Issue Category: Prevention and Public Health Policy
Prevention and Public Health Fund: Preventing Chronic Disease and Reducing Long-Term Health Costs (March 2021)
Nearly 70 Organizations Call on Congress to Advance the Pandemic and All-Hazards Preparedness & Advancing Innovation Act
March 22, 2019
The Honorable Mitch McConnell Majority Leader U.S. Senate
The Honorable Charles Schumer Minority Leader U.S. Senate
The Honorable Nancy Pelosi Speaker U.S. House of Representatives
The Honorable Kevin McCarthy Minority Leader U.S. House of Representatives
On behalf of the undersigned organizations, representing public health, healthcare providers, emergency managers, environmental health, biotechnology innovators, and researchers, we are again writing to encourage you to advance the Pandemic and All-Hazards Preparedness & Advancing Innovation Act (PAHPAI, H.R. 269), which overwhelmingly passed the House of Representatives in January. A similar version passed the Senate Health Education, Labor & Pensions (HELP) Committee last year. The HELP and Energy & Commerce Committees have made tremendous, bipartisan progress on this important legislation, and it would be a setback for our national health security to further delay reauthorization. The disaster relief package being considered by Congress would be a logical vehicle for PAHPAI.
The recent wildfires, hurricanes and measles outbreaks have demonstrated that all sectors – public health, healthcare and private sector – play a critical role in saving lives during disasters and outbreaks. PAHPA is the backbone of our nation’s health security, providing the U.S. Department of Health and Human Services (HHS) with authorities for preparing the healthcare and public health systems for disasters and strengthening the medical countermeasures enterprise. The legislation addresses gaps we have seen in recent responses, such as the speed of funding for public health emergencies, development and deployment of medical countermeasures for significant threats and preparedness for children in disasters.
The time is now to move this legislation. We are particularly concerned that several authorities have expired as of 2018, including temporary reassignment of state and local personnel, the National Advisory Committee on Children and Disasters, limited antitrust exemption and other provisions critical to HHS contracting. We believe that time is of the essence in reauthorizing these important authorities.
We commend the work of the committed Senators, Representatives and their staff who have devoted considerable thought to this legislation. Our organizations are committed to our nation’s health security, and we remain ready to assist in order to see this legislation enacted into law as soon as possible.
Sincerely,
AABB (formerly known as American Association of Blood Banks)
AFSCME
Alliance for Biosecurity
American Academy of Pediatrics
American Association of Poison Control Centers
American Association on Health and Disability
American Hospital Association
American Public Health Association
American Society for Microbiology
America’s Blood Centers
Asian & Pacific Islander American Health Forum
Association for Professionals in Infection Control and Epidemiology
Association of American Medical Colleges
Association of American Veterinary Medical Colleges
Association of Maternal & Child Health Programs
Association of Public Health Laboratories
Association of Schools and Programs of Public Health
Association of State and Territorial Health Officials
Barnesville Hospital
Berger Health System
Big Cities Health Coalition
Biotechnology Innovation Organization (BIO)
California Life Sciences Association
Central Ohio Trauma System
Child Care Aware of America
Colorado Association of Local Public Health Officials
Commissioned Officers Association of the U.S. Public Health Service, Inc. (COA)
Coshocton Regional Medical Center
Council of State and Territorial Epidemiologists
Entomological Society of America
Fayette County Memorial Hospital
Federation of American Hospitals
Future of Life Institute
Genesis Community Ambulance
Global Health Technologies Coalition
Health Industry Distributors Association
Health Resources in Action
Healthcare Distribution Alliance
Healthcare Leadership Council
Healthcare Ready
Hogg Foundation for Mental Health
Hospital Council of Northwest Ohio
Infectious Diseases Society of America
International Association of Emergency Managers
Johns Hopkins Center for Health Security
Los Angeles County Department of Public Health
Louisiana Public Health Institute
March of Dimes
Mount Carmel Health System
National Association of Counties
National Association of County and City Health Officials
National Association of Federal Veterinarians
National Association of Pediatric Nurse Practitioners
National Association of State Emergency Medical Services Officials
National Center for Disaster Preparedness, Columbia University
National Emergency Management Association National Network of Public Health Institutes
NEHA
Oklahoma City-County Health Department
One Health Commission
One Health Initiative Autonomous pro bono Team
Suburban Hospital Alliance of New York State
The Antimicrobials Working Group (Amplyx Pharmaceuticals, Aridis Pharmaceuticals, Cidara Therapeutics Inc., ContraFect Corporation, Entasis Therapeutics Inc., Iterum Therapeutics Ltd., Melinta Therapeutics Inc., Motif Bio plc, Nabriva Therapeutics US Inc., Paratek Pharmaceuticals Inc., Qpex Biopharma Inc., SCYNEXIS Inc., Summit Therapeutics plc andVenatoRx Pharmaceuticals Inc.)
The Society for Healthcare Epidemiology of America
Trauma Center Association of America
Trust for America’s Health
UCSF Benioff Children’s Hospitals
Virginia Hospital & Healthcare Association
Promoting Health and Cost Control in States
States Can Improve Residents’ Health and Reduce Healthcare Spending by Adopting Policies Outside of the Healthcare Sector, New Report Shows
February 21, 2019
Policies that can improve health and save money include: Pre-K and school nutrition programs, syringe access, tobacco and alcohol taxes, paid family leave, the Earned Income Tax Credit and rapid rehousing.
(Washington, DC) — States can improve their residents’ health and well-being, and lower healthcare costs, by implementing a range of policies in sectors beyond healthcare, according to a new report, Promoting Health and Cost Control: How States Can Improve Community Health and Well-being through Policy Change, released today by Trust for America’s Health (TFAH).
The new report analyzes state action on 13 policies outside the healthcare sector that have a long-term impact on health and an evidence base showing their effectiveness. They include: tobacco and alcohol taxes, syringe access programs, universal pre-K and rapid rehousing laws, among others. The wide policy lens of the report, which covers numerous sectors, including taxation, employment, education, housing and transportation, underscores the many economic and social factors beyond medical care that influence health.
In the context of the longest decline in life expectancy since World War I, and, insufficient resources dedicated to preventing health problems before they arise, this new report serves as an urgent call to state policymakers to take concrete steps to improve residents’ health. The report was made possible by financial support from the Robert Wood Johnson Foundation and Kaiser Permanente.
“In the current environment, states have an even more vital role to play in promoting the health and well-being of their residents,” said John Auerbach, President and CEO of Trust for America’s Health. “Our goal in creating this report is to provide state public health officials and policymakers the evidence and business case for the adoption of policies that have been shown to improve community health.”
| Policies Analyzed in the Report | Number of States with the Policy |
| Universal Pre-K program* | 10 (incl. DC) |
| School breakfast program | 31 (incl. DC) |
| School lunch program | 20 |
| School competitive foods (snacks and drinks) | 28 (incl. DC) |
| Syringe access programs | 27 (incl. DC) |
| Smoke-free laws** | 29 (incl. DC) |
| Tobacco taxes*** | 51 (incl. DC) |
| Alcohol taxes*** | 51 (incl. DC) |
| Complete streets | 30 (incl. DC) |
| Housing rehabilitation loan and grant programs**** | 40 (incl. DC) |
| Rapid re-housing laws | 9 (incl. DC) |
| Earned income tax credit | 30 (incl. DC) |
| Paid sick leave | 12 (incl. DC) |
| Paid family leave | 7 (incl. DC) |
| Fair hiring protections (ban the box) | 34 (incl. DC) |
The economic benefits of these policies can be substantial. For example:
- Pre-K education programs can generate $4.63 in benefits to participants, taxpayers, and others in society for every $1 spent on such programs.
- Expanding syringe exchange programs could return $7.58 for every $1 invested in the long run, by lowering HIV rates and reducing treatment costs. There is no evidence such programs lead to higher drug use.
- Rapid re-housing programs, which focus on getting homeless individuals into stable housing before addressing other challenges, can reduce hospital admissions and jail bookings. One pilot study found that such an approach saved more than $36,000 in treatment costs per person over the course of a year, nearly twice what the program cost.
“While the healthcare sector plays an important role in providing health services when someone gets sick, many of the factors that keep people healthy are outside the healthcare system and involve where people live, work, play and learn,” said Adam Lustig, Manager of the Promoting Health and Cost Control in States initiative and one of the report authors. “This report gives state policymakers a menu of evidence-based policies that have been shown to improve individual and community health.”
“I encourage all state policymakers to read this important report. Doing so will give them access to proven solutions to the challenge of run-away healthcare spending yet so little improvement in health outcomes. To improve Americans’ health, we have to think beyond the healthcare sector and about the many factors that impact health,” said Anand Parekh, MD, MPH, Chief Medical Advisor, Bipartisan Policy Center and a member of the Promoting Health and Cost Control in States Advisory Board.
To create the report, TFAH reviewed approximately 1,500 evidence-based programs and strategies. The 13 policies ultimately included in the report all:
- Have a strong health impact and economic evidence of that impact, such as cost avoidance or reduction.
- Focus on prevention at the population health level, i.e., are designed to prevent illness or injury at the community level rather than the individual level.
- Focus on primary prevention, preventing an injury or illness rather than treating it.
- Can be implemented by state legislative action.
The findings show dramatic variability in how states approach these health-promoting policies. For instance, all 50 states plus DC institute tobacco and alcohol taxes. But only nine states and DC have laws in place to encourage universal pre-K programs, which have been shown to set children up for better health later in life. Universal pre-K programs are state funded programs that support pre-K for nearly 50 percent or more of the state’s 4-year-olds. Only six states and DC support paid family leave, even though data show such policies support maternal and child health, and, can save employers money in the long run.
“Action is imperative,” said Auerbach. “As a nation, we spend trillions of dollars a year on healthcare and yet Americans are getting less healthy. The solution is two-fold: direct more spending to prevention efforts and address the social determinants of health instead of their impact after someone is sick.”
Notes:
*states that support state-funded pre-K to nearly 50% or more of the state’s 4-year-olds.
**comprehensive smoke-free as per the American Lung Association
*** rates vary, and higher taxes are generally more effective
**** many states fund such programs in the absence of statewide legislation
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Trust for America’s Health is a nonprofit, nonpartisan organization that promotes optimal health for every person and community and makes the prevention of illness and injury a national priority. www.tfah.org
TFAH Statement on Texas Court ACA Ruling
John Auerbach, President and CEO of Trust for America’s Health released the following statement in response to the Texas court ruling on the ACA.
“Last Friday’s ruling by a Texas court that the Affordable Care Act (ACA) is unconstitutional due to the elimination of the individual mandate puts millions of Americans – particularly those with pre-existing conditions – at risk of losing health coverage. It would also eliminate the Prevention and Public Health Fund, coverage of preventive services, and many other health protections. The ACA remains the law of the land as this lawsuit moves through the appeals process, and TFAH calls on Congress to ensure the health care coverage, public health investments and other protections that Americans depend on remain available.”
Countering Childhood Obesity in Georgia
Countering Childhood Obesity in Georgia
Georgia Shape, a statewide multifaceted initiative, seeks to advance the health and well-being of children by utilizing a cross-sectors approach to tackle childhood obesity in the state.
By cultivating strong relationships with institutions throughout the State, Georgia Shape has been able to focus on upstream interventions, namely providing time in each students’ day for physical activity. Upstream interventions refer to programs and policies that impact the root causes of health or social conditions.
Through the development of community-wide interventions, particularly Georgia Shapes’ ‘Power Up for 30’ program, rates of childhood obesity in Georgia have started to decrease. The Center for Disease Control and Prevention recognizes school based programs to increase physical activity, such as ‘Power Up for 30’, as one of fourteen non-clinical community-wide interventions that can lead to cost-effective and cost-saving health outcomes within five years.
How It Took ‘Shape’
After the implementation of the 2009 Georgia Student Health and Physical Education Act (SHAPE), Georgia Shape was created to end the increasing rates of obesity among children in the state. In 2011, the Governor declared childhood obesity prevention as the number one public health priority and state leaders understood the importance of bridging the efforts of multi-sector partners to bolster the goals set forth by SHAPE. A governing council comprised of experts from a variety of disciplines was established to ensure that multiple perspectives were considered. Through the utilization of an obesity systems modelling program, factors contributing to obesity were identified, including a substantial lack of physical activity.
The overall goal of Power Up for 30 is to promote and protect the health of all children by incorporating 30 minutes of physical activity before, during, or after each school day. In collaboration with researchers, the Georgia Department of Public Health developed a comprehensive model to strategically focus and measure the health and economic impacts of school-based programs to increase physical activity.
The Power Up for 30 Model
Implementation of ‘Power Up for 30’ in schools relied on the support and acceptance of school superintendents and educators. Georgia Shape was promoted throughout elementary schools with messaging tailored to the interests of teachers and administrators to help garner support and establish applicability for the intervention. Tailored messages emphasized the benefits school principals, physical education teachers, and classroom teachers each prioritized including improved attendance and discipline, improved health, and improved academic performance. By identifying perceived barriers in each school, program developers were able to mold ‘Power Up For 30’ to fit each school’s specific environment and/or needs and assist teachers and administrators in achieving their respective goals.
| School Based Activity Programs Increase | School Based Activity Programs Decrease |
| ● School attendance
● Academic performance ● Concentration and attention in the classroom ● Scores on State competency tests ● Physically activity in the classroom |
● Childhood Obesity
● Number of students receiving discipline ● Negative health outcomes |
Shape encouraged the utilization of physically active academic lessons as both a supplement to physical education in schools and to complement student learning. Former teachers served as subject matter experts to ensure the design of the program incorporated the realities of what would work in the classroom. Furthermore, the former teachers lent their knowledge of the unique needs of specific communities, which helped increase the programs ability to fit the diverse norms of different school environments.
In order to measure the effects of the intervention, the program assessed health knowledge, classroom physical activity time, time spent doing moderate to vigorous activity during physical education, availability of before school activity programs, and student aerobic capacity and BMI. For each school, data was compiled to discern the best available strategies for increasing physical activity within their individual environments. Buy-in and engagement was created at the individual school levels by training at least one administrator, one physical education teacher, and one classroom teacher to lead the ‘Power Up for 30’ program in their respective schools. Cultivating within-the-school leaders for the Power Up 30 program was a key to its success.
Success and Sustainability
At the beginning of 2012 the Power Up for 30 program launched across 40 Georgia elementary schools. ‘Power Up for 30’ expanded from a 5-county pilot program to a statewide approach by the 2013-2014 school year. As of 2016, more than 880 schools enlisted in Power Up for 30. Initially an elementary school pilot, ‘Power Up for 30’ is now embedded into Georgia’s elementary school educational curriculum and augmented to incorporate a middle school pilot.
Georgia Shape’s success in large part is due to its more than 120 partnerships and its sustainable and adaptable practices. Through utilizing evidence-based and sustainable models such as online training modules, low or no cost resources, free training, and continuous technical support, the Power Up for 30 program supports the implementation needs of all schools and educators. Assistance from public and private sector partners, such as the Georgia Department of Education, Department of Child and Family Services, the CDC, and corporate sponsors have been vital to Georgia Shapes’ achievements in tackling childhood obesity and protecting the health of every child.
For more information visit:
(December 2018)
New Collaborative Will Hone Public Health Resources to Improve Well-Being of Older Adults
FOR RELEASE: November 13, 2018
Public Health Leaders from 37 Florida Counties Participate in Planning Forum
Washington, DC — Trust for America’s Health (TFAH) is pleased to announce the launch of the Florida Age-Friendly Public Health Collaborative and Action Network. Working directly with the Florida Department of Health and with generous funding from The John A. Hartford Foundation, the collaborative and action network will help Florida’s local health departments improve the health and well-being of older adults. During the launch with representatives of Florida’s 37 participating counties, TFAH President and CEO John Auerbach called this effort “a historic moment in public health and a crucial collaboration between the public health and aging sectors.”
There is growing momentum for public health to contribute to programs, policies, and innovative interventions to promote health as people age. Although public health efforts are partly responsible for the dramatic increases in longevity over the 20th Century, historically, there have been limited collaborations across the health and aging fields.
“Longevity and our growing older adult population is a remarkable success story, and it requires all sectors of society to prepare,” said Terry Fulmer, PhD, RN, FAAN, President of The John A. Hartford Foundation. “I’ve been extremely impressed with Florida’s commitment and creativity in pro-actively getting ahead of the curve, so that age-friendly public health solutions are in place for the state and as a model for the entire country.”
“Florida is excited about the opportunity to work with TFAH to advance age-friendly public health,” said Florida’s State Surgeon General Dr. Celeste Philip. “Addressing the needs of older populations is an important aspect of promoting health equity and the Department is committed to ensuring that every Floridian has the opportunity to be healthy in every stage of their life. The counties participating in this project represent two-thirds of our population, but we know that all our citizens will benefit from the policies and best practices this partnership will develop.”
Demographic changes now underway are spurring an urgency among all sectors and professions to focus on the comprehensive needs of our aging society. In 1900, about three million Americans—about four percent of the total population—were aged 65 and over. By 2014, that number had risen to 46 million—about 15 percent of the population. The oldest members of the baby-boomer generation turned 65 in 2011, launching a rapid increase in the number of older adults that will continue indefinitely—by 2030, about one in five Americans will be 65 or older.
In October 2017, TFAH brought together 30 experts in public health, aging, research, and policy to explore whether and how public health could contribute to the health of older adults. Convening participants all agreed that public health could play many unique and important roles in healthy aging and developed a Framework for Creating an Age-Friendly Public Health System to advance public health’s role at the local, state, and national levels.
Through the Florida Age-Friendly Public Health Network, TFAH is identifying and sharing case studies and best practices, developing tools and training resources, and offering expert technical assistance based on the variety of needs of Florida’s diverse communities. More than half of Florida’s local health departments have already identified issue areas that could be strengthened via the collaborative, including emergency preparedness, social isolation, chronic disease management, transportation, and housing. TFAH looks forward to sharing the results of this initiative with public health stakeholders and policymakers, and to work with state and national partners to advance the work nation-wide.
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Trust for America’s Health is a nonprofit, nonpartisan organization that promotes optimal health for every person and community and makes the prevention of illness and injury a national priority. WWW.tfah.org
The John A. Hartford Foundation, based in New York City, is a private, nonpartisan, national philanthropy dedicated to improving the care of older adults. The leader in the field of aging and health, the Foundation has three priority areas: creating age-friendly health systems, supporting family caregivers, and improving serious illness and end-of-life care. For more information, visit johnahartford.org and follow @johnahartford.
Trust for America’s Health and Well Being Trust Launch National Resilience Strategy Blueprint to Raise Awareness of and Offer Solutions for Drug, Alcohol and Suicide Crises
(Washington, DC and Oakland, Calif., July 2) – A new web-based blueprint designed to help communities deal with the drug, alcohol and suicide crises launched today.
In November of 2017, Trust for America’s Health (TFAH) and Well Being Trust (WBT) released Pain in the Nation: The Drug, Alcohol and Suicide Crises and the Need for a National Resilience Strategy. The report detailed the growing number of “despair deaths” – deaths due to drug and alcohol misuse and suicide – and more than 60 evidence-based programs proven to help fight contributing factors and save lives.
This companion piece, the Pain in the Nation: National Resilience Strategy website, will help policy-makers and community leaders access critical data and prevention-oriented programs and policies – including promotion of responsible opioid prescribing practices, enforcement of underage drinking laws, and anti-bullying and social-emotional learning programs in schools, among others. The website also provides state level data on how the drug, alcohol and suicide crises are impacting lives across the country and includes case studies describing community and school-based prevention programs that work.
“The numbers of these deaths are staggering and tragic. They are also preventable,” says John Auerbach, president and CEO of Trust for America’s Health. “As a nation, we need to apply what we know about prevention to address the root causes of this epidemic of substance abuse and suicide. The time to act is now.”
According to the Trust for America’s Health and the Well Being Trust, a National Resilience Strategy must be comprehensive and focused at both the crisis intervention level and on early identification of and action on the causes of poor mental and physical health. The Pain in the Nation: National Resilience Strategy website provides a high-level roadmap for communities to tackle these difficult issues.
“To better support the conditions that can prevent these deaths of despair, we must intervene at the source and look at the issue through a more comprehensive systems lens,” says Benjamin F. Miller, Psy.D., Chief Strategy Officer, Well Being Trust. “While closing the treatment gap is important, we’ll never get there if we don’t also focus on closing the prevention gap – by increasing attention on adverse childhood experiences, chronic stress, food deserts and all the additional health inequities across geographies and demographics.”
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Trust for America’s Health is a non-profit, non-partisan organization that promotes optimal health for every person and community and makes the prevention of illness and injury a national priority. Twitter: @HealthyAmerica1
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 wellness. http://wellbeingtrust.org/. Twitter: @WellBeingTrust
Separating parents and children at US border is inhumane and sets the stage for a public health crisis
(Washington, D.C., June 15, 2018) — “The Trump administration’s policy of separating parents and children at the U.S.-Mexico border will have a dire impact on their health, both now and into the future.
“As public health professionals we know that children living without their parents face immediate and long-term health consequences. Risks include the acute mental trauma of separation, the loss of critical health information that only parents would know about their children’s health status, and in the case of breastfeeding children, the significant loss of maternal child bonding essential for normal development. Parents’ health would also be affected by this unjust separation.
“More alarming is the interruption of these children’s chance at achieving a stable childhood. Decades of public health research have shown that family structure, stability and environment are key social determinants of a child’s and a community’s health.
“Furthermore, this practice places children at heightened risk of experiencing adverse childhood events and trauma, which research has definitively linked to poorer long-term health. Negative outcomes associated with adverse childhood events include some of society’s most intractable health issues: alcoholism, substance misuse, depression, suicide, poor physical health and obesity.
“There is no law requiring the separation of parents and children at the border. This policy violates fundamental human rights. We urge the administration to immediately stop the practice of separating immigrant children and parents and ensure those who have been separated are rapidly reunited, to ensure the health and well-being of these children.”
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APHA champions the health of all people and all communities. We strengthen the public health profession. We speak out for public health issues and policies backed by science. We are the only organization influence federal policy, has a nearly 150-year perspective and brings together members from all fields of public health. Visit us at www.apha.org.
Trust for America’s Health is a non-profit, non-partisan organization that promotes optimal health for every person and community and makes the prevention of illness and injury a national priority. Twitter: @HealthyAmerica1