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Press Release on health-related topics.

Trust for America’s Health Statement on Supreme Court stay of the EPA’s Clean Power Plan

Washington, D.C., February 9, 2016 – The following is a statement from Richard Hamburg, interim president and CEO of Trust for America’s Health (TFAH) on the U.S. Supreme Court’s decision to stay implementation of the Environmental Protection Agency (EPA) Clean Power Plan pending final legal resolution.

“Tonight’s decision by the Supreme Court to stay the EPA’s Clean Power Plan pending resolution of ongoing litigation is extremely disappointing. The Supreme Court has already previously ruled in favor of EPA’s endangerment finding that carbon pollution poses a threat to human health and therefore is subject to the federal bipartisan Clean Air Act. TFAH believes the Clean Power Plan as proposed and finalized by the EPA, in close consultation via the rulemaking process with the general public and all affected stakeholders, is on a firm legal foundation.

Climate change poses serious public health concerns — from natural disasters to reduced water resources to new insect-based infectious diseases associated with higher temperatures to worsening air quality to the effects of the extreme weather we’ve seen across the country over the past several years.  Further unnecessary delay of the Clean Power Plan will only exacerbate the dangerous public health challenges we face as a nation.”

TFAH Calls for Urgent Action in Flint, MI, Jackson, MS and Renewed National Priority on Environmental Health

Washington, D.C., February 2, 2016 – The following is a statement by Gail C. Christopher, D.N., board chair of the Trust for America’s Health (TFAH) and vice president for policy and senior advisor at the W.K. Kellogg Foundation:

“The Trust for America’s Health lends its voice to the call for urgent action to be taken to protect the health of the citizens of Flint, Michigan and for immediate, rapid assessment of the water in Jackson, Mississippi.

Every possible step must be taken to provide clean, safe water to every community on a permanent basis.  But that’s not enough; sufficient resources must be available to provide for the lifelong health needs of those harmed.  Poisoning from lead and other contaminants have severe consequences – especially for young children and pregnant women – including putting babies and children at high risk for serious developmental, neurobehavioral and cognitive delays.

An appropriate response requires not only short-term medical care, but ongoing, intensive health, social service and educational support.  Members of the community must be an equal partner in the response and plans moving forward.  The Flint tragedy was created by looking to solve problems on the cheap at the expense of the health of the city.  It is a national responsibility to now commit to long-term, sustained solutions to improve the future of the city.  We must never turn our backs on them again.

The Flint fiasco also is a clarion call to re-examine and renew our nation’s environmental health policies and practices.  Of course, the fact that 40 percent of the people of Flint live at or below the poverty line and 56 percent are Black makes this situation particularly troubling – and, as raised in the New York Times last month, issues of environmental justice and racism must be at the top of the agenda.

We must not let tragedies go unanswered.  It is time to take action on long-neglected environmental health concerns – and make them a national priority.  TFAH is committed to redoubling efforts to improve environmental health and is committed to working with policymakers, partners and the public on a range of top concerns, including:

Ensuring families have safe, healthy homes and communities:  Currently millions of families live in conditions that adversely impact their health.  In 2009, the Surgeon General issued a call to Action To Promote Healthy Homes, identifying health concerns and evidence-based policies for prevention, such as improving air quality, carbon monoxide poisoning prevention, radon gas mitigation, reducing allergens and asthma, improving water quality, reducing harmful chemicals, preventing elevated lead levels, reducing disparities in access to healthy and safe homes, addressing community factors that affect health and homes and housing instability.

Assuring clean water for all Americans:  In addition to lead being an ongoing problem in the drinking water in some communities, waterborne illnesses overall still pose a serious threat generally.  Despite advances in water management and even though water-related illnesses are largely unreported unless they are severe, each year around 30 outbreaks and 1,000 reported drinking water-related cases and around 24 outbreaks and 1,300 recreational water-related cases occur.  Measures like the Environmental Protection Agency’s (EPA) Clean Water Rule help improve and restore guaranteed protection of safe water availability.

Eliminating lead poisoning in children:  Through contaminated water and lead paint (which still remains in some older, low-income urban housing, but banned from use in 1978), around 2.6 percent of children ages 1 to 5 (535,000 nationwide) have elevated levels of lead in their blood.  Some U.S. water systems still have levels of lead contamination and an estimated 24 million Americans, including 4 million young children, are estimated to face significant lead-based paint exposure.  Rates of lead poisoning are significantly higher for children living in poverty or very low-income homes (4.4 percent) and are highest among Black children (5.6 percent).  Public health efforts – including improving water systems, lead paint remediation and required screening of exposure in children — have helped reduce lead poisoning levels by 70 percent since 1990.

  • The Centers for Disease Control and Prevention (CDC) estimates it can cost $5,600 for just the medical and special education needs per year per child with lead poisoning.  The return on investment for lead control programs found that for every dollar spent, $17 to $221 is returned in health benefits, increased intelligence quotient (IQ), higher lifetime earnings, tax revenue, reduced spending on special education and reduced criminal activity, resulting in a potential net benefit of $181 billion to $269 billion.

Reducing asthma:  Around one in 11 American children currently have asthma, which can be triggered by pollen, mold, animal dander, cockroaches, rodents and dust mites — and children are at greater risk to these threats if they live in a household where they experience regular exposure to them.  In the past decade, asthma rates have increased by nearly 15 percent, growing by more than 50 percent among Black children.  Efforts to reduce triggers via home remediation services and housing support options can greatly reduce numbers of asthma attacks and recurring emergency room visits.  For instance, a Boston Community Asthma Initiative led to a return of $1.46 to insurers/society for every $1 invested.  In addition, EPA’s Clean Air Act and similar rules can help lower emissions rates of a number of air pollutants, including mercury, arsenic, dioxins, volatile organic compounds, acid gases, heavy metals, smog and soot, which in turn reduce not only asthma and respiratory episodes, but also premature mortality, chronic bronchitis and heart attacks.

  • More than 12 percent of children in families living in poverty have asthma, compared to 8.2 percent of middle and higher income families.  More than 16 percent of Black children, 16.5 percent of Puerto Rican children, and 10 percent of American Indian and Native Alaskan children have asthma.  It is the second most costly medical condition among children, at nearly $12 billion, and it contributes to more than 10.5 million missed school days annually. In May 2012, the President’s Task Force on Environmental Health and Safety Risks to Children released a Coordinated Federal Action Plan to Reduce Racial and Ethnic Asthma Disparities, a three- to five-year partnership between the U.S. Department of Health and Human Services (HHS), U.S. Department of Housing and Urban Development (HUD) and EPA.

Limiting exposure to environmental hazards, including pollution, toxic chemicals, contaminated water and food and waste from landfills:  Exposure to environmental toxins can have a negative impact on health, particularly for children.  Even relatively low levels of exposure contribute to lower birth weights, lower test scores and lower lifelong earning potential.  Low-income housing is more likely to be located close to sources of pollution.  Black and less educated women are more likely to live within 200 meters of Superfund hazardous waste sites or factories emitting toxic releases.  Superfund cleanups have been linked to a reduction of incidence in cognitive anomalies in infants by around 20 percent.  Lead has been found at 75 percent of National Priority List (NPL) Superfund sites.

Expanding research on the connection between the environment and health, including a National Environmental Public Health Tracking Network:  While there are clear connections showing the negative impact of lead, mercury and many other toxins on health, more research is needed to better understand the impact and scope of different environmental factors on health – and/or to disprove potential theories.  A better research system could provide “early warning” information about environmental-exposure emergencies, such as in Flint.  With initial funding, CDC created a pilot system in 20 states to study disease and health problem patterns in different communities.  Today, the Tracking program funds 26 state and local health departments. Additional resources are needed to build out the system to better identify the connections and causes of many diseases and to expand to all states.  A fully functioning Tracking Network holds the potential to help unlock a range of medical mysteries, including a better understanding of patterns related to autism, some forms of birth defects and the impact of pollution on asthma and other respiratory illnesses.

  • Exposure to some chemicals have been shown to increase the risk of a child developing developmental disabilities. These chemicals include alcohol, arsenic, lead, manganese, mercury, nicotine, pesticides, polybrominated diphenyl ethers (PBDEs), polychlorinated biphenyls (PCBs), polycyclic aromatic hydrocarbons (PAHs) and solvents.”

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

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Trust for America’s Health Statement on Bipartisan Senate Agriculture Committee Compromise on Child Nutrition Reauthorization

Washington, D.C., January 19, 2016 – The following is a statement from Richard Hamburg, interim president and CEO of the Trust for America’s Health (TFAH), on the bipartisan compromise legislation introduced earlier this week by Senate Agriculture Committee Chairman Pat Roberts (R-KS) and Ranking Member Debbie Stabenow (D-MI).

“The Improving Child Nutrition Integrity and Access Act of 2016 is an important step toward ensuring healthier nutrition for all of the nation’s children.  We applaud the committee leadership and staff for their hard work in achieving a compromise that will build on the important accomplishments that were made in the Healthy, Hunger-Free Kids Act of 2010.

Around 15.5 million children experience food insecurity each year, with their access to adequate food and nutrition limited due to cost, proximity and/or other resources. At the same time, 17 percent of children are obese.  There’s clearly still a lot of work to do to ensure this generation of children receive the support they need to thrive.  In our annual State of Obesity report, TFAH highlights programs and policies at the U.S. Department of Agriculture, U.S. Department of Health and Human Services and in states and localities that can help ensure all children have the chance to grow up with good nutrition.  We know what works – but we need to keep moving forward and increasing support to realize the promise of these efforts.

This bill advances some important improvements by increasing investments in school kitchen equipment, Farm-to-School programs and other programs that help feed kids outside of traditional school settings. Unfortunately, there are some provisions in the bill that are not ideal and deviate from the evidence-base, such as not requiring 100 percent whole grains in school meals. But, on balance, the bill represents continued progress in the right direction.

We urge members of Congress to move forward with markup and embrace the spirit of compromise embodied in this legislation. TFAH stands ready to work with policymakers and partners to help ensure reauthorization legislation is best able to support our children, their families and schools.”

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

TFAH Applauds the Obama Administration for Showing Strong Support for Increased Collaboration between the Health and Education Sectors

Washington, D.C., January 15, 2016 – Trust for America’s Health (TFAH) applauds the Obama Administration for showing strong support for increased collaboration and coordination between the health and education sectors. The following is a statement from Richard Hamburg, interim president and CEO, TFAH and co-chair of the National Collaborative for Education and Health.

“The release of the Healthy Students, Promising Futures toolkit and joint letter from the U.S. Department of Health and Human Services and U.S. Department of Education is an important step in ensuring all of the nation’s children can succeed in school and life.

Healthy children are more prepared to learn, and academic success puts children on track for healthier and more productive lives.  The toolkit importantly recognizes the inextricable link between health and education — and provides communities with ways to take action to help this generation of children thrive.

TFAH, as a co-founder with Healthy Schools Campaign of the National Collaborative for Education and Health, is excited to see real, high-impact opportunities to improve joint outcomes – including through:

  • Ensuring children have health coverage;
  • Expanding reimbursable health services available in schools;
  • Supporting wrap-around case management for at-risk students–including addressing health conditions and exposure to violence or trauma and toxic stress–to remove barriers to learning;
  • Promoting nutrition, physical activity and health education; and
  • Improved assessments of local community needs and building of partnerships across schools, hospitals, public health departments and others to provide services and programs that can better meet those needs.

We look forward to working with the Administration and state and local communities to support greater adoption and implementation of the Healthy Students, Promising Futures opportunities – and continuing to build toward a vision of healthy schools and communities for our children.”

 

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

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

28 States and Washington, D.C. Reach Half or Fewer of Key Indicators

Washington, D.C., December 17, 2015 – A new report released today found that more than half (28) of states score a five or lower out of 10 key indicators related to preventing, detecting, diagnosing and responding to outbreaks. The report, from Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF), concluded that the United States must redouble efforts to better protect the country from new infectious disease threats, such as MERS-CoV and antibiotic-resistant superbugs, and resurging illnesses like whooping cough, tuberculosis and gonorrhea.

Five states—Delaware, Kentucky, Maine, New York and Virginia—tied for the top score, achieving eight out of 10 indicators. Seven states—Idaho, Kansas, Michigan, Ohio, Oklahoma, Oregon and Utah—tied for the lowest score at three out of 10.

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

Some key findings from the Outbreaks: Protecting Americans from Infectious Diseases report include:

  • Healthcare-associated Infections: Around one out of every 25 people who are hospitalized each year contracts a healthcare-associated infection, leading to some 75,000 deaths a year.
    • Only nine states reduced the standardized infection ratio (SIR) for central line-associated blood stream infections (CLABSI) between 2012 and 2013.
  • Childhood Vaccinations: In 2014, there were more than 600 cases of measles and nearly 33,000 cases of whooping cough reported. While more than 90 percent of all U.S. kindergarteners receive all recommended vaccinations, rates are lower in a number of communities and states. More than 28 percent of preschoolers do not receive all recommended vaccinations.
    • 20 states have laws that either exclude philosophical exemptions entirely or require a parental notarization or affidavit to achieve a religious or philosophical exemption for school attendance.
  • Flu Vaccinations: Based on the severity of the strain, the flu can cause 3,000 to 49,000 deaths a year, more than $10 billion in direct medical expenses and more than $16 billion in lost earnings.
    • 18 states vaccinated at least half of their population (ages 6 months and older) for the seasonal flu from Fall 2014 to Spring 2015. The national average is 47.1 percent. Rates are lowest among young and middle age adults (only 38 percent of 18- to 64-year-olds are vaccinated).
  • Hepatitis C and HIV/AIDS: Of the more than 1.2 million Americans living with HIV, almost one in eight do not know they are infected. Hepatitis C infections—related to a rise in heroin and injection drug use from people transitioning from prescription painkillers—increased more than 150 percent from 2010 to 2013.
    • 16 states and Washington, D.C. explicitly authorize syringe exchange programs.
    • 43 states and Washington, D.C. require reporting all (detectable and undetectable) CD4 cell count (a type of white blood cell) and HIV viral load data to their state HIV surveillance program, as of July 2013.
  • Food Safety: Around 48 million Americans get sick from a foodborne illness each year.
    • 39 states met the national performance target of testing 90 percent of E.coli O157 cases within four days (in 2013).
  • Preparing for Emerging Threats: Significant advances have been made in preparing for public health emergencies, including potential bioterror or natural disease outbreaks, since the September 11, 2001 and anthrax attacks. Gaps remain, however, and have been exacerbated as resources have been cut.
    • 36 states have a biosafety professional in their state public health laboratories – which are responsible for helping detect, diagnose and contain disease outbreaks.
    • 15 states have completed climate change adaption plans that include the impact on human health.
  • Superbugs: More than two million Americans contract antibiotic-resistant infections each year, leading in excess of 23,000 deaths, $20 billion in direct medical costs and more than $35 billion in lost productivity.

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

The Outbreaks report features priority recommendations, including:

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

The indicators represent examples of important capabilities, policies and trends, and were selected in consultation with leading public health and healthcare officials.

Score Summary: 

A full list of all of the indicators and scores and the full report are available on TFAH’s website. For the state-by-state scoring, states received one point for achieving an indicator or zero points if they did not achieve the indicator, with zero the lowest possible overall score and 10 the highest. The data for the indicators are from publicly available sources or were provided from public officials.

8 out of 10: Delaware, Kentucky, Maine, New York and Virginia

7 out of 10: Alaska, California, Maryland, Massachusetts, Minnesota and Nebraska

6 out of 10: Arkansas, Illinois, Iowa, New Hampshire, New Jersey, New Mexico, North Carolina, North Dakota, Vermont, West Virginia and Wisconsin

5 out of 10: Arizona, Colorado, Connecticut, Georgia, Hawaii, Mississippi, Missouri, Montana, Pennsylvania, Rhode Island, Texas and Washington

4 out of 10: Alabama, District of Columbia, Florida, Indiana, Louisiana, Nevada, South Carolina, South Dakota, Tennessee and Wyoming

3 out of 10: Idaho, Kansas, Michigan, Ohio, Oklahoma, Oregon and Utah

 

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

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

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TFAH Opposes any Attempts to Defer or Transfer any portion of the Prevention and Public Health Fund

Washington, D.C., December 10, 2015 – Trust for America’s Health (TFAH) strongly opposes cutting, deferring or transferring any portion of the Prevention and Public Health Fund. The following is a statement from Jeffrey Levi, PhD, executive director of TFAH.

“It is important to help Puerto Rico, but eliminating any funding for the Prevention and Public Health Fund would be a tremendous setback for public health.

For the past six years, the Prevention Fund has provided nearly $5.25 billion in resources to states, communities, territories (including Puerto Rico), and tribal and community organizations to support community-based prevention, including tobacco use prevention, healthy eating and active living, childhood immunizations and clinical prevention. In total, the Fund has:

  • Doubled the Preventive Health and Health Services Block Grant, which provides all 50 states, the District of Columbia, two American Indian tribes, and eight U.S. territories with flexible funding to address their unique public health issues at the state and community level;
  • Expanded access to cancer screenings;
  • Supported the successful Tips from Former Smokers campaign, which has inspired more than 1.6 million people to try to quit smoking, with more than 100,000 smokers have quit for good; and
  • Increased funding for the section 317 childhood immunization program, which has been vital to preventing and responding to measles outbreaks.

Lastly, Puerto Rico has received more than $431 million through the Fund to prevent tobacco use, improve lab capacity, strengthen surveillance systems, and to address their unique public health needs.

Clearly, cutting even a portion of the Prevention Fund would dramatically impede efforts underway to improve health across the nation and in Puerto Rico, as noted by the more than 900 national, state and local organizations, including the Puerto Rico Department of Health, that have pledged their support for the Fund.

We urge Congress to find a realistic source of funding to provide the assistance Puerto Rico needs.”

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

Nearly Half of States Score 5 or Lower out of 10 on Substance Misuse Prevention Report Card

Youth Drug Overdose Death Rates more than Doubled in 35 States in Just Over a Decade

Washington, D.C., November 19, 2015– According to a new Trust for America’s Health (TFAH) report, Reducing Teen Substance Misuse: What Really Works, 24 states scored five or lower out of 10 on key indicators of leading evidence-based policies and programs that can improve the well-being of children and youth and have been connected with preventing and reducing substance – alcohol, tobacco or other drugs – misuse.

Four states tied for the lowest score of three out of a possible 10 – Idaho, Louisiana, Mississippi and Wyoming – while two states achieved 10 out of 10 – Minnesota and New Jersey.  The indicators were developed in consultation with top substance misuse prevention experts.

The Reducing Teen Substance Misuse report includes an analysis of the most recent drug overdose death rates among 12- to 25-year-olds, finding that:

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

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

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

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

The report highlights 10 indicators of the types of policy strategies that can help curb substance misuse by tweens, teens and young adults:

  • Limiting Access:
    • 37 states and Washington, D.C. have liability “dram shop” laws holding establishments accountable for selling alcohol to underage or obviously intoxicated individuals.
    • 30 states and Washington, D.C. have smoke-free laws prohibiting smoking in public places, including restaurants and bars.
  • Supporting Improved Well-being of Tweens, Teens and Young Adults:
    • 30 states had rates of treatment for teens with major depressive episodes above 38.1 percent.
    • 29 states and Washington, D.C. increased funding for mental health services in Fiscal Year 2015.
    • 21 states have comprehensive bullying prevention laws.
    • 35 states have at least an 80 percent high school graduation rate.
    • 31 states and Washington, D.C. have taken action to roll back “one-size-fits-all” sentences for nonviolent drug and other offenses.
  • Improving Counseling, Early Intervention and Treatment and Recovery Support:
    • 32 states and Washington, D.C. have explicit billing codes for Screening (questionnaires/conversations), Brief Intervention (short counseling) and Referral to Treatment (SBIRT) in their medical health (Medicaid or private insurance) programs, yet currently fewer than half of pediatricians report talking to teen patients about alcohol and other drug use.
    • 31 states and Washington, D.C. have laws in place to provide a degree of immunity from criminal charges or mitigation of sentencing for an individual seeking help for themselves or others experiencing an overdose.
    • 30 states and Washington, D.C. provide Medicaid coverage for all three medications approved by the Food and Drug Administration for the treatment of painkiller addiction.

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

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

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

The report provides additional research-based recommendations for preventing and reducing youth substance misuse. It was supported by a grant from the Conrad N. Hilton Foundation.

Score Summary: 

A full list of all of the indicators and scores, listed below. For the state-by-state scoring, states received one point for achieving an indicator or zero points if they did not achieve the indicator. Zero is the lowest possible overall score, 10 is the highest.

10 out of 10: Minnesota and New Jersey

9 out of 10: California, Connecticut, Maine, Maryland, New Mexico, New York and Vermont

8 out of 10: Delaware, District of Columbia, Massachusetts, New Hampshire, Ohio, Oregon, Virginia, Washington and Wisconsin

7 out of 10: Colorado, Iowa, North Carolina and Pennsylvania

6 out of 10: Alabama, Illinois, Missouri, Rhode Island and Utah

5 out of 10: Arkansas, Florida, Hawaii, Kansas, Kentucky, Michigan, Montana, North Dakota and Oklahoma

4 out of 10: Alaska, Arizona, Georgia, Indiana, Nebraska, Nevada, South Carolina, South Dakota, Tennessee, Texas and West Virginia

3 out of 10: Idaho, Louisiana, Mississippi and Wyoming

STATE-BY-STATE YOUTH DRUG OVERDOSE DEATH RANKINGS

Note: Rates include drug overdose deaths, for 2011-2013, a three-year average, for 12- to 25-year-olds. 1 = Highest rate of drug overdose fatalities, 50 = lowest rate of drug overdose fatalities. States with statistically significant (p<0.05) increases since 2005-2007 are noted with an asterisk (*), while states with a statistically significant decrease are noted with two asterisks (**).

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

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

New TFAH Report Focuses on Priority Policies for Reducing Toxic Stress and Adverse Childhood Experiences

Washington, D.C., November 3, 2015— A new report, A Healthy Early Childhood Action Plan: Policies for a Lifetime of Well-being, released today by the Trust for America’s Health (TFAH), highlights more than 40 policy target areas that are key to achieving national goals of reducing toxic stress and Adverse Childhood Experiences (ACEs) and improving the lives of millions of children.

Living with prolonged stress and/or adverse experiences can significantly increase a child’s risk for a range of physical, mental and behavioral problems – increasing the likelihood for hypertension, diabetes, heart disease, stroke, cognitive and developmental disorders, depression, anxiety and a range of other concerns.

Currently, around one-quarter of children ages 5 and younger live in poverty and more than half of all children experience at least one ACE. According to research from the Centers for Disease Control and Prevention (CDC), more than one-quarter of children experience physical abuse (28.3 percent) and substance abuse in the household (26.9 percent) while sexual abuse (24.7 percent for girls and 16 percent for boys) and parent divorce or separation (23.3 percent) are also prevalent.

“More and more studies show investing in early childhood pays off in a lifetime of better health and well-being,” said Jeffrey Levi, PhD, executive director of TFAH. “There are dozens of policy levers we can and should be pushing to ensure all children have high-quality preventive healthcare; safe, stable, nurturing relationships, homes and communities; good nutrition and enough physical activity; and positive early learning experiences.”

The report calls for increased public health engagement in early childhood areas, with a series of recommendations including to:

Build beyond the traditional healthcare system by integrating health and other social supports, including accountable health communities for children, by:

  • Ensuring every child has access to high-quality and affordable healthcare;
  • Building systems to help identify and provide support for children’s needs beyond the traditional medical system, but that have a major impact on health;
  • Focusing on a two generation approach to healthcare – and social service support;
  • Modernizing and expanding the availability of mental health and substance misuse treatment services – for both parents and children;
  • Expanding the focus of a trauma-informed approach across a wider range of federal, state and locally supported services; and
  • Improving services and care coordination for Children and Youth with Special Healthcare Needs (CYSHCN).

Promote protective, healthy communities and establish expert and technical assistance backbone support to help spread and scale programs nationally and in every state, by:

  • Improving the collection, analysis and integration of child health, well-being and services data to better assess trends and target services and programs;
  • Strengthening the role of federal, state and local health departments as the chief health strategist in communities; and
  • Establishing a support organization in every state that provides expertise and technical assistance.

Increase investments in core, effective early childhood policies and programs, by:

  • Making programs and services that promote early childhood well-being a higher priority to ensure they can be delivered on a scale to help all families (ranging from home visiting programs to child welfare services to increasing economic opportunity for families to child care and early education); and
  • Better aligning systems and financial resources to improve the effectiveness and efficiency of health, social services and education services.

The report includes a series of maps showing the status of different states on key trends and policy areas and case studies of evidence-based and model programs, organizations and initiatives—which are putting these recommendations into action—including the Nurse Family Partnership, Family Check Up Models, Abriendo Puertas/Opening Doors, Good Behavior Game, Child-Parent Center Program, Crittenton Children’s Center at Saint Luke’s Health System, Wholesome Wave, Community Asthma Initiative at Boston Children’s Hospital and many others.

“If we work together across sectors – bringing together the collective energy and resources of diverse partners – we will have a better chance of achieving the common goal of a healthy start for all of America’s children,” said Gail Christopher, chair of TFAH’s Board of Directors and vice president for policy and senior advisor at the WK Kellogg Foundation. “This report shines a light on many promising policies and programs. But the question remains whether we can garner the public will to turn the potential into the promise that improves the lives of our next generation.”

The full report was supported by a grant from the Robert Wood Johnson Foundation.

 

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

TFAH Commends President Obama and Congressional Leadership for Securing the Bipartisan Budget Act of 2015

Washington, D.C., October 28, 2015 – The Trust for America’s Health (TFAH) commends President Obama and Congressional leadership for the Bipartisan Budget Act of 2015, and is pleased to announce its support for this legislation. The following is a statement from Jeffrey Levi, PhD, executive director of TFAH.

“This agreement is an important step toward ensuring the nation has adequate resources to help people be healthy, happy and productive. TFAH calls on Congress to pass the Bipartisan Budget Act.

By largely replacing sequestration’s harmful cuts—which forced historically low and grossly inadequate funding for critical public health programs—Congress is now able to increase investments in vital public health and other domestic programs that keep Americans healthy, safe, and secure.

TFAH recommends Congress use this funding to invest in programs that build a public health system that focuses on preventing disease in the first place by restoring funding to chronic disease programs—such as Partnerships to Improve Community Health, Racial and Ethnic Approaches to Community Health and Tips From Former Smokers—at the Centers for Disease Control and Prevention.  These programs support proven strategies that prevent and control the development of numerous chronic diseases.

We also urge Congress to pass appropriations bills that do not include ideologically driven, partisan policy riders that could threaten the implementation of this historic deal.

Every American deserves to be healthy. By maintaining funding for the Prevention and Public Health Fund and passing this Act, the nation’s leaders will have finally signaled that they are serious about providing the support needed to keep Americans healthy and happy.”

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

TFAH Supports the EPA and Obama Administration in Beginning to Address the Serious Health Consequences of Ground-level Ozone

Washington, D.C., October 1, 2015 – The Trust for America’s Health (TFAH) is pleased that the Environmental Protection Agency (EPA) has announced it will finalize an update to the National Ambient Air Quality Standard (NAAQS) for Ground-level Ozone. The following is a statement by Jeffrey Levi, PhD, executive director of TFAH.

“Today the EPA and Obama Administration announced they will finalize a long overdue update to the ground-level ozone standard. TFAH commends EPA for meeting the latest deadline and finalizing a ground-level ozone standard of 70 parts-per-billion (ppb)—far more in line with the current scientific evidence and an important improvement over the flawed 2008 standard.

However, as we have made clear in public statements to EPA, TFAH strongly believes that a standard of 60 ppb would best meet the expectations of the Clean Air Act and would give our nation’s families an ozone standard that protects their health.

EPA’s own science is clear that even healthy adults can experience adverse health effects from ozone at 65 ppb. And, research has told us for years that elevated levels of smog can cause asthma attacks, shortness of breath, trips to the emergency room and even premature death. Now, we are beginning to see research link low birth weight babies, negative neurological effects, and many additional health hazards to ozone.

At a time when obesity levels are stabilizing at an unspeakably high level and we are encouraging more and more Americans to be active, we aren’t providing clean air to breathe. In reality, the Americans—young children, the elderly, and those who already suffer from certain chronic diseases—who are most likely to benefit from being active outdoors are unfortunately those who are most vulnerable to the dangers of dirty air and ground-level ozone.

Improving the standard to 70 ppb is undoubtedly progress towards cleaner air and a healthier nation – however it also represents a missed opportunity for EPA to act on the best available science and truly protect the public’s health.”

 

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