Press Releases Archive - Page 9 of 32

Report: Pandemic Exposed a Public Health System ‘Hollowed Out’ From Lack of Funding and Neglect

March 10, 2021

Joseph P. Williams
U.S. News and World Report

When the coronavirus pandemic raced across the U.S. in March 2020, life as we knew it changed almost completely, seemingly in an instant.

Schools and offices shut down to stop the virus from spreading. Hospital intensive care units filled to overflowing with the sick and refrigerated trailers became makeshift morgues. States fought over protective equipment and high-tech ventilators. Grocery store workers became as important – and as stressed out – as emergency room doctors, nurses and paramedics. And a once-in-a-century public-health emergency set one grim milestone after another, passing 500,000 deaths in the U.S., and counting, the highest COVID-19 mortality rate in the world.

Read the full article

Nuevo informe encuentra lagunas en la preparación de los estados para emergencias de salud pública

La COVID-19 muestra daño crítico de subinversión en infraestructura de salud pública

(Washington, DC) — 10 de marzo de 2021 – La pandemia de COVID-19 ha demostrado claramente que la inversión insuficiente en la preparación para responder a emergencias de salud pública puede costar cientos de miles de vidas y causar estragos en la economía. Un nuevo informe publicado hoy por Trust for America’s Health (TFAH) midió el desempeño de los estados en 10 indicadores clave de preparación para emergencias y encontró espacio para mejorar en todas las jurisdicciones.

El informe Ready or Not 2021: Protecting the Public’s Health from Diseases, Disasters and Bioterrorism midió la preparación de los estados para emergencias de salud de cualquier tipo (no solo la crisis del COVID-19). Este informe colocó a 20 estados y al Distrito de Columbia en una categoría de alto nivel de preparación, 15 estados en un nivel de preparación medio y 15 estados en un nivel de preparación bajo.

Durante casi dos décadas, TFAH ha examinado la preparación para emergencias de salud pública de la nación en este informe anual. Durante ese tiempo, todos los estados han mejorado su preparación para emergencias, pero todos continúan teniendo espacio para un fortalecimiento adicional de sus programas de respuesta de salud pública.

Rendimiento estatal, por nivel de puntuación, 2020

Performance Tier	States	Number of States
High Tier	CO, CT, DC, DE, GA, ID, KS, MA, MD, ME, MS, NC, NE, NM, OK, RI, UT, VA, VT, WA, WI	20 states and DC
Middle Tier	AL, CA, FL, IA, IL, KY, LA, MI, MN, MT, ND, NJ, OR, TN, TX	15 states
Low Tier	AK, AR, AZ, HI, IN, MO, NH, NV, NY, OH, PA, SC, SD, WV, WY	15 states

“La importancia de este informe es que brinda a los estados datos procesables para adoptar políticas que salven vidas. La crisis de COVID-19 muestra que tenemos mucho más trabajo por hacer para proteger a los estadounidenses de las amenazas a la salud, particularmente en las formas en que el racismo estructural crea y exacerba los riesgos para la salud dentro de las comunidades de color ”, dijo John Auerbach, presidente y director ejecutivo de Trust for Salud de Estados Unidos. “Los estados deben tomar medidas enérgicas para apuntalar su preparación para todo tipo de emergencias de salud pública”.

Si bien los hallazgos del informe no son una medida de la respuesta COVID-19 de ningún estado, demuestran que si bien la preparación de los estados es importante, las emergencias de salud nacionales en la escala de una pandemia requieren un liderazgo y una coordinación federales fuertes, e inversiones a largo plazo en salud pública. infraestructura y mano de obra. Los estados por sí solos, incluso aquellos que ocupan un lugar destacado en este informe, no están lo suficientemente equipados para responder a una pandemia sin ayuda federal, dicen los autores del informe.

El informe encontró:

La mayoría de los estados han hecho preparativos para expandir la atención médica y las capacidades de salud pública en una emergencia, a menudo a través de la colaboración. Treinta y cuatro estados participaron en el Nurse Licensure Compact, en comparación con 26 en 2017. El pacto permite a las enfermeras registradas y las enfermeras prácticas o vocacionales con licencia ejercer en múltiples jurisdicciones con una sola licencia. En caso de emergencia, esto permite a los funcionarios de salud aumentar rápidamente sus niveles de personal. Además, los hospitales de la mayoría de los estados tienen un alto grado de participación en coaliciones de salud. En promedio, el 89 por ciento de los hospitales estaban en una coalición y 17 estados y el Distrito de Columbia tenían participación universal, lo que significa que todos los hospitales de la jurisdicción eran parte de una coalición. Dichas coaliciones unen a los hospitales y otras instalaciones de atención médica con la gestión de emergencias y los funcionarios de salud pública para planificar y responder a los incidentes. Finalmente, todos los estados y el Distrito de Columbia tenían laboratorios de salud pública que tenían planes para una gran afluencia de necesidades de pruebas. Esta capacidad de aumentar la capacidad de prueba de laboratorio durante la crisis de COVID-19 fue extremadamente crítica.

La mayoría de los estados están acreditados en las áreas de salud pública, manejo de emergencias o ambos. A diciembre de 2020, la Junta de Acreditación de Salud Pública (PHAB) o el Programa de Acreditación de Gestión de Emergencias (EMAP) acreditaron 42 estados y el Distrito de Columbia; 29 estados y el Distrito de Columbia fueron acreditados por ambos grupos, un aumento neto de uno desde noviembre de 2019. Ambos programas ayudan a garantizar que los sistemas necesarios de preparación y respuesta ante emergencias estén en su lugar y con personal calificado.

Las tasas de vacunación contra la influenza estacional, aunque aún son demasiado bajas, han aumentado significativamente. La tasa de vacunación contra la influenza estacional entre los estadounidenses de 6 meses o más aumentó del 42 por ciento durante la temporada 2017-2018 al 52 por ciento durante la temporada 2018-2019, pero aún está por debajo de la tasa de vacunación objetivo del 70 por ciento establecida por Healthy People 2030.

En 2019, solo el 55 por ciento de los residentes estatales empleados, en promedio, usaron tiempo libre remunerado, el mismo porcentaje que en 2018. Aquellos sin licencia remunerada tienen más probabilidades de trabajar cuando están enfermos y corren el riesgo de propagar la infección. Esto se volvió particularmente relevante durante la pandemia de COVID-19, ya que el aislamiento y la cuarentena son herramientas importantes para controlar el brote.

La mayoría de los residentes que obtuvieron el agua de su hogar a través de un sistema de agua comunitario tenían acceso a agua potable. En promedio, solo el 5 por ciento de los residentes del estado utilizó un sistema de agua comunitario en 2019 que no cumplía con todos los estándares de salud aplicables.

El informe incluye recomendaciones de acciones por parte de los legisladores federales y estatales para mejorar la preparación para emergencias de salud pública de la nación en siete áreas prioritarias:

Proporcionar financiación suficiente y estable para la seguridad de la salud pública nacional y mundial.
Fortalecer las políticas y los sistemas para prevenir y responder a brotes y pandemias.
Construir comunidades resilientes y promover la equidad en salud en general y en la preparación.
Asegurar liderazgo, coordinación y fuerza laboral efectivos en salud pública.
Acelerar el desarrollo y la distribución, incluida la distribución de última milla, de contramedidas médicas.
Fortalecer la capacidad del sistema de salud para responder y recuperarse durante y de emergencias de salud.
Prepárese para las amenazas ambientales y el clima extremo.

El informe de la serie Ready or Not está financiado por la Fundación Robert Wood Johnson con el apoyo adicional de The California Endowment, W.K. Fundación Kellogg y Fundación Kresge.

###

Trust for America’s Health es una organización no partidista sin fines de lucro que promueve la salud óptima para cada persona y comunidad y hace de la prevención de enfermedades y lesiones una prioridad nacional. Twitter: @HealthyAmerica1

New Report Finds Gaps in States’ Preparedness for Public Health Emergencies

COVID-19 Illuminated critical harm of underinvestment in public health infrastructure

(Washington, DC – March 10, 2021) The COVID-19 pandemic has starkly demonstrated that underinvestment in preparedness to respond to public health emergencies can cost hundreds of thousands of lives and wreak havoc on the economy. A new report released today by Trust for America’s Health (TFAH) measured states’ performance on 10 key emergency preparedness indicators and found room for improvement in every jurisdiction.

The report, Ready or Not 2021: Protecting the Public’s Health from Diseases, Disasters and Bioterrorism measured states’ readiness for health emergencies of any kind (not just the COVID-19 crisis). It placed 20 states and the District of Columbia in a high level of preparedness category, 15 states in a middle preparation tier and 15 states in a low degree of preparation tier.

State performance, by scoring tier, 2020

Performance Tier	States	Number of States
High Tier	CO, CT, DC, DE, GA, ID, KS, MA, MD, ME, MS, NC, NE, NM, OK, RI, UT, VA, VT, WA, WI	20 states and DC
Middle Tier	AL, CA, FL, IA, IL, KY, LA, MI, MN, MT, ND, NJ, OR, TN, TX	15 states
Low Tier	AK, AR, AZ, HI, IN, MO, NH, NV, NY, OH, PA, SC, SD, WV, WY	15 states

For nearly two decades, TFAH has examined the nation’s public health emergency preparedness in this annual report. During that time, all states have made improvements in their emergency preparedness, but all continue to have room for additional strengthening of their public health preparedness and response.

“The importance of this report is that it gives states actionable data to adopt policies that save lives. The COVID-19 crisis shows that we have much more work to do to protect Americans from health threats, particularly in the ways in which structural racism create and exacerbate health risks within communities of color,” said John Auerbach, President and CEO of Trust for America’s Health. “States need to take aggressive steps to shore up their preparedness for all types of public health emergencies.”

While the report’s findings are not a measure of any state’s COVID-19 response, they demonstrate that while states’ readiness is important, national health emergencies on the scale of a pandemic require strong federal leadership and coordination, and long-term investment in public health infrastructure and workforce. States alone, even those that rank high in this report, are not sufficiently equipped to respond to a pandemic without federal help, say the report’s authors.

The report found:

A majority of states have made preparations to expand healthcare and public health capabilities in an emergency, often through collaboration. Thirty-four states participated in the Nurse Licensure Compact, up from 26 in 2017. The compact allows registered nurses and licensed practical or vocational nurses to practice in multiple jurisdictions with a single license. In an emergency, this enables health officials to quickly increase their staffing levels. In addition, hospitals in most states have a high degree of participation in healthcare coalitions. On average, 89 percent of hospitals were in a coalition and 17 states and the District of Columbia had universal participation, meaning every hospital in the jurisdiction was part of a coalition. Such coalitions bring hospitals and other healthcare facilities together with emergency management and public health officials to plan for and respond to incidents. Every state and the District of Columbia had public health laboratories that had plans for a large influx of testing needs. This ability to surge laboratory testing capacity during the COVID-19 crisis was extremely critical.

Most states are accredited in the areas of public health, emergency management, or both. As of December 2020, the Public Health Accreditation Board (PHAB) or the Emergency Management Accreditation Program (EMAP) accredited 42 states and the District of Columbia; 29 states and the District of Columbia were accredited by both groups, a net increase of one since November 2019. Both programs help ensure that necessary emergency preparation and response systems are in place and staffed by qualified personnel.

Seasonal flu vaccination rates, while still too low, have risen significantly. The seasonal flu vaccination rate among Americans ages 6 months or older rose from 42 percent during the 2017–2018 season to 52 percent during the 2019–2020 season but is still below the 70 percent target vaccination rate set by Healthy People 2030.

In 2019, only 55 percent of employed state residents, on average, used paid time off, the same percentage as in 2018. Those without paid leave are more likely to work when they are sick and risk spreading infection. This became particularly relevant during the COVID-19 pandemic, as isolation and quarantine are important tools for controlling the outbreak.

Most residents who got their household water through a community water system had access to safe water. On average, just 5 percent of state residents used a community water system in 2019 that did not meet all applicable health-based standards.

The report includes recommendations for actions by federal and state policymakers to improve the nation’s public health emergency preparedness in seven priority areas:

Provide stable, sufficient funding for domestic and global public health security.
Strengthen policies and systems to prevent and respond to outbreaks and pandemics.
Build resilient communities and promote health equity generally and in preparedness.
Ensure effective public health leadership, coordination, and workforce.
Accelerate development and distribution, including last mile distribution, of medical countermeasures.
Strengthen the healthcare system’s ability to respond and recover during and from health emergencies.
Prepare for environmental threats and extreme weather.

The Ready or Not report series is funded by the Robert Wood Johnson Foundation with additional support from The California Endowment, W.K. Kellogg Foundation and The Kresge Foundation.

###

Trust for America’s Health is a nonprofit, nonpartisan organization that promotes optimal health for every person and community and makes the prevention of illness and injury a national priority. Twitter: @HealthyAmerica1

Over 300 Health and Public Health Groups Call on Congress to Fund Public Health Infrastructure and Workforce as Part of Next COVID-19 Recovery Package

(Washington, DC – February 12, 2021) – The nation’s leading health and public health organizations today wrote to Congressional leaders recommending $4.5 billion in long term, additional annual funding for CDC and states, localities, tribes and territories to support public health infrastructure and workforce.

The letter, endorsed by 316 organizations, calls on Congress to include such funding in the next COVID-19 legislation to not only strengthen the response to the current pandemic but to better prepare the country for the next public health emergency. A significant, sustained investment is needed to support essential public health activities including disease surveillance, epidemiology, laboratory capacity, all-hazards preparedness and response, and policies to advance health equity, the letter said.

“The COVID-19 pandemic is illustrating in the direst terms the consequences of underfunding public health,” the letter said. “For too long, the nation has neglected basic public health capacity, and the nation’s response to the pandemic reflects this chronic underfunding.”

The letter applauded Congress for taking quick action to provide funding for the initial pandemic response but also noted that short-term, supplemental funding does not allow public health to recruit and retain the workforce needed to protect the public’s health against a number of growing threats including surging levels of chronic disease, substance misuse and suicide, infectious disease and weather-related events.

New Datasets Show Opportunities Exist for States to Bolster Fair Hiring Protections and Workers Rights with Earned Sick Leave and Ban the Box Laws

(Washington DC – January 28, 2021) — Two new datasets published to LawAtlas.org today offer a comprehensive look at state laws that address earned sick leave laws and Ban the Box policies. These datasets provide a snapshot of how earned sick leave, also known as paid sick leave, and ban the box policies differ between states, how such policies help promote the well-being of state residents, and opportunities for states to adopt or expand such regulations.

“States have a critical role to play in promoting the health and well-being of their residents. These data provide a clear picture that opportunities exist nationwide for states to foster equitable economies in which job seekers are evaluated on their merits and workers have access to paid leave benefits to care for themselves and loved ones,” Adam Lustig, MS, Senior Policy Development Manager and Co-Principal Investigator of the PHACCS initiative.

Earned Sick Leave

As of January 1, 2021, 15 states and the District of Columbia have an earned sick leave law that requires employers of varying sizes to provide paid time away to address medical needs for themselves or their families as a benefit to their employees. Across states, eligibility requirements, employer size, how and when an employee may use their time, and rate of leave accrual of the laws vary:

All 16 jurisdictions allow for earned sick leave to be used to care for a family member.
Geographically, earned sick leave laws are almost exclusively in place in the northeast and on the west coast, with Colorado, Arizona, and Michigan being exceptions.
Of the 16 jurisdictions that have earned sick leave laws, just six require employers of all sizes to provide this benefit.
Only two states, New York and Colorado, allow employees to use earned leave immediately upon accrual.
Eight states provide the most generous accrual of earned sick leave, enabling workers to earn one hour of sick leave for every 30 hours worked.
Washington is the only state that does not specify a limit on the amount of earned sick leave that can be accrued within one year.

Ban the Box

As of January 1, 2021, 36 states and the District of Columbia have a Ban the Box policy that prevents an employer from asking about a potential employee’s criminal history until after fairly considering the applicant’s relevant qualifications. These laws vary greatly in who they apply to, and their enforcement mechanisms:

Thirty-six jurisdictions have Ban the Box policies that regulate public employers. However, significant gaps remain, as only three of these jurisdictions apply this protection to government contractors.
Only 15 of the 37 jurisdictions with Ban the Box policies regulate private employers, leaving a significant portion of the workforce lacking access to this important fair hiring practice.
The most common private positions exempt from Ban the Box policies include: working with children, working with vulnerable adults, law enforcement, and positions where a criminal history check is required by law.

“We have seen a growing body of evidence supporting that earned sick leave laws and Ban the Box policies are important legal approaches to ensuring equity in hiring in the United States,” said Lindsay K. Cloud, JD, Director of the Center’s Policy Surveillance Program. “These datasets are an invaluable resource as we continue to seek to better understand the impact of employer-provided protections and fair chance hiring practices on health, and particularly on the social determinants of health amidst the Covid-19 pandemic.”

The Promoting Health and Cost Control in States initiative’s legal data resources are a collaboration of the Temple University Center for Public Health Law Research with Trust for America’s Health, and support from the Robert Wood Johnson Foundation. The earned sick leave and Ban the Box datasets are the fifth and sixth in a series of datasets on laws and policies that can support cost-savings for states and promote health and well-being.

Access the datasets on LawAtlas.org.

###

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

The Center for Public Health Law Research at the Temple University Beasley School of Law supports the widespread adoption of scientific tools and methods for mapping and evaluating the impact of law on health. Learn more at http://phlr.org.

Increases in Drug Overdose Death Rates Were Up Before COVID-19 and Are Continuing to Rise During the Pandemic

Trust for America’s Health and Well Being Trust Call for Renewed Focus on Preventing Deaths of Despair

DISTRICT OF COLUMBIA & OAKLAND, CA – Dec. 23, 2020 – According to data released this week by the National Center for Health Statistics, in 2019 age-adjusted drug overdose deaths increased slightly over the prior year. Coupled with data released last week by the CDC showing increases in drug overdose deaths in early 2020, these reports demonstrate the continuing upward trajectory of drug deaths in the U.S, a trend that is being compounded by the COVID-19 pandemic.

The age-adjusted rate of drug overdose during 2019 was 21.6 per 100,000 deaths, up from the 2018 rate of 20.7 per 100,000. In 2019, 70,630 people died due to drug overdose in the United States.

Between 1999 and 2019 the rate of drug overdose deaths increased for all groups aged 15 and older, with people aged 35-44 experiencing the highest single year increase in 2019. While rates of drug overdose deaths involving heroin, natural and semisynthetic opioids, and methadone decreased between 2018 and 2019 the rate of overdose deaths involving synthetic opioids other than methadone continued to increase.

2018 data showing only minor progress after decades of worsening trends, provisional drug overdose data showing an 18% increase over the last 12 months, and the recent CDC Health Alert Network notice on early 2020 increases in fatal drug overdoses driven by synthetic opioids all underscore the continued impact of the deaths of despair crisis and how the COVID-19 pandemic has further diminished the mental health and well-being of many Americans.

“These 2019 overdose rates and the outlook for 2020 are extremely alarming and the result of insufficient prioritization and investment in the well-being and health of Americans for decades,” said John Auerbach, President and CEO of the Trust for America’s Health. “As we work to recover from the COVID-19 pandemic, we must take a comprehensive approach that includes policies and programs that help Americans currently struggling and target upstream root causes, like childhood trauma, poverty and discrimination in order to help change the trajectory of alcohol, drug, and suicide deaths in the upcoming decades.”

Over the last five years, Trust for America’s Health (TFAH) and Well Being Trust (WBT) have released a series of reports on “deaths of despair” called Pain in the Nation: The Drug, Alcohol and Suicides Epidemics and the Need for a National Resilience Strategy, which include data analysis and recommendations for evidence-based policies and programs that federal, state, and local officials.

“If leaders don’t act now to stymie America’s mental health and addiction crises, next year’s data will easily surpass the astounding numbers we’re seeing today,” said Dr. Benjamin F. Miller, PsyD, Chief Strategy Officer at Well Being Trust. “Overdose deaths can be prevented if individuals who are struggling are able to access the appropriate services and supports – and with greater demonstrated success if the care individuals receive is rooted in their immediate communities.”

Drug Overdose Deaths, 1999-2019 (Rates age-adjusted)

Year	Deaths	Deaths per 100,000
1999	16,849	6.1
2000	17,415	6.2
2001	19,394	6.8
2002	23,518	8.2
2003	25,785	8.9
2004	27,424	9.4
2005	29,813	10.1
2006	34,425	11.5
2007	36,010	11.9
2008	36,450	11.9
2009	37,004	11.9
2010	38,329	12.3
2011	41,340	13.2
2012	41,502	13.1
2013	43,982	13.8
2014	47,055	14.7
2015	52,404	16.3
2016	63,632	19.8
2017	70,237	21.7
2018	67,367	20.7
2019	70,630	21.6

Sources:
CDC – NCHS – National Center for Health Statistics
https://emergency.cdc.gov/han/2020/han00438.asp
https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm

# # #

About Trust for America’s Health
Trust for America’s Health is a nonprofit, nonpartisan organization that promotes optimal health for every person and community and makes the prevention of illness and injury a national priority. Twitter: @HealthyAmerica1

About Well Being Trust
Well Being Trust is a national foundation dedicated to advancing the mental, social, and spiritual health of the nation. Created to include participation from organizations across sectors and perspectives, Well Being Trust is committed to innovating and addressing the most critical mental health challenges facing America, and to transforming individual and community well-being. www.wellbeingtrust.org Twitter: @WellBeingTrust

Policymakers and Health Systems Must Earn Trust within Communities of Color and Tribal Nations to Ensure COVID-19 Vaccine Receptivity, Say Health and Public Health Leaders

Policy brief calls for building vaccine acceptance in communities of color and tribal communities through data transparency, tailored communications via trusted messengers, ensuring ease of vaccine access and no out-of-pocket costs

(Washington, DC – Dec. 21, 2020) – A woeful history of maltreatment of communities of color and tribal nations by government and the health sector, coupled with present day marginalization of these communities by the healthcare system, are the root of vaccine distrust among those groups, according to a policy brief, Building Trust in and Access to a COVID-19 Vaccine Among People of Color and Tribal Nations released today by Trust for America’s Health (TFAH) and co-authors the National Medical Association (NMA) and UnidosUS.

This historic maltreatment, coupled with current day structural racism, has played out in COVID-19’s disproportionate impact on communities of color and tribal communities. These factors also make ensuring vaccine receptivity and access within those communities challenging and of critical importance to protecting lives and ending the pandemic.

In October 2020, TFAH, NMA and UnidosUS hosted a policy convening with 40 leading health equity, healthcare, civil rights, and public health organizations. The purpose of the convening was to advise policymakers on the barriers to vaccine receptivity within communities of color and tribal communities and how to overcome those barriers.

“Earning trust within communities of color and tribal communities will be critical to the successful administration of the COVID-19 vaccine. Doing so will require prioritizing equity, ensuring that leaders from those communities have authentic opportunities to impact vaccine distribution and administration planning, and, the resources to fully participate in supporting vaccine outreach, education and delivery in their communities,” said Dr. J. Nadine Gracia, Executive Vice President and COO of Trust for America’s Health.

The convening created recommendations for policy actions that should be taken immediately within six key areas:

Ensure the scientific fidelity of the vaccine development process.

HHS and vaccine developers should release all available vaccine data at frequent and regular intervals to improve transparency and increase confidence in the vaccine evaluation process. Leadership at FDA and HHS must commit to advancing any vaccine only after it has been validated based on established federal and scientific protocols. Programs to monitor for adverse events must also be in place and transparent. Any perception of bypassing safety measures or withholding information could derail a successful vaccination effort.
FDA should engage health and public health professional societies, particularly those representing healthcare providers of color, local public health officials, as well as other stakeholders with a role in vaccination, and allow these groups to validate all available data, review the vaccine development and approval process, and issue regular updates on data to their patients, members, and the public.

Equip trusted community organizations and networks within communities of color and tribal nations to participate in vaccination planning, education, delivery and administration. Ensure their meaningful engagement and participation by providing funding.

Congress should fund CDC and its state, local, tribal, and territorial partners to provide training, support, and financial resources for community-based organizations to join in vaccination planning and implementation, including community outreach, training of providers, and participation in vaccination clinics. State, local, tribal, and territorial authorities should authentically engage and immediately begin vaccination planning with community-based organizations, community health workers/promotores de salud, faith leaders, educators, civic and tribal leaders, and other trusted organizations outside the clinical healthcare setting as key, funded partners.

Provide communities the information they need to understand the vaccine, make informed decisions, and deliver messages through trusted messengers and pathways.

Congress should provide at least $500 million to CDC for outreach, communication, and educational efforts to reach priority populations in order to increase vaccine confidence and combat misinformation. All communications must be culturally and linguistically appropriate and tailored as much as possible to reach diverse populations as well as generations within groups.
FDA and CDC should initiate early engagement with diverse national organizations and provide funding and guidance for state, local, tribal, and territorial planners to help shape messaging and engage locally with healthcare providers in communities of color and tribal communities, such as nurses, pharmacists, promotores de salud, community health workers, and others to ensure they have the information they need to feel comfortable recommending the vaccine to their patients. Congress and HHS should provide funding for training and engagement of trusted non-healthcare communicators to help shape messaging and to train informal networks, civic and lay leaders, and other trusted community leaders and community-based organizations to answer questions and encourage vaccination.
All messaging about the vaccine must be appropriate for all levels of health literacy. Communication should be realistic and clear about timelines and priority groups (and the rationale for these decisions), vaccine effectiveness, types of vaccines, the number of doses, costs, and the need for ongoing public health protections. Planners must provide information that meets people where they are (e.g., barber shops, bodegas, grocery stores, places of worship, etc.) and ensure that trusted messengers in those places have the information they need to be credible and authentic spokespeople.

Ensure that it is as easy as possible for people to be vaccinated. Vaccines must be delivered in community settings that are trusted, safe and accessible.

We urge the administration and Congress to appropriate the resources necessary to expand and strengthen federal, state, local, territorial, and tribal capacity for a timely, comprehensive, and equitable COVID-19 vaccination planning, communications, distribution, and administration campaign, including funding to support vaccine distribution at the local level and by community-based organizations.
Congress and HHS should allocate funding to increase access to vaccination services to ensure that people seeking to be vaccinated do not experience undue increased exposure to the virus as they travel to, move through, and return home from vaccination sites. Flexibility in funding is needed to enable transport of people to vaccination sites, increase accessibility to people without cars, and promote safety and minimize exposure at vaccination locations. Funding should also be provided to health and community-based agencies to assist those for whom transportation or childcare costs are an obstacle to receipt of the vaccine.
Planners should ensure that vaccination sites are located in areas that have borne a disproportionate burden of COVID-19, especially leveraging community-based organizations such as Federally Qualified Health Centers, community health centers, rural health centers, schools and places of worship. Mobile services will be particularly important in rural areas. Planners should prioritize congregate living facilities, such as long-term care, prisons, and homeless shelters. In addition, some families, displaced by the COVID economic fallout, may be living with relatives. Planners should ensure vaccination sites have services that meet the Americans with Disabilities Act (ADA) and HHS Office for Civil Rights (OCR) standards for disability and language access.
Federal state, local, tribal, and territorial officials must guarantee and communicate with the public that immigration status is not a factor in people’s ability to receive the vaccine and that immigration status is not collected or reported by vaccination sites/providers. Similarly, the presence of law enforcement officers or military personnel could be a deterrent for vaccination at locations, so planners should consider other means of securing sites.
In the initial phase, as communities vaccinate healthcare workers, planners must be sure to prioritize home health, long-term care, and other non-hospital-based healthcare workers, who are more likely to be people of color. Other essential workers that comprise large numbers of workers who are people of color and should be treated as within the vaccination priority groups are the food service industry, farmworkers and public transportation employees.

Ensure complete coverage of the costs associated with the vaccine incurred by individuals, providers of the vaccine, and state/local/tribal/territorial governments responsible for administering the vaccine and communicating with their communities about it.

Congress, the Centers for Medicare and Medicaid Services, and private payers must guarantee that people receiving the vaccine have zero out-of-pocket costs for the vaccine, related health care visits, or any adverse events related to the vaccine, regardless of their health insurance status.
HHS, with emergency funding from Congress, should provide funding so that state, local, tribal, and territorial governments do not bear any cost of vaccine communication efforts, working with their communities, organizing sites, training their staff, and providing personal protective equipment (PPE).

Congress must provide additional funding and require disaggregated data collection and reporting by age, race, ethnicity, gender identity, primary language, disability status, and other demographic factors on vaccine trust and acceptance, access, vaccination rates, adverse experiences, and ongoing health outcomes.

CDC, and state, local, tribal, and territorial authorities should include leaders from communities of color and tribal communities and to plan on-going data collection on vaccination efforts, interpret data, add cultural context, share data with communities, and determine implications and next steps.
CDC, and state, local, tribal, and territorial authorities should use these data to inform ongoing prioritization of vaccine distribution and rapidly address gaps in vaccination that may arise among subpopulations by race, ethnicity, neighborhood, or housing setting.

# # #

Climate change: Many states most at risk also the least prepared

December 9, 2020
by Megan Latshaw, Jon Links and Matt McKillop
USA Today

Climate change is often seen as a problem for the future, a calamity that looms over the coming decades. In fact, it is already here, and wreaking havoc.

Hundreds of millions of Americans are now dealing with record flooding, longer and more intense heat waves, more powerful hurricanes, warmer winters and other devastating effects of climate change.

Read the full article

John Auerbach on Health Agency Leadership

December 9, 2020
by Ed Baker
JPHMP Direct

As the COVID-19 pandemic expands across the nation, public health leaders are faced with unprecedented challenges. In this context, wise and experienced health agency leadership is more vital now than before.

Read the full article

Los estados con mayor riesgo de impactos en la salud del cambio climático suelen estar menos preparados para proteger a los residentes durante eventos relacionados con el clima, según un nuevo informe

(Washington, DC y Baltimore, MD – 9 de diciembre de 2020) – Muchos de los estados con mayor riesgo de cambio climático también son los menos preparados para lidiar con él, según un nuevo informe publicado hoy por Trust for America’s Health y Escuela de Salud Pública Bloomberg de la Universidad Johns Hopkins. Este grupo de estados enfrenta mayores peligros, incluidos huracanes, inundaciones, olas de calor y enfermedades transmitidas por vectores, pero han hecho lo mínimo para prepararse, según el informe Cambio climático y salud: evaluación de la preparación estatal.

El informe evaluó los 50 estados y el Distrito de Columbia en su nivel de preparación para los efectos del cambio climático en la salud. Los investigadores encontraron una gran variación: algunos estados han hecho preparativos importantes, mientras que otros apenas han comenzado este proceso. Ocho estados en particular son los más vulnerables a los impactos del cambio climático en la salud y los menos preparados.

Los estados en el grupo más vulnerable / menos preparado fueron: Georgia, Kentucky, Mississippi, Oklahoma, Carolina del Sur, Tennessee, Texas y Virginia Occidental. En general, cuanto más vulnerable era un estado, menos preparado solía estar. Muchos de estos estados de alta vulnerabilidad / baja preparación se encuentran en el sureste o sur de las Grandes Llanuras.

“Queríamos comprender mejor los riesgos que se plantean a los estados individuales y su nivel de preparación para proteger a los residentes”, dijo el autor principal del informe, Matt McKillop. “Nuestra esperanza es que el informe brinde a los funcionarios de todos los niveles información útil para prepararse mejor”.

Otro grupo de estados ha hecho mucho más para prepararse. Este grupo incluye: Colorado, Maine, Maryland, New Hampshire, Utah, Vermont, Wisconsin y el Distrito de Columbia. (Consulte el anexo para obtener un resumen de preparación estado por estado).

Los investigadores enfatizaron que todos los estados, incluidos los calificados como los más preparados, pueden hacer mucho más para proteger a los residentes de los efectos nocivos para la salud del cambio climático.

“Los impactos del cambio climático en nuestra salud exigen que los legisladores respondan”, dijo Megan Latshaw, científica de la Escuela de Salud Pública Johns Hopkins Bloomberg. “Nuestro objetivo es que todos los estados tomen esto como una llamada de atención y piensen en este informe como un punto de partida para hacer más para ayudar a que la vida de los residentes sea más segura”.

Algunos eventos relacionados con el clima, como huracanes e incendios forestales, tienen impactos obvios en la salud. Pero otros son más insidiosos, incluidas olas de calor más frecuentes; deterioro de la calidad del aire; inundaciones crónicas; y aumentos de enfermedades relacionadas con vectores, agua y alimentos. Estas amenazas ya existen. Pero el cambio climático los exacerba y también modifica o expande las regiones y poblaciones en riesgo. Además, todos estos efectos pueden afectar gravemente la salud mental y el bienestar.

Los investigadores calcularon la vulnerabilidad de cada estado analizando una variedad de factores. El medio ambiente y la geografía son cruciales, pero además, los factores sociales y demográficos también juegan un papel clave. Algunas poblaciones y comunidades son especialmente vulnerables. Los residentes de alto riesgo incluyen aquellos que son muy jóvenes o muy mayores, personas con discapacidades y quienes viven en la pobreza. A menudo, el legado y la presencia continua del racismo sistémico, incluidos los patrones de privación y discriminación, hace que las comunidades de color sean especialmente vulnerables.

El informe hace recomendaciones sobre cómo las autoridades federales, estatales y locales pueden hacer más para salvaguardar la salud de los residentes, particularmente la de los más vulnerables.

Las evaluaciones estatales se basaron en tres indicadores: vulnerabilidad, preparación para la salud pública y adaptación relacionada con el clima. Todos los hallazgos del informe son relativos, es decir, se basan en comparaciones entre estados.

Las recomendaciones incluyen:

Federal

El Congreso debería promulgar legislación que cree un plan nacional de preparación climática.
La administración y el Congreso deben financiar completamente el programa de Clima y Salud de los CDC y la Red Nacional de Seguimiento de la Salud Pública Ambiental.
Fortalecer el sistema nacional de salud pública y la fuerza laboral, incluso mediante la modernización de las capacidades de datos y vigilancia.

Estadal

Complete todos los pasos del marco de construcción de resiliencia contra los efectos climáticos (BRACE) de los CDC.
Reforzar la capacidad básica de preparación para la salud pública y establecer y mantener fondos y personal dedicados para los preparativos relacionados con el clima.
Planifique con las comunidades, no para ellas.

# # #

La Escuela de Salud Pública Bloomberg de la Universidad de Johns Hopkins se dedica a la mejora de la salud de todas las personas a través del descubrimiento, la difusión y la traducción del conocimiento, y la educación de una comunidad global diversa de científicos investigadores, profesionales de la salud pública y otros.