Issue Category: Public Health Preparedness

Public Health Leaders Make Urgent Joint Call to Protect Prevention and Healthcare

Joint Statement from American Public Health Association, Prevention Institute, Public Health Institute and Trust for America’s Health

June 20, 2017

The fight to protect public health is more important than ever.

The Senate is moving quickly—and secretively—on their version of legislation to repeal the Affordable Care Act (ACA). While we don’t know the content of the bill, we do know that the House-passed repeal bill—the American Health Care Act—would cause over 23 million people to lose their healthcare, restructure Medicaid, pare down essential benefits like maternity and newborn care, result in the loss of over a million American jobs, and zero out the Prevention and Public Health Fund. As leaders of organizations dedicated to protecting and advancing the public’s health, we call on Congress now to protect federal investments in public health funding, the Prevention and Public Health Fund, and affordable, high-quality healthcare.

Public health is at the very core of keeping our country safe, healthy, resilient, and secure. It works behind the scenes to ensure we have clean water to drink, safe food to eat, and healthy air to breathe. It works to safeguard us from infectious diseases like measles or Ebola by preventing the onset or spread of disease. It builds on time tested strategies to reduce the toll of chronic diseases and injuries. Public health works to redress long-standing inequities in health and safety, by investing in communities of greatest need. Through prevention, evidence-based treatment of substance use, prescription drug monitoring, and improved opioid prescribing, public health can solve the opioid epidemic, which kills ninety-one Americans a day. From opioid overdoses to rising infant and maternal mortality rates, Americans are seeing both the length and quality of their lives decline—and we need more, not fewer, investments in public health to turn the tide.

Repealing the ACA and its investments in public health and prevention dismantles the capacity of public health to do its work. The pain will be felt in every state, every congressional district, and every neighborhood, and those who are most vulnerable will suffer the most. If the Prevention Fund is eliminated, over the next five years states stand to lose over $3 billion they rely on to prevent chronic disease, halt the spread of infections, and invest in the community resources that support health and safety. Repealing the ACA and the Prevention Fund ensures there is no progress to reduce healthcare spending or improve the health of our workforce. Repealing the ACA will result in an America where preventable suffering and death are more widespread, and an America where the poorest and sickest communities fall even farther behind.

A strong public health infrastructure is at the very core of making our country safe, healthy, and secure. We need to act now to protect it.

The President’s FY 2018 Budget Proposal Would be Perilous for the Nation’s Health

Washington, D.C., May 23, 2017 – The below is a statement from John Auerbach, president and CEO, of Trust for America’s Health (TFAH) on the President’s Fiscal Year (FY) 2018 proposed budget announcement.

“The proposed $1.2 billion cut to the Centers for Disease Control and Prevention (CDC) would be perilous for the health of the American people.

From Ebola to Zika to opioid misuse to diabetes to heart disease, the CDC is on the frontlines keeping Americans healthy. Cutting nearly 20 percent of the CDC’s Chronic Disease Prevention and Health Promotion center’s budget would be disastrous.

Enormous cuts are also proposed throughout the rest of the agency including to programs that protect the American people from infectious diseases, environmental contaminants, exposure to tobacco and much more. If these budget cuts were to occur, they would cripple CDC’s operations and result in increased illnesses, injuries and preventable deaths.

CDC has already lost more than $580 million in funding since 2010 – and the proposed American Healthcare Act would, in FY 2019, repeal the Prevention and Public Health Fund, which supplies 12 percent of CDC’s budget—of which more than $620 million goes yearly to states.

Even now, with a relatively stable FY 2017 budget, CDC is operating with nearly 700 vacancies and will function with diminished resources once the Zika emergency supplemental funding runs out.

As such, this unprecedented and dramatic cut would have unparalleled and drastic consequences for our nation’s health and would likely lead to staggering increases in our healthcare service costs. It would also create massive holes in state public health funding, as states and local communities rely on the hundreds of millions they receive from CDC every year.

In essence, the proposed budget would force CDC to fight epidemics and health threats with both hands tied behind their back while wearing a blindfold.

We urge the Administration and Congress to work together to ensure CDC is able to protect the American people and help Americans be healthy and thrive.”

 

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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.

House ACA Replacement will Cripple the Nation’s Health, Trust for America’s Health Statement

Washington, D.C., May 4, 2017 – The below is a statement from John Auerbach, president and CEO, of Trust for America’s Health (TFAH).

“As historic as the passage of the Affordable Care Act was, any passage of the American Health Care Act will be just as infamous.

Tens of millions of American citizens will lose coverage. And millions of people on private insurance and Medicaid may lose access to life- and cost-saving clinical preventive services.

In particular, the Meadows-MacArthur Amendment would permit states to eliminate the requirement around essential health benefits (EHBs) and allow for the discrimination of people with pre-existing conditions.

Research tells us time and again two truths: Americans with coverage of preventive services are more likely to access these services and investing in preventive services improves health and reduces costs, yielding massive returns on investment.

Additionally, the agencies responsible for keeping us safe daily from ever-increasing public health threats will have their budgets slashed.

If the bill eventually becomes law, the Centers for Disease Control and Prevention (CDC) will lose 12 percent of its budget, of which a significant portion—$625 million a year—goes directly to state and local health departments.

This is a double whammy to the nation’s health.

Every day, the CDC and local public health departments are on the front lines in preventing disease outbreaks like Zika and Ebola, in protecting our children from lead poisoning, in lowering rates of heart disease, in stopping epidemics like prescription drug misuse and in helping people quit tobacco.

If the bill eventually passes, the results won’t be celebrated—they’ll be infamous.

We will likely see more overdoses and untreated STDs, rises in infant mortality and increases in innumerable other preventable health issues—not to mention mounting healthcare costs. All the while, our most vulnerable—the elderly, children, sick and less advantaged—will be at most risk.

That should not be the result of a health law.

We hope the United States Senate sees the many problems in the legislation.”

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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.

TFAH Statement: Budget Proposes Devastating Cuts for Public Health

Washington, D.C., March 16, 2017 – The below is a statement from John Auerbach, president and CEO, of Trust for America’s Health (TFAH).

“The President’s proposed budget – which includes nearly an 18 percent cut to the Department of Health and Human Services (HHS) – would be devastating to the public health and safety of Americans.  This would constitute an unprecedented harmful blow to the nation’s health.

While there are not sufficient details in the budget blueprint about the impact to HHS agencies, including at the Centers for Disease Control and Prevention (CDC), it is clear that such a big decrease would undercut core health programs that are needed to address any and all health problems.

There is nothing more valuable than the health and vitality of the American people.  To achieve that, we need to maintain a strong and stable public health system.  Such significant cuts would hurt the country’s health system – which is essential for taking on the range of epidemics we face – from major disease outbreaks to diabetes to prescription painkiller misuse.

A few CDC-specific areas referenced in the budget blueprint include:

  • A proposal for a $500 million block grant program for states via CDC.  The proposal does not provide specifics about the program or where the funds would come from, beyond encouraging flexibility for states to focus on their leading public health challenges.  We would raise major concerns that in the past – when funding sources have been combined, they have also been reduced – leaving states with less funding and with less ability to address the health problems of their citizens.  States then end up in a position of having to make tough trade-offs about which health problems they can address.
  • The creation of a Federal Emergency Response Fund.  The document, however, does not provide sufficient information to evaluate what the fund would look like or if there would be new resources to support it, or if support would be diverted at the expense of funding for other programs.  While creating such a fund is important – to allow for access to immediate funds during health emergencies – it is essential that such a fund be supplemental – and not come at the expense or instead of maintaining an ongoing public health security and defense programs.  We need both steady ongoing capabilities – as well as the ability to quickly access emergency supplemental funds in times of crises.
  • 500 million to address the opioid epidemic.  A national commitment to this priority health crisis is important.  However, the budget proposal was unclear as to whether these are new funds, funds that came from passage of the CURES bill or funds diverted from other programs.  In addition to specific funding to address the crisis, it is also essential to maintain and sufficiently support the underlying public health system that any response would build upon.

Proposed cuts to other agencies and programs also threaten to adversely impact the health of Americans.  For instance, the 31 percent proposed cut to the Environmental Protection Agency (EPA) could potentially roll back decades of progress protecting against the health impacts of air and water pollution.  And, stable and secure housing is a major factor for maintaining good health – and the proposed 13 percent cut to the Department of Housing and Urban Development (HUD), including eliminating the Community Development Block Grant program, would contribute to harming the health and stability of numerous vulnerable families.

These cuts would be historically damaging to our nation’s health.  The country is at a crossroads – where we have the knowledge and capability to help Americans have healthier, longer lives – but if we don’t invest and maintain these efforts, we will be taking a turn down the wrong path.  The lives of our families are too valuable, and the stakes are too high to undercut our health and wellbeing.”

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.

 

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TFAH Statement: Strongly Opposed to the House Obamacare Replacement Bill

Washington, D.C., March 7, 2017 – The below is a statement from John Auerbach, president and CEO, of Trust for America’s Health (TFAH).

“We are strongly opposed to the House Obamacare Replacement bill, which would repeal significant portions of the Affordable Care Act (ACA), including the Prevention and Public Health Fund.

Under this plan, millions of people could lose health insurance—a devastating blow to the health of many of our nation’s most vulnerable individuals and families. Without affordable insurance coverage we will see increased levels of preventable illnesses, injuries and deaths.

In addition, eliminating the Prevention Fund would erase 12 percent of the Centers for Disease Control and Prevention’s (CDC) budget. Of that investment, $625 million directly supports state and local public health efforts to fight preventable diseases such as diabetes, heart disease and cancer.

Losing this funding would wreak havoc on our efforts to reduce chronic disease rates, immunize our children, stop the prescription drug and opioid epidemic and prepare the public health system to prevent infectious disease outbreaks.

We know how to prevent many chronic and infectious illnesses—which make up a significant portion of the $3 trillion the nation spends yearly on healthcare.  If we lose access to health care coverage and to the Prevention Fund, our children, families and communities will suffer and ultimately costs will rise.

The bottom line? This Bill would make untold numbers of the American people less healthy.”

 

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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.

TFAH Statement on the Draft House Republican Obamacare Replacement Bill: Our Nation’s Health Will Suffer

Washington, D.C., February 24, 2017 – The below is a statement from John Auerbach, president and CEO, of Trust for America’s Health (TFAH).

“The draft House Republican Obamacare replacement bill—which would eliminate the Prevention and Public Health Fund—would threaten the health of American children, families and communities.

Thanks to the Prevention Fund, hundreds of thousands of Americans benefit from increased access to vaccines and other preventive health services. Quite simply, more people are getting and remaining healthy because of the Prevention Fund.

Yet, the proposed replacement bill would eliminate this important Fund and 12 percent of the U.S. Centers for Disease Control and Prevention’s (CDC) budget along with it.

And, without the Prevention Fund, states will lose substantial sums of money—totaling as much as $3 billion over the next 5 years—which fight growing epidemics and emerging diseases.

Every year, we spend $3 trillion on healthcare, yet millions suffer from chronic diseases and death rates among Blacks and other people of color remain too high. At the same time, death rates among white middle-aged Americans increased for the first time in decades, mainly due to preventable conditions.

Time and again research shows that the vast majority of these conditions—heart disease, diabetes and others—can be prevented by investing in addressing the root causes. Yet, the country has repeatedly failed to do so.

The nation cannot afford to trade away our single best investment in preventing disease, preparing for and responding to infectious disease outbreaks, reducing rates of chronic illness, and saving lives and money.

If this draft becomes law, our nation’s health will suffer—and it will be exponentially harder to fight growing epidemics, like the rise in prescription drug and heroin overdoses.”

 

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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.

CDC to Lose More than $5 Billion, States to Lose More than $3 Billion to Fight Health Epidemics over Five Years, if the ACA and Prevention and Public Health Fund are Repealed

Washington, D.C., January 17, 2017 – The U.S. Centers for Disease Control and Prevention (CDC) would lose 12 percent of its annual budget if the Prevention and Public Health Fund, part of the Affordable Care Act (ACA), were repealed, according to an analysis by the Trust for America’s Health (TFAH).

States would end up losing more than $3 billion over the next five years – from grants and programs supported by the Prevention Fund.

“CDC is the world’s leading public health authority and the front line against major threats to the health and well-being of the American people—such as disease outbreaks, prescription drug  misuse and diabetes,” said John Auerbach, President and CEO of TFAH. “Losing the Prevention Fund would result in diminished support for public health in every state, undermining their ability to fight epidemics and keep people safe. The costs of these vital public health efforts will either be passed along to states or the efforts will be eliminated—resulting in more people becoming sick and higher healthcare costs.”

The $890 million gap in CDC’s annual funding created by eliminating the Prevention Fund could not be filled under current laws without drawing funds away from other Department of Labor, Education and Health and Human Services programs. Among activities supported directly by the Prevention Fund are grants to states for infectious disease control, resources through the Preventive Health and Health Services Block Grant and other core public health programs which, if cut, would increase illness, injuries and preventable deaths.

If the Prevention Fund is eliminated, the impact will be felt at the local, state and federal levels as public health organizations respond to several major health crises that are on the rise, such as:

  • Health Security Funds for Disease Outbreaks, Disasters and Bioterrorism:  With the exception of the one-time-only funding for Ebola and Zika, the core funding for preparedness and response to health emergencies has been cut by more than one-third in the past decade. CDC has responded to more than 750 health emergencies in the past two years. Infectious diseases cost the country more than $120 billion per year, and that cost grows exponentially when major new diseases strike.
  • Prescription Painkiller and Heroin Use: Deaths from opioids have more than quadrupled in the past 15 years. Nationally, more than 2 million Americans misuse prescription drugs, and nearly a half million are addicted to heroin, costing the country more than $55 billion a year in healthcare, workplace and criminal justice spending. CDC plays a critical role by providing support to states and healthcare providers to monitor and control the inappropriate prescribing of opioids.
  • Obesity and Diabetes: Nearly 38 percent of adults are obese and more than one-third of children are overweight or obese, contributing to more than $200 billion in direct health costs. One in three children could develop diabetes in their lifetime, and one in four are not healthy enough to serve in the military by the ages of 17 to 24.
  • Declining Life Expectancy:  Life expectancy in the United States has declined for the first time in two decades. While death rates are higher among Blacks and other people of color, death rates have increased the fastest (by 10 percent since 1999) among middle-aged White men and women (ages 45 to 54). Increasing death rates among middle-aged Whites are the highest in West Virginia, Mississippi, Oklahoma, Tennessee, Kentucky, Alabama and Arkansas. Amounts each state stands to lose over the next 5 years if the Prevention Fund was repealed (based on fiscal year 2016 grants to state)

State

Potential Five Year PPHF Loss, Based on FY 2016 Funding

Alabama

$44,867,115

Alaska

$22,312,985

Arizona

$46,840,075

Arkansas

$29,599,945

California

$307,768,530

Colorado

$44,671,845

Connecticut

$36,728,860

Delaware

$12,462,820

District of Columbia

$51,533,080

Florida

$101,864,250

Georgia

$100,421,755

Hawaii

$40,025,880

Idaho

$22,428,585

Illinois

$93,084,850

Indiana

$41,381,450

Iowa

$35,630,210

Kansas

$45,329,065

Kentucky

$40,687,570

Louisiana

$45,111,030

Maine

$27,588,000

Maryland

$84,876,045

Massachusetts

$88,112,505

Michigan

$110,739,075

Minnesota

$80,759,870

Mississippi

$31,276,855

Missouri

$53,853,865

Montana

$24,831,145

Nebraska

$47,957,625

Nevada

$19,174,580

New Hampshire

$24,967,020

New Jersey

$60,558,365

New Mexico

$43,257,135

New York

$207,587,230

North Carolina

$85,917,320

North Dakota

$14,975,550

Ohio

$114,951,125

Oklahoma

$46,585,755

Oregon

$46,462,400

Pennsylvania

$111,991,355

Rhode Island

$40,238,960

South Carolina

$56,576,525

South Dakota

$18,732,825

Tennessee

$67,537,910

Texas

$147,214,850

Utah

$49,396,510

Vermont

$14,637,565

Virginia

$77,104,520

Washington

$70,060,890

West Virginia

$22,669,320

Wisconsin

$64,120,145

Wyoming

$11,024,970

 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. 

Survey Finds 73 Percent Support Investments to Improve Health; Obesity, Future Health of Children Top Concerns

Washington, D.C., January 19, 2017 —A new national survey of registered voters has found that nearly three-quarters (73 percent) of Americans support increasing investments to improve the health of communities.  Support spans across party lines (57 percent of Republicans, 87 percent of Democrats and 70 percent of Independents) and regionally across the country (75 percent in the Northeast, 71 percent in the Central U.S., 72 percent in the South, and 75 percent in the West).  Women are the strongest proponents of supporting health improvement efforts (62 percent of Republican women, 87 percent of Democratic women and 80 percent of Independent women).

The survey, released today by the Robert Wood Johnson Foundation and the Trust for America’s Health, was conducted by Greenberg Quinlan Rosner Research, in consultation with Bellweather Research, on September 8-9, 2016 of a nationwide sample of 1302 registered voters across the country.

A majority (51 percent) believe that today’s children will be less healthy than previous generations when they reach adulthood.  The groups who hold this belief most strongly include: Republicans (55 percent); rural residents (60 percent); Southerners (57 percent); Independent women (62 percent); and Black women (68 percent).  Most registered voters with children under age 18, however, believe their own children are very healthy (92 percent give an 8-10 rating on a 10-point scale); this is the case for parents of all ideologies, incomes, education levels, and ethnicities.

Additionally, 64 percent believe that the number of health issues facing the country has grown in recent years. Obesity is the top health concern (41 percent), cancer ranked second (33 percent), followed by heart disease and stroke (14 percent) and diabetes and substance misuse (both at 11 percent).

Americans also rate their own health better than the health of the community where they live (66 percent rate their own health as 8-10 (very good) on a 10 point scale, but only 36 percent rank their community’s health as very good).  There are differences based on income, age, education and area of the country on how people rank their health.  For instance:

  • 73 percent of college-educated Whites rank their health as very good compared to 57 percent of Whites without college degrees; and
  • 72 percent of individuals with a household income above $50,000 per year rank their health as very good compared to 59 percent of those with incomes below $50,000.

A majority of American registered voters also strongly support (rating 8-10 out of a 10 point scale) a range of priorities and strategies for improving health, including:

  • 74 percent of people highly support providing enough time — during the school day and afterschool – for kids’ physical education, physical activity or community sports;
  • 74 percent also highly support creating partnerships among farmers, food suppliers and community health groups to bring fresh produce trucks or mobile markets to communities that lack access to grocery stores;
  • 65 percent highly support providing kids with more information on making healthy food choices and being physically active;
  • 63 percent highly support investing more in preventing obesity and chronic diseases like heart disease, diabetes and stroke;
  • 62 percent highly support increasing early childhood health programs, including home visit programs, mobile health screenings and treatment for diseases like asthma;
  • 61 percent highly support investing more in preventing the spread of infectious diseases like the Zika virus, bird flu and hepatitis;
  • 60 percent highly support treating substance use, including addiction to prescription painkillers and heroin, like a disease, not a crime;
  • 60 percent highly support planning for building more parks, walking and biking trails and other recreation areas for people to be physically active in all communities;
  • 60 percent highly support increasing access to safe and affordable housing and routinely testing for things that create health problems in homes, like lead in water and paint, carbon monoxide, and harmful chemicals in the air;
  • 59 percent highly support increasing incentives that encourage business owners to open grocery stores in communities that lack access to healthy food options; and
  • 58 percent highly support building local partnerships across businesses, health systems, schools and community organizations to address specific health problems in communities.

Methodology:  On behalf of the Robert Wood Johnson Foundation and the Trust for America’s Health, Greenberg Quinlan Rosner Research, in consultation with Bellwether Research, conducted a survey among 1,320 registered voters nationwide (1,019 weighted). The survey was conducted between September 8th and 19th, 2016. Voters were randomly selected from a list of registered voters and reached on a landline or cell phone depending on the number they designated on their voter registration. Interviews were conducted by live telephone interviewers; 50 percent were reached on a cell phone. Included in the sample were three oversamples: 100 Black voters, 100 Hispanic voters, and 100 White non-college voters. Upon completion of the survey, the results were weighted to bring the three oversamples into line with the racial and ethnic composition of registered voters nationwide. The data was weighted to reflect the total population of registered voters, taking into account regional and demographic characteristics according to known census estimates and voter file projections. The data are subject to a margin of error of +/- 3.1 percentage points.  Full survey and topline results are available upon request.

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

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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.