Archives: Press Releases

Press Release on health-related topics.

COVID-19 and Drug Overdose Deaths Drive U.S. Life Expectancy Down

(Washington, DC – January 17, 2023) — Data released by the Centers for Disease Control and Prevention in December 2022 showed that U.S. life expectancy decreased from 77 years in 2020 to 76.4 years in 2021, the second consecutive year that U.S. life expectancy decreased. The last time the U.S. experienced a two-year decrease in life expectancy was during World War II.

Age-specific death rates from 2020 to 2021 increased for all age groups other than infants less than one year old. American Indian and Alaska Native females experienced the largest increase in death rates, jumping 7.3 percent in 2021. Lower life expectancy for some populations groups, disproportionately among people of color, have been attributed to the structural inequities and barriers to optimal health that those communities experience.

Heart disease remained the leading cause of death in the U.S. during 2021 followed by cancer and COVID-19. In addition, drug overdose accounted for over a third of all unintentional deaths. During 2021, 106,699 people died in the U.S. due to a drug overdose, a 14 percent increase in the overdose death rate over 2020.

“These data underscore the importance of TFAH’s work to advance public health, prevention, and health equity,” said TFAH President and CEO J. Nadine Gracia, MD, MSCE. “The COVID-19 pandemic has highlighted the impact of social and economic conditions on people’s health and a community’s ability to be resilient during an emergency. TFAH will remain steadfast in advocating for policies that promote optimal health and well-being for every person and community. Among our priorities are supporting policies and programs that will strengthen the nation’s public health workforce and data systems; investment in substance misuse and suicide prevention including school-based mental health services and primary prevention programs; increased investments in chronic disease prevention programs including obesity prevention; and addressing the social determinants of health.”

Learn more about the causes of declining U.S. life expectancy in this TFAH issue brief: U.S. Experienced Steepest Two-year Decline in Life Expectancy in a Century – TFAH

For more on TFAH’s recommendations to improve the nation’s emergency preparedness: Ready or Not 2022: Protecting the Public’s Health from Diseases, Disasters, and Bioterrorism – TFAH

For more on TFAH’s recommendations on needed investments in the nation’s public health system: The Impact of Chronic Underfunding on America’s Public Health System: Trends, Risks, and Recommendations, 2022 – TFAH

For more on TFAH’s recommendations on addressing the nation’s drug, alcohol and suicide crisis: Pain in the Nation 2022: U.S. Experienced Highest Ever Combined Rates of Deaths Due to Alcohol, Drugs, and Suicide During the First Year of the COVID-19 Pandemic – TFAH

For more on TFAH’s recommendations to address the nation’s obesity crisis: State of Obesity 2022: Better Policies for a Healthier America – TFAH

TFAH’s Board Chair and President and CEO, Statement in Honor of Martin Luther King, Jr. Day and the National Day of Racial Healing

(Washington, DC – January 16, 2023) – “Today’s observation of Martin Luther King, Jr. Day and tomorrow’s National Day of Racial Healing are a time to take action to end racism, heal the impacts of centuries of racial injustice, and promote equity for all people.

As the COVID-19 pandemic has demonstrated, long-standing structural racism within our society causes a disproportionate negative impact on people of color, especially during public health emergencies.

TFAH’s goal is to secure the opportunity for optimal health for everyone and make all communities more resilient. This includes advancing policies that promote health and address the primary drivers of health disparities.

We are committed to continuing to support and advocate for policies that overcome the impacts of racism and advance health equity. Meaningful change will require racial healing, which will in turn necessitate acknowledging the historical and contemporary impacts of racism, building meaningful relationships across communities, and policy change.”

Among TFAH’s policy priorities for promoting health equity in 2023 are the following:

Invest in policies and capacity to address the social determinants of health: Congress should fund the Centers for Disease Control and Prevention’s Social Determinants of Health work to enable communities to work across sectors to address the non-medical drivers of poor health outcomes.

Target the elimination of poverty by implementing living wage policies and expanding the Earned Income Tax Credit at the national and state levels.

Strengthen leadership for health equity and incorporate lessons learned from the COVID-19 pandemic into future preparedness and response capabilities. The White House, Congress, and relevant federal, state, local, tribal, and territorial agencies should continue to implement the recommendations of President Biden’s COVID-19 Health Equity Task Force. The White House should create a permanent health equity infrastructure to implement and ensure accountability for these recommendations and bolster equity leadership and coordination for future health crises.

Provide job-protected paid leave. The pandemic called attention to the fact that paid family, sick, and medical leave protect individual’s and families’ economic security and are important infection-control measures. Congress should enact a permanent federal paid family and medical leave policy and dedicated paid sick days protections, including for preventive services such as vaccination.

Congress and federal agencies should ensure federal funding is reaching localities and organizations that represent and serve communities that encounter disproportionate barriers to good health.

Public health agencies should appoint chief health equity officers who would be part of the response, planning, and activation teams for all emergencies.

Increase access to high-quality healthcare for all by strengthening incentives to expand Medicaid and by making marketplace coverage more affordable for people with low- and moderate-incomes.

Increase funding for programs that promote long-term security and good health for children and families, including programs designed to expand access to affordable housing and Head Start, Early Head Start, and nutrition support programs such as Healthy School Meals for All, the Supplemental Nutrition Assistance Program (SNAP), and the Special Supplemental Nutrition Assistance Program for Women, Infants, and Children (WIC).

For more information, see TFAH reports: Reports – tfah

Trust for America’s Health is a nonprofit, nonpartisan organization that promotes optimal health for every person and community and works to make the prevention of illness and injury a national priority. www.tfah.org

The National Day of Racial Healing, is sponsored by the W.K. Kellogg Foundation. According to the Foundation, the day is a time to contemplate our shared values and create a blueprint for #HowWeHeal from the effects of racism. W.K. Kellogg Foundation (wkkf.org)

TFAH Announces Board Chair Transition

Distinguished Board Chair Dr. Gail C. Christopher to Step Down, Board Member Dr. Stephanie Mayfield Gibson elected Incoming Chair

(Washington, DC – December 19, 2022) — Trust for America’s Health (TFAH) announced today that the chairperson of its Board of Directors, Gail C. Christopher, DN, will be stepping down after 10 years of visionary leadership.  The Board of Directors has unanimously elected Board member Stephanie Mayfield Gibson, MD, as the incoming Board Chair, effective January 1, 2023.

Dr. Christopher has a noteworthy 15 years of service on the TFAH Board, becoming a member of the Board in 2007, and serving as chair for a decade.  She informed the Board of her intention to step down as chair at last year’s annual Board meeting, and the Board subsequently underwent a thoughtful succession planning process.  Dr. Mayfield, who joined the TFAH Board in 2017, and is currently a member of the Board’s Finance Committee, was nominated and elected as the next chair.

“Drs. Christopher and Mayfield are nationally renowned and visionary leaders in public health and health equity,” said TFAH’s President and CEO Dr. J. Nadine Gracia.  “TFAH is extremely fortunate to have benefited from Dr. Christopher’s brilliant leadership and will continue to be guided by Dr. Mayfield’s passion and vast experience in our next chapter as an organization.”

While stepping down from the TFAH Board, Dr. Christopher will continue in her roles as the Executive Director of the National Collaborative for Health Equity and as a Senior Scholar at George Mason University’s Center for Well-Being. In addition, Dr. Christopher is president and founder of Ntianu Center for Healing and Nature. Prior to her Ntianu Center tenure, Dr. Christopher was senior adviser and vice president at the W.K. Kellogg Foundation where she was the architect of the Foundation’s Truth, Racial Healing, and Transformation Initiative, an adaptation of the globally recognized Truth and Reconciliation Commission model.

“It has been my honor to serve TFAH and to follow the leadership of former statesman, and Connecticut senator, Lowell Weicker in this vital role as President, then Chair of the TFAH board,” Dr. Christopher said. “I am particularly proud of TFAH’s legacy as a bipartisan convener and problem-solver during challenging and polarized times. I will continue to cherish the meaningful relationships with all my fellow board members and the outstanding staff, stakeholders, funders, and partners of this amazing organization. TFAH is a strong organization and I’m sure that we’ll continue to do great things lead by our incoming board chair, Dr. Stephanie Mayfield, our outstanding organizational president, Dr. Nadine Gracia, and all of the dedicated members of the TFAH Board.”

During Dr. Christopher’s tenure, TFAH experienced tremendous growth and notable achievement in addressing our nation’s most pressing public health issues, such as public health funding, emergency preparedness, obesity, substance misuse and suicide, healthy aging, healthy schools, the health impacts of climate change, and the social determinants of health.  Her exemplary leadership strengthened TFAH’s focus on health equity as foundational to policymaking at all levels.  And, along with her fellow Board members, Dr. Christopher provided steady and sage counsel to the organization in navigating the unprecedented COVID-19 pandemic.

“TFAH owes Dr. Christopher a large debt of gratitude for her service to the organization. Her vision, mentorship, and expertise in racial healing and equity have been an inspiration to her fellow Board members and to the TFAH staff,” said Dr. Gracia.  “We look forward to working with her in the future as she continues to be a leader in the nation’s journey toward health equity.”

VIDEO: Drs. Gracia and Christopher discuss TFAH’s work

Dr. Stephanie Mayfield is a board-certified anatomic and clinical pathologist and an experienced health executive in both the public and private sectors.  As the incoming TFAH Board Chair, she brings critical frontline public health, healthcare system, and academic experience to the position.  Furthermore, she is a longtime advocate of promoting population health and advancing health equity.

“It’s a privilege to be the incoming board chair for Trust for America’s Health, a well-established and meaningful organization,” said Dr. Mayfield. “As a former state public health commissioner and former state laboratory director, we utilized TFAH’s reports for their rich data and policy recommendations to shape an informed systems approach to advance health equity. It’s an exciting time to support the organization in this new role in furtherance of our mission – to promote optimal health for every person and community and make the prevention of illness and injury a national priority. Thank you to our funders for enabling TFAH to pursue its mission and to our outgoing board chair, Dr. Gail Christopher, for her keen stewardship and visionary leadership.”

From 2020 to 2022, Dr. Mayfield served as the Director of the U.S. COVID-19 Response Initiative and Senior Advisor for U.S. Partnerships for Resolve to Save Lives.  The initiative provided COVID-19 response guidance and technical support to local and state health departments, other community partners, and to agencies of the Federal government. In her role as senior advisor, Dr. Mayfield additionally advised on a multi-sector, community-driven, best practices hypertension control initiative focused on optimizing patient empowerment and addressing social determinants of health.

In 2012, Dr. Mayfield was appointed commissioner of public health for the Commonwealth of Kentucky. She was the first African American and first woman to serve in that role. Prior to her tenure as state public health commissioner, she was the state’s director of laboratory services under the Cabinet of Health and Family Services. In 2016, Dr. Mayfield joined KentuckyOne Health and KentuckyOne Health Partners, as the senior vice president and chief medical officer for population health and led the transformation of the state’s largest healthcare system by addressing basic human needs across the continuum of health. Dr. Mayfield has also held faculty positions at the Louisville School of Medicine and served as the Associate Chief of Staff and Staff Pathologist at the Louisville Veteran’s Administration Medical Center. Dr. Mayfield’s research includes early evaluation of what is now the gold-standard heart disease marker, Troponin.

 

 

New CDC Data Shows 4 Percent Rise in Suicides in 2021

On September 30, the Centers for Disease Control and Prevention (CDC) released a new report on provisional data on suicide mortality in 2021. The new data shows a 4 percent increase in the national suicide rate—rising from 13.5 deaths per 100,000 population in 2020 to 14.0 deaths per 100,000 population in 2021. In contrast, the national suicide rate declined in both 2019 and 2020, though it had steadily increased over the previous two decades.

The report also includes additional information on suicide by sex, age group, and month. Key takeaways:

  • Suicide rates increased more among males (3 percent increase) than females (2 percent increase).
  • Suicide rates increased for people in nearly all age groups. The only exception was a 2 percent decline for people age 75 and over, though it was not a statistically significant change.
  • The largest statistically significant increase among all sex/age groups was for males aged 15–24, with an 8 percent increase in suicide rate from 2020 to 2021. Females aged 10–14 had the largest percentage increase in suicide rate (15 percent), though the change was not statistically significant due to a relatively small numbers of cases.
  • There were more suicides across all months of 2021 compared with 2020, except in January, February, and July. The largest increase across all the months was an 11 percent increase in suicide rate in October.

The report does not include racial/ethnic or geographic information, nor information on suicide method—all critical pieces to understanding the full picture. For example, data from 2020 showed higher rates of  suicide among American Indian, Black, and Latino people and of suicide by firearm—all in a year when the overall suicide rate declined. The National Center for Health Statistics will likely release final 2021 mortality data, including these additional data points, in December.

“The increase in suicide is devastating,” said J. Nadine Gracia, M.D., MSCE, President and CEO of Trust for America’s Health (TFAH). “The new data underscores the need for more attention on this issue and action to prevent future suicides—by federal policymakers, the private and non-profit sectors, and every community across the nation. This study is a wakeup call that we continue to face a mental health and substance use crisis, but we can prevent these tragic deaths.”

The most recent Pain in the Nation report from TFAH includes 2020 data and an analysis of longer-term trends, as well as policy recommendations for reducing alcohol, drug, and suicide deaths. The new CDC report reaffirms the importance of many of these recommendations, including to:

  • Strengthen the continuum of crisis intervention programs with a focus on the newly established “988” lifeline.
  • Expand CDC’s comprehensive suicide-prevention efforts, including measures to strengthen economic supports, promote connectedness, and create protective environments.
  • Address the social determinants of health and promote resilience in children, families, and communities, including through economic supports, access to quality childcare, and prevention and early intervention efforts in schools.
  • Build grassroots community capacity for early identification and intervention for individuals with mental health and substance use disorders, including through community-based or non-traditional settings.
  • Limit access to lethal means of suicide, including drugs and firearms, among individuals at higher risk of suicide through state and federal laws, more funding of foundational research, and the adoption of counseling programs in healthcare systems.

 

 

Nation’s Obesity Epidemic is Growing: 19 States Have Adult Obesity Rates Above 35 Percent, Up From 16 States Last Year

Social and Economic Factors Are Key Drivers of Increasing Obesity Rates

(Washington, DC – September 27, 2022) – Four in ten American adults have obesity, and obesity rates continue to climb nationwide and within population groups, according to a report State of Obesity 2022: Better Policies for a Healthier America released today by Trust for America’s Health (TFAH). The report amplifies the importance of the White House Conference on Hunger, Nutrition and Health happening tomorrow. The Conference and the report are intended to spotlight the links between hunger, nutrition, and health, and diet-related diseases including obesity. In addition, they will drive policy action to address food insecurity and health disparities, factors often at the root of diet-related health issues.

The report finds that persistent increases in obesity rates across population groups underscores that obesity is caused by a combination of factors including societal, biological, genetic, and environmental, which are often beyond personal choice. The report’s authors conclude that addressing the obesity crisis will require attending to the economic and structural factors of where and how people live.

Based in part on newly released 2021 data from the Centers for Disease Control and Prevention’s Behavioral Risk Factors Surveillance System, and analysis by TFAH, the report tracks rates of overweight and obesity by age, race/ethnicity, and state of residence. Among the most striking findings are:

Nineteen states have adult obesity rates over 35 percent.  West Virginia, Kentucky, and Alabama have the highest rate of adult obesity at 40.6 percent, 40.3 percent, and 39.9 percent, respectively. The District of Columbia, Hawaii, and Colorado had the lowest adult obesity rates at 24.7 percent, 25 percent, and 25.1 percent respectively.

A decade ago, no state had an adult obesity rate at or above 35 percent.  (See state-by-state rate chart).

National data from the 2017-2020 National Health and Nutrition Examination Survey also included in the report show the following:

  • Nationally, 41.9 percent of adults have obesity.
  • Black adults had the highest level of adult obesity at 49.9 percent.
  • Hispanic adults had an obesity rate of 45.6 percent.
  • White adults had an obesity rate of 41.4 percent.
  • Asian adults had an obesity rate of 16.1 percent.
  • Rural parts of the country had higher rates of obesity than did urban and suburban areas.

Structural and social determinants are significantly influencing the rates of obesity among adults and youth.  Factors such as structural racism, discrimination, poverty, food insecurity, housing instability, and lack of access to quality healthcare are key drivers of the differences in obesity rates across racial and ethnic groups. These systemic barriers make it inappropriate to assign blame to individuals with obesity for their weight. The purpose of this report is to analyze conditions in people’s lives which make them more likely to develop obesity and recommend policies to address those conditions.

Obesity rates are also increasing among children and adolescents with nearly 20 percent of U.S. children ages 2 to 19 having obesity. These rates more than tripled since the mid-1970s and Black and Latino youth have substantially higher rates of obesity than do their white peers.

A special section of the report looks at the relationship between food insecurity and obesity. Food insecurity, defined as being uncertain of having or unable to acquire enough food because of insufficient money or resources, is driven by many of the same social and economic factors that drive obesity including poverty and living in communities with many fast-food establishments but limited or no access to healthy, affordable foods such as available in full-service supermarkets or farmers markets. Being food and nutrition insecure often means families must eat food that costs less but is also high in calories and low in nutritional value.

Obesity is multifactored and involves more than individual behavior

Social and economic factors including experiencing poverty and the impact of long-standing structural racism and health inequities are strongly associated with obesity and are at the root of higher rates of obesity in low-income communities that have fewer resources to support healthy eating and being physically active.

“The continued increase in rates of obesity across all population groups is alarming,” said J. Nadine Gracia, M.D., MSCE, President and CEO of Trust for America’s Health. “Policies and programs to reduce obesity need to be implemented at a systems level. We must advance policies that address the community, institutional, and structural factors that are barriers to healthy eating and physical activity and that exacerbate health inequities.”

Addressing obesity is critical because it is associated with a range of diseases including type 2 diabetes, heart disease, stroke, arthritis, sleep apnea, and some cancers. Obesity is estimated to increase U.S. healthcare spending by $170 billion annually (including billions by Medicare and Medicaid).

The report includes recommendations for policy actions that federal, state, and local policymakers and other stakeholders should take including:

  • Increase funding for the CDC’s National Center for Chronic Disease Prevention and Health Programs to prevent obesity and related chronic diseases. Funding increases need to be sufficient to put proven obesity prevention programs to work in every state and should prioritize those communities where the need is greatest to address health inequities.
  • Make healthy school meals for all students a permanent policy, extend COVID-19 flexibilities that expand nutrition access for students and their families, strengthen school nutrition standards, and increase students’ opportunities for physical activity during the school day.
  • Expand the CDC’s social determinants of health program to address the upstream, structural drivers of chronic disease.
  • Decrease food insecurity and improve the nutritional quality of available food by increasing funding for and participation in nutrition assistance programs such as the Supplemental Nutrition Assistance Program (SNAP), the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and the Child and Adult Care Food Program.
  • End unhealthy food marketing to children by closing tax loopholes and eliminating business-cost deductions related to the advertising of unhealthy food and beverages to young people.
  • Impose excise taxes on sugary drinks and devote the revenue to local obesity prevention programs and to reduce health disparities.
  • Expand support for maternal and child health, including supporting breastfeeding.
  • Fund active transportation projects like pedestrian and biking paths in all communities and make local spaces more conducive to physical activity such as opening school recreational facilities to community groups outside of school hours.
  • Expand access to healthcare and require insurance coverage with no cost sharing for U.S. Preventive Task Force recommended obesity prevention programs.

Read the full report

 

La epidemia de obesidad de la nación está creciendo: 19 estados tienen tasas de obesidad en adultos superiores al 35 por ciento, frente a los 16 estados del año pasado

Factores sociales y económicos son impulsores clave del aumento de las tasas de obesidad

(Washington, DC – 27 de septiembre de 2022) – Cuatro de cada diez adultos estadounidenses tienen obesidad, y las tasas de obesidad continúan aumentando en todo el país y dentro de los grupos de población, según un informe State of Obesity 2022: Better Policies for a Healthier America publicado hoy por Trust for American Health (TFAH). El informe amplifica la importancia de que la Conferencia de la Casa Blanca sobre el Hambre, la Nutrición y la Salud (White House Conference on Hunger, Nutrition and Health) que se llevara cabo mañana. La Conferencia y el informe tienen como objetivo destacar los vínculos entre el hambre, la nutrición y la salud, y las enfermedades relacionadas con la dieta, incluida la obesidad. Además, impulsarán la acción política para abordar la inseguridad alimentaria y las disparidades en la salud, factores que a menudo son la raíz de los problemas de salud relacionados con la dieta.

El informe encuentra que los aumentos persistentes en las tasas de obesidad en los grupos de población subrayan que la obesidad es causada por una combinación de factores que incluyen factores sociales, biológicos, genéticos y ambientales, que a menudo están más allá de la elección personal. Los autores del informe concluyen que abordar la crisis de la obesidad requerirá prestar atención a los factores económicos y estructurales de dónde y cómo vive la gente.

Basado en parte en los datos recientemente publicados en el 2021 del Sistema de Vigilancia de Factores de Riesgo de Comportamiento de los Centros para el Control y la Prevención de Enfermedades y el análisis realizado por TFAH, el informe rastrea las tasas de sobrepeso y obesidad por edad, raza/etnicidad y estado de residencia. Entre los hallazgos más llamativos se encuentran:

Diecinueve estados tienen tasas de obesidad en adultos superiores al 35 por ciento. West Virginia, Kentucky y Alabama tienen la tasa más alta de obesidad en adultos con un 40,6 %, 40,3 % y 39,9 %, respectivamente. El Distrito de Columbia, Hawái y Colorado tenían las tasas más bajas de obesidad en adultos con 24,7 %, 25 % y 25,1 %, respectivamente.

Hace una década, ningún estado tenía una tasa de obesidad en adultos igual o superior al 35 por ciento. (Consulte el cuadro de tarifas estado por estado).

Los datos nacionales de la Encuesta Nacional de Examen de Salud y Nutrición 2017-2020 también incluidos en el informe muestran lo siguiente:

  •  A nivel nacional, el 41,9 por ciento de los adultos tienen obesidad.
  • Los adultos afroamericanos tenían el nivel más alto de obesidad en adultos con un 49,9 por ciento.
  • Los adultos hispanos tenían una tasa de obesidad del 45,6 por ciento.
  • Los adultos blancos tenían una tasa de obesidad del 41,4 por ciento.
  • Los adultos asiáticos tenían una tasa de obesidad del 16,1 por ciento.
  • Las zonas rurales del país tenían tasas más altas de obesidad que las zonas urbanas y suburbanas.

Los determinantes estructurales y sociales están influyendo significativamente en las tasas de obesidad entre adultos y jóvenes. Factores como el racismo estructural, la discriminación, la pobreza, la inseguridad alimentaria, la inestabilidad de la vivienda y la falta de acceso a una atención médica de calidad son factores clave de las diferencias en las tasas de obesidad entre los grupos raciales y étnicos. Estas barreras sistémicas hacen que sea inapropiado culpar a las personas con obesidad por su peso. El propósito de este informe es analizar las condiciones en la vida de las personas que las hacen más propensas a desarrollar obesidad y recomendar políticas para abordar esas condiciones.

Las tasas de obesidad también están aumentando entre los niños y adolescentes, con casi el 20 por ciento de los niños estadounidenses de 2 a 19 años que tienen obesidad. Estas tasas se triplicaron con creces desde mediados de la década de 1970 y los jóvenes negros y latinos tienen tasas de obesidad sustancialmente más altas que sus pares blancos.

Una sección especial del informe analiza la relación entre la inseguridad alimentaria y la obesidad. La inseguridad alimentaria, definida como la incertidumbre de tener o no poder adquirir suficientes alimentos debido a la insuficiencia de dinero o recursos, está impulsada por muchos de los mismos factores sociales y económicos que impulsan la obesidad, incluida la pobreza y vivir en comunidades con muchos establecimientos de comida rápida, pero con pocos recursos o ningún acceso a alimentos saludables y asequibles, como los disponibles en supermercados de servicio completo o mercados de agricultores. La inseguridad alimentaria y nutricional a menudo significa que las familias deben comer alimentos que cuestan menos pero que también tienen un alto contenido de calorías y un bajo valor nutricional.

La obesidad es multifactorial e involucra más que el comportamiento individual

Los factores sociales y económicos, incluida la experiencia de la pobreza y el impacto del racismo estructural de larga data y las desigualdades en salud, están fuertemente asociados con la obesidad y son la raíz de las tasas más altas de obesidad en comunidades de bajos ingresos que tienen menos recursos para apoyar una alimentación saludable y estar físicamente bien activo.

“El aumento continuo de las tasas de obesidad en todos los grupos de población es alarmante”, dijo J. Nadine Gracia, M.D., MSCE, presidenta y directora ejecutiva de Trust for America’s Health. “Las políticas y los programas para reducir la obesidad deben implementarse a nivel de sistemas. Debemos promover políticas que aborden los factores comunitarios, institucionales y estructurales que son barreras para la alimentación saludable y la actividad física y que exacerban las inequidades en salud”.

Abordar la obesidad es fundamental porque está asociada con una variedad de enfermedades que incluyen diabetes tipo 2, enfermedades cardíacas, derrames cerebrales, artritis, apnea del sueño y algunos tipos de cáncer. Se estima que la obesidad aumenta el gasto en atención médica en los Estados Unidos a más de $ 170 mil millones anuales (incluidos los miles de millones de Medicare y Medicaid).

El informe incluye recomendaciones para acciones de políticas que los legisladores federales, estatales y locales y otras partes interesadas deben tomar, incluyendo:

  • Aumentar la financiación del Centro Nacional para la Prevención de Enfermedades Crónicas y los Programas de Salud de los CDC para prevenir la obesidad y las enfermedades crónicas relacionadas. Los aumentos de fondos deben ser suficientes para poner en funcionamiento los programas probados de prevención de la obesidad en todos los estados y deben priorizar aquellas comunidades donde la necesidad es mayor para abordar las inequidades en salud.
  • Hacer que las comidas escolares saludables para todos los estudiantes sean una política permanente, extender las flexibilidades de COVID-19 que amplían el acceso a la nutrición para los estudiantes y sus familias, fortalecer los estándares de nutrición escolar y aumentar las oportunidades de actividad física de los estudiantes durante el día escolar.
  • Ampliar el programa de determinantes sociales de la salud de los CDC para abordar los impulsores estructurales de las enfermedades crónicas.
  • Disminuir la inseguridad alimentaria y mejorar la calidad nutricional de los alimentos disponibles al aumentar la financiación y la participación en programas de asistencia nutricional como el Programa de Asistencia Nutricional Suplementaria (SNAP), el Programa Especial de Nutrición Suplementaria para Mujeres, Bebés y Niños (WIC), y el Programa de Alimentación para el Cuidado de Niños y Adultos.
  • Poner fin a la comercialización de alimentos no saludables para los niños cerrando las lagunas fiscales y eliminando las deducciones de costos comerciales relacionadas con la publicidad de alimentos y bebidas no saludables para los jóvenes.
  • Imponer impuestos especiales sobre las bebidas azucaradas y dedicar los ingresos a los programas locales de prevención de la obesidad y para reducir las disparidades en la salud.
  • Ampliar el apoyo a la salud materno infantil, incluido el apoyo a la lactancia materna.
  • Financiar proyectos de transporte activo como senderos para peatones y ciclistas en todas las comunidades y hacer que los espacios locales sean más propicios para la actividad física, como abrir instalaciones recreativas escolares a grupos comunitarios fuera del horario escolar.
  • Ampliar el acceso a la atención médica y requerir cobertura de seguro sin costo compartido para los programas de prevención de la obesidad recomendados por el Grupo de trabajo preventivo de EE. UU.

Lea el informe completo.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Recommendations for policy actions

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

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

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

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

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

Read the full report

 

 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Recomendaciones para tomar medidas de acción:

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

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

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

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

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

 

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

 

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