Issue Category: Child and School Health

Reducing Teen Substance Misuse: What Really Works

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Washington, D.C., November 19, 2015– In a new report, Reducing Teen Substance Misuse: What Really Works, «intro_text»

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The report’s analysis of the most recent drug overdose death rates among 12- to 25-year-olds found:

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

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No. Indicator «state» Number of States Receiving Points
A “Y” means the state received a point for that indicator
1 Support Academic Achievement: State has at least an 80 percent high school graduation rate (2012-2013).
Source: U.S. Department of Education, ED Data Express, Regulatory Adjusted Cohort Graduation Rates, 2013-2014.		 «metric1» 35
2 Preventing Bullying: State has comprehensive bullying prevention laws.
Source: American Academy of Pediatrics.		 «metric2» 21
3 Preventing Smoking: State has smoke-free laws that prohibit smoking in public places, including restaurants and bars.
Source: Campaign for Tobacco-Free Kids.		 «metric3» 30 and Washington, D.C.
4 Preventing Underage Alcohol Sales: State has liability (dram shop) laws holding establishments accountable for selling alcohol to underage or obviously intoxicated individuals.
Source: National Conference of State Legislatures and NOLO.		 «metric4» 37 and Washington, D.C.
5 Screening, Brief Intervention and Referral to Treatment Support: State has billing codes for Screening, Brief Intervention and Referral for Treatment (SBIRT) in their medical health (Medicaid or private insurance) programs.
Source: Institute for Research Education & Training in Addictions and Community Catalyst.		 «metric5» 32 and Washington, D.C.
6 Mental Health Funding: State increased funding for mental health services for Fiscal Year 2015.
Source: National Alliance on Mental Illness.		 «metric6» 29 and Washington, D.C.
7 Depression Treatment: State has rates of treatment for teens with major depressive episodes above the National percentage of 38.1 percent (2009-2013).
Source: SAMHSA, Behavioral Health Barometer: United States, 2014. 		«metric7» 30 and Washington, D.C.
8 Good Samaritan Laws: State has laws in place to provide some immunity from criminal charges or mitigation of sentencing of seeking help for an overdose.
Source: Network for Public Health Law.		 «metric8» 31 and Washington, D.C.
9 Treatment and Recovery Support for Prescription Drug Misuse: State provides Medicaid coverage for all three FDA-approved medications for the treatment of painkiller dependence.
Source: American Society of Addiction Medicine.		 «metric9» 30 and Washington, D.C.
10 Sentencing Reform: State has taken action to roll back “one-size-fits-all” sentences for nonviolent drug offenses.
Sources: The Vera Institute of Justice for 2000-2013 laws. For 2014 updates, The Sentencing Project, National Conference of State Legislatures and additional legislative scans for states meeting the thresholds set by the Vera Institute review.		 «metric10» 31 and Washington, D.C.
Total «score_upper»

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

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

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

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

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

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

The report provides additional research-based recommendations for preventing and reducing youth substance misuse. It was supported by a grant from the Conrad N. Hilton Foundation and is available on TFAH’s website at www.healthyamericans.org.

Score Summary:

A full list of all of the indicators and scores, listed below, is available along with the full report on TFAH’s web site at www.healthyamericans.org.  For the state-by-state scoring, states received one point for achieving an indicator or zero points if they did not achieve the indicator. Zero is the lowest possible overall score, 10 is the highest.

  • 10 out of 10: Minnesota and New Jersey
  • 9 out of 10: California, Connecticut, Maine, Maryland, New Mexico, New York and Vermont
  • 8 out of 10: Delaware, District of Columbia, Massachusetts, New Hampshire, Ohio, Oregon, Virginia, Washington and Wisconsin
  • 7 out of 10: Colorado, Iowa, North Carolina and Pennsylvania
  • 6 out of 10: Alabama, Illinois, Missouri, Rhode Island and Utah
  • 5 out of 10: Arkansas, Florida, Hawaii, Kansas, Kentucky, Michigan, Montana, North Dakota and Oklahoma
  • 4 out of 10: Alaska, Arizona, Georgia, Indiana, Nebraska, Nevada, South Carolina, South Dakota, Tennessee, Texas and West Virginia
  • 3 out of 10: Idaho, Louisiana, Mississippi and Wyoming

State-by-state Youth Drug Overdose Death Rankings:

Note: Rates include drug overdose deaths, for 2011-2013, a three-year average, for 12- to 25-year-olds. 1 = Highest rate of drug overdose fatalities, 51 = lowest rate of drug overdose fatalities. States with statistically significant (p<0.05) increases since 2005-2007 are noted with an asterisk (*), while states with a statistically significant decrease are noted with two asterisks (**).

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

 

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

Increasing Access to Breastfeeding Friendly Hospitals: The Iowa Experience

By Jane Stockton, Community Health Consultant, Bureau of Nutrition and Health Promotion, Iowa Department of Public Health & Catherine Lillehoj, Ph.D. Research Analyst, Iowa Department of Public Health

The Iowa Department of Public Health (IDPH) has a long tradition of striving to improve the health and wellness of all residents. Because breastfeeding is a key strategy to preventing obesity among children and youth, IDPH has worked for the past several years to increase rates of breastfeeding initiation and duration.

Five years ago, Iowa ranked 31 out of 53 states and territories on a national survey, the Maternity Practices in Infant Nutrition and Care (mPINC). When we looked a little deeper, we realized that the rural nature of our state made maternal nutrition and care somewhat difficult.

For instance, 89 percent of Iowa counties are considered rural, with hospitals in rural counties having a higher proportion of Medicaid births (40 to 60 percent of births). Sadly, these hospitals often don’t have the necessary resources to truly improve breastfeeding education and provide the appropriate technical assistance. In general, rural hospitals experience unique barriers due to distance between hospitals, patients and other facilities, plus staff are often not dedicated to working in maternity care units.

To get over these hurdles, IDPH targeted hospitals in rural counties with significant numbers of Medicaid births. One of the preliminary activities to improve breastfeeding was to meet with key hospital partners (e.g., OB managers, Chief Nursing Officers, Directors of Nursing, Educators). Along with key partners, hospital policies related to breastfeeding were reviewed and results of the mPINC survey were discussed. Following these initial meetings, 53 hospitals voluntarily completed a pre-assessment using a self-appraisal tool. Subsequently, the IDPH hosted a training, called 6 Steps 4 Success, which we developed specifically to address the Ten Steps to Successful Breastfeeding, a set of evidence-based practices that have been shown to increase breastfeeding initiation and duration.

After receiving technical assistance, resources and staff education, 37 of the 53 hospitals completed a post-assessment. The majority of the hospitals implemented at least three of the Ten Steps and the most widely adopted policy, encouraging breastfeeding on demand, was implemented by 83 percent of the hospitals. After attending the 6 Steps 4 Success training, one nurse stated, “This gave me a lot to think about. I have changed my position and going to change my ideas, way I promote breastfeeding.” Hospitals frequently express their gratitude for the technical assistance and education being brought to them in their rural setting, rather than having to go to the larger cities for these services.

To further enhance statewide breastfeeding initiatives, efforts for the past two years have focused on improving maternity practice in four or five hospitals each year that meet three criteria: rural location, Medicaid birth rate higher than statewide average and an mPINC score of less than the statewide composite score. Using their mPINC survey data, hospitals are given assistance in reviewing the results, determining where the greatest opportunities for improvement are, and developing an improvement plan to address at least two of the dimensions of care. Over the course of one year, hospitals are offered:

  1. Technical assistance related to breastfeeding policy – telephone, face-to-face, electronic messaging;
  2. Resources – desk references such as Hale’s Medications and Mother’s Milk, Continuity of care in Breastfeeding: Best Practices in the Maternity setting; model breastfeeding policy, and a Self Attachment video;
  3. Educational opportunities – funding to send one staff nurse to Certified Lactation Counselor (or comparable) training, Breastfeeding Education for Iowa Communities, a four hour training developed by the Iowa Breastfeeding Coalition, and/or 6 Steps 4 Success training; and
  4. Networking opportunities – Iowa’s Annual Breastfeeding Conference and networking call for all participating hospitals.

The most recent data indicate all participating hospitals demonstrated improvement in several areas including: Labor and delivery practice (an improvement ranging from 3 to 230 percent), Staff Training (63 percent improvement), Breastfeeding Assistance (18 percent improvement), and Structural and Organizational Aspects of Care (94 percent improvement). In addition, staff who became Certified Lactation Counselors are now educating other nurses in their hospital.

To truly make these activities pervasive and sustainable, the IDPH knew it was important to collaborate with key partners with valuable expertise, including:

  • University of Iowa Statewide Perinatal Team – Breastfeeding Guidelines were written and incorporated into the Guidelines for Perinatal Services published by IDPH and distributed by the University of Iowa’s Perinatal Care Program. The Guidelines for Perinatal Services provides the framework to be used in defining and evaluating the level of perinatal services being offered by hospitals.
  • Iowa Breastfeeding Coalition – Breastfeeding Education for Iowa Communities, a four hour training curriculum, is being presented to healthcare communities throughout the state. The training curriculum, based on WIC’s Grow and Glow curriculum, was written as a collaborative effort by IDPH staff and ICBLC members of the coalition.

Over the past five years Iowa hospitals have gone from understanding what the term “Baby Friendly” meant and about the significance of the Ten Steps to Successful Breastfeeding, to having one hospital designated as Baby Friendly and many other hospitals in the process of achieving that designation

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References

Lillehoj, C. & Dobson, B. (2012). Implementation of the Baby-Friendly Hospital Initiative Steps in Iowa Hospitals. http://authorservices.wiley.com/bauthor/onlineLibraryTPS.asp?DOI=10.1111/j.1552-6909.2012.01411.x&ArticleID=1043603.

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

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

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

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

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

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

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

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

An Action Plan for Reducing Absences Due to Asthma

The full version of this story, published by Healthy Schools Campaign, is available at https://healthyschoolscampaign.org/policy/an-action-plan-for-reducing-absences-due-to-asthma/. Below is just an introduction.

Asthma kept Stephanie Godbolt’s grandson John home from school time and time again. John’s school, Tench Tilghman Elementary, serves 425 students, more than 95 percent of whom are black and 95 percent of whom also qualify for free or reduced price lunch. The school sits in Baltimore’s Patterson Park neighborhood on the city’s southwest side, just a few blocks away from Johns Hopkins Hospital. John’s asthma got so bad, he was missing nearly a week of school each and every month for six months. And he was losing ground academically.

Fighting Chronic Absence with a Flu Shot

The full version of this story, published by Healthy Schools Campaign, is available at https://healthyschoolscampaign.org/policy/fighting-chronic-absence-with-a-flu-shot/. Below is just an introduction.

Schools in Central Texas had a problem. Students in that region were missing more days than the state average at every single grade level.

This absence problem hits Texas schools on two fronts: student achievement and funding. Data shows high school students who miss 10 or more days of school are three times more likely to drop out than students who miss five days or fewer. In some states, Texas included, school funding is based on a figure called “average daily attendance” rather than total enrollment. That means that schools receive funding only for students that are in school. That also means that the more students are absent—for whatever reason—the less funding the school gets.

New Report Finds 23 of 25 States with Highest Rates of Obesity are in the South and Midwest

Obesity rates at or above 30 percent in 42 states for Blacks, 30 states for Latinos, 13 states for Whites

Washington, D.C., September 21, 2015 – U.S. adult obesity rates remained mostly steady―but high―this past year, increasing in Kansas, Minnesota, New Mexico, Ohio and Utah and remaining stable in the rest, according to The State of Obesity: Better Policies for a Healthier America, a report from the Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF).

Arkansas had the highest adult obesity rate at 35.9 percent, while Colorado had the lowest at 21.3 percent. The 12th annual report found that rates of obesity now exceed 35 percent in three states (Arkansas, West Virginia and Mississippi), are at or above 30 percent in 22 states and are not below 21 percent in any. In 1980, no state had a rate above 15 percent, and in 1991, no state had a rate above 20. Now, nationally, more than 30 percent of adults, nearly 17 percent of 2 to 19 year olds and more than 8 percent of children ages 2 to 5 are obese.

Obesity puts some 78 million Americans at an increased risk for a range of health problems, including heart disease, diabetes and cancer.

“Efforts to prevent and reduce obesity over the past decade have made a difference. Stabilizing rates is an accomplishment. However, given the continued high rates, it isn’t time to celebrate,” said Jeffrey Levi, PhD, executive director of TFAH. “We’ve learned that if we invest in effective programs, we can see signs of progress. But, we still haven’t invested enough to really tip the scales yet.”

Other key findings from The State of Obesity include:

  • Obesity rates differ by region, age and race/ethnicity.
  • 7 of the 10 states with the highest rates are in the South and 23 of the 25 states with the highest rates of obesity are in the South and Midwest.
  • 9 of the 10 states with the highest rates of diabetes are in the South. Diabetes rates increased in eight states – Colorado, Hawaii, Kansas, Massachusetts, Missouri, Montana, Ohio and Pennsylvania.
  • American Indian/Alaska Natives have the highest adult obesity rate, 54 percent, of any racial or ethnic group.
  • Nationally, obesity rates are 38 percent higher among Blacks than Whites; and more than 26 percent higher among Latinos than Whites. (Obesity rates for Blacks: 47.8 percent; Latinos: 42.5 percent; and Whites: 32.6 percent.)
  • Adult obesity rates are at or above 40 percent for Blacks in 14 states.
  • Adult obesity rates are at or above 30 percent in: 42 states for Blacks; 30 states for Latinos; and 13 states for Whites.
  • Obesity rates are 26 percent higher among middle-age adults than among younger adults― rates rise from 30 percent of 20- to 39- year olds to nearly 40 percent of 40- to 59-year-olds.
  • More than 6 percent of adults are severely obese – more than a 125 percent increase in the past two decades. Around 5 percent of children are already severely obese by the ages of 6 to 11.
  • Among children and teens (2 to 19 years old), 22.5 percent of Latinos, more than 20 percent of Blacks and 14.1 percent of Whites are obese.
  • Prevention among children is key. It is easier and more effective to prevent overweight and obesity in children, by helping every child maintain a healthy weight, than it is to reverse trends later. The biggest dividends are gained by starting in early childhood, promoting good nutrition and physical activity so children enter kindergarten at a healthy weight.
  • Healthy communities can help people lead healthy lives. Small changes that make it easier and more affordable to buy healthy foods and beverages and be physically active can lead to big differences. The U.S. Centers for Disease Control and Prevention, The New York Academy of Medicine, and other experts have identified a range of policies and programs (e.g., improving school nutrition, physical activity and lifestyle interventions, health screenings, walking programs) that can help create healthier communities. Lower-income communities often face higher hurdles, and need more targeted efforts.

“In order to build a national Culture of Health, we must help all children, no matter who they are or where they live, grow up at a healthy weight,” said Risa Lavizzo-Mourey, president and CEO of RWJF. “We know that when we take comprehensive steps to help families be more active and eat healthier foods, we can see progress. Now we must extend those efforts and that progress to every community in the country.”

The State of Obesity also reviews key programs that can help prevent and address obesity by improving nutrition in schools, child care and food assistance; increasing physical activity before, during and after school; expanding healthcare coverage for preventing and treating obesity; making healthy affordable food and safe places to be active more accessible in neighborhoods, such as through Complete Streets and healthy food financing initiatives; increasing healthy food options via public-private partnerships; and creating and sustaining policies that help all children maintain a healthy weight and adults be as healthy as possible, no matter their weight.

This is the 12th annual edition of The State of Obesity (formerly known as the F as in Fat report series) report. The full report, with state rankings in all categories and updated interactive maps, charts and graphs, is available at http://stateofobesity.org. Follow the conversation at #StateofObesity.

2014 STATE-BY-STATE ADULT OBESITY RATE

Based on an analysis of new state-by-state data from the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance Survey, adult obesity rates by state from highest to lowest were:

Note: 1 = Highest rate of adult obesity, 51 = lowest rate of adult obesity.

1. Arkansas (35.9); 2. West Virginia (35.7); 3. Mississippi (35.5); 4. Louisiana (34.9); 5. Alabama (33.5); 6. Oklahoma (33.0); 7. Indiana (32.7); 8. Ohio (32.6); 9. North Dakota (32.2); 10. South Carolina (32.1); 11. Texas (31.9); 12. Kentucky (31.6); 13. Kansas (31.3); 14. (tie) Tennessee (31.2) and Wisconsin (31.2); 16. Iowa (30.9); 17. (tie) Delaware (30.7) and Michigan (30.7); 19. Georgia (30.5); 20. (tie) Missouri (30.2) and Nebraska (30.2) and Pennsylvania (30.2); 23. South Dakota (29.8); 24. (tie) Alaska (29.7) and North Carolina (29.7); 26. Maryland (29.6); 27. Wyoming (29.5); 28. Illinois (29.3); 29. (tie) Arizona (28.9) and Idaho (28.9); 31. Virginia (28.5); 32. New Mexico (28.4); 33. Maine (28.2); 34. Oregon (27.9); 35. Nevada (27.7); 36. Minnesota (27.6); 37. New Hampshire (27.4); 38. Washington (27.3); 39. (tie) New York (27.0) and Rhode Island (27.0); 41. New Jersey (26.9); 42. Montana (26.4); 43. Connecticut (26.3); 44. Florida (26.2); 45. Utah (25.7); 46. Vermont (24.8); 47. California (24.7); 48. Massachusetts (23.3); 49. Hawaii (22.1); 50. District of Columbia (21.7); 51. Colorado (21.3).

 

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

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

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Teledentistry: Reducing Absenteeism by Supporting Student Health

The full version of this story, published by Healthy Schools Campaign, is available at https://healthyschoolscampaign.org/policy/teledentistry-reducing-absenteeism-by-supporting-student-health/. Below is just an introduction.

A terrible toothache is virtually impossible to ignore. For millions of children across the nation, the consequences of untreated tooth decay extend far beyond momentary pain to include potentially devastating effects on their long-term learning and opportunity.

Now, a new approach called teledentistry offers the promise of addressing this issue and relieving the lifelong burden it places on young children.

TFAH Releases Issue Brief – The Clean Water Rule: Clearing up Confusion to Protect Public Health

Washington, D.C., July 23, 2015 – Today, the Trust for America’s Health (TFAH) released an issue brief examining the country’s Clean Water Rule and how it will improve and protect Americans’ health and restore guaranteed protections for a range of waters.

The brief, The Clean Water Rule: Clearing up Confusion to Protect Public Health, finds that, despite advances in water management, waterborne illnesses still pose a serious threat to Americans’ health.  Even though water-related illnesses are largely underreported, the United States annually experiences a significant number of waterborne illnesses. In fact, each year around 30 outbreaks and 1,000 reported drinking water-related cases and around 24 outbreaks and 1,300 recreational water-related cases occur.

According to the brief, water pollution affects Americans’ health on a regular basis. In the summer of 2014, the country witnessed a dramatic example of the effects of contaminated waterways when a toxic algal event in Lake Erie shut off the main drinking water supply for 400,000 people in Toledo, Ohio.

In another recent example, in Charleston, West Virginia, hundreds of thousands of people were unable to use their tap water because of toxic substances in the water supply. And, across the country, industrial pollution, animal and human waste, and waterborne pathogens are often found in these headwaters—from which 117 million Americans get their drinking water.

To help resolve these issues, the Environmental Protection Agency (EPA) and the Army Corps of Engineers — which implement the Clean Water Act—held more than 400 stakeholder meetings, sifted through  more than a million public comments (of which 87 percent favored the action), and developed a detailed scientific report, Connectivity of Streams and Wetlands to Downstream Waters, that examined more than 1,200 peer-reviewed publications on the connections between upstream and downstream bodies of water.

These actions resulted in the creation of the Clean Water Rule, which clarifies the scope of the headwaters that are protected under the Clean Water Act. According to the brief, by providing protection for these waters, the Clean Water Rule will safeguard headwaters, better hold industrial polluters of headwaters accountable and greatly improve the nation’s health.

“We want to un-muddy the waters – the Clean Water Act’s legacy has been to ensure Americans have sustainable access to a healthy water supply,” said Jeffrey Levi, PhD, executive director of TFAH. “Moving forward, the Clean Water Rule will further the Act’s great successes by strengthening protections for our nation’s water supply and reducing instances of waterborne illness. The Rule should be administered—without delay or further changes—to avoid putting the public’s health at further risk.”

The brief also notes that protecting America’s headwaters is popular across political lines. A recent poll found that 80 percent of American voters favor the Rule, with half of voters saying they strongly favor it. Support for the rule cuts across party lines, with large majorities of Democrats, Independents and Republicans in favor.

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