Stories Archive - Page 4 of 18

TFAH Celebrates Public Health Contributions of Hispanic & Latino People During Hispanic Heritage Month

In honor of Hispanic Heritage Month 2023, TFAH is highlighting the careers of a select number of people of Hispanic and Latino/Latina descent who have made important contributions to the field of public health.

Carlos Juan Finlay, M.D. (1833 – 1915)
Dr. Carlos Juan Finlay was an epidemiologist and a physician and a pioneer in yellow fever research. He discovered that yellow fever was a vector-borne disease from mosquitoes. As one of the most revered Cuban doctors and scientists, Finlay was nominated seven times for the Nobel Prize in Physiology or Medicine. In 1928, in his honor, Cuba created the National Order of Merit Carlos Finlay as the highest recognition for contributions in healthcare and medicine.

José Celso Barbosa, M.D. (1857 – 1921)
Dr. José Celso Barbosa was the first Puerto Rican and person of African descent to earn an M.D. in the U.S. As a physician and politician, he was supportive of healthcare and fought against racism. After being denied admittance to Columbia University because of his race and ethnicity, he attended and graduated from the University of Michigan Medical School as valedictorian in 1880. He also worked closely with the Red Cross during the Spanish-American War.

César Milstein (1927 – 2002)
César Milstein was a biochemist who was elected a Fellow of the Royal Society in 1975 and awarded the Nobel Prize for Physiology or Medicine in 1984. He advanced technology related to monoclonal antibodies that is still relevant to protect against viruses and pathogens. Learn more about César Milstein here.

Helen Rodríguez-Trías (1929 – 2001)
Dr. Helen Rodríguez-Trías was a pediatrician and women’s rights advocate and in 1993 became the first Latina president of the American Public Health Association. In 2001, Dr. Rodriguez-Trias was a Presidential Citizens Medal recipient and helped create federal guidelines for consent to medical procedures in response to involuntary sterilization. She also established the first newborn care center in Puerto Rico. Learn more about Dr. Rodríguez-Trías here.

Antonia Novello, M.D. (1944 – present)
Dr. Antonia Novello was appointed the 14th United States Surgeon General in 1990. She was the first Hispanic and first woman to serve in that position. She began her career as a pediatric nephrologist then shifted towards the field of public health. Dr. Novello made many contributions at the National Institutes of Health, including in the areas of pediatrics and AIDS research. Dr. Novello was elected to the National Academy of Medicine in 2000. Learn more about Dr. Novello here.

Jane Delgado, Ph.D. (1953 – present)
Dr. Jane Delgado is a psychologist and graduate of NYU and SUNY Stony Brook. She is the current and first woman president and CEO of the National Alliance for Hispanic Health and contributed to the 1985 Landmark Report of the Secretary’s Task Force on Black & Minority Health aka The Heckler Report. Dr. Delgado has also authored many books on health, including the groundbreaking Salud: The Latina Guide to Total Health. Learn more about Dr. Delgado here.

Omar Estrada
Omar Estrada is a University of Colorado graduate who works with the Colorado Department of Education to improve access to mental and physical health services for Colorado’s youth. Estrada was recognized by the de Beaumont Foundation’s 40 Under 40 in Public Health for 2023.

Bamby Salcedo
Bamby Salcedo is the President and CEO of the TransLatin@ Coalition. She is a prominent LGBTQ+ and human rights activist and helped develop the blueprint on providing competent healthcare services for transgender people and LGBT people in the U.S., Latin America, and the Caribbean. Salcedo also helped create the Center for Violence Prevention and Transgender Wellness in Los Angeles. Learn more about Bamby Salcedo here.

Children’s Environmental Health Day- Protecting Children From Environmental Health Threats

October 12^th is Children’s Environmental Health Day. It is a day to consider how children’s health can be impacted by the world around them, and what interventions are available to ensure that young people grow up in safe, healthy, and equitable environments. Children should be top of mind while strategizing environmental health efforts, as they are often more susceptible to hazards. Examples include:

Clean Air: Air pollution can impact children before they are even born. From conception to age two, air pollution has been linked with a variety of negative health impacts including early birth, low birth weight, and improper immune system development. Prenatal exposure to air pollution has also been linked with impaired lung function in infants and children, as well as childhood asthma. It is recommended that women especially in early or late stages of pregnancy limit exposure to air pollution as much as possible.

Indoor air quality has a significant impact on children as well. Special attention should be paid to the quality of air at home and at school. Homes should have sufficient ventilation to ensure fresh air is getting cycled into the home. Without proper ventilation, pollution can build up indoors as well as concentrations of dangerous gases such as carbon monoxide and radon.

Schools in particular face challenges such as limited budgets for repairs to ventilation systems and reduced efficiency of older buildings and equipment. The U.S. Environmental Protection Agency (EPA), in partnership with the American Lung Association, has designed the Indoor Air Quality Tools for Schools program to give schools the information and skills they need to manage air quality in a low-cost, practical manner.

Clean Water: Unfortunately, not all communities in the United States have the same access to clean water. A federal emergency was recently declared in Louisiana due to saltwater intrusion, which has contaminated the water system in parts of the state. Louisiana’s Women, Infants, and Children (WIC) program put out a guidance about using bottled water while mixing formula because infants are especially vulnerable. Other hazards, such as lead and PFAS may find their way into drinking water. Clean Water for US Kids provides information on water testing kits as well as information on improving home water filtration.

Extreme Heat: As average temperatures continue to rise year after year, so have instances of heat-related illnesses. Since children have smaller body mass and are more likely to spend extended periods outdoors, they are more susceptible to morbidity and mortality from heat-related causes. It is important that children are adequately hydrated before, during, and after exposure to high outdoor temperatures, wear breathable clothing, or stay inside if temperatures are simply too high.

Pregnant women are also at increased risk, and exposure to high temperatures may have a negative impact on the fetus, especially early in pregnancy. Pregnant women should avoid peak midday temperatures and balance fluid intake with beverages with sodium and other electrolytes.

Lead Exposure: Lead exposure can cause a series of often irreversible health impacts on children including damage to the brain and nervous system, slow growth and development, learning and behavior problems, and hearing and speech problems. These can result in lower IQ, decreased ability to pay attention, and underperformance in school. It is important to identify potential sources of lead around the home and remediate them before they can take hold. Homes built prior to 1978 should be checked for the use of lead paint which can crack and make lead dust, which can be inhaled. If a child may have been exposed to lead, it is important that they receive blood lead testing and follow-up care and referral. According to an analysis from the Health Impact Project eliminating lead hazards from the places where children live, learn, and play could generate approximately $84 billion in long-term benefits per birth cohort.

Trust for America’s Health Celebrates Healthy Aging Month

September is Healthy Aging Month. It is a time to pause, ponder, and consider the potential we have before us to take the concept of healthy aging to the next level. Healthy aging is often defined as “the development and maintenance of optimal physical, mental (cognitive and emotional), spiritual, and social well-being and function in older adults.”

What needs to happen to take all those components to the next level? Multi-sector collaboration, coordination, funding, and prioritization of the health and social needs of older people.

Collaboration: Most policy actors understand that policy and systems changes do not happen without unified, strategic planning and working across sectors to achieve the desired changes. The power of a collective impact approach is its ability to bring together the aging services, healthcare, public health, and community sectors to work together to assess and understand the needs of older adults in any given community.

Coordination: Once the above systems are assessed for their strengths or gaps in providing age-friendly services, sectors can come together to coordinate activities and interventions to reduce duplication and maximize the distribution of limited public resources for programs and services that support older people, their caregivers, and their families.

Investment: Funding is a much-needed aspect of providing systems and services that support healthy aging, but advocates face numerous challenges in securing additional funding for older adult programs. Since much of what happens in older age can be attributed to lifestyle choices in early age, funding healthy habits all along the life course is one way to reduce demands on the long-term care system. Unfortunately, the return on investment is also long-term and therefore often a hard one for policymakers to see and act on.

Prioritization of healthy aging, from birth to the end of life: This process may take the form of addressing the social and economic issues that impact health at the community level, as well as dismantling the systemic structures that lead to health disparities. Prioritizing healthy housing, access to nutritious food sources, quality education, quality healthcare, and other community supports that lift all people will inevitably improve the opportunities for all people to grow older with optimal physical, mental, spiritual, emotional, and social health and function. It’s up to everyone to see ourselves in this process and make our communities better for all.

Navigating Climate-Related Threats to the Public’s Health

The Urgency of Emergency Preparedness in Light of Extreme Weather Events

(August 29, 2023) In the first eight months of 2023, the United States confronted numerous climate challenges, indicating a pivotal moment for the nation and the planet. Hawaii faced the country’s deadliest wildfires in over a century, claiming more than 100 lives and leaving a staggering cost in their wake. In California, storms tested the state’s resilience through floods and mudslides, while in Phoenix, weeks of intense heat threatened its most vulnerable residents. In Vermont, rivers surged past their banks, while haze from Canadian wildfires degraded air quality in more than a dozen states. And all this as the year’s hurricane season is just getting underway.

These events demonstrate the escalating public health threats driven by climate change and the need for public health officials to play a role in addressing them. As global temperatures rise, we are seeing an uptick in heat-related illnesses and even fatalities, especially among individuals who are most at risk. Rising sea levels and intensified storms lead to flooding, which can contaminate drinking water and spread waterborne diseases. Meanwhile, wildfires, exacerbated by droughts and higher temperatures, compromise air quality, leading to a spike in respiratory problems, from asthma to chronic bronchitis. Furthermore, shifting climate patterns are expanding the range of many infectious disease vectors, like mosquitoes, exposing new populations to illnesses like malaria or dengue. The ripple effects of climate change touch nearly every aspect of public health, demanding policymakers’ attention and action.

Below is a partial round-up of the climate-related challenges that the country has already faced in 2023.

Wildfires in Hawaii. The U.S. grappled with its deadliest wildfires in over a century when fires that began as isolated brush incidents on the islands of Hawaii and Maui were intensified by the effects of Hurricane Dora and quickly escalated. Many public officials and residents were caught off guard by the size and rapid spread of the flames, leading to the tragic loss of more than 100 lives. Residents and officials now confront daunting reconstruction needs. Despite Hawaii’s reputation for lush greenery, its defenses have been compromised by significant reductions in rainfall. Diminished La Niña patterns, which traditionally bring cooler and wetter conditions to the region, have shifted, leading to warmer and drier trends. Furthermore, the proliferation of flammable invasive grasses, supplanting native vegetation, increases the fire risks.

Smoky skies. Canada, grappling with one of its harshest wildfire seasons, has seen tens of millions of acres of its landscape consumed by flames. The repercussions have been felt beyond its borders, with smoke significantly degrading air quality in several U.S. regions, including New England, the Southeast, and the Midwest. These conditions have led the Environmental Protection Agency to issue air quality alerts affecting millions of Americans. This sharp rise in fires is largely linked to the effects of global warming, which brings about drought and intense heat, rendering forests more vulnerable to blazes.

California storms. In early 2023, intense rains hit California. While they replenished reservoirs and snowpacks, they also caused flooding, mudslides, sinkholes, and tree damage that impacted infrastructure. A severe winter storm in late February trapped residents and led to the deployment of the California National Guard. Shortly after, another storm in the Sierra Nevada caused two fatalities and power disruptions. March saw the arrival of two bomb cyclones that brought tornadoes, heavy rain, and snow. These extreme weather events, exacerbated by climate change, underscore California’s oscillation between droughts and powerful storms. Such climatic shifts create atmospheric rivers that deliver heavy precipitation.

Notably, Southern California effectively weathered Tropical Storm Hilary’s record-setting rainfall in August, in part due to proactive measures like school closures and swift emergency response to road flooding and fallen trees. Despite the storm’s potential severity, no deaths were reported in major areas like Los Angeles and San Diego, highlighting the importance of preparedness.

Groundwater shortages in Arizona. Arizona officials sounded the alarm in June on groundwater shortages, signaling a potential halt to the rapid housing development in the Phoenix area, which is among the fastest-growing regions in the U.S. Although existing building permits will remain unaffected, the announcement underscores the urgent need for alternative water sources and conservation measures in future projects. Governor Katie Hobbs reassured that Arizona is not immediately running out of water, but shortages could have significant implications for the region’s future. Prolonged drought, combined with increasing water demand, have depleted the Colorado River and intensified water scarcity, posing a challenge for the region’s long-term sustainability.

Vermont flooding. In July, Vermont experienced severe flash and river flooding, leading to extensive damage to communities, roads, bridges, and causing significant property losses. This event broke several records, with Montpelier’s airport receiving the highest single-day rainfall since 1948. The destruction was comparable to the damage from Tropical Storm Irene in 2011. In terms of impact, the destruction from the 2011 and 2023 events was only surpassed by the Great Flood of November 1927, which took place before modern flood control measures were implemented in the state.

Hot water off the coast of Florida. A buoy off Florida’s coast this summer measured a sea surface temperature of 101.1 degrees Fahrenheit, potentially setting a new world record and far exceeding the typical range of 73F to 88F. This extreme heat, part of a concerning trend of warming waters in Florida, poses grave risks to marine life, ocean ecosystems, and human livelihoods. Increasing temperatures, intensified by phenomena like El Niño, could also boost the strength of tropical storms and hurricanes.

Extreme heat in Phoenix. Phoenix endured an unprecedented heatwave in July, with temperatures exceeding 110°F for 31 straight days, surpassing a 1974 record. This coincided with a global trend marking July the warmest month ever registered. Hospitals reported an uptick in heat-related cases, ranging from heat cramps to lethal heat strokes. The city’s medical examiner confirmed 25 heat-related deaths and is investigating many more. Critical infrastructure, such as air conditioners in shelters and medical buses, malfunctioned due to the extreme temperatures. With shelters at full capacity and public housing waitlists stretching for months, many unhoused residents were left without a haven from the oppressive temperatures.

President Biden announced initiatives in July to support communities suffering from extreme weather. To combat the rising heat, the primary weather-related cause of death in the U.S., he directed the Department of Labor (DOL) to issue its first-ever Hazard Alert concerning heat, with the intent to reinforce worker protections against heat-related dangers under federal law. This alert will educate employers on their responsibilities and help ensure that workers know their rights. The DOL has committed to intensifying its enforcement against heat-safety violations, focusing especially on high-risk sectors like construction and agriculture. Meanwhile, the National Oceanic and Atmospheric Administration is allocating up to $7 million to enhance weather forecasting in collaboration with educational institutions, aiming to boost preparedness for extreme weather events. Additionally, the Department of the Interior is in the process of investing $152 million to bolster water storage and climate resilience in California, Colorado, and Washington, addressing the challenges of prolonged drought and ensuring access to clean drinking water.

These efforts build on past actions by the Biden-Harris Administration, such as channeling billions of dollars via the Department of Housing and Urban Development for energy-efficient building upgrades and the establishment of cooling centers. Additionally, in collaboration with Congress, it earmarked over $50 billion from the Infrastructure Investment and Jobs Act to bolster climate resilience throughout the nation.

As Trust for America’s Health (TFAH) has previously highlighted, preparing for weather-related events is a critical element of public health emergency preparedness. Collaboration between public health officials and partners—such as federal, state, local, tribal, and territorial agencies, emergency response teams, community-based organizations, and hospitals—is fundamental. Working together, they can pave the way for better preparation and response strategies, utilizing data to predict and lessen potential health impacts. Proactive measures are crucial in safeguarding communities from these escalating threats. For example, the nation needs significant investment in climate-resilient infrastructure — from storm-resistant housing to updated water management systems. To protect people from extreme heat, communities must prioritize public education on heat risks, establish cooling centers, and adapt urban infrastructure to reduce heat retention. It’s crucial to acknowledge that socioeconomic and health inequities have historically worsened the impact of extreme heat on communities of color, making targeted interventions in these communities even more essential. Strengthening early warning systems and ensuring equitable access to hydration and emergency healthcare resources are vital steps. It’s also imperative to bolster our health systems’ readiness to respond to the increasing burden of climate-related illnesses. This includes enhancing disease surveillance and training healthcare professionals to recognize and treat emerging health threats, especially in communities that face disproportionate risks.

In line with a comprehensive public health approach, the Building Resilience Against Climate Effects (BRACE) framework from the Centers for Disease Control and Prevention (CDC) offers a vital tool. This strategic framework empowers officials to develop and implement health adaptation plans tailored to their specific climate change challenges. By guiding health departments through a five-step process — from forecasting climate impacts and assessing vulnerabilities to developing and implementing a comprehensive adaptation plan — the BRACE framework ensures a data-driven response that accounts for local nuances. Recognizing the disparate effects of climate change on various populations, this approach emphasizes not just broad community safeguards but also targeted interventions to protect those most at risk. To more adequately support these crucial initiatives, TFAH recommends funding the CDC’s Climate and Health Program at a level of $110 million for Fiscal Year 2024. This program collaborates with state, local, tribal, and territorial health agencies to address climate change impacts, primarily utilizing the BRACE framework. Additionally, it offers resources, funding, and support through various initiatives to enhance community preparedness and communication regarding climate-related health risks. As communities continue to witness the tangible effects of a changing climate, leaning into systematic and strategic frameworks like BRACE becomes paramount. The synthesis of proactive planning, community-specific interventions, and overarching public health strategies helps bring about a resilient and equitable response.

Acting to protect health and well-being by improving our systems’ readiness and enhancing protective measures—commonly termed climate adaptation—is a critical public health priority. Climate mitigation refers to efforts to reduce or prevent greenhouse gas emissions or to remove them from the atmosphere, aiming to curb future global warming. Both the Intergovernmental Panel on Climate Change, a scientific body under the auspices of the United Nations that assesses climate change information, and the United States Global Change Research Program, which coordinates U.S. research on global environmental changes and evaluates climate change impacts, emphasize that mitigation and adaptation are complementary strategies crucial for reducing the human impacts of climate change.

August is National Immunization Awareness Month

August is National Immunization Awareness Month. This annual observance is designed to remind everyone that staying up to date on vaccinations is an important way to protect not only their health but the health of everyone around them.

Vaccines are a public health success story. Today, we are fortunate to have a broad spectrum of safe and effective vaccines, which if received on schedule, protect patients of all ages against vaccine-preventable diseases. Current vaccines protect against childhood disease including chicken pox, measles, and whooping cough, while protecting adults from the flu, Tdap, and shingles. Vaccines have also eradicated or nearly eradicated life-threatening diseases, such as smallpox and polio.

Children as young as 1-2 months old should be vaccinated against childhood illnesses and school-age children may need vaccine updates before they can return to school this fall. Ensuring that every child sees their doctor for a well-child visit and to receive any needed vaccine or vaccine updates is one of the best ways a parent can protect their child’s health and that of the community. Because the immunity created by a vaccine can lessen overtime, it’s important that children receive their vaccines on the recommended schedule. Adults may also need vaccine updates or to receive recently approved vaccines such as the RSV vaccine for adults 60 years of age and older.

During the COVID-19 pandemic, routine childhood vaccination levels among school-age children in the U.S. decreased, likely due to missed well-child medical visits. Globally, a report by UNICEF and the World Health Organization found that childhood vaccination coverage worldwide increased with about 4 million more children receiving full immunizations in 2022 compared to 2021, but were still below pre-pandemic levels.

Vaccines meet strict safety and effectiveness measures
In the U.S., safety measures are strict and prioritized to ensure that vaccines are safe for patients. Before any vaccine is approved for use, it is tested for safety and effectiveness through clinical trials and then must be approved by the Food and Drug Administration (FDA) and recommended by the Center for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices. While some people experience mild side effects after receiving a vaccine, such as swelling at the shot area, mild fevers and chills, serious reactions are extremely rare. Overall, the safety of all vaccines is closely monitored to ensure their continued safe use. If patients have questions about a vaccine including any potential side effects, they should speak to their healthcare provider.

Visit the Centers for Disease Control and Prevention website for more information on vaccine safety and for child and adult immunization schedules.

Centuries of Systemic Racism Has Created Distinct Mental Health Challenges for Minority Communities

In 2008, July officially became National Minority Mental Health Awareness Month, originally designated as Bebe Moore Campbell National Minority Mental Health Awareness Month by the United States House of Representatives. Until her passing in 2006, Bebe Moore Campbell was an author, advocate, co-founder of the National Alliance on Mental Illness (NAMI) Urban Los Angeles, and a national spokesperson, dedicating herself tirelessly to promoting mental health education and eradicating stigma within diverse communities. National Minority Mental Health Awareness Month is observed to recognize the distinct hardships that members of minority communities often face concerning their mental health.

According to the U.S. Department of Health and Human Services Office of Minority Health, in 2021, “only 39 percent of Black or African American adults, 25 percent of Asian adults, and 36 percent of Hispanic/Latino adults with any mental illness were treated, compared to 52 percent of non-Hispanic white adults.” The 2023 Pain in the Nation Report by Trust for America’s Health (TFAH), also found an increase in suicide mortality “by 4 percent between 2020 and 2021 with the highest increases among American Indian/Alaska Native and Black people.” In addition, TFAH’s report also explained that youth who were American Indian/Alaska Native, Black, Latino, and multiracial had the “highest rates of poor mental health behavior and/or suicidal behaviors compared to other groups in 2021.”

Minority communities experience these disparities in mental health outcomes and care due to factors that are beyond their control. Among other social determinants of health (SDOH), discrimination and economic insecurity contribute to the disparities in access and treatment that members of minority communities can encounter.

Cultural and social stigma around mental health issues among minority communities also contributes to poor mental health outcomes in these populations and can act as barriers to necessary mental healthcare. Systemic racism and discrimination present in the healthcare field and among healthcare professionals also prevent individuals of various racial and ethnic groups from receiving the best mental health treatment available. Negative experiences due to these factors can undermine trust in healthcare professionals and result in patients feeling ignored despite serious mental health issues, which can deter patients from seeking or staying in treatment. Lack of trust can also arise from difficulties patients experience in finding providers from the same ethnic or racial group who share similarities in culture, literacy, and language.

Minority individuals are also more likely to be uninsured, raising financial barriers to seeking and receiving mental healthcare. According to the Kaiser Family Foundation, for example, “Nonelderly American Indian and Alaska Native (AIAN) and Hispanic people had the highest uninsured rates at 21.2% and 19.0%, respectively as of 2021.”

Policy recommendations to address these disparities and barriers can range from prevention efforts, increases in funding, and systemic improvements to the healthcare system. Policy recommendations by TFAH to advance health equity include enacting and funding the Health Equity and Accountability Act, as well as increasing funding for the Centers for Disease Control and Prevention’s (CDC) Racial and Ethnic Approaches to Community Health (REACH) program and its Healthy Tribes program to provide support for all approved applicants. As mentioned in TFAH’s Pain in the Nation Report, TFAH also recommends that Congress support policies and programs that address SDOH to better implement interventions at both an individual and community level; this should include increased CDC funding and a greater emphasis on the importance of screening for SDOH in the healthcare system. Continuous efforts to reduce stigma and bring positive messaging will also encourage individuals in minority communities to seek mental health screening and care. Efforts to ensure accessible mental healthcare, including through enforcement of the Mental Health Parity and Addiction Equity Act and passage of the Effective Suicide Screening and Assessment in the Emergency Department Act, should also be prioritized.

Mental health is a critical public health issue. It is important to understand and recognize the mental health disparities and unique struggles faced by racial and ethnic groups to better help these populations overcome mental health barriers. Acknowledging that minority communities continue to face disproportionate mental health challenges–and responding accordingly on the federal level–can increase awareness of this public health issue and help ensure individuals in minority communities achieve optimal health.

At One Year Mark Data Show 988 Suicide and Crisis Lifeline Has Improved Crisis Care Access and Response, and that Sustained and Increased Funding is Needed

This month marks the one-year anniversary of the 988 Suicide and Crisis Lifeline, which replaced the previous National Suicide Prevention Lifeline with a single three-digit number for mental health, substance misuse, and crisis services. With oversight and funding from the Substance Abuse and Mental Health Services Administration (SAMHSA) and assistance from partners like Crisis Text Line and The Trevor Project, 988 consists of independently operated and funded call and text/chat centers across the country. When individuals in crisis contact 988, trained crisis counselors at these centers listen, provide support, and share resources if necessary. Access to 988 can play a critical role in improving depressed, suicidal, or overwhelming feelings—in fact, SAMHSA estimates that 98% of individuals contacting 988 receive the crisis support they need in the moment. SAMHSA has also identified the current 988 system as a first step toward evolving crisis care to include mobile crisis units, which provide in-person responses, and stabilization centers, which provide a safe place to stay for individuals in crisis.

Even its current form, however, 988 represents a momentous advancement in the effort to connect more Americans with crisis services. In May 2023, for example, 988 answered 45% more calls, 52% more chats, and 938% texts compared to the previous lifeline in May 2022. In total, 988 answered nearly 160,000 more contacts in May 2023 compared to May 2022, and the average time to answer these contacts decreased from 140 seconds to 35 seconds. 988 has also launched specialized services for the LGBTQ+ population, and SAMHSA just announced the addition Spanish language text and chat services. Other specialized services will likely follow for hearing impaired individuals and American Indian/Alaska Native people.

In 2022, Congress supplemented the establishment of 988 with several pieces of legislation containing significant investments and policies to advance behavioral health. The Bipartisan Safer Communities Act (BSCA), passed in June 2022, for example, provided onetime support for 988 and increased support for the National Child Traumatic Stress Network. The BSCA also provided funding for Project AWARE at SAMHSA, which empowers education agencies through training for school personnel, increases awareness and detection of mental health issues, and connects youth and families to needed services. In addition, Congress directed the Centers for Medicare and Medicaid Services to assist schools with expanding school-based health services through Medicaid and funded initiatives at the U.S. Department of Education to hire and retain mental health professionals providing these services.

In the Consolidated Appropriations Act (CAA), enacted in December 2022, Congress built on these accomplishments by reauthorizing the Garrett Lee Smith Suicide Prevention Program, which funds mental health programs for college-age students, as well as several programs to improve the behavioral health workforce. The CAA also bolstered crisis-intervention programs by directing guidance and funding to providers and improving payment for their services.

The U.S. Department of Health and Human Services (HHS) also acted throughout 2022 to expand access to community-based mental health services. In partnership with the Department of Education, for example, HHS has worked to facilitate the use of Medicaid and Children’s Health Insurance Program funds to support school-based behavioral health services. SAMHSA also launched the Mental Health Crisis Response Partnership Pilot Program to improve access to mobile crisis services in high-need areas.

988 is part of a series of investments to address Americans’ mental health needs

Despite this progress, significant challenges remain in the effort to strengthen 988 and connect individuals in crisis to behavioral health services. For example, although state governments carry the responsibility for funding and operating 988 call centers, only a handful of states have passed legislation to secure long-term financial support for the lifeline through telecommunications fees. A recent study, moreover, found that only around half of states have earmarked sufficient funding to meet increased 988 center costs. Due in part to insufficient funding, call centers can also struggle to hire and retain qualified staff and answer rates can vary significantly by state. Improved data collection and analysis concerning 988 services is also necessary to help identify gaps in crisis care and improve lifeline implementation.

On the federal level, ongoing negotiations in Congress could result in cuts to appropriations for 988, which is an alarming prospect given that SAMHSA estimates outreach to the lifeline will increase by up to 50%—to a total of around 9 million contacts—in FY 2024. States will also require additional federal support to develop and implement mobile responses and stabilization units and publicize the full range of 988 services. A recent survey by the Pew Charitable Trusts, for example, found that only 13% of U.S. adults knew about the existence and purpose of 988; awareness was higher among white adults and individuals with a college education compared to Black adults and individuals with a high school degree or less.

Trust for America’s Health (TFAH) will continue to advocate for additional funding and resources to bolster the 988 lifeline and transform the behavioral health crisis system more broadly. Continued bipartisan support is necessary not only to ensure access to existing services, but also to build the next generation of care to meet the growing demand from Americans in crisis.

Recommendations for addressing Americans’ mental health needs and other issues are available in TFAH’s 2023 Pain in the Nation report.

Indicators of Healthy Aging: A Guide to Explore Healthy Aging Data through Community Health Improvement

Collecting, analyzing, and translating relevant and robust data on older adults.

For over a century, public health interventions – from vaccines to food safety and vector control – have contributed to Americans’ longevity, and state and local health departments play a key role in supporting their communities by promoting healthy living. Healthy aging programs uniquely dovetail with local health department Community Health Improvement Plans (CHIPs). Both allow health departments and partnering organizations to understand and address healthy aging priorities through data.

An analysis conducted by the National Association of County and City Health Officials (NACCHO), found that most CHIPs include priorities that, while not specifically addressing older adults (e.g., 65 years of age and older), could be adapted for healthy aging programs. These priorities include chronic diseases, including heart disease, diabetes, stroke, and cancer, as well as substance use, depression, and other mental health conditions.

To develop and strengthen age-friendly public health systems, a more comprehensive set of healthy aging indicators is needed to help health departments and community partners at the local, state, tribal, and territorial levels measure and identify population-level health disparities and inequities. Additionally, Community Health Improvement (CHI) partners need a robust, unified source of secondary data that aligns with healthy aging indicators to inform strategic and action planning.

This guide, developed by Trust for America’s Health (TFAH) and the National Association of County and City Health Officials (NACCHO) and with funding from The John A. Hartford Foundation, is designed to augment NACCHO’s Mobilizing for Action through Planning and Partnerships (MAPP) framework. MAPP is the most widely used CHI framework among governmental public health departments and, increasingly, community-based organizations, nonprofit hospital systems, and community health centers that lead or engage in CHI processes. This also serves as a resource for health departments seeking to attain Age-Friendly Public Health Systems (AFPHS) recognition.

Download your free copy of the Guide.

TFAH President & CEO Dr. J. Nadine Gracia speaks to JHU’s Public Health on Call podcast about the steps necessary to improve state and national emergency response readiness.

J. Nadine Gracia, M.D., MSCE, President and CEO of the Trust for America’s Health (TFAH), joined the Johns Hopkins Bloomberg School of Public Health podcast, Public Health on Call to discuss the nation’s and states’ readiness to respond to public health emergencies and the findings of TFAH’s Ready or Not 2023: Protecting the Public’s Health from Diseases, Disasters, and Bioterrorism report.

“As we transition out of the emergency phase of the pandemic, now is not the time to turn our focus away from public health,” Dr. Gracia told podcast host Dr. Joshua Sharfstein. In addition, Dr. Gracia highlights the importance of sustained public health funding, as well as a focus on health equity. Listen to the full interview.

TFAH hosted the Congressional Briefing and National Webinar, Ready or Not 2023 on May 3, where a panel of experts discussed national emergency preparedness and areas for additional focus.

TFAH Applauds OMB for Recognizing the Need for Improved Race and Ethnicity Data

The 2020 Census revealed a country increasingly characterized by its diverse population. The proportion of non-Hispanic white people, though still the largest racial or ethnic group, has decreased as the nation’s overall diversity index climbs. This dynamic landscape demands a reevaluation of federal regulations about population data collection which have remained unchanged for over two decades.

The United States finds itself grappling with the complexities of its ever-evolving racial and ethnic composition and the interplay between race and health. It is well-documented that race, while a sociopolitical construct, is inextricably linked to health outcomes. Having complete and accurate data about all population groups, while also protecting individual privacy, is key to effectively addressing the myriad public health challenges facing the nation and contending with structural discrimination. Trust for America’s Health (TFAH) supports a reevaluation of the way the nation collects and analyzes race and ethnicity data. As the country’s demographics continue to shift, so too must our approach to understanding and addressing health disparities.

In June 2022, Dr. Karin Orvis, Chief Statistician of the United States, announced her office’s intention to begin a formal review process to revise the Office of Management and Budget’s (OMB) Statistical Policy Directive No. 15 (Directive No. 15): Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity. Six months later, an interagency technical working group spanning 20 federal agencies published an initial set of recommendations and invited public comment. TFAH submitted comments, applauding OMB for undertaking the process as well as the working group’s governing principles and proposals, and offering technical input.

The pervasive influence of structural racism and discrimination in the U.S. has led to stark disparities in health and well-being. For instance, Black Americans, burdened by the legacy of redlining and underinvestment in communities, experience higher rates of chronic diseases such as diabetes, hypertension, obesity, asthma, and heart disease than their white counterparts. Furthermore, their life expectancy at birth is nearly six years lower than that of white Americans.

The urgent need for accurate and comprehensive race and ethnicity data is highlighted by a series of health crises, from the maternal health crisis among Black women, owed to factors such as variation in healthcare quality, underlying chronic conditions, structural racism, and implicit bias, to the disproportionate impact of COVID-19 on people of color. As we strive to address these issues, precise data can illuminate the unique needs of different populations, helping to guide resource allocation and the development of targeted interventions.

For example, as the COVID-19 pandemic unfolded, it became evident that communities of color were disproportionately affected. Race and ethnicity data, while uneven across jurisdictions, proved invaluable in pinpointing these disparities, catalyzing in many places a more equitable distribution of tests, vaccines, and healthcare resources. Furthermore, such data has been critical in deciphering the disparate impacts of events like Hurricane Katrina on distinct New Orleans zip codes and unmasking the systemic racism at the heart of the Flint water crisis.

While these health crises have been acknowledged, we continue to require accurate data to comprehend the disaggregated effects of these events, and others, on particular population subgroups, the recovery and resilience of specific subgroups, and the outcomes experienced by these subgroups. This understanding will ensure the strategic development and application of policies and programs, ultimately bolstering our collective pursuit of health equity.

America’s ever-changing demographics, shaped by immigration and migration patterns, necessitate a reevaluation of the current racial and ethnic categories used in the Census and other data sets. Updated and accurate data can expose the distinct health challenges faced by different subgroups, enabling policymakers and public health officials to respond effectively. For example, accurate data could reveal disparities in access to nutrient-dense foods or mental health services, providing valuable insight for targeted public health initiatives.

A more granular approach to race and ethnicity data could also help identify and address additional public health challenges, such as subgroup-specific obesity trends, mental health conditions, and substance use disorder rates. By understanding the needs of different populations, public health officials can develop targeted interventions that address specific needs, such as culturally-sensitive dietary education and exercise programs—bolstered by communities that foster and enable healthful lifestyles, rather than obstructing them—or mental health services that are thoughtfully tailored to the experiences of specific communities.

TFAH underscores the significance of reevaluating Directive No. 15 in order to more accurately account for the variegated tapestry of contemporary America. By refining our methodology for gathering and studying race and ethnicity data—in part by enhancing data collection techniques and working to ensure that the assembled information genuinely represents the experiences of diverse populations—we can more adeptly comprehend public health needs within the United States and devise equitable resolutions for our most urgent health challenges.

As the primary entities responsible for implementing public health policies and interventions, state and local governments are uniquely positioned to address the specific needs of their diverse populations. Therefore, it is important for state and local governments to update and improve their data collection methods in a manner similar to what the OMB is proposing. Collaboration between federal, state, and local governments, as well as community organizations, is key to improved data collection and sharing. Through these efforts, state and local governments can align their data collection practices with any updated OMB standards.

In this era of rapid demographic change, the quest for health equity demands a renewed commitment to complete, accurate, actionable data. As we strive for a more equitable and inclusive society, it is imperative that our approach to public health reflects and respects the unique experiences of all Americans. Only by understanding the intricate connections between race, ethnicity, and health can we begin to dismantle the structural barriers that perpetuate disparities and chart a course towards a healthier, more equitable future for all.