizarse y responder a las diversas amenazas que afectan a nuestras comunidades”, dijo J. Nadine Gracia, M.D., MSCE, presidente y directora ejecutiva de Trust for America’s Health.

Este informe anual examina las tendencias de financiación de la salud pública a nivel federal, estatal y local, recomendando inversiones y acciones políticas para construir un sistema de salud pública más fuerte, dándole prioridad a la prevención, abordando temas como las desigualdades sociales y económicas las cuales crean barreras para lograr un buen sistema de salud en muchas comunidades.

La falta de fondos para programas básicos de salud pública desaceleró la respuesta a la pandemia de COVID-19 y exacerbó su impacto, particularmente en las comunidades de bajos ingresos, comunidades de color y en los estadounidenses de avanzada edad los cuales son las poblaciones que representan las tasas más altas de enfermedades crónicas y tienen menos recursos para recuperarse de una emergencia. TFAH es una de las numerosas organizaciones dentro de la comunidad de salud pública que solicita una inversión anual de $4500 millones en infraestructura de salud pública a nivel estatal, local, tribus y territorial.

“A medida que atravesamos nuevas etapas de la pandemia vemos más allá, y se observa que la necesidad fundamental es que se modernice la infraestructura de datos de salud pública, que aumentemos y diversifiquemos la fuerza laboral de salud pública, que se invierta en programas de prevención y promoción de la salud, reduciendo las desigualdades en el sector de la salud. Las inversiones en salud pública son necesarias en todas las comunidades, pero deben dirigirse particularmente a aquellas comunidades que, debido a los impactos del racismo estructural, la pobreza, la discriminación sistémica y la desinversión, se encuentran en mayor riesgo durante una emergencia de salud”, dijo el Dr. Gracia.

El fondo de emergencia no es suficiente para atender las debilidades del sistema creadas por la falta de financiación crónica

Las agencias de salud pública estatales y locales manejaron dos realidades divergentes durante el 2021. La financiación a corto plazo aumentó significativamente ya que el gobierno federal proporcionó fondos de emergencia en respuesta a los estados y localidades en esfuerzo para controlar la pandemia. Pero esta financiación de dinero se realizó sola vez, y en algunos casos específicamente vinculado al COVID-19. Gran parte de este fondo de emergencia no pudo ser utilizada para abordar los déficits de larga data en el sistema de salud pública, los cuales incluían asegurar provisiones para cubrir los gastos básicos de salud pública, sustituir los sistemas desactualizados de datos y aumentar la fuerza laboral de salud pública. Un análisis de octubre del 2021 realizado por la Fundación de Beaumont y el Centro Nacional de Innovaciones de Salud Pública encontró que los departamentos estatales y locales de salud necesitan un aumento del 80 por ciento en el campo de su fuerza laboral para poder brindar servicios integrales de salud pública a sus comunidades.

Otro desafío para los departamentos de salud a nivel estatal y local es que los fondos de emergencias, si bien es una gran ayuda durante la emergencia, es demasiado tarde para trabajar en un plan de preparación y prevención, ya que estos programas deben implementarse antes de una emergencia para proteger vidas. Para estar adecuadamente preparado para la próxima emergencia de salud pública, la nación debe mantener los niveles de fondos más altos respecto a la salud pública y proveer una financiación flexible.

Los fondos de dos programas clave de preparación y respuesta de emergencias se han visto drásticamente reducidos en las últimas dos décadas:

  • Los Centros para el Control y la Prevención de Enfermedades (CDC) de EE. UU. son la principal agencia de salud pública del país y la principal fuente de financiación para los departamentos de salud estatales, locales, tribales y territoriales. La financiación anual de los CDC para los programas de preparación para emergencias de salud pública (PHEP, por sus siglas en inglés) aumentó ligeramente entre el año fiscal 2021 y el año fiscal 2022, de $840 millones a $862 millones, pero ha reducido un poco más de una quinta parte desde el año fiscal 2002, ó aproximadamente a la mitad cuando se ajusta por inflación.
  • El Programa de Preparación Hospitalaria, administrado por la Oficina del Subsecretario de Preparación y Respuesta del Departamento de Salud y Servicios Humanos de EE. UU., es la fuente principal de financiamiento federal para ayudar a los sistemas de atención médica a prepararse para emergencias. El programa ha sufrido una reducción de casi dos tercios en las últimas dos décadas cuando se ajusta a la inflación.

Los fondos para la promoción de la salud, la prevención y la equidad también necesita un crecimiento sostenido

Como nación, gastamos $4,1 billones en salud en 2020, pero solo el 5,4 % de ese gasto se destinó a la salud pública y la prevención. Notablemente, casi se duplicó la cifra del año pasado en comparación con el 2019. Esto se debe a la respuesta de fondos implementados a corto plazo en respuesta al COVID-19. Sin embargo, esta cifra sigue siendo insuficiente y muy probable que regrese a los niveles en los que se encontraba antes de la pandemia, si el patrón histórico de aumento de fondos para la salud pública aumenta durante otra emergencia, volveremos a estar en la misma situación.  La financiación inadecuada significa que los programas efectivos de salud pública, como aquellos para prevenir el suicidio, la obesidad y las amenazas ambientales para la salud, solo llegan a una fracción de los estados. Esta negligencia de larga data contribuye a las altas tasas de enfermedades crónicas y a las persistentes desigualdades en el ámbito de la salud.

“Debemos romper el patrón de invertir solo en el sistema de salud pública durante una emergencia, ya que no permite trabajar en la preparación y prevención. Es muy importante invertir en salud pública y equidad sanitaria de manera continua, incluso en tiempos que no sean de emergencia, para lograr salvar vidas, reduciendo los costos económicos para nuestra nación durante y entre emergencias”, dijo la Dra. Gracia.

Los impactos del racismo estructural, la pobreza, la discriminación y la desinversión son temas que deben de igual manera abordarse mediante inversiones a través de programas que aseguren que cada comunidad tenga acceso a alimentos saludables, vivienda segura, atención médica, transporte, educación y empleo, ya que todos estos factores afectan la salud de las personas.

Recomendaciones para tomar medidas de acción:

El informe exige la adopción de medidas de acción por parte de la administración, el Congreso y funcionarios tanto estatales como locales en cuatro áreas:

Aumentar sustancialmente los fondos básicos para fortalecer la infraestructura de salud pública y desarrollar su fuerza laboral, incluyendo el aumento de la asignación básica de los CDC y la modernización de los sistemas de seguimiento de enfermedades y datos de salud pública de la nación.

Invertir en la seguridad de la salud de la nación, aumentando los fondos de salud pública para la preparación de emergencias de sanidad, mejorando la infraestructura de inmunización y tomando en cuenta los impactos del cambio climático.

Abordar las desigualdades de la salud y su impacto como causas principal de  enfermedades abordando los factores sociales de la salud que tienen un impacto descomunal en temas de salud pública.

Proteger y mejorar la salud a través del tiempo en vida. Muchos programas que promuevan la salud y prevengan las principales causas de enfermedad, discapacidad y muerte se han descuidado durante mucho tiempo, además de no estar disponibles en todos los estados ni a las poblaciones que se encuentran en mayor riesgo. Es de vital importancia, activar los programas que frenan las enfermedades crónicas, apoyar a niños y familias para prevenir el uso indebido de sustancias y colocar como máxima prioridad el suicidio.

 

Lea el reporte completo en: The Impact of Chronic Underfunding on America’s Public Health System: Trends, Risks, and Recommendations, 2022

 

Trust for America’s Health es una organización no partidista sin fines de lucro que promueve la salud óptima para cada persona y comunidad a través de la acción política y trabaja para hacer de la prevención de enfermedades y lesiones una prioridad nacional.

 

 

 

 

 

 

Over Thirty-Five Health and Child Wellness Organizations Endorse the Improving Data Collection for Adverse Childhood Experiences Act

(Washington, DC – July 11, 2022) – Adverse Childhood Experiences (ACEs) can have long-lasting effects over the lifetime of an individual including negative health impacts. Research shows that the higher the number of ACEs an individual experiences the higher their risk for negative health outcomes like asthma, diabetes, cancer, substance use, and suicide in adulthood. The Centers for Disease Control and Prevention estimate that 61 percent of U.S. adults report having at least one ACE, and that the prevention of ACEs could reduce cases of depression in adults by 44 percent and avoid 1.9 million cases of heart disease.

The Improving Data Collection for ACEs Act is a bipartisan effort to enable the collection of more inclusive data about ACEs. It would support additional research on the impact of ACEs with a focus on understanding of the frequency and intensity of ACEs, the relationship between ACEs and negative health outcomes, and the influence of risk and protective factors.

For more information, contact Brandon Reavis, Senior Government Relations Manager at Trust for America’s Health, [email protected].

Public Health Leaders Discuss the Importance of Sustained Public Health Funding in the Post COVID-19 Landscape

Trust for America’s Health (TFAH) President & CEO J. Nadine Gracia, and Coalition for Health Funding’s (CHF) Executive Director Erin Will Morton issued the following statement regarding the June 22nd Beyond Emergency Funding: Sustaining Public Health Funding in the Post-COVID Landscape discussion.

(Washington, DC) — Trust for America’s Health and the Coalition for Health Funding are proud to have hosted the Beyond Emergency Funding: Sustaining Public Health Funding in the Post-COVID Landscape discussion on June 22, 2022. This discussion included three expert panelists; Dr. Gracia, Trust for America’s Health, Lisa Macon Harrison, MPH, Health Director, Granville Vance Public Health (North Carolina), and the current President of the National Association of County and City Health Officials, and Dr. Michael Fraser, Chief Executive Officer, the Association of State and Territorial Health Officials. CHF’s president, Mila Becker, moderated the event.

According to the panelists, the COVID-19 pandemic demonstrated a clear need for a well-funded, broad-based public health infrastructure and workforce at all levels. Our organizations urge lawmakers to increase annual funding to achieve these goals and create a sustainable, long-term funding strategy for public health beyond emergency supplemental funding.

The panelists emphasized the following issues during the session:

  • The public health system our country needs cannot be built on the boom-and-bust cycle of emergency funding.
  • The system needs long-term, flexible funding. Short term and inflexible funding lines for public health make investing in essential infrastructure, workforce, and cross-cutting approaches to prevention, including addressing the social determinants of health, impossible.
  • Public health emergency response is more expensive than funding core public health infrastructure. Billions of dollars spent in the years before the COVID-19 pandemic could have saved the trillions of dollars spent in response to the crisis and would have saved lives.
  • We must invest in the public health programs and workforce needed to prevent illness and injury. Doing so would decrease the amount of money now spent on treating preventable disease.
  • We must be nimbler and better prepared in order to save lives during the next public health emergency. Core public health services most in need of sustained investment are:
  • Modernized data systems that provide real-time data for decision-making.
  • Sustained funding for recruitment and retention of a larger and more diverse public health workforce.
  • Programs to achieve health equity – during the pandemic many health departments increased their engagement with community leaders and organizations. Those partnerships and networks should be sustained and grown.
  • We are approaching a COVID “funding cliff” – emergency funding has been spent or is expiring, but core public health services still need to be provided, particularly in those communities where health inequities were exacerbated by the pandemic.

Listen to the full session at: https://www.tfah.org/webinars-briefings/beyond-emergency-funding/

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About TFAH
Trust for America’s Health is a non-partisan public health policy, research and advocacy organization that envisions a nation that values the health and well-being of all and where prevention and health equity are foundational to policymaking at all levels of society.

About CHF
The Coalition for Health Funding works to preserve public health investments in the interest of all Americans. Our 81 member organizations together represent more than 100 million patients and consumers, health providers, professionals, and researchers. Coalition for Health Funding (publichealthfunding.org)

Trust for America’s Health (TFAH) Statement in Recognition of Juneteenth, 2022

Chair of the TFAH Board of Directors Gail Christopher, D.N. and President and CEO J. Nadine Gracia, M.D., MSCE released the following statement in recognition of Juneteenth, 2022

(Washington, DC – June 17, 2022) — “Juneteenth is a celebration of freedom. It’s also a day on which we should recognize that as a nation we have more work to do before all Americans are free from the burdens of social, economic, and health inequities.

Well over a century after the first Juneteenth, structural racism continues to have far-reaching impacts on health, well-being, and opportunity.

Our goal is to recommend policies that will advance the social, economic, and environmental conditions that promote health by ensuring equitable access to high-quality childcare, education, employment, safe and affordable housing, transportation, and healthcare for all Americans.”

Trust for America’s Health calls for the following policy actions to reverse the impact of structural racism in America:

  • Make advancing health equity and eliminating health disparities a national priority. This includes increasing funding for programs that advance healthy equity, such as the Centers for Disease Control and Prevention’s (CDC) Racial and Ethnic Approaches to Community Health and Healthy Tribes Programs.
  • Invest in multisector efforts to address upstream drivers of poor health through CDC’s Social Determinants of Health program.
  • Target the elimination of poverty by increasing the minimum wage and expanding the Earned Income Tax Credit at the national and state levels.
  • Increase access to high-quality healthcare for all by strengthening incentives to expand Medicaid in all states and by making marketplace coverage more affordable for low-and moderate-income people.
  • Create a national standard mandating job-protected paid family and medical leave for all employees.
  • Increase funding for programs that promote long-term security and good health for children and families, including programs designed to expand access to affordable housing, Head Start, Early Head Start, and nutrition support programs such as Healthy School Meals for All, the Supplemental Nutrition Assistance Program (SNAP), and the Special Supplemental Nutrition Assistance Program for Women, Infants, and Children (WIC).

For more information about these and other policy recommendations see these TFAH reports:

A Blueprint for the 2021 Administration and Congress – The Promise of Good Health for All: Transforming Public Health in America.

Leveraging Evidence-Based Policies to Improve Health, Control Costs, and Create Health Equity

Additional statement from the National Collaborative for Health Equity

The National Collaborative for Health Equity (NCHE) applauds the work of TFAH and supports these vital social policy actions. NCHE recognizes that we have to generate the public will for enacting and sustaining the needed policies. One vehicle for doing this is the Truth, Racial Healing, and Transformation (TRHT) work of communities across America. This work involves changing false narratives, building trusted relationships, as well as addressing the systemic and institutional legacies of the false ideology of the hierarchy of human value.

While the federal holiday, Juneteenth, enables us to celebrate the end of slavery, we must all remember that the beliefs that animated it for centuries lived on and continue to exist today. Racism must end.

Dr. Christopher is the Executive Director of the National Collaborative for Health Equity, in addition to her role as the TFAH Chair of the Board of Directors.

 

Trust for America’s Health Announces Two Additions to its Leadership Team

Dr. Tekisha Everette to join as Executive Vice President and Stacy Molander as Chief Operating Officer

“I am thrilled that Dr. Tekisha Everette and Stacy Molander will join the leadership team of Trust for America’s Health at this critical time. The challenges that confront our nation are many, including the critical need to modernize our public health system and to address longstanding social, economic, and health inequities. These two excellent leaders bring vast experience and skills that are vital to accelerating TFAH’s mission of promoting optimal health for every person and community.  They share our talented and dedicated team’s commitment to ensuring that prevention and health equity are foundational to policymaking at all levels.”

J. Nadine Gracia, M.D., MSCE, President and CEO, Trust for America’s Health

(Washington, DC – June 17, 2022)

Tekisha Dwan Everette, PhD, MPA will serve as TFAH’s Executive Vice President. In this role, she will work in partnership with TFAH’s President and CEO to chart and implement the organization’s strategic direction and priorities, will provide counsel on current and emerging policy issues, and will engage with key organizations, policymakers, and other partners to advance policy priorities to improve public health and promote equity.

A successful executive leader and public policy strategist with a passion for health justice, Everette’s career spans service in the non-profit, state, and private sectors. Most recently, she served as the inaugural Executive Director of Health Equity Solutions, a statewide non-profit dedicated to advancing health equity through policy and advocacy in Connecticut. Prior to Health Equity Solutions, Everette was the Managing Director of Federal Government Affairs with the American Diabetes Association, where she provided strategic leadership on policy and advocacy initiatives with the White House, several federal agencies, and Congress. Everette also worked as a government relations consultant with Drinker, Biddle, and Reath, LLC, where she represented the interests of several non-profit healthcare organizations on issues such as health reform, Medicare, Medicaid, and federal appropriations. Everette has also worked for the Service Employees International Union and the State of Maryland. Recognized for her achievements in health policy and advocacy, Everette is an alumna of the National Urban Fellows America’s Leaders of Change program and is a member of the Association of Black Sociologists.

Everette earned a doctorate in Sociology from American University with a concentration in race, gender, and social justice as it relates to social policy. She received a Master of Public Administration from Virginia Tech and holds two Bachelor of Arts degrees in Political Science and Interdisciplinary Studies also from Virginia Tech. She will complete a Master of Public Health from Yale University in December 2022.

 

Stacy Molander will serve as the Chief Operating Officer of Trust for America’s Health. In this role, she will work in partnership with TFAH’s President and CEO to shape and implement the organization’s strategic direction and organizational priorities, will conceptualize and help build and execute strategic partnerships to promote public health and equity, and will oversee and manage TFAH’s core business functions and internal operations.

A mission-focused executive and accomplished leader who is passionate about public health, Molander has extensive leadership experience in the non-profit and corporate sectors.  Most recently, she served as the Chief Operating Officer of Partnership for a Healthier America (PHA), a national non-profit organization working to ensure that every family, in every zip code, has affordable access to healthy food. As Chief Operating Officer, Molander served as a strategic advisor to the CEO, oversaw the organization’s operations, and managed the finance and development teams. During her decade of service at PHA, Molander led the development of partnerships with Fortune 500 companies that improved the nutritional composition of food products, increased availability of healthy food, and created opportunities for physical activity. She led the creation and execution of PHA’s signature campaign, Pass the Love—a collaboration with Netflix and Higher Ground Productions, a production company founded by former President Barack Obama and former First Lady Michelle Obama. The campaign delivered more than a million meals to low-income families in communities nationwide. Prior to PHA, Molander served as Senior Vice President and General Manager at Pierce Global, an Omnicom marketing agency, where she launched the Washington, DC office. Molander spent nearly a decade in policy and communications with roles at CNN, Discovery Communications, and on Capitol Hill.

Molander earned a Bachelor of Arts degree in Public Communications with a minor in International Studies from American University. She completed the Nonprofit Financial Stewardship Program of the Harvard Kennedy School Executive Education Program. She is also a graduate of L’Academie de Cuisine.

Everette and Molander will join Trust for America’s Health in the summer of 2022.

Trust for America’s Health Celebrates Older Americans Month

The month of May provides America with the opportunity to celebrate our families, neighbors, colleagues, and friends as we all age.  It is an opportunity to recognize and share the collective wisdom and rich history afforded by older age.  It is also a time to reflect on how we, as a nation, view ourselves as we age, and to reflect on how well we are working to create supportive environments for equitable health and well-being across the lifespan.

Trust for America’s Health (TFAH), as a non-profit public health policy, research, and advocacy organization committed to ensuring healthy environments for all individuals and communities, prioritizes the roles of the public health sector in creating such supportive environments.  We have seen the significant toll that the COVID-19 pandemic has taken on not just the health, but also the social and economic well-being of older adults.  We commend the public health sector for actively addressing these challenges and working across sectors to collaboratively and equitably support our nation’s older adults, their families, and caregivers.

Older Americans Month offers us the opportunity to examine the public health practices that can be expanded to include older adults beyond the COVID-19 pandemic.  We must continue to elevate healthy aging as a core public health function, from collecting robust data on older adult health, to embedding multi-sector partnerships, to prioritizing and advancing health equity, to exploring how the social determinants of health can be framed with an aging lens.  And public health departments can continue to collaborate with America’s aging services network to support and build opportunities and options for more older adults to age in the communities and spaces of their choice.

TFAH will continue to explore new opportunities with state and local health departments to embed healthy aging within public health practice, to develop resources to support this engagement, and to advocate for policy changes to ensure appropriate authority and funding for these efforts.  For more information on TFAH’s Age-Friendly Public Health Systems initiative, please visit www.afphs.org.

Estados Unidos experimentó las tasas combinadas más altas de muertes debido al alcohol, las drogas y el suicidio durante la pandemia de COVID-19

Las muertes abarcaron edades, grupos raciales y étnicos y geografía, pero dañaron de manera desproporcionada a ciertos jóvenes y personas de color.

Las soluciones son conocidas y deben implementarse

 

(Washington, DC – 24 de mayo de 2022) – Las muertes asociadas con el alcohol, las drogas y el suicidio cobraron la vida de 186.763 estadounidenses en el 2020, un aumento del 20 % en un año en la tasa de mortalidad combinada y la mayor cantidad de muertes por uso indebido de sustancias jamás registrada durante un solo año, según un informe publicado hoy por Trust for America’s Health (TFAH) y Well Being Trust.

Además, los datos provisionales de los Centros para el Control y la Prevención de Enfermedades muestran que las muertes por sobredosis de drogas continuaron aumentando en el 2021.

Si bien las muertes por alcohol, drogas y suicidio han aumentado durante décadas, el aumento durante el 2020 no tuvo precedentes y fue impulsado por un aumento del 30 % en la tasa de muertes inducidas por drogas y un aumento del 27 % en la tasa de muertes inducidas por el alcohol. Las tasas combinadas de muertes por alcohol, drogas y suicidio aumentaron en los 50 estados excepto New Hampshire, y por primera vez dos estados (Virginia Occidental y Nuevo México) superaron las 100 muertes por cada 100,000 residentes estatales por alcohol, drogas y suicidio combinados en un solo año

o La tasa general de muertes inducidas por drogas aumentó en un 30 por ciento, en gran parte impulsada por aumentos en las muertes debido al uso de opioides sintéticos y psicoestimulantes. La tasa de muerte inducida por drogas aumentó para todos los grupos de población menos uno: los mayores de 75 años. Hubo aumentos particularmente grandes en las comunidades de color, entre los jóvenes (de 17 años o menos) y los adultos jóvenes (de 18 a 34 años) y en las regiones sur y oeste del país.

o Las tasas de mortalidad inducida por el alcohol aumentaron en un 27 por ciento, y el aumento abarcó grupos demográficos y partes del país, incluidos los 50 estados y el Distrito de Columbia. Los aumentos fueron particularmente altos entre los adultos jóvenes, los indios americanos/nativos de Alaska y las comunidades asiáticas, y entre los que viven en el Medio Oeste.

o Las tasas generales de suicidio disminuyeron en un 3 por ciento, pero esa tendencia no fue universal. La disminución se produjo entre los blancos, pero las muertes por suicidio durante el año aumentaron entre los indios americanos, los negros y los latinos. Las tasas de suicidio de adultos de 35 a 74 años de edad disminuyeron, pero las tasas de jóvenes y adultos jóvenes aumentaron.

“Con las tendencias que continúan yendo en la dirección equivocada, debemos preguntarnos, ¿qué se necesita para pasar a una acción sólida e integral? La historia detrás de estos datos es más que devastadora y desgarradora para aquellas familias que han sufrido pérdidas”, dijo el Dr. Benjamin F. Miller, presidente de Well Being Trust. “Empecemos a atender esta crisis con la urgencia que se merece llevando atención donde está la gente. Desde las escuelas hasta la atención primaria y nuestros lugares de trabajo, asegurémonos de que todos los lugares estén equipados para abordar la salud mental y el abuso de sustancias. Esta no es solo la responsabilidad del campo de la salud mental y las adicciones, sino toda nuestra responsabilidad”.

TFAH y Well Being Trust han estado informando muertes inducidas por alcohol, drogas y suicidio como parte de su iniciativa Pain in the Nation desde 2018. En el informe inaugural de la iniciativa de 2018, las muertes por alcohol, drogas y suicidio representaron 55,403 muertes por año, en comparación con las 186.763 muertes asociadas con el alcohol, las drogas o el suicidio en el informe de este año. Según los autores del informe y otros expertos, el sorprendente aumento de las muertes por alcohol y drogas en el 2020 se vio exacerbado por: un aumento continuo de las sobredosis de opioides sintéticos y psicoestimulantes y la ansiedad, el estrés, el dolor, la interrupción de los programas de recuperación del abuso de sustancias y las dificultades financieras muchas personas y familias experimentaron durante la pandemia de COVID-19.

El informe incluye recomendaciones sobre los pasos que los gobiernos federal, estatal y local deben tomar para comenzar a revertir la crisis de las muertes por desesperación. Incluyen:

Invertir en programas que promuevan la salud y prevengan el uso indebido de sustancias y el suicidio:

  • Apoyar programas en la escuela enfocados en la salud mental de los estudiantes y la prevención del uso de sustancias.
  • Fortalecer los programas informados sobre el trauma y culturalmente competentes y lingüísticamente apropiados dentro de todas las agencias que atienden a los jóvenes, incluido el sistema de justicia juvenil.
  • Fortalecer la continuidad de los programas de intervención en crisis con un enfoque en la línea de vida “988” recientemente establecida.
  • Expandir los esfuerzos integrales de prevención del suicidio de los CDC, incluidas medidas para fortalecer los apoyos económicos, promover la conexión y crear entornos protectores.
  • Desarrollar programas que aborden los determinantes sociales de la salud y promuevan la resiliencia en los niños, las familias y las comunidades, incluidos aquellos enfocados en la prevención de experiencias infantiles adversas.

 

Abordar las crisis de uso indebido y sobredosis de sustancias:

  • Promover políticas de reducción de daños para reducir las sobredosis y las infecciones transmitidas por la sangre, incluido el aumento del acceso a programas de servicio de jeringas, naloxona y tiras reactivas de fentanilo.
  • Preservar y ampliar los programas que crean un acceso más flexible al tratamiento del trastorno por consumo de sustancias durante la pandemia.
  • Financiamiento directo del acuerdo de litigio de opioides para la prevención primaria del abuso de sustancias por parte de los jóvenes.
  • Reducir el consumo excesivo de alcohol mediante políticas que limiten dónde y cuándo se puede servir/comprar alcohol y mediante el uso de impuestos especiales sobre el alcohol.

Transformar el sistema de prevención de salud mental y abuso de sustancias

  • Aumentar el acceso al tratamiento de salud mental y uso de sustancias a través de la plena aplicación de la Ley de Equidad en Adicción y Paridad en Salud Mental.
  • Combatir el estigma sobre los problemas de salud mental y el acceso al servicio.
  • Modernizar los servicios de salud física y mental alineando la prestación de servicios, el pago de los proveedores, las medidas de calidad y la capacitación hacia la salud integral de las personas y la atención integrada.
  • Desarrollar la capacidad comunitaria de base para la identificación e intervención tempranas de personas con trastornos de salud mental y uso de sustancias, incluso a través de entornos comunitarios o no tradicionales.

“Es imperativo que los funcionarios de todos los niveles del gobierno actúen sobre las políticas recomendadas en este informe. Los datos son sorprendentemente claros: las vidas corren peligro en todas las comunidades debido al alcohol, las drogas y el suicidio, y las comunidades que experimentan desventajas debido a las desigualdades sociales, económicas y ambientales de larga data sufren un impacto desproporcionado. Existe una necesidad urgente de actuar para salvar vidas”, dijo J. Nadine Gracia, presidenta y directora ejecutiva de Trust for America’s Health.

 

Lea el informe completo

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

Well Being Trust es una filantropía de impacto dedicada a promover la salud mental, social y espiritual de la nación.