Trust for America’s Health 2023 Year in Review


The past year included divergent trends within the public health sector. While the country emerged from the emergency phase of the COVID-19 pandemic, other threats to the nation’s health, including chronic disease rates, substance misuse and suicide, and the impacts of climate change continued to increase. TFAH spent the past year raising awareness and advancing policy actions to address these long-standing and emerging public health challenges with a particular focus on the ways these issues disproportionally impact certain communities.

Public Health Warning Signs in 2023

The work of public health and healthcare professionals was key to turning the corner in the fight to control COVID-19. However, the end of the public health emergency and Congressional action resulted in the rollback of federal and state funds allocated to respond to the pandemic and strengthen public health capacity. Consequently, money for thousands of public health positions funded by temporary response dollars was lost, and public health measures were given less priority. Being fully prepared for the next public health emergency will depend on breaking out of the boom-and-bust cycle of public health funding and growing and diversifying the public health workforce.

Obesity rates also continued to increase, as TFAH noted in this year’s State of Obesity: Better Policies for a Healthier America report.  As reported, obesity rates continued their 20-year climb for every demographic group measured. Nearly 42 percent of all adults in the United States have obesity compared to 30 percent in 1999-2000. One in five children ages 2-19 have obesity, according to 2017-2020 data from the National Health and Nutrition Examination Survey. That’s three times the rate from the 1970s.

Extreme weather events fueled by climate change took lives and caused billions of dollars in damage in communities across the country. Parts of the south and southeast experienced unprecedented and dangerous levels of extreme heat. Wildfires that erupted in Hawaii in August devastated the town of Lahaina, and wildfires in Canada created health-impacting smoke events across the U.S. Mid-Atlantic and into the Midwest. The 2023 edition of Ready or Not: Protecting the Public’s Health from Diseases, Disasters, and Bioterrorism showed that many states have improved their public health and emergency management systems, but 15 states were placed in the low-performing tier for preparedness.

This year’s edition of TFAH’s Pain in the Nation report also noted that the alarming increase in the number of deaths from substance misuse and suicide over the last decade is continuing. There was an all-time record of 209,225 Americans that lost their lives due to drugs, alcohol, or suicide in 2021, which was double the amount in 2011.

TFAH’s 2023 Policy Activities

During the year, TFAH worked to raise awareness and educate policymakers about the importance of investment in public health programs and the benefits of those investments.

Our outreach efforts went beyond Capitol Hill. TFAH provided advice throughout the year to key staff at the White House, federal agencies and the health and public health sectors.

  • TFAH submitted comments to the Office of Management and Budget on its plan to update the way the federal government collects data by race and ethnicity. Ensuring health equity starts with accurate and comprehensive collection of data on race and ethnicity.
  • The White House created the Office of Pandemic Preparedness and Response in July. Solidifying this type of federal leadership structure is a long-standing recommendation of our annual Ready or Not
  • TFAH collaborated regularly with the Office of National Drug Control Policy including providing comments on the Biden-Harris Administration’s efforts to curb substance misuse.
  • TFAH President and CEO Dr. J. Nadine Gracia was appointed by President Joe Biden to serve on the President’s Council on Sports, Fitness, & Nutrition, along with other leaders from the world of sports, fitness, nutrition, and advocacy.
  • TFAH supported policy initiatives to promote healthy eating. Dr. Gracia also provided testimony before the Dietary Guidelines for Americans Advisory Committee on the public health impacts of updating the dietary guidelines.
  • The U.S. Department of Agriculture proposed aligning school nutrition standards with the standard Dietary Guidelines for Americans. This was a key recommendation in the State of Obesity
  • TFAH’s Age-Friendly Public Health Systems movement expanded to include working with state public health institutes to build expertise in healthy aging policy and programs with the goal of elevating healthy aging as a core function of state departments of health.
  • TFAH partnered with the Office of Disease Prevention and Health Promotion at the U.S. Department of Health and Human Services to facilitate collaborations between state departments of health and state departments of aging that prioritize older adult health issues, such as mitigating the effects of social isolation, including older adults in emergency planning, and addressing shortages in the direct care workforce.

Amplifying Our Voice 

TFAH also continued to work to disseminate data and key messages to the public health community and to our partners to not only inform the field at large, but also to help build a unified front to protect critical public health functions and authorities.

In 2020, TFAH, the CDC Foundation and the de Beaumont Foundation formed the Public Health Communications Collaborative to provide the field with science-based messages and resources to help state and local public health officials be effective communicators during the pandemic and to counter misinformation. This year, as the collaborative began to create messaging materials on public health issues beyond the pandemic, the appetite for PHCC information was just as strong as it was during its inception, which included providing resources on effective crisis communications and culturally-relevant messaging. Messaging support materials created during the year included communicator toolkits on when to take an at-home COVID-19 test, managing health during air quality alerts, and on fall respiratory illness prevention. PHCC’s monthly webinars averaged over 1,000 participants and newsletter subscriptions were up over 13 percent.

During 2024

Our strategic priorities to advance a strong, resilient, trusted, and equitable public health system and to ensure that prevention and health equity are foundational to policymaking will be central to and at the forefront of TFAH’s work in the coming year.

Our research, policy, advocacy, and organizational development efforts will lead to:

  • A strong, resilient, trusted, and equitable public health system that addresses our nation’s public health opportunities and challenges.
  • Innovation that drives systemic change to promote and protect health and well-being for all.
  • The advancement of health equity in public health and prevention.
  • Ensuring that TFAH is a dynamic, sought-after, people-centered organization that is thriving.

TFAH is committed to being a tireless advocate for the nation’s public health needs and system. Return to our website throughout the coming year for information and updates.