Prevention and Public Health Policy Archives - Page 11 of 19

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:

http://georgiashape.org/

(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 20^th 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

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.”

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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

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.”

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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.

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.”

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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. 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

Issue Category: Prevention and Public Health Policy