Prevention and Public Health Policy Archives - Page 11 of 19

TFAH and WBT: The Nation Must Heed Calls for Help, We Must do More to Prevent Deaths of Despair

Washington D.C., and Oakland, Calif., June 14 – In response to new data showing nearly 1 in 3 high school students report persistent feelings of sadness or hopelessness, Benjamin F. Miller, Psy.D., Chief Strategy Officer, Well Being Trust, and John Auerbach, President and CEO, Trust for America’s Health, issued the following statement:

“It is tragic to see the latest indication that deaths of despair are increasing at a rapid rate, but, sadly, it’s not surprising. The drumbeat of data over the past six months supports our recent research suggesting that over the next decade there could be 2 million deaths from drug and alcohol misuse and suicide.

This latest report must lead to action. With tragic news seemingly occurring weekly, these data threaten to desensitize us to this crisis. We know how to stop this. In our Pain in the Nation report, we called for the creation of a National Resilience Strategy that takes a comprehensive approach by focusing on prevention, early identification of issues and effective treatment – and we highlighted more than 60 policies, programs and initiatives that can get us there.

Specifically, to prevent suicides, we must better integrate mental health into primary care, increase access to appropriate and affordable treatment, reduce the conditions that lead people to consider suicide and expand, knit together, and increase funding for:

Crisis intervention services;
Anti-bullying and social-emotional learning in schools;
Support systems for veterans;
Campaigns that normalize mental health conversations;
Programs that teach effective coping, problem solving and parenting skills; and
Suicide risk training for health professionals.

One example that combines a lot of these elements is the Zero Suicide Model, which utilizes a comprehensive approach involving screening, provision of services and a reduction of risk factors. It requires primary care doctors to screen every patient during every visit with two questions: How often have you felt down in the past two weeks? And how often have you felt little pleasure in doing things?

High scores lead to further questions about sleep disturbances, changes in appetite and/or thoughts of hurting oneself. Providers must indicate on each patient’s medical record that they completed the screening – and, when they recognize a mental health problem, assign patients to appropriate care, which could include cognitive behavioral therapy, medication, group counseling or new care models such as same-day psychiatric evaluations, drop-in group therapy visits, and hospitalization, if necessary. Hospital staff are also trained to ensure that patients who need follow-up care do not leave without an appointment, and to conduct follow-up telephone calls. Additionally, providers partner with patients and families to limit access to guns and other lethal means of suicide.

The model, originally adopted by the Henry Ford Health System’s Behavioral Health Services division in 2001, led to an 80 percent reduction in suicide among Henry Ford HMO members -and this reduction continues today even as the overall suicide rate in Michigan and across the country increases.

As a nation, we must do better and we must be better for our neighbors and family. Enough is enough. It’s time to increase investments in programs that prevent suicide and demand that our elected officials – across all levels of government – create and fund policies that will ensure everyone can realize their fullest potential.”

###

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

TFAH Applauds the Introduction of the Bipartisan Pandemic And All-Hazards Preparedness And Advancing Innovation Act—But Improvements Can Be Made

Washington, D.C., May 22, 2018 – The following is a statement from John Auerbach, President and CEO, of Trust for America’s Health (TFAH) on the introduction of the Senate HELP Committee’s Pandemic and All-Hazards Preparedness and Advancing Innovation (PAHPAI) Act:

“We applaud the Senate introduction of the bipartisan Pandemic and All-Hazards Preparedness and Advancing Innovation Act and urge the Senate to pass the bill.

As we mark the 100-year anniversary of the devastating 1918 flu pandemic, it is a stark reminder of how important preparedness is and how far we’ve come.

While we are much better prepared than we were a century — or even 17 years — ago, some important gaps remain. The nation needs to better prepare our healthcare system for disasters and unusual outbreaks and ensure thoughtful planning occurs for community members who could be at higher risk during disasters, such as older adults, children and people with complex health conditions.

And, the nation must be better at moving vaccines and other lifesaving medications from initial research all the way through to dispensing.

The bill also addresses the needs of the public health sector. It would formally integrate public health into decision-making around the medical products in development for major health threats.

The bill also clarifies the role of the U.S. Centers for Disease Control and Prevention (CDC) in preparing public health departments for disasters and gives CDC tools to improve biosurveillance capabilities to detect new threats.

And, taking lessons learned from Ebola cases, the bill helps develop specialized hospitals that are capable of responding to extraordinary outbreaks.

While the bill fills many of the existing gaps, TFAH is concerned that authorized funding levels included in this bill are inadequate compared to the scope of the threat. The devastation that we saw this year due to the hurricanes in Puerto Rico, the U.S. Virgin Islands, Texas and Florida, the wildfires in California and the severe flu season throughout the nation illustrate the importance of creating effective and well-prepared public health and healthcare systems. TFAH is also concerned the bill does not go far enough in creating and funding a standing emergency fund to ensure timely response to major public health threats.

Health security is key to our national security, and we are pleased the Senate bill reflects that fact. We look forward to working with policymakers to ensure PAHPAI is as strong as possible — and we are adequately safeguarding all of our nation’s residents.”

###

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.

New “Pain in the Nation” Issue Brief Focuses on How Healthcare Systems Can Help Address and Prevent Deaths of Despair

Washington, D.C., May 17, 2018 –Trust for America’s Health (TFAH) and Well Being Trust (WBT) released Pain in the Nation: Healthcare Systems Brief, which focuses on how healthcare systems can help address the deaths of despair due to drug and alcohol misuse and suicide.

According to the brief, hospital stays for mental health and/or substance use were the only categories of hospitalizations that increased from 2005 to 2014. Between 2009 and 2014, opioid-related inpatient stays increased 64 percent while emergency department visits doubled—placing hospitals and health systems on the front lines in providing and/or linking patients to behavioral health services and integrating mental health services across systems.

To address these issues, the brief recommends healthcare systems apply a careful systems approach that focuses on preventive interventions, clinical care and behavioral health services—building a “whole health” approach with integrated and linked programs.

The brief follows the release of the national report and projections: Pain in the Nation: The Drug, Alcohol and Suicide Epidemics and the Need for a National Resilience Strategy, which found that, in 2016, 142,000 Americans—one every four minutes—died from the diseases of despair and two additional briefs focused on the education sector and an updated data analysis finding that—while drug overdoses were still highest among Whites in 2016—there were disproportionately large increases in drug deaths among racial/ethnic minority groups.

“Healthcare systems are often in a unique place to bring about clinical change that can impact countless individuals seeking care,” said Benjamin F. Miller, PsyD, Chief Strategy Officer, Well Being Trust. “We need better integration within healthcare so that people seeking help for mental health and addiction can have their needs met in a more seamless and timely fashion. Trying harder is not going to be enough – we need systems level change.”

The Pain in the Nation: Healthcare Systems Brief provides extensive recommendations that will enhance behavioral health services:

Better care integration and coordination—Many providers have never been trained in suicide prevention and lack the confidence to effectively deal with suicide. And, while behavioral health services have long operated in their own silo apart from the traditional medical care systems, systems and providers should continue to shift towards an integrated or “whole health” mentality to ensure coordinated medical and behavioral healthcare services and systems.

Boosting medication-assisted treatment—Enhancing behavioral health services requires ensuring providers are employing up-to-date treatments that have been proven clinically effective, notably medication-assisted treatment (MAT)—the use of FDA-approved medications in combination with therapy to treat substance use disorders. In addition to being clinically effective, MAT also makes fiscal sense. A 2015 study found that treatment of opioid dependence with methadone and buprenorphine was associated with $153 to $223 lower total healthcare expenditures per month than behavioral health treatment without MAT.

Improve pain treatment and management practices—Evidenced-based strategies should be used to better address pain. Healthcare providers have a responsibility to ensure they are working with their patients on increasing overall functionality and quality of life in ways that do not leave their patients vulnerable to substance misuse. Healthcare systems should develop practices that require physicians to treat pain responsibly, including: guidelines on appropriate opioid prescribing; training healthcare providers to identify early signs of opioid use disorders; and strengthening prescription drug monitoring programs (PDMP) and other tools to detect misuse.

Foster community partnerships—Prevention efforts are most effective when multiple sectors in a community work together to support prevention and identify at-risk community members to ensure they receive the support and services they need. For example, the Massachusetts General Hospital (MGH) Center for Community Health Improvement created four coalitions focused on take-back programs, naloxone distribution, connections to treatment through recovery coaches, and screening all patients for substance misuse. In one neighborhood, Emergency Medical Services responses for heroin overdoses decreased 62 percent over a seven-year period.

Screening for substance misuse, suicide and mental health issues—Healthcare systems should coordinate with schools and other community partners to implement screening and provide access to treatment for individuals identified as at-risk for substance misuse, suicide or other mental health concerns. Systems also play a role in supporting evidence-based primary prevention efforts in their community—including social-emotional learning programs.

Reduce access to lethal suicide means—Healthcare systems can encourage providers to counsel patients to safely store both firearms and medications. One method, the Counseling on Access to Lethal Means (CALM) at Children’s Hospital Colorado, found that parents of children being treated for suicide risk who were educated about safe storage of medications and guns made significant changes in their behavior. Additionally, take back programs can help prevent drug misuse.

Ensuring people have better access to behavioral health providers—A successful behavioral healthcare system requires sufficient providers. Currently, 55 percent of U.S. counties do not have any practicing behavioral health workers and 77 percent report unmet behavioral health needs. While it is incredibly difficult to close this gap, the nation should focus on innovative interventions—including telehealth—to ensure people have better access to the health providers they need to be well.

“By prioritizing prevention, working together and improving behavioral health services, healthcare systems can help mitigate the devastating crises of drug overdoses, alcohol-related fatalities and suicides,” said John Auerbach, president and CEO of TFAH. “Healthcare systems can and should advocate for the policies and resources necessary—both within and beyond the clinical setting—to reduce alcohol, drug and suicide deaths among their patients.”

###

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. 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. www.wellbeingtrust.org. Twitter: @WellBeingTrust

Pain in the Nation

New Report: «state»’s Drug, Alcohol and Suicide Death Rate Could Increase «inc_percent» in Next Decade; «state» Would have «rank_25_upper» Rate in Country

Study Highlights Solutions, Calls for National Resilience Strategy

Washington, D.C., November 21, 2017 – «state»’s drug, alcohol and suicide death rate could increase by «inc_percent» in the next 10 years, according to a new report, Pain in the Nation: The Drug, Alcohol and Suicide Epidemics and the Need for a National Resilience Strategy, released today by the Trust for America’s Health (TFAH) and Well Being Trust (WBT).

«state»’s rate could rise to «rate_25» per 100,000 people from these three causes by 2025 – which would be the «rank_25_lower» – compared to the state’s current rate of «rate_15» per 100,000 (as of 2015), which is the «rank_15_lower».

Nationally, deaths from drugs, alcohol and suicide could account for 1.6 million fatalities over the coming decade (2016 to 2025). This would represent a 60 percent increase compared to the past decade, if recent trends hold, based on an analysis conducted by the Berkeley Research Group (BRG) for this report. From 2006 to 2015, there were 1 million deaths from these three causes.

Nationally, in 2015, there were 127,500 deaths from drugs, alcohol and suicide. The epidemics currently are responsible for 350 deaths per day, 14 per hour and one every four minutes.
According to the report’s projections, this could reach 192,000 per year by 2025 (39.7 deaths per 100,000 in 2015 compared to 55.9 per 100,000 in 2025).
At a state level, in 2005, 21 states and Washington, D.C. had death rates from these three causes above 30 per 100,000, and only six states had death rates above 40 per 100,000.
As of 2015, 48 states and Washington, D.C. had rates above 30 per 100,000, 30 were above 40 per 100,000 and five states had rates above 60 per 100,000, including New Mexico which had the highest rate of 77.4 per 100,000.
By 2025, 26 states could reach 60 deaths per 100,000 – and two states (New Mexico and West Virginia) could reach rates of 100 deaths per 100,000.

The study found, however, that these numbers may be conservative, especially with the rapid rise of heroin, fentanyl and carfentanil use. If the nation continues along recent trajectories, death rates would actually double to 2 million by 2025.

“These numbers are staggering, tragic – and preventable,” said John Auerbach, president and CEO of TFAH. “There is a serious crisis across the nation and solutions must go way beyond reducing the supply of opioids, other drugs and alcohol. Greater steps – that promote prevention, resiliency and opportunity – must be taken to address the underlying issues of pain, hopelessness and despair.

Current Nationwide Trends

Drug overdose deaths tripled between 2000 and 2015 (with a total of 52,400 deaths in 2015), with rural community opioid-related death rates increasing seven-fold. Provisional data shows drug overdoses could exceed 64,000 in 2016, with fentanyl deaths alone accounting for 21,000 of these deaths (and fentanyl-related deaths doubling between 2015 and 2016).«state»’s drug overdose death rate was «deaths_drug» per 100,000 in 2015, which ranked «rank_drug».
Alcohol-induced deaths increased 37 percent between 2000 and 2015, reaching a 35-year high at 33,200 deaths in 2015. This excludes alcohol-attributable deaths related to injury and violence.«state»’s alcohol-induced death rate was «deaths_alcohol» per 100,000 in 2015, which ranked «rank_alcohol».
Suicide deaths increased by 28 percent between 2000 and 2015 to more than 44,000 deaths (as of 2015). Rural suicide rates are 40 percent higher than in metro areas.«state»’s suicide death rate was «deaths_suicide» per 100,000 in 2015, which ranked «rank_suicide».
As of 2015, more than 43 million Americans experienced a mental health issue, more than 20 million had a substance use disorder and more than 8 million experienced both – and these numbers are likely to be underestimates due to stigma and lack of available treatment; and
Only around one in 10 people with substance use disorders receive recommended treatment.

Report Calls for a National Resilience Strategy

“We’re facing a generational crisis. And it calls for bigger and bolder action. Simply creating new programs to address one piece of the problem is insufficient – we need more robust and systematic change. The good news is: we know a lot about what works and can make a difference,” said Benjamin F. Miller, PsyD, Chief Policy Officer, Well Being Trust. “This report highlights the need for investments that take a whole-person approach to wellbeing – encompassing the physical, mental, emotional and spiritual aspects of wellbeing – to truly address the drivers of pain, ultimately saving lives.”

Pain in the Nation calls for the creation of a National Resilience Strategy that takes a comprehensive approach by focusing on prevention, early identification of issues and effective treatment. The report highlights more than 60 research-based policies, practices and programs to reduce substance misuse and suicide and improve well-being.

Example State Policies and Rates: The report features more than 60 policies – the following are some example policies where state activity can be tracked	«state»	National Trends
A “Y” means the state has a particular policy
State Law Requires Prescribers to Query the Prescription Drug Monitoring Program (PDMP) Before Submitting an Opioid Prescription (as of 2017)	«policy_pdmp»	37 States
State Law Allows Laypersons to Possess Naloxone Without a Prescription (as of 2017)	«policy_possession»	14 States + D.C.
State Has a Good Samaritan Law Protecting People from Reporting/Experiencing an Overdose from Liability (as of 2017)	«policy_samaritan»	40 States + D.C.
State Has a Law Supporting Sterile Syringe Access Programs (as of 2016)	«policy_syringe»	24 States + D.C.
State Has a Commercial Host Liability Law (also known as dram shop laws, which hold a seller responsible for providing alcohol to minors or intoxicated individuals, laws vary in terms of levels and types of allowed liability) (as of 2016)	«policy_commercial_host»	37 States + D.C.
State Has a Comprehensive Anti-Bullying Laws (all states have some form of law, American Academy of Pediatrics reviewed laws for comprehensiveness) (as of July 2017)	«policy_anti_bullying»	22 States
State Requires Annual Suicide Prevention Training for School Personnel (as of 2016)	«policy_suicide_prevention»	9 States
Number of Physicians in the State Certified to Provide Buprenorphine (Medication-Assisted) Treatment to 100 or more patients (as of October 2017)	«policy_buprenorphine»	1,297 Physicians Nationwide
Children Confirmed as Victims of Maltreatment by Child Welfare Services – Rate Per 1,000 Children. (as of 2015)	«policy_maltreatment_rate»	9 per 1,000
State Has an Earned Income Tax Credit (which supports better outcomes for low-income families, including boosting millions of families out of poverty) (as of 2016)	«policy_eitc»	26 States + D.C.

Some key recommendations from the report include to:

Improve Pain Management and Treatment by helping people heal physically, mentally and emotionally. Approaches must acknowledge that there are different types of pain and experts from mental health, medical care and other disciplines must develop team-based solutions that focus on proactively addressing pain before it gets worse.
Stem the Opioid Crisis with a full-scale approach – including promoting responsible opioid prescribing practices (such as provider education and best practices for Prescription Drug Monitoring Programs); public education about misuse and safe disposal of unused drugs; “hotspot” intervention strategies; anti-trafficking to stop the flow of heroin, fentanyl and other illicit drugs; and expanding the use and availability of rescue drugs, sterile syringes and diversion programs.
Address the Impact of the Opioid Epidemic on Children – and the Need for a Multi-Generational Response that includes substance use disorder treatment for parents and wrap-around services for children and families, including grandparents and other relatives who help care for children, and expand support for the foster care system.Model programs for families struggling with opioid and other substance misuse disorders have been twice as effective in helping mothers achieve sobriety, reduced state custody placement of children by half and had a return on investment of $2.22 for every $1 spent on child welfare programs.
Lower Excessive Alcohol Use through evidence-based policies, such as by increasing pricing, limiting hours and density of alcohol sales, enforcing underage drinking laws and holding sellers and hosts liable for serving minors.For example, a 10 percent increase in the price of alcoholic beverages is shown to reduce consumption by 7.7 percent.
Prevent Suicides by expanding crisis intervention services; anti-bullying and social-emotional learning in schools; and support systems for Veterans; and better integrating mental health into primary care.For instance, the Zero Suicide model program has shown 80 percent reductions in suicides.
Expand and Modernize Mental Health and Substance Use Disorder Treatment Services – Toward a Goal of Focusing on the “Whole Health” of Individuals by prioritizing innovative integrated delivery models for rural and underserved urban areas and expanding the provider workforce, including those who can deliver medication-assisted treatment.Some effective substance use treatment programs have a return of $3.77 per $1 invested.
Prioritize Prevention, Reduce Risk Factors and Promote Resilience in Children, Families and Communities by limiting trauma and adverse experiences, which have the biggest long-term impact on later substance misuse, and promoting better mental health.For instance, nurse family home visiting programs have a return of $5.70 for every $1 invested, and early childhood education programs have a $4 to $12 return for every $1 invested.
Reboot Substance Misuse Prevention and Mental Health in Schools by scaling up evidence-based life- and coping-skills programs and inclusive school environments and increasing the availability of mental health and other services.Top school substance misuse prevention programs have a $3.80 to $34 return for every $1 invested; social-emotional learning programs have an $11 for $1 return; and school violence prevention (including suicide) programs have a $15 to $81 for $1 return.

The report was supported by grants from WBT and the Robert Wood Johnson Foundation (RWJF). Data analysis and projections were provided by the Berkeley Research Group. The full report is available on TFAH’s website at www.healthyamericans.org.

2015 STATE-BY-STATE DRUG, ALCOHOL AND SUICIDE DEATH RATES AND 2025 PROJECTIONS

Based on an analysis of new state-by-state data from the Centers for Disease Control and Prevention’s Wide-ranging ONline Data for Epidemiologic Research (CDC WONDER), current (2015) and projected (2025) rates of deaths per 100,000 people from drugs, alcohol and suicide from highest to lowest were:

Note: 1 = Highest rate, 51 = lowest.

2025 PROJECTIONS, STATE-BY-STATE DRUG, ALCOHOL AND SUICIDE DEATH RATES

1. New Mexico (105.7); 2. West Virginia (99.6); 3. Wyoming (88.8); 4. New Hampshire (88.1); 5. Alaska (84.4); 6. Kentucky (81.3); 7. Rhode Island (79.7); 8. Arizona (75.8); 9. Montana (75.6); 10. Nevada (75.0); 11. Ohio (74.6); 12. Oregon (72.8); 13. Maine (71.5); 14. (tie) Oklahoma (70.0) and Utah (70.0); (tie) 16. Colorado (67.8) and Tennessee (67.8); 18. Pennsylvania (67.7); 19. Massachusetts (66.6); 20. Michigan (65.9); 21. Vermont (65.8); 22. Idaho (63.4); 23. Washington (63.3); 24. Connecticut (61.2); 25. Indiana (61.0); 26. Delaware (60.4); 27. Florida (59.6); 28. (tie) Louisiana (58.5) and Missouri (58.5); 30. South Dakota (57.4); 31. Wisconsin (55.5); 32. South Carolina (55.4); 33. Arkansas (54.2); 34. North Carolina (53.1); 35. (tie) District of Columbia (52.2) and Maryland (52.2); 37. Alabama (51.9); 38. Kansas (49); 39. California (48.9); 40. North Dakota (47.4); 41. Minnesota (47.3); 42. Iowa (46); 43. Virginia (44.9); 44. Georgia (44.6); 45. (tie) Illinois (44.4) and 45. New Jersey (44.4); 47. (tie) Hawaii (43.3) and New York (43.3); 49. Mississippi (42.8); 50. Texas (38.9); 51. Nebraska (37.7).

2015 STATE-BY-STATE DRUG, ALCOHOL AND SUICIDE DEATH RATES

1. New Mexico (77.4); 2. West Virginia (67.4); 3. Wyoming (66.4); 4. Alaska (63); 5. New Hampshire (60.6); 6. Montana (56.7); 7. Kentucky (56.1); 8. Arizona (55); 9. Rhode Island (54.5); 10. Oregon (54); 11. Nevada (53.8); 12. Maine (51.1); 13. Ohio (50.8); 14. Oklahoma (50.5); 15. (tie) Colorado (49.7) and Utah (49.7); 17. Vermont (47.6); 18. Tennessee (47.3); 19. Idaho (47.1); 20. Pennsylvania (46.3); 21. Washington (45.9); 22. Michigan (45.8); 23. Massachusetts (44.9); 24. South Dakota (43.8); 25. Indiana (43); 26. Florida (42.9); 27. (tie) Connecticut (41.9) and Delaware (41.9); 29. Missouri (41.7); 30. Louisiana (41.2); 31. Wisconsin (39.9); 32. South Carolina (39.7); 33. Arkansas (39.5); 34. North Carolina (37.7); 35. Alabama (36.8); 36. Kansas (36); 37. (tie) District of Columbia (35.7) and North Dakota (35.7); 39. California (35.4); 40. Maryland (35.1); 41. Minnesota (34.5); 42. Iowa (33.9); 43. Virginia (32.3); 44. Georgia (31.9); 45. Illinois (31.3); 46. Hawaii (31.2); 47. Mississippi (30.9); 48. New Jersey (30.5); 49. New York (30); 50. Texas (28.4); 51. Nebraska (28.2).

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. For more information, visit www.healthyamericans.org. 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. www.wellbeingtrust.org. Twitter: @WellBeingTrust

Pain in the Nation: Education Brief

Prevention and Public Health Policy

Health and well-being involve more than treating illness. Fostering optimal health means understanding the factors that lead to both illness and health. A modern public health system serves as a community’s chief health strategist. Such a system uses the best available evidence to inform strategies, policies and programs to improve and protect the health and well-being of the communities it serves.

TFAH’s mission is to report on and help amplify evidence-based programs and policies that promote healthy behaviors and support conditions in communities, schools and workplaces that foster health and well-being. Our work is designed to advance a national public health system that supports optimal health for every person and community, resolves health disparities and is centered on prevention.

Pain in the Nation Update: Deaths from Alcohol, Drugs and Suicide Reach the Highest Level Ever Recorded

Building a Community Roadmap to Health and Equity in Jackson, Mississippi

By Beneta D. Burt, Executive Director, Mississippi Roadmap to Health Equity

The Mississippi Roadmap to Health Equity, a community-run organization that seeks to generate and mobilize resources, utilizes our expertise to improve how community institutions operate and, at the same time, protect and promote the health of community members.

By working with everyday institutions that touch everyone’s life, we can advocate for changes that are good for the bottom line and promote better health equity in Jackson. By building important relationships, we can ensure community institutions support the community’s efforts to be healthy—and are true partners in making the healthy choice the easy choice.

How we started

With primary support from the W.K. Kellogg Foundation, Mississippi Roadmap’s work began in 2003 with a series of sessions aimed at addressing why African-Americans are sicker and die sooner than their peers.

Through concept mapping, we identified the many factors that contribute to poor health. And, just one year later, nearly 200 community residents, members of the Mississippi Roadmap Community Steering Committee (CSC) and National Advisory Board members created ideas to improve community health outcomes. Participants laid out a “roadmap” for a healthy present and an even healthier future, especially for the economically-disadvantaged citizens of Jackson. While the state of affairs regarding the health of African-Americans was central to the purpose of the conference, the overall goal was to develop a community-driven health movement that fostered equity, justice and respect for all people.

Initially we set out to improve access to fresh and affordable produce and safe and affordable places for people to exercise – there were simply no grocery stores or farmers’ markets in the area and no price-conscious fitness centers.

To solve these problems, we re-purposed a shuttered grocery store to include:

A state-of-the-art adult fitness center;
An indoor farmers’ market;
A children’ fitness area that accommodates pre-school through teens;
Space for healthy cooking classes, in partnership with dietitians from The University of Mississippi Medical Center;
A venue for senior citizens to congregate;
An affordable rental facility for community events and a venue to convene community conversations; and
A Technology Learning Lab that serves 4^th and 5^th grade students who participate in our afterschool program.

Additionally—in an effort to promote healthy eating habits, to demonstrate to city kids where good food comes from, and to encourage them to eat more fruits and vegetables—we developed 15 garden-based projects in elementary/middle schools in the Mississippi Delta, in Jackson, and on the Gulf Coast.

How we do it

A Community Steering Committee guides our work. An executive director, together with a staff of six, provides day-to-day management. CSC members each have their own “community constituents” who they work with and/or advocate for. These community constituents range from neighborhood associations to church groups to social justice and advocacy organizations—they run the full gamut of the community.

The diversity of ages, backgrounds, interests, professions, and community connections of the CSC members provide access to the pulse of each segment of Jackson and provides a voice for their issues, ideas, needs and concerns.

Going Forward

We are scaling up our work to focus even more on promoting the health and well-being of children by creating job training programs targeted to non-college bound high school graduates and other out of- school youth.

To do so, we began the process of becoming an affiliate of the National Urban League—this vital partnership, which was fully formed in February 2018, will promote employment equity.

Unemployment among teenagers and young adults are major issues in Jackson, especially during the summer, while unemployment among out-of-school youth is equally concerning. In 2016, approximately 600 Jackson high school graduates did not attend college and most had no plans or employment prospects.

In an effort to close this gap, Roadmap entered into a Memorandum of Understanding (MOU) with the City of Jackson in to acquire a city-owned, soon-to-be-shuttered golf course and club house that we will now use to develop a job training program in golf course management designed to develop landscaping-related employment opportunities.

Out-of-school youth will be recruited during the course of the year and enrolled in a GED program provided by Hinds Community College prior to enrolling in the job training program. We will incentivize participant training to encourage consistent attendance and attainment of GEDs prior to transitioning to the program. Additionally, a job developer will work with non-college bound high school seniors in March of each year to prepare them for entering the training program.

Upon completion of classroom and on-the-job training activities, and with Roadmap’s oversight, some participants will bid on landscaping management contracts with local public school districts. Successful bids will result in permanent, unsubsidized employment for participants.

To leverage these relationships and also improve physical fitness, golf pros will develop a program for integration into the curriculum of the local elementary school, which is located next to the golf course. And, a concurrent physical fitness program will be incorporated into the program. Eventually, we hope these plans and resources can benefit the health of the entire community.

Partnerships are Vital

Any measure of success that we have achieved can be attributed to the long-term support from the W. K. Kellogg Foundation, and to the large group of public and private sector members whose actions demonstrate that community partnerships play an integral part in achieving improved health outcomes. We have the good fortune to have local chefs, hospitals and health professionals, church ministries, and community-academic partners involved.

Just one partnership example: we are the grant recipient in partnership with the Mississippi State Department of Health and the University of Mississippi Medical Center (UMMC). For this grant, the Department of Health provides staff resources and UMMC provides the required match for the project, which allows us to create a culture of breastfeeding among young women in Jackson.

Leading Public Health Groups: Using the Prevention Fund to help fund CHIP: A Serious Mistake

Statement from Trust for America’s Health, American Public Health Association, National Association of County and City Health Officials, Prevention Institute, and Public Health Institute

December 22, 2017

Washington, D.C., December 22, 2017 –It is a serious mistake to cut $750 million from the Prevention and Public Health Fund to provide very short-term funding for the Children’s Health Insurance Program (CHIP) and community health centers. The below is a statement from the American Public Health Association, National Association of County and City Health Officials, Prevention Institute, Public Health Institute, and Trust for America’s Health:

“The Prevention Fund supports critical public health activities—including lead poisoning surveillance, vaccination initiatives and other programs—in every state and community across the country. Cutting this significant funding source would leave communities without the vital resources needed to keep children and families happy, healthy and safe.

It is even more alarming and contradictory that this cut will be used to provide very short-term funding for CHIP and community health centers. Our organizations are united in support of CHIP and community health centers, which are vital to improving children’s health. But losing the Prevention Fund would just create another hole in the public health support children need.

The Prevention Fund is supported strongly by national, state and local groups alike—indeed to-date 1,142 have joined the Prevention Fund supporter’s list. They know the value of the $630 million annually that goes directly to states and communities to prevent illness and disease.

A strong public health system makes the difference between health and illness, safety and injury, life and death.

We urge Congress to oppose any and all future cuts to the Prevention Fund and to begin the long-overdue process of increasing support to CHIP, community health centers, CDC and other public health agencies so today’s children can be our healthiest and happiest generation.”

John Auerbach, President & CEO, Trust for America’s Health

Georges C. Benjamin, MD, Executive Director, American Public Health Association

Larry Cohen, Executive Director, Prevention Institute

Laura Hanen, MPP, Interim Executive Director and Chief of Government Affairs, National Association of County and City Health Officials

Mary A. Pittman, President & CEO, Public Health Institute

###

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

The American Public Health Association 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 that combines a 145-year perspective, a broad-based member community and the ability to influence federal policy to improve the public’s health. Visit us at www.apha.org.

The National Association of County and City Health Officials (NACCHO) represents the nation’s nearly 3,000 local governmental health departments. These city, county, metropolitan, district, and tribal departments work every day to protect and promote health and well-being for all people in their communities. For more information about NACCHO, please visit www.naccho.org.

The Public Health Institute, an independent nonprofit organization, is dedicated to promoting health, well-being and quality of life for people throughout California, across the nation and around the world.

Prevention Institute is an Oakland, California-based nonprofit research, policy, and action center that works nationally to promote prevention, health, and equity by fostering community and policy change so that all people live in healthy, safe environments.

Mental Health is Vital to Preparedness and Response

By Dr. Octavio N. Martinez, Jr., MD, MPH, MBA, FAPA, Executive Director, the Hogg Foundation for Mental Health at The University of Texas at Austin

This story was published in Ready or Not: Protecting the Public’s Health from Diseases, Disasters and Bioterrorism.

The health effects from a public health emergency go way beyond the physical, taking an enormous mental toll in the immediate aftermath and the years following—and often can harm our children the most.

We must do more to know how to ensure mental health and physical health go hand-in-hand in response planning and efforts. We must also do a far better job of increasing our mental health workforce and ensuring and increasing access to mental health services both during and after an emergency.

Using Data to Plan for Maintaining Access to Mental Health Services

To prepare for any type of emergency, communities must be aware of vulnerable populations—typically children, the elderly and those who have an underlying medical condition or are mentally ill. We have gotten better at identifying where groups of these populations live.

And, we should also be able to access databases to predict what portion of a certain population might have substance use disorders, for example—and then understand what kind of continued treatment and medication are needed and where they might best be distributed.

Paired with this, we should be able to identify geographically which communities will have the hardest time bouncing back from an emergency and will need more resources.

While some neighborhoods might have good infrastructure and better access to transportation and physical and mental health services, others will struggle. The neighborhoods that will struggle should be identified in advance and plans created to help them. And, we can create plans based on any number of scenarios: fires, floods, wind damage, loss of power, etc. If you combine all the knowledge and data together, you can then coordinate resources and everyone has a chance to be healthy.

Long-term Strategies to Improve Responses to Emergencies

We also must acknowledge that human connections are incredibly important. In-between disasters, preparedness work should focus on strengthening families and communities so they are resilient enough to weather an emergency.

For example, after Hurricane Katrina, New Orleans developed community leaders specifically focused on mental wellness, resilience and recovery. The gains in improved access to care and lessened stigma were noticeable—and these should help ensure responders and communities can work together to forge a better response during the next emergency.

While this is by no means a quick fix, taking a long-term approach to emergency preparedness and community health will pay dividends in improved health of the entire population. We should bring this research to other cities and communities that will likely face similar events.

Additionally, psychological effects can take years to manifest and get under control—especially if there isn’t access to mental health services. We learned from Hurricanes Katrina and Sandy that PTSD and suicidal ideation increased dramatically after these events. However, if we were able to step in earlier and connect individuals with mental health professionals, it’s likely these issues and potentially other health issues (substance use disorders, increased anxiety, depression, etc.) could have been prevented or lessened.

Further, while we are getting better at recognizing that mental health is a key component to physical health, the workforce in this area is inadequate—and we’ve known this for a while, especially as the opioid epidemic has continued. By increasing our workforce and ensure they have the right skill sets; we could help tackle the opioid epidemic and better prepare our communities to bounce back from a disaster.

Additional Research is Needed

The devil is often in the details and coordination among the various federal, state and local agencies, organizations and others must be improved. To do so, the nation has to prioritize funding into research and assessments post emergencies—so we can truly understand how these events affect the mental health and stability of a community at a population level.

While the National Institutes of Health has a Disaster Research Response Project, it needs to better include measures on mental health and substance use disorders. We must take each disaster as a learning opportunity that can prepare us for the next one and enable us to save more lives. Increasing research would also help build a network of behavioral health disaster experts.

First Responders

Our first responders and volunteers must be trained to identify and assist people who exhibit psychiatric symptoms, i.e., in “psychological first aid.” And, going beyond this training, we know that mental health must be better integrated with the traditional health services.

Responders and volunteers must also be cared for—they are at risk for suffering secondary psychiatric distress themselves. We need better ways to monitor them during but also after the crisis to ensure they are receiving the appropriate interventions and care.

Part of the solution is increased mental health providers, which would serve many roles: keeping our first responders in good shape, filling gaps in mental health services and, by increasing access to care, hopefully preventing someone from developing a serious and chronic mental health illness.

Quite simply, if we intentionally make mental health part of our preparedness and response systems it will have untold benefits for communities before, during and after an emergency—we will build resiliency and improve well-being.