State Category: California

Newly Announced Order for Hospitals to Bypass CDC and Send Coronavirus Patient Information Directly to Washington Database Likely to Worsen Pandemic Response Rather than Improve It

(Washington, DC – July 15, 2020) — The U.S. Centers for Disease Control and Prevention (CDC), as the nation’s lead public health agency, is uniquely qualified to collect, analyze and disseminate information regarding infectious diseases. It has been serving in that role since its creation and, in close collaboration with U.S. healthcare facilities nationwide, has developed a health statistics infrastructure that is the gold standard worldwide.

The problems with regard to the COVID-19 data collection have largely been a result of the decentralized and fragmented nature of both healthcare and public health in the United States. Furthermore, hospital data is only one aspect of what we need to know to fight the pandemic. A key role of health departments at all levels of government is to aggregate data to produce a detailed picture of a health problem at the national, state and local levels. Inadequate funding for data infrastructure, at CDC and at the local, state, tribal and territorial levels, is also a contributing factor.  That underfunding should be corrected rather than bypassed.

In the midst of the worst public health crisis in a century, it is counter-productive to create a new mechanism which will be extremely complicated to build and implement.  Another area of concern is that the planning for this new approach did not substantively involve officials at the local, state, tribal and/or territorial levels.  This is a time to support the public health system not take actions which may undermine its authority and critical role.

Americans must have confidence in the integrity of health data and its insulation from even the suggestion of political interference.  Sending these sensitive data to a newly created entity overseen directly by the White House will not eliminate such concerns, it will increase them.

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

Dr. Tom Frieden, President and CEO, Resolve to Save Lives

Lori T. Freeman, Chief Executive Officer, National Association of County and City Health Officials

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

Thomas M. File, Jr., M.D., MSc, FIDSA; President, Infectious Disease Society of America

Chrissie Juliano, MPP, Executive Director, Big Cities Health Coalition

William H. Dietz, MD, PhD, Chair, Redstone Center for Prevention and Wellness, George Washington University

Nearly 350 Public Health Organizations Implore HHS Secretary Azar to Support CDC’s Critical Role in the COVID-19 Pandemic Response

Letter calls on Secretary Azar to “speak up” and be an advocate for CDC and public health

(Washington, DC – July 7, 2020) – The expertise of the U.S. Centers for Disease Control and Prevention (CDC) and all public health agencies is critical to protecting Americans’ health during the COVID-19 crisis, said a letter to Health and Human Services Secretary Alex Azar from 347 health and public health organizations released today.

The authoring organizations, including the American Public Health Association, Association of State and Territorial Health Officials, Big Cities Health Coalition, National Association of County and City Health Officials and Trust for America’s Health,  expressed “deep concern” about increasing reports of resistance to evidence-based public health messages and threats to public health leaders and agencies, and called on the Secretary to be an advocate for public health.

At this sentinel moment, during the worst public health emergency in over a century, all of the nation’s leaders must resist any efforts that would undermine the critical role of the CDC to respond to the pandemic and must be an advocate for increased investment in public health, said the letter signatories.

“Secretary Azar, we urge you to speak up and amplify the critical role of CDC and that of all public health agencies during this monumental crisis,” the letter said.

The public health community’s work to respond to the pandemic, via the federal government, including within the CDC, and at the state, local, territorial and tribal levels, has been tireless but has been hamstrung by shrunken programs and inadequate technology; the result of decades of underfunding.

Public health leaders are calling attention to the need for CDC to play a central role as the nation’s navigates the COVID-19 pandemic, including:

“CDC is the world’s premier public health institution and should be treated as such during this pandemic. It must be appropriately funded and allowed to speak based on the best available science and with an unfettered voice,” said John Auerbach, President and CEO of Trust for America’s Health.

“When you look at the global response to the COVID-19 pandemic, countries that listen to and prioritize public health fare best,” said Dr. Tom Frieden, former director of the CDC, President and CEO of Resolve to Save Lives, an initiative of Vital Strategies. “Trying to fight this pandemic without daily, public guidance from the CDC is like fighting with one hand tied behind your back.”

“There’s no federal agency better suited to lead the response to this unprecedented pandemic. CDC has experts who have studied and helped control coronaviruses and other viral threats for decades, and can help our country emerge from this crisis,” said Dr. Julie Gerberding, former director of the CDC, Co-Chair CSIS Commission on Strengthening America’s Health Security.

The COVID-19 crisis has also illuminated the ways in which racial inequities impact health. Higher rates of COVID-19 deaths within communities of color illustrate the importance of all of CDC’s work, including its focus on chronic disease prevention. It is not possible to effectively meet the needs of the American people if that scope is narrowed.

The letter furthermore calls on Secretary Azar to be an advocate for increased funding for CDC’s core budget. While emergency supplemental funding has been critical to begin to address the immediate COVID-19 response needs, robust, sustained, and predictable funding for its full public health mission is essential to sustain its public health activities and to prevent the next emergency.  Increasing the federal investment in public health will be particularly important, as state and local government budgets are likely to be severely hampered in the coming fiscal year due to tax revenue losses during the COVID-19 related economic shutdown.

Today’s laser focus should be on preventing further deaths and disruptions due to the pandemic and the CDC, as the world’s premier public health institution, should be at the helm of that effort, the letter said. Once the pandemic is controlled, the CDC, other federal agencies, state and local leaders and the public health community should collaboratively evaluate their performance and must acknowledge and address shortcomings of the response in order to be better prepared for the next public health emergency.

Signing the letter were:

1,000 Days

Academic Health Resource

Academy for Eating Disorders

Action on Smoking and Health

Advocates for Better Children’s Diets

AES Consulting

AFSCME

AIDS Alliance for Women, Infants, Children, Youth & Families

AIDS United

AlohaCare

Alzheimer’s and Dementia Alliance of WI

Alzheimer’s Association

Alzheimer’s Impact Movement (AIM)

Alzheimer’s of Central Alabama

Alzheimer’s Orange County

American Academy of Family Physicians

American Academy of Pediatrics

American Academy of Pediatrics, California

American Association for Clinical Chemistry

American Association for Dental Research

American Association for the Study of Liver Diseases

American Association of Colleges of Pharmacy

American Association on Health and Disability

American Cancer Society Cancer Action Network (ACS CAN)

American College Health Association

American College of Clinical Pharmacy

American College of Clinical Pharmacy (ACCP)

American College of Obstetricians and Gynecologists

American College of Physicians

American College of Preventive Medicine

American Council on Exercise

American Dental Association

American Foundation for Suicide Prevention

American Geriatrics Society

American Heart Association

American Kidney Fund

American Lung Association

American Medical Women’s Association

American Organization for Nursing Leadership

American Public Health Association

American School Health Association

American Sexual Health Association

American Society for Clinical Pathology

American Society for Microbiology

American Society of Hematology

American Society of Pediatric Nephrology

American Society of Tropical Medicine & Hygiene

American Thoracic Society

American University Department of Health Studies

APLA Health

Arizona Community Health Workers Association

Arizona Public Health Association

Art & Science of Health Promotion Institute

Asian Health Coalition

Asian Health Services

Association for Prevention Teaching and Research

Association for Professionals in Infection Control and Epidemiology

Association of American Cancer Institutes

Association of American Medical Colleges

Association of Asian Pacific Community Health Organizations (AAPCHO)

Association of Departments of Family Medicine

Association of Family Medicine Residency Directors

Association of Food and Drug Officials

Association of Immunization Managers

Association of Maternal & Child Health Programs

Association of Minority Health Professions Schools

Association of Ohio Health Commissioners

Association of Population Centers

Association of Public Health Laboratories

Association of Schools and Programs of Public Health

Association of SNAP Nutrition Education Administrators

Association of State and Territorial Health Officials

Association of State Public Health Nutritionists

Autistic Self Advocacy Network

Big Cities Health Coalition

Bipartisan Policy Center

Black AIDS Institute

Black Men’s Health Initiative

Boston Public Health Commission

Bristol Health Equity Zone

Bronx Health REACH

California Coalition for Children’s Safety and Health

California Immunization Coalition

California Pan-Ethnic Health Network

California School Nurses Organization

Cambridge Public Health Department

Campaign for Tobacco-Free Kids

Cancer Council of the Pacific Islands

Caring Ambassadors Program

Cascade AIDS Project

Center for Community Resilience

Center for Health and Learning

Center for Law and Social Policy (CLASP)

CenterLink: The Community of LGBT Centers

Ceres Community Project

ChangeLab Solutions

Child Welfare League of America

Children’s Environmental Health Network

Children’s Mental Health Network

Christian Council of Delmarva

City of Houston Health Department

City of Milwaukee of Health Department

Climate for Health, ecoAmerica

Coalition for a Tobacco Free Arkansas

Coalition of National Health Education Organizations

Cohen Veterans Bioscience

Colorado Association of Local Public Health Officials

Colorado Public Health Association

Colorado Public Health Nursing Leaders

Community Access National Network

Community Education Group

Connecticut Public Health Association

Cooley’s Anemia Foundation

Council of State and Territorial Epidemiologists

Counter Tools

County Health Executives Association of California

Cuyahoga County Board of Health

Cystic Fibrosis Foundation

Delaware Academy of Medicine

Delaware Academy of Medicine / Delaware Public Health Association

Delaware Academy of Medicine and the Delaware Public Health Association

East Shore District Health Dept.

Eating Disorders Coalition for Research, Policy & Action

Education Development Center

Element Health, Inc.

Endocrine Society

Enlace Chicago

Epilepsy Alliance America

Epilepsy Foundation

Equality California

Eta Sigma Gamma

Families USA

Family Voices

Fetal Alcohol Syndrome Information Network

FHI 360

FIRST Family Service Center

Fletcher Group, Inc.

Florida Institute for Health Innovation

Florida Public Health Association

Foundation for Healthy Generations

Galaxy Aviation Corp

Gateway Region YMCA

George Mason University Center for Climate Change Communication

GLMA: Health Professionals Advancing LGBTQ Equality

Global Alliance for Behavioral Health and Social Justice

Global Health Council

Global Health Technologies Coalition (GHTC)

Global Healthy Living Foundation

Global Liver Institute

Grand Traverse County Health Department

Green & Healthy Homes Initiative

Harm Reduction Michigan

Hawaii Public Health Association

Hawaii State Dept of Health, Office of Primary Care and Rural Health

Health by Design

Health Care Improvement Foundation

Health Enhancement Research Organization (HERO)

Health Resources in Action

Healthcare Foundation Northern Sonoma County

Healthcare Ready

HealthHIV

HealthPartners Institute

Healthy Schools Campaign

Healthy Weight Partnership Inc.

Heartland Alliance

Hep B United

Hepatitis B Foundation

HIV Medicine Association

Hogg Foundation for Mental Health

Hope and Help Center of Central Florida, Inc.

Idaho Public Health Association

Immunization Action Coalition

Immunize Nevada

Impetus – Let’s Get Started LLC

Indiana Public Health Association

Infectious Diseases Society of America

Institute for Family Health

Interdisciplinary Association for Population Health Science (IAPHS)

International Association of Emergency Managers

International Association of Fire Chiefs

IWC Resources, LP

Jeffrey Modell Foundation

Journal of Public Health Management and Practice

Jump IN for Healthy Kids

Kaplan Health Innovations

Kentucky Health Departments Association

KidsAndCars.org

L.A. Care Health Plan

Lakeshore Foundation

League of American Bicyclists

Linn County Public Health

Louisiana Community Health Worker Outreach Network

Louisiana Public Health Association

Lupus and Allied Diseases Association, Inc.

Macoupin County Public Health Department

Maine Public Health Association

March of Dimes

MaryCatherine Jones Consulting, LLC

Maryland Association of County Health Officers (MACHO)

Maryland Office of Minority Health

Massachusetts Public Health Association

Medicago

MEND Foundation

Metropolitan Group

Michigan Association for Local Public Health

MindWise Innovations

Minneapolis Health Department

Mississippi Public Health Institute

Montana Public Health Association

Monterey County Health Department

Morehouse School of Medicine

MountainCare

Multnomah County Health Department

NAACP

NAPHSIS

NASTAD

National Adult Day Services Association

National Association of Chronic Disease Directors

National Association of Community Health Workers

National Association of County and City Health Officials

National Association of Pediatric Nurse Practitioners

National Association of School Nurses

National Athletic Trainers’ Association

National Birth Equity Collaborative

National Center for Disaster Preparedness, Columbia University

National Center for Healthy Housing

National Coalition for LGBT Health

National Coalition for the Homeless

National Coalition of STD Directors

National Environmental Health Association (NEHA)

National Forum for Heart Disease & Stroke Prevention

National Hemophilia Foundation

National Kidney Foundation

National Lipid Association

National Medical Association (NMA)

National Network of Public Health Institutes

National Nurse-Led Care Consortium

National Prevention Science Coalition to Improve Lives

National REACH Coalition

National Safety Council

National Viral Hepatitis Roundtable

National WIC Association

Nebraska Association of Local Health Directors

Network for Environmental & Economic Responsibility of United Church of Christ

Nevada Public Health Organization

Nevada Rural Hospital Partners

New Jersey Association of County and City Health Officials

New Jersey Public Health Association

New York State Public Health Association

North American Primary Care Research Group

North Carolina Healthcare Foundation

Northwest Center for Public Health Practice

NYU Grossman School of Medicine

NYU School of Global Public Health

Ohio Public Health Association

Onyx Strategic Consulting LLC

Pacific Island Health Officers Association

Partnering for Community Transformation Inc

Partnership to Fight Chronic Disease

Partnership to Fight Infectious Disease

PATH

Patrick Risha CTE Awareness Foundation

Pawtucket Central Falls Health Equity Zone

Peggy Lillis Foundation

Pennsylvania Public Health Association

PFLAG National

Population Association of America

Population Health Alliance

Prevent Blindness

Prevent Child Abuse America

Prevention Institute

Preventive Cardiovascular Nurses Association

Public Health Advocates

Public Health Alliance of Southern California

Public Health Foundation

Public Health Institute

Public Health Law Center

Public Health Solutions

Puerto Rico Public Health Association

Pulmonary Hypertension Association

Redstone Global Center for Prevention and Wellness GWU

Research!America

Residential Eating Disorders Consortium

RESOLVE

Resolve to Save Lives, an initiative of Vital Strategies

Respiratory Health Association

Rhode Island Department of Health

RiverStone Health

Rural Health Association of Tennessee

Rural Health Association of Utah

Safe Routes Partnership

Safe States Alliance

Samueli Integrative Health Programs

SANIPLAN

School-Based Health Alliance

SF Hep B Free – Bay Area

SHAPE America – Society of Health and Physical Educators

Shoals Community Clinic

Silver State Equality-Nevada

Smoke Free St. Joe

Society for Advancement of Violence and Injury Research

Society for Maternal-Fetal Medicine

Society for Public Health Education

Society of State Leaders of Health and Physical Education

Society of Teachers of Family Medicine

Southern California Public Health Association

Southwick BOH

Stanislaus County Medical Society

Susan G. Komen

Tennessee Justice Center

Tennessee Public Health Association

Texas Public Health Association

The AIDS Institute

The Broussard Company

The Center for Community Resilience, George Washington University

The Consortium

The Foundation for Sustainable Communities

The George Washington University (GW) Cancer Center

The Gerontological Society of America

The Immunization Partnership

The John A. Hartford Foundation

The Kennedy Forum

The Los Angeles Trust for Children’s Health

The National Commission for Health Education Credentialing, Inc

The Nourished Principles, LLC

The Permanente Medical Group

Thomas Jefferson University

Training Resources Network, Inc.

Treatment Action Group

Trillium Health

Trust for America’s Health

Truth Initiative

U.S. Breastfeeding Committee

UCLA Fielding School of Public Health

UNC Gillings School of Global Public Health

United Ostomy Associations of America

United Way of Greenwood and Abbeville Counties

University of Washington Department of Global Health

University of Washington School of Nursing

University of Washington School of Public Health

University of Wisconsin Population Health Institute

USAgainstAlzheimer’s

Vaccinate Your Family

Washington State Association of Local Health Officials

Washington State Department of Health

Washington State Public Health Association

WelCore Health, LLC

West Valley Neighborhoods Coalition

Whitefoord

Winer Family Foundation

Wisconsin Public Health Association

Women Of A Certain Age

WomenHeart: The National Coalition for Women with Heart Disease

Women’s Resource Center

Woodhull Freedom Foundation

Xavier University for Population Health

YMCA of the USA

Zell Community Health Strategies

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The ACA is Critical to the Health of all Americans, Particularly as the Nation Struggles to Contain the Coronavirus

(Washington D.C. – June 29, 2020)

The Trump Administration’s efforts to dismantle the Affordable Care Act (ACA), including urging the Supreme Court to overturn the act, is ill-conceived and puts the health of millions of Americans at risk during the worst public health crisis in over a century.

While always a bad idea, overturning the ACA as COVID-19 infection rates hit new highs in five states, would be catastrophic and could result in excess deaths. The loss of the ACA would also exacerbate the racial inequities that exist in healthcare access, adding to the disproportionate deaths of Blacks and other people of color due to the pandemic.

The ACA has been the law of the land for over a decade and millions of people rely on it for essential health services.  If the act was overturned, more than 20 million Americans who gained access to healthcare through the ACA created marketplace and Medicaid expansion would lose that coverage, including vital protections related to pre-existing conditions. Plus, the nearly 30 million Americans who have lost their healthcare due to COVID-19 layoffs would lose access to the critical back-up source for health coverage provided by the ACA marketplace.

There are also major implications for public health. If the law is overturned, it would gut the nation’s investment in public health by eliminating over $15 billion over the next 10 years (FY2021-FY2030) for the Centers for Disease Control and Prevention (CDC) and other public health agencies. The Prevention and Public Health Fund, a dedicated funding stream created by the ACA and specifically designated for public health and prevention, funds approximately 11 percent of the CDC’s budget. These funds are put to work in every state to expand immunizations, prevent suicide, modernize laboratory and epidemiology services to detect and contain disease outbreaks, prevent childhood lead poisoning, and prevent diabetes and other chronic conditions.

Also at risk is the requirement that insurers cover recommended clinical preventive services without cost-sharing. These provisions have meant that an estimated additional 71 million Americans now have access to vaccines, tobacco cessation services, blood pressure and diabetes screenings and other life-saving services previously inaccessible to them.

Public Health Needs Our Support

(Washington D.C. – June 23)

John Auerbach, President and CEO of Trust for America’s Health, issued the following statement:

“As our nation struggles to manage the continued surge of COVID-19 cases, we need to strengthen the public health response.   Resistance to public health messages and threats to public health leaders and agencies undermine the efforts to protect the health and wellbeing of America’s residents.  We need to support the leadership of Centers for Disease Control and Prevention (CDC) and state, local, tribal, and territorial public health agencies in the efforts to re-open safely.

CDC, state, local, tribal, and territorial public health staff have been working around the clock for months to respond to the pandemic and protect the public, while often relying on overworked staff and inadequate systems that are the result of decades of underfunding.

CDC is a scientific agency that must be able to function in an apolitical manner.  We must amplify the unfettered voice of CDC, not stifle it.

The broad scope of CDC’s work – from chronic disease to injury prevention to environmental health to emergency preparedness to infectious disease – is critical.   It isn’t possible to effectively meet the needs of the American people if the scope is narrowed.   The COVID-19 pandemic demonstrates that the underlying health of Americans – including, for example, obesity, heart disease and diabetes – has a direct impact on the risk of serious illness and death. And the pandemic has also starkly highlighted the unacceptable health disparities related to racism and discrimination which can only be addressed with a sweeping health focus.

The mission of the CDC is clear and replicated in every state and local community’s public health department: save lives through sound public health.  Now more than ever we need them to accomplish their mission.”

Addressing the Crisis of Black Youth Suicide: Interview with Dr. Michael A. Lindsey

Dr. Lindsey is the executive director of the McSilver Institute for Poverty Policy and Research at New York University. He also leads the working group of experts supporting the Congressional Black Caucus Emergency Task Force on Black Youth Suicide and Mental Health. The Task Force report, Ring the Alarm: The Crisis of Black Youth Suicide, released in December 2019, is a comprehensive examination of the alarming rise in suicide rates for Black youth over the past generation; a survey of available data and evidence; and a call for policymakers and communities to take action to better understand and to reverse this emergent trend.[1]

 

TFAH: Please describe your work at the McSilver Institute.

Dr. Lindsey: We focus on the social determinants of mental health, as well as trauma and treatment disparities, all of which intersect with intergenerational poverty. If you are experiencing inequality related to, for example, food insecurity or underemployment, that has a psychological impact. We are looking for ways to break that cycle. We are committed to studying intergenerational poverty, not only to understand its consequences, but to also do something about it.


TFAH: Where does your passion for your work come from?

Dr. Lindsey: I’ve always been interested in mental health treatment disparities, particularly the lack of treatment access for serious mental health issues among Black people. I know the consequences of lack of mental health treatment. My passion derives from growing up in the Southeast section of Washington, D.C., where I saw the effects of drug use and undiagnosed, untreated addiction and mental health issues. I want to bridge that gap to make sure kids and families are connected to treatment in meaningful ways.


TFAH: If you could recommend to policymakers one or two actions that would make a real difference on the social determinants of mental health, what would they be?

Dr. Lindsey: Let’s focus that a bit. And that’s a key point. Whatever we design as an intervention has to speak to the unique issues that are experienced by a specific group. For example, looking at the rising rates of suicide among Black youth. We need to have mental health professionals in schools, proportionate to the number of kids in that school. We can’t have one provider trying to serve 500 kids or even 100 kids; that’s too many. We also need to see more federal research dollars, specifically, for studying the increasing rate of Black youth suicide. The data are clearly telling us that Black youth are at high risk.


TFAH: Does the research you are calling for need to be population-focused?

Dr. Lindsey: No question, it does. The research also needs to be gender-sensitive and culturally appropriate. We need to understand how families of color, in this case, Black families, resolve mental health challenges. For example, do we need to involve clergy in the intervention programs? Do we need services in non-traditional settings? Do we need to provide services in places other than those that the community believes are where “crazy people” go? Setting up services from the consumer perspective will help us establish services that are going to be meaningful.

TFAH: What’s the impact of the school environment on the lives of Black children? Are you concerned about school disciplinary policies that have unintended consequences for students who end up in trouble with the juvenile justice system?

Dr. Lindsey: This is something I’m particularly concerned about. For students of color, there’s implicit bias in how their behaviors are interpreted. If you have a White kid and a Black kid and a Latino kid—if the Black or Latino kid aggresses toward someone, the reaction is that kid is a bad kid, one who should be removed from school. But if a White kid acts up, he is perceived as having emotional challenges. The White kid is not suspended, he’s offered mental health services. It happens a lot.

When Black kids are suspended from school, they can be wayward in the community, they’re not engaged, their behavior comes to the attention of law enforcement—it’s a vicious cycle. It’s also tough for those same kids who are suspended from school to return to school because those school communities often don’t want them back. The largest number of students who have this lack of school engagement tend to be Black and Brown.

If we had intervened on those behaviors early on and gotten those kids to mental health treatment and associated services, we could have averted that later suspension from school. It’s a matter of how we interpret the behavioral presentations of kids. It happens to be that Black and Brown students are the ones who are not getting the requisite services surrounding their mental health.


TFAH: What has been the impact of zero-tolerance policies in schools on students of color?

Dr. Lindsey: Zero-tolerance has had a big impact on what I would call school persistence and staying connected to school among Black and Brown kids. Zero-tolerance policies do not work, and they disadvantage low-income kids and kids of color.


TFAH: McSilver’s Step Up program is established in two New York City high schools. Can you tell us more about it?

Dr. Lindsey: Step Up is focused on positive youth development. What we do is take students who are at risk for truancy or school dropout, and we wrap-around services to support them. It includes peer support—so a lot of peer-based mentoring—as well as professionally led activities to help kids stay on a positive course. The program has an 85 percent graduation rate; that’s about 10 percent higher than the general graduation rate in New York City. Programs like Step Up or school mental health services that can be offered to kids who are struggling can be very important to ensure that these kids stay connected.

TFAH: You led the expert working group that helped inform the work of the Congressional Black Caucus Emergency Task Force on Black Youth Suicide and Mental Health. What did the task force find and what did it recommend?

Dr. Lindsey: Black youth suicide and suicidal behaviors are rising. Black boys (ages 5 to 12 years old) are twice as likely to die by suicide as compared with their White peers. We led a study at the McSilver Institute that found that the self-reported suicide attempt rate for Black youth increased by 73 percent between 1991 and 2017; meanwhile, self-reported suicide attempt rates fell for White and Latino kids and for Asian and American Indian/Alaska Native kids during the same period.

What needs to be done is many of things we’ve talked about. We’re calling for mental health professionals in every school and for more National Institutes of Health funding. We’re calling for Mental Health First Aid to be widely implemented in schools. All the professionals in schools should be well-versed in the presentation of mental health issues, the signs that a student may be having trouble and how to get that student connected to supportive treatment.

We are also calling for more demonstration projects, programs that would implement evidence-based and best practices for clinicians and teachers and anyone who interacts with Black youth. We are calling for investment in demonstration projects to identify exemplars and then implement those programs at scale.


TFAH: What is required to scale up promising programs?

Dr. Lindsey: We have a program called Making Connections. In this program, we are targeting kids who have depression. The program works to reduce stigma. It is designed to help families understand what mental health treatment is all about and to address any concerns they might have about it. It’s a promising program I’d like to see delivered at scale. In order to do that, we are going to have to invest dollars in understanding how this program works. We are currently funded by NIMH [National Institute of Mental Health], but we are going to need increased funding to be able to do this in other places. If we are going to deliver these programs at scale, we are going to have to engage in the research to take them to scale. That means establishing the efficacy of programs like Making Connections, but also determining how best to implement programs like it at scale.


TFAH: Anything else you want to share?

Dr. Lindsey: I’m reminded of the power of storytelling. We need to demonstrate how implicit bias is impacting Black and Brown kids, bias that is potentially an underlying feature of why we are seeing the rising suicide trends. We need to tell the story of implicit bias in compelling ways. I believe that will challenge folks to action. It’s also important to recognize the role that stigma and mistrust play in the disconnection from services. They play a huge role in terms of the disconnection from mental health treatment. We need to work on bridging those gaps between need and use of treatment.

[1] Watson Coleman B. Ring the Alarm: The Crisis of Black Youth Suicide in America. Washington, D.C.: Congressional Black Caucus Emergency TaskForce on Black Youth Suicide and Mental Health, December 2019. https://watsoncoleman.house.gov/uploadedfiles/full_taskforce_report.pdf (accessed April 30, 2020).

 

TFAH’s Statement on Racism and Health and Well Being in America

Trust for America’s Health (TFAH) stands in solidarity with those opposing racism and seeking racial justice. The recent horrific deaths of George Floyd, Breonna Taylor, and Ahmaud Arbery further expose the persistence of racism and racial violence in American society. We must remember the lives of so many Black people taken by such violence. We keep the families in our minds and hearts.

Systemic racism undermines equity and opportunity and is far-reaching – in health, education, economic opportunity, employment, housing, transportation, and criminal justice, only to name a few examples. The toll from racism on the lives and health of Black people and other people of color is vast.  It is seen in the impact of the disinvestment in and marginalization of communities of color, the unhealthy social, economic, and environmental conditions, and the lack of opportunities within community, work and school settings, which result in deaths at earlier ages and high rates of chronic and infectious diseases.  It is seen in the impact of racial violence as well as daily instances of prejudice and racial discrimination that result in adverse mental and physical health effects such as stress, trauma, and elevated blood pressure.  The recent cases of violence against Black people and the disproportionate impact of the COVID-19 pandemic on people of color have highlighted once again the importance of combating racism as a public health imperative.

At Trust for America’s Health, we envision a nation that values the health and well-being of all, where equity is foundational to policymaking at all levels of society.  Together with all justice-seeking people in America, we remain steadfast in advocating for policy solutions to achieve equity so that everyone has a fair and just opportunity for optimal health.

Las muertes anuales debidas al alcohol, las drogas o el suicidio excedieron los 150,000 según los datos más recientes, y podrían empeorar debido a COVID-19

A pesar de las disminuciones en las muertes por sobredosis de opioides en general, las muertes por opioides sintéticos, cocaína y otros psicoestimulantes aumentaron bruscamente y las muertes por alcohol y suicidio también aumentaron

 

(Washington, DC y Oakland, CA – 21 de mayo de 2020) – Los datos recientemente publicados muestran que 151,964 estadounidenses murieron debido al alcohol, las drogas o el suicidio en el 2018. Esta tasa nacional de mortalidad por alcohol, drogas y muertes por suicidio fue solo muy ligeramente inferior a lo que había sido en el 2017 a pesar del progreso en la reducción de algunos tipos de sobredosis de opioides, según un nuevo estudio realizado por Trust for America’s Health (TFAH) y Well Being Trust (WBT).

Por el año, las muertes por alcohol aumentaron un 4 por ciento y las muertes por suicidio aumentaron un 2 por ciento. Los nuevos datos también muestran un cambio continuo dentro de la crisis de opioides con reducciones en las muertes por sobredosis de opioides recetados, pero aumentan las muertes que involucran opioides sintéticos, incluido el fentanilo.

Las tasas de mortalidad de todos los opioides disminuyeron un 2 por ciento, pero la tasa de mortalidad de los opioides sintéticos aumentó un 10 por ciento. Además, las muertes por sobredosis con heroína fueron menores, pero las muertes por cocaína y otros psicoestimulantes, como la metanfetamina, el éxtasis, la anfetamina y los estimulantes recetados, fueron mayores.

Aunque todavía es inquietantemente alto, los datos del 2018 son la primera vez desde 1999, cuando comenzó la recopilación de datos actual, que no ha habido un aumento considerable en el alcohol, las drogas y las muertes por suicidio por una tasa de 100,000. Sin embargo, esta estabilización en la tasa de mortalidad no fue uniforme. Algunos lugares y grupos de población están experimentando tasas de mortalidad estables o decrecientes, mientras que las tasas entre otros grupos o en otros lugares continúan aumentando.

“Estos datos son un llamado a la acción”, dijo John Auerbach, presidente y CEO de Trust for America’s Health. “Sabemos lo que funciona para abordar las muertes por desesperación, pero el progreso ha sido desigual y las tasas de mortalidad continúan aumentando, con comunidades de color que experimentan tasas más altas de aumentos en las muertes inducidas por drogas y alcohol. Y hay otra preocupación inmediata: la crisis de COVID-19 ha aumentado las cargas sanitarias y las presiones económicas en muchas comunidades de color “.

Los indios americanos, asiáticos, negros, latinos y adultos mayores experimentaron aumentos en las muertes inducidas por drogas entre 2017 y 2018. Los negros y los indios estadounidenses tuvieron el mayor aumento absoluto. Los negros ahora tienen tasas más altas de sobredosis de opioides sintéticos (10.7 por 100,000), tasas de sobredosis de cocaína (8.8 por 100,000) y casi la misma tasa general de mortalidad inducida por drogas (21.8 por 100,000) que los blancos, después de décadas de tener tasas sustancialmente más bajas.

Los grupos de población que experimentaron tasas de mortalidad más bajas inducidas por drogas en el 2018 incluyeron adultos de 18 a 54 años y blancos.

“Simplemente, muchos estadounidenses están muriendo por causas prevenibles. Las profundas disparidades raciales de salud observadas en estos datos muestran que muchos grupos de minorías étnicas se están quedando atrás en nuestros esfuerzos de respuesta “, dijo Benjamin F. Miller, PsyD, director de estrategia de Well Being Trust. “La nación necesita un marco integral para la excelencia en la salud mental y el bienestar, uno que intencionalmente brinde soluciones para los indios americanos, negros, asiáticos y latinos. Con todas las demás inversiones relacionadas con COVID-19, es hora de que el gobierno federal invierta completamente en salud mental ahora y que todos los estados tomen medidas “.

La reducción de ciertas muertes por opioides sugiere que las políticas y los programas dirigidos a la epidemia de opioides pueden estar afianzándose en algunas poblaciones, pero muchos grupos raciales y étnicos no están viendo el mismo progreso que los blancos. La nación debe basarse en el pequeño grado de éxito y llevar el mismo enfoque a las poblaciones que están en mayor riesgo, especialmente los negros, los latinos y los indios estadounidenses.

Las recomendaciones de política descritas en el informe incluyen:

o Invertir en prevención abordando los factores importantes que crean las condiciones que mejoran los resultados. Numerosos factores contribuyen al bienestar o la falta de este, incluida la pobreza intergeneracional, el racismo sistémico, la discriminación étnica y la homofobia / transfobia se encuentran entre los factores sociales, económicos y ambientales que elevan el riesgo. Las agencias gubernamentales a todos los niveles deben tomar medidas para promover la equidad racial y combatir el racismo y la discriminación.

o Reducir los factores de riesgo y promover la resiliencia en niños, familias y comunidades. Apoyo de políticas y programas equitativos que reduzcan las experiencias traumáticas y adversas, como la exposición a la violencia, la vivienda inestable, la discriminación racial y étnica y el sesgo implícito, que tienen profundos impactos a largo plazo en el uso posterior de sustancias y la salud mental.

o Integrar, aumentar el acceso y mejorar la atención médica al involucrar a todos los sectores de la sociedad para abordar los trastornos de salud mental y uso de sustancias. Las escuelas, los lugares de trabajo, los centros comunitarios, las bibliotecas y los programas públicos deben incorporar formas de abordar los problemas de salud mental y adicciones, desde aumentar la conciencia y reducir el estigma, hasta proporcionar capacitación en intervenciones de crisis y facilitar referencias, e incluso integrar la atención médica en su programación donde sea posible.

o Limitar el acceso a medios letales de suicidio. Promover el almacenamiento seguro de medicamentos y armas de fuego proporcionando educación pública; restringir el acceso a armas de fuego a niños y personas en crisis o en riesgo de suicidio; y la creación de protocolos para proveedores de atención médica, consejeros y personal de primera respuesta sobre cómo interactuar y aconsejar a los pacientes y sus familias para crear entornos seguros. Implementar verificaciones de antecedentes universales para la compra de armas y órdenes de protección de riesgo extremo en todo el país, y ampliar los programas para involucrar a las partes interesadas, como el Proyecto Gun Shop, que educa al personal de las tiendas de armas sobre la prevención del suicidio.

 

Resumen de datos de 2018

Muertes por tipos de drogas

Muertes por sobredosis de opioides sintéticos: en el 2018, 31,355 estadounidenses murieron por sobredosis de opioides sintéticos; un aumento del 10 por ciento desde el 2017. En total, la tasa de mortalidad por sobredosis con opioides sintéticos ha aumentado casi 10 veces desde el 2013.

Muertes por sobredosis de cocaína: en el 2018, 14,666 estadounidenses murieron por sobredosis relacionadas con la cocaína; hasta un 5 por ciento desde el 2017. La tasa general de mortalidad por sobredosis de cocaína ha aumentado en un 187 por ciento desde el 2013.

Otras muertes por sobredosis de psicoestimulantes: en el 2018, 12,676 estadounidenses murieron por sobredosis de psicoestimulantes y 52,279 murieron en la última década debido al abuso de psicoestimulantes. La tasa de mortalidad por sobredosis de psicoestimulantes en el 2018 fue un 22 por ciento más alta que en el 2017.

Muertes inducidas por alcohol

En el 2018, 37,329 estadounidenses murieron debido a causas inducidas por el alcohol; La tasa de muertes inducidas por el alcohol en el 2018 fue un 4 por ciento más alta que el año anterior.

Las muertes inducidas por el alcohol son más altas entre los indios americanos (30.0 por 100,000) y adultos de 55 a 74 años (27.6 por 100,000). Todos los grupos de población tuvieron tasas más altas de muertes por alcohol en 2018 en comparación con el año anterior, excepto los jóvenes de 0 a 17 años, cuya tasa se mantuvo estable.

Muertes por suicidios

En el 2018, 48,344 estadounidenses murieron como resultado del suicidio. A nivel nacional, la tasa de suicidios de 2018 fue dos por ciento más alta que el año anterior (después de un aumento de cuatro por ciento en 2017). Las tasas de suicidio aumentaron en todos los datos demográficos, excepto en adultos de 18 a 54 años cuya tasa se mantuvo estable. Además, todos los grupos minoritarios raciales y étnicos experimentaron cambios proporcionales mayores en las tasas de suicidio que los blancos.

La muerte por suicidio en el 2018 fue más alta entre los hombres (23.4 por ciento por 100,000), aquellos que viven en áreas rurales (19.7 por 100,000), blancos (16.8 por 100,000) y nativos de los indios americanos / Alaska (14.1 por 100,000).

Tendencias estatales

Entre 2017 y 2018, 27 estados experimentaron tasas más altas (por encima del 0,04%) de muertes por alcohol, drogas y suicidio. Veintitrés estados y el Distrito de Columbia tuvieron menos muertes por alcohol, drogas y suicidio durante el mismo período.

Los estados con las tasas más altas de mortalidad por alcohol, drogas y suicidio en el 2018 fueron: West Virginia (84.9 por 100,000), Nuevo México (82.8 por 100,000), New Hampshire (68.2 por 100,000) y Alaska (67.8 por 100,000).

Los estados con las tasas más bajas de alcohol, drogas y suicidio en 2018 fueron: Texas (31.7 por 100,000), Mississippi (31.7 por 100,000) y Hawaii (34.6 por 100,000).

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Trust for America’s Health es una organización sin fines de lucro y no partidista que promueve la salud óptima para cada persona y comunidad y hace de la prevención de enfermedades y lesiones una prioridad nacional. www.tfah.org. Twitter: @HealthyAmerica1

 

Well Being Trust es una fundación nacional dedicada a promover la salud mental, social y espiritual de la nación. Creado para incluir la participación de organizaciones de todos los sectores y perspectivas, Well Being Trust se compromete a innovar y abordar los desafíos de salud mental más críticos que enfrenta Estados Unidos, y a transformar el bienestar individual y comunitario. www.wellbeingtrust.org. Twitter: @WellBeingTrust

When Two Health Risks Merge – Rising Obesity Rates Put More Americans at Risk for Serious Health Impacts of the Novel Coronavirus

High obesity rates in communities of color may be one of a number of factors leading to severe COVID-19 impacts in those communities

(Washington, DC – May 6, 2020) – New data drawn from the National Health and Nutrition Examination Survey (NHANES) found that 42.4 percent of U.S. adults age 20 and older have obesity. That rate was up nearly three percentage points from the previous NHANES survey taken in 2015-2016 when 39.6 percent of the nation’s adults had obesity. After remaining relatively stable in the 2000s, these new data represent the third consecutive NHANES survey that found increases in the nation’s adult obesity rate of 2.8, 1.9 and 2.8 percentage points respectively.

The latest survey also showed a continuing pattern of higher rates of obesity in Black and Latino communities than in the White population. Among adults, the prevalence of both obesity and severe obesity was highest in Black adults compared with other races/ethnicities.

Rates of Obesity – U.S. Adults by Race:

  • Blacks – 49.6%
  • Latinos – 44.8%
  • Whites – 42.2%

Rates of Obesity – U.S. Adults by Race and Gender

  • Black Women – 56.9%
  • Black Men – 41.1%
  • Latina Women – 43.7%
  • Latino Men – 45.7%
  • White Women – 39.8 %
  • White Men – 44.7 %

Childhood obesity is also increasing across the country. Having obesity as a child puts you at a higher risk of having obesity as an adult.


Having obesity puts people at higher risk for severe COVID-19 impact
It is well-established that obesity is associated with serious health risks.  The risk of diabetes is closely associated with obesity. In addition, people with obesity have higher levels of pre-existing respiratory and cardiac disease which puts them at higher risk for serious impacts if infected by the novel coronavirus.  In a study in review for publication, researchers at New York University found that obesity is one of three of the most common risk factors for COVID-19 hospitalizations.

The COVID-19 crisis is disproportionately causing severe illness and taking the lives of Black Americans. As of April, of COVID-19 positive tests where the patient’s race/ethnicity was known, 28.5 percent were Black. Blacks make-up 13.4 percent of the U.S. population.  Additional examples include Milwaukee County, Wisconsin, Blacks are 28 percent of the county’s population but as of early April were 73 percent of its coronavirus deaths. In Michigan, Blacks are 14 percent of the state’s population and 41 percent of the state’s coronavirus deaths. In Chicago, Blacks are 23 percent of the city’s residents and 58 percent of its coronavirus deaths.

The social, economic, and environmental conditions that lead to higher rates of obesity and other chronic diseases in communities of color are tied to factors that also elevate the risk of COVID-19 related hospitalizations and death.  Factors such as lack of economic opportunities, for example in the form of good jobs with living wages, contribute to obesity by making it more difficult to afford healthier foods or have access to stores that sell affordable healthy produce.  Additional conditions in many communities of color that contribute COVID-19 infections, hospitalizations and deaths are living in multigenerational households, working in public-facing jobs that elevate COVID-19 risk (such as work in home health care, grocery stores, delivery services and the public transit system) and less access to healthcare.

“Numerous factors are leading to the tragic overrepresentation of people of color in the nation’s COVID-19 deaths, among them the number of people of color working on the frontlines as essential workers, where telework or physical distancing is not possible,” said Dr. J. Nadine Gracia, Trust for America’s Health’s Executive Vice President and Chief Operating Officer. “In addition, high levels of chronic disease within communities of color, such as diabetes and heart disease, are contributing to higher levels of COVID-19 deaths”.

The nation’s obesity crisis and the COVID-19 pandemic will continue to interact in additional ways. For example, food insecurity is associated with obesity. An additional contributing factor is lack of physical activity. Unfortunately, COVID-19 will increase both of those concerns as millions of families are currently food insecure due to job loss and many places to exercise such as gyms, community centers and parks are closed.

“The COVID-19 crisis has illuminated systemic and structural inequities that impact the health and well-being of people of color,” Dr. Gracia said. “The factors associated with maintaining a healthy weight are another example of the ways in which where people live, the neighborhood resources available, and the economic opportunities afforded to them drive their health, and are now driving their degree of health risk due to COVID-19.”

While federal and state leaders are immediately focused on protecting lives during the current crisis, investing in programs to stem the rise in the country’s obesity rates will not only improve Americans’ health, it will also make the country more resilient during future health emergencies.

Some of the federal policy actions TFAH recommends to reverse the country’s rising obesity rates are:

  • Congress should fully fund CDC’s Division of Nutrition, Physical Activity and Obesity’s SPAN (State Physical Activity and Nutrition program) grants for all 50 states and the District of Columbia. Current CDC funding only supports 16 states out of 50 approved applications.
  • Congress should increase funding for CDC’s Racial and Ethnic Approaches to Community Health (REACH) program which works with community organizations to deliver effective local and culturally appropriate obesity prevention programs in communities that bear a disproportionate burden of chronic disease. Current funding only supports 31 grantees out of 261 approved applications.
  • Build capacity for CDC and public health departments to work with other sectors (such as housing and transportation) to address social determinants of health, the nonmedical factors that affect communities’ health status including rates of obesity.
  • Without decreasing access or benefit levels, ensure that anti-hunger and nutrition-assistance programs, like the Supplemental Nutrition Assistance Program (SNAP), Special Supplemental Nutrition Program for Women, Infants and Children (WIC) follow the Dietary Guidelines for Americans and make access to nutritious food a core program tenet.
  • Expand the WIC program to age 6 for children and for two years postpartum for mothers. Fully fund the WIC Breastfeeding Peer Counseling Program.
  • Increase the price of sugary drinks through excise taxes and use the revenue to address health and socioeconomic disparities. Increasing the price of surgery drinks has been shown to decrease their consumption.
  • Enforce existing laws that direct most health insurers to cover obesity-related preventive services at no-cost sharing to patients. Comprehensive pediatric weight management programs and services should also be covered by Medicaid.
  • Encourage safe physical activity by funding Complete Streets, Vision Zero and other pedestrian safety initiatives through federal transportation and infrastructure funding.
  • In schools, strengthen and expand school nutrition programs beyond federal standards to include universal meals and flexible breakfasts, eliminate all unhealthy food marketing to students, support physical education programs in all schools and expand programs that ensure students can safely walk or ride bicycles to and from school.

See TFAH’s State of Obesity: Better Policies for a Healthier America 2019 for additional recommendations on how to stem the country’s obesity crisis. https://www.tfah.org/report-details/stateofobesity20