(Washington, DC – June 30, 2023) – “On behalf of the staff and Board of Directors of Trust for America’s Health (TFAH), we are saddened to learn of the passing of our organization’s founding president, Governor Lowell Weicker. Governor Weicker lived a life of public service and a commitment to protecting the health of all communities. His work leading TFAH’s Board of Directors helped establish and strengthen the organization as a voice for public health in the decade after 9/11. We extend our thoughts of comfort to his family and friends during this sorrowful time.”
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Nuevo informe: La inversión insuficiente en salud pública deja a la nación menos preparada para los riesgos de salud actuales y futuros
El financiamiento de emergencia del COVID-19 ayudó a controlar la pandemia, pero no abordó las debilidades estructurales en el sistema de salud pública de la nación
(Washington, DC – 14 de junio de 2023) – Décadas de financiación insuficiente han dejado al sistema de salud pública del país mal equipado para proteger la salud de los estadounidenses, según un nuevo informe, El impacto de la financiación insuficiente crónica en el sistema de salud pública de Estados Unidos: Tendencias, Riesgos y recomendaciones 2023, publicado hoy por Trust for America’s Health.
La financiación insuficiente de los programas de salud pública ha sido un problema de larga data. La crisis del COVID-19 demostró las debilidades en la infraestructura de salud pública de la nación, incluidos los sistemas de datos anticuados, la capacidad insuficiente de los laboratorios de salud pública, una fuerza laboral de salud pública con recursos insuficientes y la necesidad de mejorar las comunicaciones de salud pública. Estas capacidades fundacionales de salud pública requieren una financiación mayor, flexible y sostenida.
Si bien el financiamiento de emergencia para la respuesta a la pandemia fue fundamental para abordar la crisis, representó un financiamiento único y, a menudo, se limitó a gastos específicos del COVID-19, es decir, no se pudo gastar en necesidades de infraestructura subyacentes. Además, en la mayoría de los casos, esta financiación ha finalizado o se rescindió en el reciente acuerdo de límite de deuda. Por lo tanto, la nación corre el riesgo de volver a un patrón de auge y caída de aumentos esporádicos de fondos para la salud pública durante emergencias, seguido de fondos insuficientes en períodos que no son de emergencia.
Los Centros para el Control y la Prevención de Enfermedades (CDC) de los Estados Unidos, la principal fuente de financiación de la salud pública para los departamentos de salud estatales, locales, tribales y territoriales, dependen del proceso anual de asignaciones federales. Durante la última década (año fiscal 2014 – 2023), el presupuesto de los CDC aumentó solo un 6 % después de ajustarse a la inflación, lo que generó una financiación insuficiente en áreas clave del programa, como la preparación para emergencias y la prevención de enfermedades crónicas.
Dos programas de los CDC enfocados en la preparación y respuesta de salud pública, el Programa de Preparación para Emergencias de Salud Pública (PHEP) y el Programa de Preparación y Recuperación de Atención Médica, han experimentado importantes recortes presupuestarios en las últimas dos décadas. Después de ajustar por inflación, la financiación de PHEP se ha reducido a la mitad desde el 2003, y el presupuesto para el Programa de Preparación y Recuperación de Atención Médica se ha reducido en casi dos tercios durante el mismo período.
Además de los riesgos asociados a las emergencias sanitarias, el país enfrenta un número creciente de personas que viven con enfermedades crónicas y los costos de salud asociados. Hoy en día, aproximadamente el 60 % de la población adulta de los Estados Unidos tiene al menos una enfermedad crónica, como obesidad, diabetes o enfermedades cardíacas. El tratamiento de estas enfermedades crónicas, junto con las afecciones de salud mental, representa la gran mayoría del gasto en atención médica de los Estados Unidos. Si bien los programas de salud pública basados en evidencia que ayudan a prevenir enfermedades crónicas están haciendo un trabajo importante, la financiación insuficiente ha limitado su accesibilidad e impacto en muchas comunidades.
“Debemos abordar el grave desajuste entre las necesidades de salud pública de la nación y su inversión en salud pública”, dijo J. Nadine Gracia, M.D. MSCE, Presidenta y Directora Ejecutiva de Trust for America’s Health. “La inversión en salud pública dirige el gasto hacia programas de seguridad y prevención en salud. Dicho gasto no solo nos prepararía mejor para futuras emergencias de salud pública, sino que también ayudaría a abordar las causas profundas de la mala salud y las disparidades en la salud”.
TFAH solicita una financiación anual para CDC de al menos $ 11,581 mil millones en el año fiscal 2024, el nivel solicitado en el presupuesto del presidente para el año fiscal 24 (la financiación de CDC para el año fiscal 2023 es de $ 9,2 mil millones).
Otras recomendaciones de política dentro del informe incluyen:
- Aumentar y mantener el financiamiento relativo a enfermedades para fortalecer la infraestructura de salud pública. Los expertos en salud pública calculan un déficit anual de $4500 millones en fondos necesarios para que los departamentos de salud estatales y locales brinden servicios integrales de salud pública en sus comunidades.
- Fortalecer la preparación para emergencias de salud pública, incluso dentro del sistema de salud. Las inversiones deben incluir la restauración de los fondos para el Acuerdo de Cooperación de Preparación para Emergencias de Salud Pública, el Programa de Preparación y Recuperación de Atención Médica y programas diseñados para respaldar la infraestructura de vacunas, así como para prevenir, detectar y contener infecciones resistentes a los antimicrobianos.
- Modernizar el sistema de datos de salud pública para garantizar el intercambio de datos completos y en tiempo real durante las emergencias de salud pública. Los expertos en salud pública estiman que se necesitan al menos $7840 millones en los próximos cinco años para que la Iniciativa de Modernización de Datos de los CDC fortalezca la recopilación y el informe de datos de salud pública a nivel estatal y local. El Congreso también debe proporcionar financiamiento sostenido para el nuevo Centro de pronóstico y análisis de brotes de los CDC.
- Reforzar el reclutamiento y la retención de la fuerza laboral de salud pública. En el 2021, se estimó que los departamentos de salud pública estatales y locales necesitaban contratar 80 000 empleados adicionales para poder brindar un conjunto mínimo de servicios de salud pública. La naturaleza de una sola vez de la financiación de emergencia a corto plazo significa que los departamentos de salud están, o pronto estarán, gravemente faltos de personal nuevamente.
- Invertir en programas para prepararse y mitigar los impactos del cambio climático.
- Abordar las disparidades de salud y las causas profundas de las enfermedades tomando en cuanta los determinantes sociales de la salud e invirtiendo en la prevención de enfermedades crónicas.
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.
New Report: Under-Investment in Public Health Leaves Nation Less Prepared for Current and Future Health Risks
COVID-19 Emergency Funding Helped Control the Pandemic, but Did Not Address Structural Weaknesses in the Nation’s Public Health System
(Washington, DC – June 14, 2023) – Decades of underfunding have left the nation’s public health system ill-equipped to protect the health of Americans, according to a new report, The Impact of Chronic Underfunding on America’s Public Health System: Trends, Risks, and Recommendations, 2023, being released today by Trust for America’s Health.
Insufficient funding for public health programs has been a long-standing problem. The COVID-19 crisis illuminated weaknesses in the nation’s public health infrastructure, including antiquated data systems, insufficient public health laboratory capacity, an under-resourced public health workforce, and the need for improved public health communications. These foundational public health capacities require increased, flexible, and sustained funding.
While pandemic response emergency funding was critical for addressing the crisis, it represented one-time funding and was often limited to COVID-19-specific spending, i.e., it could not be spent on underlying infrastructure needs. Furthermore, in most instances, this funding has now ended or was rescinded in the recent debt limit agreement. The nation is therefore at risk of returning to a boom-and-bust pattern of sporadic funding increases for public health during emergencies followed by insufficient funding in non-emergency periods.
The U.S. Centers for Disease Control and Prevention (CDC), the primary source of public health funding for state, local, tribal, and territorial health departments, is itself reliant on the annual federal appropriations process. Over the past two decades (FY 2014 – 2023), the CDC’s budget has increased by just 6 percent after adjusting for inflation, leading to insufficient funding in key program areas such as emergency preparedness and chronic disease prevention.
Two CDC programs focused on public health preparedness and response, the Public Health Emergency Preparedness Program (PHEP) and the Healthcare Readiness and Recovery Program, have both experienced major budget cuts over the past two decades. After adjusting for inflation, PHEP funding has been reduced by about half since 2003, and the budget for the Healthcare Readiness and Recovery Program has decreased by nearly two-thirds during the same period.
In addition to the risks associated with health emergencies, the country faces a growing number of people living with chronic diseases and the associated healthcare costs. Today, roughly 60 percent of the U.S. adult population has at least one chronic disease, such as obesity, diabetes, or heart disease. Treating these chronic diseases, along with mental health conditions, accounts for the vast majority of U.S. healthcare spending. While evidence-based public health programs that help prevent chronic disease are doing important work, insufficient funding has limited their accessibility and impact in many communities.
“We must address the serious mismatch between the nation’s public health needs and its public health investment,” said J. Nadine Gracia, M.D. MSCE, President and CEO of Trust for America’s Health. “Public health and prevention represent only a small fraction of the more than $4 trillion in annual health spending in our nation. Increased and sustained investment in public health would not only better prepare us for future public health emergencies, it would also help address the root causes of poor health and health disparities.”
TFAH is calling for annual funding for CDC of at least $11.581 billion in FY 2024, the level requested in the President’s FY 24 budget (FY 2023 CDC funding is $9.2 billion).
Other policy recommendations within the report include:
- Increase and sustain disease-agnostic funding to strengthen public health infrastructure. Public health experts estimate an annual shortfall of $4.5 billion in necessary funding for state and local health departments to provide comprehensive public health services in their communities.
- Strengthen public health emergency preparedness, including within the healthcare system. Investments should include the restoration of funding to the Public Health Emergency Preparedness Cooperative Agreement, the Healthcare Readiness and Recovery Program, and programs designed to support vaccine infrastructure as well as prevent, detect, and contain antimicrobial-resistant infections.
- Modernize the public health data system to ensure comprehensive and real-time data sharing during public health emergencies. Public health experts estimate that at least $7.84 billion is needed over the next five years for CDC’s Data Modernization Initiative to strengthen public health data collection and reporting at the state and local levels. Congress should also provide sustained funding for CDC’s new Center for Forecasting and Outbreak Analytics.
- Bolster the recruitment and retention of the public health workforce. In 2021, it was estimated that state and local public health departments needed to hire an additional 80,000 employees to be able to deliver a minimum set of public health services. The one-time nature of short-term emergency funding means that health departments will continue to experience understaffing.
- Address health disparities and the root causes of disease by addressing the social determinants of health and investing in chronic disease prevention.
- Invest in programs to prepare for and mitigate the impacts of climate change.
Read the full report
The State of Emergency Preparedness in the US
(Washington DC – June 7, 2023)
With the expiration of the COVID-19 emergency, how prepared are states for another crisis? Dr. Nadine Gracia, President and CEO of Trust for America’s Health, joins the public health podcast to discuss the 2023 Ready or Not report which assesses states’ performance in key areas related to emergency preparedness—including infectious disease, natural and artificial disasters, and bioterrorism.
Report: Suicide Rates Fell in Iowa While Rising Nationwide
May 2023
Radio Iowa
Iowa appears to have bucked a national trend of rising suicide rates in recent years. While more people across the country took their own lives in 2021 compared to 2020, a report from a nonprofit, nonpartisan organization finds suicide rates dropped during that period in Iowa. Brandon Reavis is the senior government relations manager at Trust for America’s Health.
La tasa de mortalidad inducida por alcohol, drogas y suicidio de los Estados Unidos ha aumentado un 11 por ciento durante el 2021
(Washington, DC – 24 de mayo del 2023) – Las muertes asociadas por el alcohol, las drogas y el suicidio cobraron la vida de 209.225 estadounidenses en el 2021, elevando la tasa de mortalidad al 11 por ciento, con respecto al año anterior, según el nuevo informe Pain in the Nación 2023 sobre Epidemias de Muertes por Alcohol, Drogas y Suicidio, publicado el día de hoy por Trust for America’s Health (TFAH, por sus siglas en ingles).
Durante este último año, se ha registrado el récord más alto en la historia con 209.225 americanos que han perdido la vida por abuso de sustancias de alcohol, drogas y suicidios. Esta tendencia de muerte ha ido incrementando bruscamente en los EE. UU. La data del 2021 demuestra que las muertes por estas causas han aumentado a través de toda la población del país, pero mayormente se observó un incremento en las comunidades de color y en las personas que viven en el sur, el oeste y las regiones rurales del país.
- Se observó que las muertes por sobredosis de drogas incrementaron un 14 por ciento entre el 2020 y el 2021, con grandes aumentos entre los nativos de Hawái, las islas del Pacífico, los indios americanos/nativos de Alaska y entre los jóvenes y adultos mayores. Durante el año, se observó que la tasas por sobredosis de drogas fue mayor entre los adultos de 35 a 54 años, hombres, personas de raza negra y adultos jóvenes entre los 18 a 34 años.
- Las muertes inducidas por alcohol aumentaron un 10 por ciento entre el 2020 y el 2021. El incremento más elevado, se encuentra entre los nativos de Hawái, las islas del Pacífico, los latinos y los indios americanos/nativos de Alaska.
- La mortalidad por suicidio aumentó un 4 por ciento entre el 2020 y el 2021. El mayor aumento, se registra entre los indios americanos/nativos de Alaska y los negros.
Aunque las tendencias del 2021 no fueron muy buenas noticias, se lograron mejores resultados con respecto a las tendencias del 2020, ya que para el 2020, la cantidad de muertes por alcohol, drogas y suicidio aumentó un 20 por ciento en comparación con el 2019.
“Los datos de mortalidad por abuso de sustancias y suicidio continúan demostrando cifras y aumentos alarmantes “, dijo J. Nadine Gracia, M.D., MSCE, presidenta y directora ejecutiva de Trust for America’s Health. “Lo que se requiere es una inversión con carácter de urgencia con políticas sostenibles, programas que ayuden a prevenir el uso y abuso de sustancias y la tendencia al suicidio tras ciertas experiencias de vida. Necesitamos invertir en programas que prevengan experiencias adversas y traumáticas durante la niñez, promoviendo servicios de salud mental en las escuelas para brindar apoyo, creando entornos de atención médica para toda la población”.
Resumen de dos décadas
Las muertes por alcohol, drogas y suicidio han ido en aumento durante más de dos décadas y se han duplicado durante este período con 104.379 muertes de este tipo en el 2011, en comparación con 209.225 en el 2021. Entre el 2016 y el 2021, el aumento en la tasa de muertes por sobredosis de drogas fue más del 60 por ciento. Estos aumentos afectaron desproporcionadamente a las comunidades negras y poblaciones latinas.
La mayoría del aumento de muertes por sobredosis de drogas, se debían por sobredosis de opiáceos, además de registrarse muertes por cocaína y psicoestimulantes. además, se halló que la xilazina, representa una nueva amenaza, ya que es un tranquilizante aprobado para uso veterinario, que se mezcla con fentanilo para crear una droga callejera altamente tóxica.
Durante las últimas dos décadas, las muertes por alcohol y suicidio también han aumentado, pero no tanto como las muertes por drogas.
Riesgo de suicidio juvenil
Durante la última década, las muertes por alcohol, drogas y suicidio entre jóvenes de 10 a 17 años han aumentado un 40 por ciento. Si bien los jóvenes tenían una tasa de suicidio mucho menor que la población en general, la tendencia al alza del suicidio juvenil comenzó antes de la pandemia de COVID-19 (incrementándose al 71 por ciento, entre el 2010 al 2021) Esto demuestra ser un hecho bastante alarmante, el cual requiere atención inmediata. A diferencia de otros grupos de edad, los jóvenes registran el mayor aumento de mortalidad por causa de suicidio, en comparación con el aumento que tuvieron otros grupos de edad.
Los jóvenes indios americanos/nativos de Alaska y LGBTQ son los que representan mayor riesgo de tener poca salud mental y de presentar conductas suicidas.
Riesgo de suicidio de veteranos
Otra Data presentó que la tasa de mortalidad por suicidio de los veteranos requiere atención inmediata, demostrando 32 muertes por cada 100.000 veteranos en el 2020, siendo ésta la tasa más alta en comparación con la de la población general.
Programas basados en evidencia pueden ayudar a revertir las tendencias de muertes por desesperación
En respuesta a la creciente crisis de muertes por desesperación, se necesita un enfoque multifacético para mejorar la salud mental y el bienestar en cada comunidad. El informe incluye recomendaciones sobre los pasos que deben tomar los gobiernos a nivel federal, estatal, local, entre otras partes interesadas, para evitar el uso y el abuso de sustancias y de prevenir el suicidio. Las recomendaciones incluyen:
- Invertir en programas de prevención y promover condiciones que promuevan la salud, este incluye programas que prevengan y reduzcan las experiencias adversas durante niñez, brindando servicios que informen sobre traumas, facilitando servicios de salud mental para estudiantes en las escuelas y programas de intervención de crisis, incluyendo la línea de crisis de vida 988.
- Prevenir el uso indebido y la sobredosis de sustancias apoyando los programas de servicio de jeringas, aumentando la disponibilidad de tiras reactivas de naloxona y fentanilo, permitiendo más fondos para fomentar los Programas de Apoyo a Comunidades Libres de Drogas y reforzando los programas de prevención específicamente para los jóvenes.
- Transformar el sistema de prevención de salud mental y el sistema de prevención de sustancias, incrementado el acceso a la atención médica para atender la salud mental y problemas por el uso de sustancias, a través de la Ley de Equidad en Adicción y Paridad, integrando la asistencia de salud mental con centros de tratamientos de abuso de substancias creando un cuidado cultural y lingüísticamente adecuado, para proporcionar el cuidado apropiado para las poblaciones de color y otras poblaciones desatendidas.
Encuentre el informe completo en: Pain in the Nación 2023 sobre Epidemias de Muertes por Alcohol, Drogas y Suicidio
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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. www.tfah.org
U.S. Death Rate Due to Alcohol, Drugs, and Suicide Increased by 11 Percent in 2021
Increases occurred among all ages, races, and geographic groups, but were particularly high for youth suicides and overdoses among certain populations of color
(Washington, DC – May 24, 2023) – The rate of U.S. deaths due to alcohol, drugs, and suicide climbed 11 percent in 2021, according to Pain in the Nation 2023: The Epidemics of Alcohol, Drug, and Suicide Deaths, a new report released today by Trust for America’s Health (TFAH).
While an all-time record, 209,225 Americans lost their lives due to alcohol, drugs or suicide last year these deaths are part of a two-decade trend of sharply increasing fatalities due to substance misuse and suicide in the U.S. The 2021 data showed such deaths were up across the U.S. population, with the largest increases occurring among certain populations of color as well as people living in the South, West, and rural regions of the country.
- Drug overdose deaths increased by 14 percent between 2020 and 2021, with larger increases among Native Hawaiians and Pacific Islanders, American Indian/Alaska Native people, and among youth and older adults. For the year, drug overdose rates were highest among adults ages 35 to 54, males, Black people, and young adults ages 18 to 34.
- Alcohol-induced deaths increased by 10 percent between 2020 and 2021, with the highest increases among Native Hawaiians and Pacific Islanders, Latino people, and American Indian/Alaska Native people.
- Suicide mortality increased by 4 percent between 2020 and 2021, with the highest increases among American Indian/Alaska Native people and Black people.
While the 2021 trends were not good news, they were an improvement over the 2020 data. For 2020, the number of alcohol, drug, and suicide deaths was up 20 percent as compared with 2019.
“The data continue to show alarming increases in deaths due to substance misuse and suicide,” said J. Nadine Gracia, M.D., MSCE, President and CEO of Trust for America’s Health. “What is needed is urgent and sustained investment in policies and programs that prevent the root causes of substance misuse and suicidality. We need to prevent adverse childhood experiences and trauma and support mental health services in schools, within healthcare settings, and in community settings for all populations.”
Two Decades Overview
Deaths due to alcohol, drugs, and suicide have been on the rise for over two decades, doubling over the period from 104,379 deaths in 2011 to 209,225 in 2021. Between 2016 and 2021, the escalation in the rate of drug overdose deaths was more than 60 percent. These increases disproportionately impacted Black and Latino populations.
Most of the upturn in deaths due to drug overdose involved opioid overdose, with additional deaths due to cocaine and psychostimulants. In addition, a new and growing threat is xylazine, a tranquilizer approved for veterinary use but mixed with fentanyl to create a highly toxic illicit drug combination.
During the last two decades alcohol and suicide deaths have also increased, but not as sharply as drug deaths.
Youth Suicide Risk
Over the last decade, alcohol, drug, and suicide deaths among youth ages 10 to 17 increased by 65 percent. While youth have a much lower suicide rate than the general population, the upward trend of youth suicide, beginning well before the COVID-19 pandemic—a 71 percent increase tween 2010 and 2021—is tragic and warrants immediate attention. Unlike for other age groups, an increase in suicide deaths among young people was the primary driver for the age group’s increased overall mortality.
American Indian/Alaska Native and LGBTQ youth are most at risk for poor mental health and suicidal behaviors.
Veteran Suicide Risk
Veteran suicide risk also needs immediate attention. The suicide mortality rate for veterans was 32 deaths per 100,000 veterans in 2020, a much higher rate than the general population.
Evidence-based Programs Can Help Reverse Deaths of Despair Trends
In response to the growing deaths of despair crisis, a multifaceted approach to improving mental health and well-being in every community is needed. The report includes recommendations for steps federal, state, and local government and other stakeholders should take to address substance misuse and suicide deaths. The recommendations include:
- Invest in prevention programs and conditions that promote health including programs that prevent or reduce adverse childhood experiences and provide trauma-informed services, student mental health services in schools, and strengthened crisis intervention programs, including the 988 crisis lifeline.
- Prevent substance misuse and overdose by supporting syringe service programs, increasing naloxone and fentanyl test strips availability, and expanding funding for the Drug-Free Communities Support Program to bolster prevention programs for youth specifically.
- Transform the mental health and substance use prevention system by increasing access to mental health and substance use healthcare through full enforcement of the Mental Health Parity and Addiction Equity Act, integrating mental health and substance use treatment with other healthcare services, and expanding culturally and linguistically appropriate care for populations of color and other underserved populations.
Read the full report
Trust for America’s Health is a nonprofit, nonpartisan organization that promotes optimal health for every person and community and makes the prevention of illness and injury a national priority.
TFAH Statement on the Braidwood Management v. Becerra Case
(Washington, DC – March 30, 2023) – Trust for America’s Health (TFAH) is deeply concerned about the recent ruling in the Braidwood Management v. Becerra case. This decision could restrict millions of Americans’ access to free preventive services that save lives and reduce healthcare costs. As a non-partisan public health policy, research, and advocacy organization dedicated to health promotion and disease prevention, we know the evidence shows that access to prevention is critical for the health and well-being of individuals and families. Coverage of preventive services without patient cost sharing means doctors detect cancers earlier. It means people get the help they need to quit smoking, families receive obesity prevention counseling, and health care providers can screen for behavioral health concerns like depression. Research shows that out-of-pocket costs are a barrier for people to receive life-saving preventive services, and they are an important tool for reducing health disparities. Our nation spends trillions of dollars on treating disease, but only a small fraction of those dollars are used to prevent people from getting sick in the first place. If this decision stands, it will be a step backward for the goal of achieving optimal health for every person and community.
Maine Gets High Marks for Public Health Emergency Preparedness
March 2023
Maine Public
A national report now ranks Maine in the top tier of states when it comes to being prepared for public health emergencies. The annual report from the nonpartisan Trust for America’s Health found Maine improved from last year’s rank in the mid-level tier and now joins 19 states at the top.
Spokesperson Rhea Farberman says Maine saw improvements in several areas between 2021 and 2022, including hospital safety, the percentage of residents vaccinated against the flu and the percentage of residents with access to paid time off, which increased from 50% to 59%.
New Report Measures States’ Emergency Preparedness and Makes Recommendations About How to Strengthen the Nation’s Public Health System
Sustained Investment in Public Health Infrastructure and Preparedness is Needed to Protect Lives During Disease Outbreaks and Natural Disasters
(Washington, DC – March 23, 2023) – As infectious disease outbreaks and extreme weather events threaten the health of more Americans, a new report shows the need for strengthened national and state public health emergency preparedness.
Ready or Not 2023: Protecting the Public’s Health from Diseases, Disasters, and Bioterrorism, released today by Trust for America’s Health, measures states’ readiness to respond to a spectrum of health emergencies and to provide ongoing public health services. The report gives federal and state health officials and policymakers actionable data and recommends policies to improve the nation’s emergency preparedness at a time when health emergencies are increasing. During 2022, the U.S. surpassed 1 million deaths due to COVID-19 and saw decreasing rates of routine vaccinations and increasing prevalence of health misinformation. In addition, the past year was the eighth consecutive year the U.S. experienced 10 or more billion-dollar weather-related disasters.
The report tiers states and the District of Columbia into three performance levels for health emergency preparedness: high, middle, and low. This year’s report placed 19 states and DC in the high-performance tier, 16 states in the middle performance tier, and 15 states in the low performance tier.
High Tier – 19 states & DC
CO, CT, DC, DE, FL, GA, KS, ME, MD, MA, MS, NJ, NC, OH, PA, UT, VT, VA, WA, WI
Middle Tier – 16 states
AK, AL, AR, CA, IA, ID, IL, IN, MO, ND, NE, NH, NY, RI, SC, TX
Low Tier – 15 states
AZ, HI, KY, LA, MI, MN, MT, NM, NV, OK, OR, SD, TN, WV, WY
“Increased and sustained investment in public health infrastructure, emergency preparedness, and health equity will save lives,” said J. Nadine Gracia, M.D., MSCE, President and CEO of Trust for America’s Health. “Federal, state, and local officials as well as leaders in the healthcare and business sectors should use our findings to identify and address gaps in public health preparedness. Neglecting to do so will mean that the country will not be as prepared as it needs to be for the next public health emergency.”
The report’s findings showed both areas of strength within the nation’s public health system and areas that need attention.
Areas of strong performance include:
- A majority of states have made preparations to expand healthcare and public health laboratory capacity in an emergency.
- Most states are accredited in the areas of public health or emergency management. Some states are accredited in both.
- Most U.S. residents who received their household water through a community water system had access to safe water. However recent water system failures in Jackson, Mississippi and Newark, New Jersey demonstrate the importance of continued attention to the integrity of municipal water systems.
Areas that need attention include:
- Too few people were vaccinated against seasonal flu last year despite significant improvement in flu vaccination rates in recent years. During the 2021-2022 flu season, 51 percent of Americans ages 6 months or older received a flu vaccine, well short of the 70 percent goal established by Healthy People 2030.
- Only half the U.S. population is served by a comprehensive public health system. Comprehensive public health systems ensure that necessary health services are available to all residents.
- Only 26 percent of hospitals in states, on average, earned a top-quality patient safety grade in 2022. Hospital safety scores measure performance on such issues as healthcare-associated infection rates, intensive-care capacity, and an overall culture of error prevention.
The report contains recommendations for policy actions that would create a stronger public health system at all levels, including:
- The Administration, Congress, and state lawmakers should modernize public health infrastructure, including by investing $4.5 billion annually to support foundational public health capabilities. In addition, Congress should continue to increase funding for the Public Health Emergency Preparedness cooperative agreement and public health data modernization to allow for earlier and more accurate detection of emerging health threats.
- Policymakers at all levels should act to protect and strengthen public health authorities and should prioritize rebuilding trust in public health agencies and leaders.
- Congress and state legislatures should invest in effective public health communications, including countering misinformation.
- Congress and states should ensure first-dollar coverage for all recommended vaccines under commercial insurance and for uninsured people. States should minimize vaccine exemptions for school children, and healthcare facilities should increase rates of vaccination for healthcare workers.
- Congress and states should provide job-protected paid leave for employees due to illness or family caregiving demands.
- Congress and states should invest in policies and capacity to address the social determinants of health such as secure housing, access to transportation, and access to healthy food.
- Congress should fund the entire medical countermeasures (MCM) enterprise, including the distribution and dispensing of MCMs. Congress should also create incentives for new products to prevent and fight antibiotic-resistant infections.
- Congress and states should strengthen readiness for climate change, extreme weather, and environmental health threats.
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Trust for America’s Health is a nonprofit, nonpartisan organization that promotes optimal health for every person and community and makes the prevention of illness and injury a national priority.