State Category: California

New Report: Fewer States Placed in Top Performance Tier for Public Health Preparedness in 2021

COVID–19 Pandemic Continues to Illustrate the Critical Need to Invest in Public Health Infrastructure and the Social Determinants of Health

(Washington, DC – March 10, 2022) – As the nation enters its third year of the COVID-19 pandemic, a new report calls for urgent investment to create a public health system able to protect all Americans’ health during emergencies. The report, released today by Trust for America’s Health, measures states’ performance on 10 key emergency preparedness indicators and identifies gaps in states’ readiness to respond to emergencies. The report includes policy recommendations for strengthening the nation’s health security.

The report, Ready or Not 2022: Protecting the Public’s Health from Diseases, Disasters and Bioterrorism, measures states’ degree of preparedness to respond to a wide spectrum of health emergencies and to provide ongoing public health services, including disease surveillance, seasonal flu vaccination, safe water, and expanded healthcare services during emergencies. It tiers states and the District of Columbia into three performance levels: high, middle, and low, placing 17 states and DC in the high-performance tier, 20 states in the middle performance tier, and 13 states in the low performance tier. The 2021 report placed, 20 states and the District of Columbia in the high-performance tier.

States’ Performance by Tiers

Performance Tier States Number of States
High Tier AL, CO, CT, DC, FL, IL, IA, KS, MD, MA, NJ, OH, PA, SC, UT, VA, VT, WA 17 states and DC
Middle Tier AZ, CA, DE, GA, ID, ME, MI, MO, MS, NE, NH, NM, NY, NC, ND, OK, RI, TN, TX, WI 20 states
Low Tier AK, AR, HI, IN, KY, LA, MN, MT, NV, OR, SD, WV, WY 13 states

 

This year’s report found that 12 states improved their performance while 16 states slipped in their ranking. All states’ performance is relative to that of other states.

Three states, Ohio, Pennsylvania and South Carolina, improved their performance by two tiers.

Nine states improved by one tier: Alabama, Arizona, Florida, Illinois, Iowa, Missouri, New Hampshire, New Jersey, and New York.

Sixteen states fell one tier: Delaware, Georgia, Idaho, Kentucky, Louisiana, Maine, Minnesota, Mississippi, Montana, Nebraska, New Mexico, North Carolina, Oklahoma, Oregon, Rhode Island, and Wisconsin.

In addition, the report found:

  • A majority of states had plans in place to expand healthcare and public health laboratory capabilities in an emergency.
  • Most states are accredited in the areas of public health, emergency management or both.
  • A large majority of Americans who receive their household water through a community water system had access to safe water.
  • Only about half of the U.S. population is served by a comprehensive local public health system.
  • Seasonal flu vaccination rates have risen significantly in recent years but are still lower than the goal set by Healthy People 2030.
  • Just over half of workers used some kind of paid time-off in a one-month sample. The need for paid time off has become particularly apparent during the pandemic, as many workers became ill or needed to care for a sick family member.
  • Only 28 percent of hospitals, on average, earned a top-quality patient safety grade during the year, down from 31 percent the year prior.

“The major takeaway of this report is that underinvestment in the nation’s public health system, and attacks on its authority, have had deadly consequences during the COVID-19 pandemic. Action and investment are urgently needed. This report’s findings can help federal and state officials identify gaps in public health preparedness and the steps needed to better protect lives and the economy during the next health emergency,” said J. Nadine Gracia, MSCE, President and CEO of Trust for America’s Health.

The report measured states’ performance during a year that presented intense demands on the nation’s public health system. In addition to the ongoing COVID-19 pandemic, 2021 saw record heat in many places, extensive flooding, wildfires throughout the Western U.S., a highly active hurricane season, and unusual and deadly December tornados in eight states. At the same time, hundreds of public health officials having experienced burn-out, threats to their safety, and attempts to limit their public health authorities have resigned, retired, or been fired.

While critical progress was made in fighting COVID-19 during 2021, particularly through the widespread availability of vaccines and a more coordinated federal response, the pandemic continued to illuminate the ways in which health inequities put communities of color and low-income communities at heightened risk for worse health outcomes during an emergency.

“Social, economic, and health inequities undermine a community’s ability to prepare for, respond to, and recover from a public health emergency. If we enter the next public health crisis with the same magnitude of health inequities in our communities as has been evident during this pandemic, the impact will be similar: preventable loss of life, disproportionate impact on communities of color and low-income communities, and widespread social and economic disruption.  It is impossible to separate strong public health emergency preparedness and health equity,” said Dr. Gracia.

Among the report’s policy recommendations:

  • Congress and states should provide stable, flexible, and sufficient funding for public health, including for infrastructure, data systems, and the public health workforce.
  • Congress should create a COVID-19 Commission to review and address gaps in the pandemic response, and leaders at all levels of government should reject attempts to weaken public health authorities.
  • Policymakers should take steps to prevent disease outbreaks by investing in vaccination infrastructure, antibiotic resistance programs, and by providing paid leave for all workers.
  • Congress should create programs to help build resilient communities by investing in health equity and the social determinants of health, including anti-poverty programs and programs that build financial security for families.
  • Congress should invest in the development and distribution of medical countermeasures to enable rapid development and effective deployment of life-saving products during emergencies and federal and state policymakers and healthcare systems leaders should work together to prioritize effective coordination and communication during emergencies.
  • The White House, Congress, and states should develop plans and provide funding to minimize the health impacts of climate change and do so in ways that address health equity.

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.  Twitter: @HealthyAmerica1

TFAH Applauds USDA’s Announcement of New Standards Improving Nutrition in School Meals

Actions will Help Address Youth Obesity Crisis

(Washington, DC – February 7, 2022) – The U.S. Department of Agriculture’s recent announcement that the agency will update school meal nutrition standards will help ensure more nutritious school meals for millions of children and adolescents and is an important step toward reversing the nation’s alarming rates of childhood obesity.

The Department announced a stepwise approach, beginning in the next school year. Among the most critical changes are:

  • Beginning in the 2022-2023 school year, requiring that schools and child-care providers serving children ages six and older offer low-fat, flavored milk, nonfat flavored milk, or nonfat or low-fat unflavored milk.
  • Requiring that 80 percent of the grains served in school meals each week are rich in whole grains, beginning with the 2022-2023 school year.
  • Requiring a 10 percent decrease in weekly sodium levels in school meals starting with the 2023-2024 school year.
  • Beginning the process for more permanent nutrition standards for the 2024-2025 school year.

Importantly, these changes will return nutritional standards for school meals to 2012 levels, which have been found to have dramatically increased the quality of students’ nutrition.

Rising obesity rates are a serious problem among children and adolescents nationwide. According to the latest available data, nearly 20 percent (19.3 percent) of U.S. children ages 2 to 19 have obesity. These data more than tripled since the mid-1970s and Black and Latino youth have substantially higher rates of obesity than do their white peers. The racial and ethnic disparities in obesity underscore the need to address social determinants of health, including food insecurity, access to healthy and nutritious foods, poverty, and other systemic barriers to health.

“These changes in school meal nutrition standards are an important step toward addressing America’s childhood obesity crisis. Millions of U.S. children get a significant proportion of their daily food intake via meals served in school. Evidence shows that ensuring that those meals are high in nutritional value will improve children’s health and help with their school performance and readiness to learn,” said J. Nadine Gracia, M.D., MSCE, President and CEO of Trust for America’s Health.

Learn more about adult and childhood obesity trends and policies to address the obesity crisis in TFAH’s 2021 State of Obesity Report: Better Policies for a Healthier America.

Trust for America’s Health Statement in Recognition of Martin Luther King, Jr. Day and the National Day of Racial Healing, 2022

Trust for America’s Health’s (TFAH) Board Chair, Gail Christopher, D.N., and President and CEO, J. Nadine Gracia, M.D., MSCE, released the following statement in honor of Martin Luther King, Jr. Day and the National Day of Racial Healing.

(Washington, D.C. – January 17, 2022)

“Today’s observation of Martin Luther King, Jr. Day and tomorrow’s National Day of Racial Healing is a time to take action on the work that needs to be done to end racism, heal the impacts of centuries of racial injustice, and promote equity for all people.

Structural racism has far-reaching impacts on people’s health, education, employment and economic opportunities, access to safe and affordable housing, access to transportation, access to high quality healthcare, and their treatment within the criminal justice system.

Our goal is to advance policies and actions that will create meaningful change, including addressing social inequities and promoting racial healing. Dismantling racism is a public health imperative. The disproportionate impact of the COVID-19 pandemic within communities of color is the most current example of the ways in which structural racism continues to have consequential and often tragic impacts on people’s lives.

TFAH is committed to continuing its work to advocate for policies that overcome the impacts of racism and advance health equity. Meaningful change will require racial healing which will in turn necessitate acknowledging the historic and contemporary impacts of racism, reframing the narrative, and building relationships across communities.”

TFAH calls for the following actions to reverse the impact of structural racism in America:

  • Make advancing health equity and eliminating health disparities a national priority. Such a priority requires ending systemic barriers and advancing policies and programs that create equitable opportunity for health and well-being.
  • Target the elimination of poverty by increasing the minimum wage and expanding the Earned Income Tax Credit at the national and state levels.
  • Increase funding for programs that address health inequities, such as the Centers for Disease Control and Prevention’s Racial and Ethnic Approaches to Community Health (REACH) and Good Health and Wellness in Indian Country programs.
  • Recruit and sustain a diverse public health workforce through public health workforce loan repayment and support the hiring of public health equity experts through investments in public health infrastructure and workforce.
  • Increase access to high-quality healthcare for all by strengthening incentives to expand Medicaid in all states and by making marketplace coverage more affordable for low-and moderate-income people.
  • Create a national standard mandating job-protected paid family and medical leave for all employees.
  • Increase funding for programs that promote long-term security and good health for children and families, including programs designed to expand access to affordable housing and Head Start, Early Head Start, and nutrition support programs such as Healthy School Meals for All, the Supplemental Nutrition Assistance Program (SNAP), and the Special Supplemental Nutrition Assistance Program for Women, Infants, and Children (WIC).
  • Funding agencies should meaningfully engage with historically underserved communities to best understand their needs and work with community leaders to co-lead teams that establish, lead, and evaluate programs.
  • Federal and state governments should act to protect voting rights for all.

For more information about these and other policy recommendations see TFAH reports A Blueprint for the 2021 Administration and Congress – The Promise of Good Health for All: Transforming Public Health in America. And Leveraging Evidence-Based Policies to Improve Health, Control Costs, and Create Health Equity

 

 

Next Iteration of the Build Back Better Act Should Include Critical Investments in Public Health, Emergency Preparedness, and the Social Determinants of Health

(January 10, 2022) — As the 117th Congress begins its work in 2022, it is critical that it seeks to bolster the nation’s public health system and address longstanding inequities that have been exacerbated by the COVID-19 pandemic. As the country continues to grapple with the health and economic impacts of COVID-19, Congress has the opportunity to make urgent investments in core public health infrastructure, to modernize national, state and local public health laboratory systems, and to direct much needed resources to address current and longstanding public health challenges. As Congress considers the next steps for the Build Back Better Act, TFAH recommends that the following policies be prioritized as negotiations move forward:

  • Investing in chronically underfunded public health infrastructure to address the COVID-19 pandemic and ensure that public health is better equipped to effectively respond to future health threats. The pandemic exposed the impact of outdated, understaffed health departments. The Build Back Better Act includes $8.4 billion in funding to enable health departments to address longstanding infrastructure and workforce gaps and modernize public health data systems and laboratories across the country. TFAH recommends an additional $4.5 billion annual investment to support and sustain federal, state, local, territorial, and Tribal foundational public health capabilities.
  • Expanding availability of nutritious foods to ensure children, regardless of their socioeconomic status, can access high-quality, nutritious meals when school is in session and during school closures. The Build Back Better Act includes provisions to expand the Community Eligibility Program (CEP), invest in a Summer Electronic Benefits Transfer (EBT) program, and establish a Healthy Food Incentives Demonstration to support schools in developing healthy food offerings. TFAH also recommends extending Healthy School Meals for All, which provides students access to school meals at no charge regardless of their family income as a step to ending child hunger and ensuring access to healthy foods.
  • Increasing access to life-saving behavioral health programs. The Build Back Better Act includes $2.5 billion in funding to support public health approaches to reduce community violence and trauma, $75 million to support the infrastructure of the National Suicide Prevention Lifeline, and $15 million to support the Substance Abuse and Mental Health Services Administration’s Project Aware program, which helps schools promote the mental health of their students. TFAH recommends focusing on primary prevention of behavioral health concerns, including through suicide and Adverse Childhood Experiences prevention and increasing investments in social-emotional learning and wellness in schools.
  • Investing in early childhood education and services to ensure families have access to high-quality childcare and early education. The Build Back Better Act includes $400 billion to establish a birth-through-five childcare and early learning entitlement program, bolster Head Start, create a universal preschool program, and significantly strengthen the early childhood education workforce through training and increased pay.
  • Establishing a comprehensive paid family and medical leave policy to ensure workers can take time off to address health or caregiving needs. The Build Back Better Act includes provisions that grew out of the FAMILY Act and would provide up to 12 weeks of partial income while employees take family or medical leave. Access to paid family and medical leave can help control disease outbreaks, improve parental and child health, and contribute to a healthier, more productive workforce.
  • Increasing access to safe and affordable housing to address housing insecurity amongst low-income families. Stable and healthy housing is a significant social determinant of health. The Build Back Better Act includes $24 billion for new Housing Choice Vouchers and supportive services, $5 billion to address lead paint and other health hazards, $15 billion to support the preservation and creation of rental homes for low-income households, and $500 million to expand the supply of affordable housing with supportive services for older adults.

TFAH Applauds Introduction of the Protecting the Health of America’s Older Adults Act

(Washington, DC – December 16) – Trust for America’s Health, a non-partisan, nonprofit public health policy, research and advocacy organization, applauds the introduction of the bipartisan Protecting the Health of America’s Older Adults Act by Representatives Lois Frankel (CA-44), Gus Bilirakis (FL-12) and Debbie Dingell (MI-12). The bill would enable state and local public health departments to better meet the needs of older adults via innovative new strategies.

If enacted, the bill would create a Healthy Aging grant program at CDC to provide grants to health departments to help states and local communities coordinate multi-sector efforts to promote the health of older adults and develop aging expertise. The grant program would allow state and local health departments to apply an aging lens to all of their work, including efforts to reduce healthcare costs and improve health equity. The COVID-19 pandemic has demonstrated the importance of public health’s role in the aging sector, and this new program will help ensure that health departments have the resources they need to make a meaningful impact for seniors.

The President and CEO of Trust for America’s Health, Dr. J. Nadine Gracia, congratulates Representatives Frankel, Bilirakis, and Dingell on the introduction of the bill, stating:

“The last year underscored how important it is for public health to be at the table when it comes to promoting the health of older adults. Health departments have been critical to addressing the needs of older adults during the pandemic; their active engagement in many other issues faced by the aging population, including transportation and housing access, chronic disease, and mental health, will promote better aging outcomes and benefit our entire society. This new grant program would be a step in the right direction to ensure that state and local health departments have the resources to do exactly that.”

In addition to TFAH, original endorsing organizations include:

  • Alliance for Aging Research
  • American Association on Health and Disability
  • American Lung Association
  • American Muslim Health Professionals
  • American Public Health Association
  • American Psychological Association
  • Association of Schools and Programs of Public Health
  • Association of State Public Health Nutritionists
  • Association of State and Territorial Health Officials
  • Authority Health
  • Catholic Health Association of the United States
  • Center for Advocacy for the Rights and Interests of the Elderly (CARIE)
  • Ceres Community Project
  • Christian Council of Delmarva
  • Coalition of National Health Education Organizations
  • Common Threads
  • Elder Options
  • Equality California
  • FLIPANY
  • Florida Public Health Association
  • The Gerontological Society of America
  • Hartsfield Health Systems Consulting, LLC
  • Lakeshore Foundation
  • Long Beach Gray Panthers
  • Maine Council on Aging
  • Maine Public Health Association
  • Mel Leaman Free Clinic
  • MindWise Innovations
  • National Association of Nutrition and Aging Services Programs
  • National Network of Public Health Institutes
  • National Recreation and Park Association
  • National Senior Games Association
  • Peggy Lillis Foundation
  • The Praxis Project
  • Prevent Blindness
  • Silver State Equality-Nevada
  • Society for Public Health Education
  • Society for Women’s Health Research
  • Tennessee Justice Center
  • Urban Health Partnerships
  • Valley AIDS Council
  • WARM, Inc.
  • Washington State Public Health Association
  • We All Rise

TFAH has prepared a fact sheet on the legislation.

 

Trust for America’s Health and Well Being Trust Applaud the Surgeon General’s Advisory on Youth Mental Health

The challenges to our children’s mental health were many before COVID-19 and made worse by the pandemic – immediate action is needed

(December 7, 2021) – Trust for America’s Health and Well Being Trust strongly applaud U.S. Surgeon General Dr. Vivek Murthy’s Advisory on Youth Mental Health released today.

“We applaud the Surgeon General for not only drawing more attention to the issue of youth mental health, but reminding us that this problem, significant before COVID-19, has been negatively impacted during, and could only get worse after the pandemic without robust action,” said Benjamin F. Miller, PsyD, President of Well Being Trust.  “By proactively addressing mental health, including bringing care to where people are, we are more likely to meet the moment in a way that can help countless young people and their families.”

The Surgeon General’s advisory calls for “a swift and coordinated response” to the nation’s youth mental health crisis and demonstrates the need for all sectors of society to be part of the solution with recommendations for what individuals, families, community organizations, technology companies and government can do to improve and protect young people’s mental health.

“One of the strengths of this advisory is that it recognizes that in order to support young people’s mental health we need to address the social and economic conditions in their lives with multisector initiatives, said J. Nadine Gracia, M.D., MSCE, President and CEO of Trust for America’s Health. “Where a child lives, where they go to school, their family’s access to employment and safe housing all impact their mental health.”

TFAH and WBT’s Pain in the Nation series has tracked the nation’s deaths of despair since 2017 including the escalating youth mental health crisis. Its report Addressing a Crisis: Cross-Sector Strategies to Prevent Adolescent Substance Use and Suicide. makes recommendations for cross sector action.

 

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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. 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 well-being. www.wellbeingtrust.org. Twitter: @WellBeingTrust

 

 

Trust for America’s Health Applauds the Bipartisan Policy Center Report Public Health Forward: Modernizing the U.S. Public Health System

Sustained Investment in the nation’s public health system is critical to safeguarding the nation’s health security and achieving health equity

(Washington, DC – December 2, 2021) – Trust for America’s Health (TFAH) applauds and strongly endorses the Bipartisan Policy Center (BPC) report, Public Health Forward: Modernizing the U.S. Public Health System, released today. The report describes the ways COVID-19 exposed weaknesses in the nation’s public health system and pervasive disparities in conditions that affect Americans’ health. It outlines a five-year vision and actionable framework for how state, territorial and local elected and public health officials can enhance their jurisdiction’s public health infrastructure. TFAH’s President and CEO J. Nadine Gracia, M.D., MSCE and Distinguished Visiting Fellow David Fleming, M.D. served on the report’s Public Health Advisory Group.

The infusion of pandemic relief funds is an opportunity to address the community conditions that negatively impact health, according to the report.  And public health has a critical role to play by addressing health inequities, working to reverse the surge in the number of Americans living with a chronic disease, promoting healthy eating and active living, controlling infectious disease, and preventing injuries.

“BPC’s report is critical reading for policymakers. It provides a roadmap for the public health system our nation’s needs to protect everyone’s health, including communities currently at disproportionate risk due to systemic inequities,” said J. Nadine Gracia, President and CEO of Trust for America’s Health. “The report should guide immediate and sustained investment in public health.”

Many of the report’s policy recommendations align with recent Trust for America’s Health recommendations. Both BPC and TFAH are calling for the following:

  • Increase and sustain predictable and flexible public health funding. TFAH recommends an annual $4.5 billion public health infrastructure fund to support foundational public health capabilities at the federal, state, local, territorial and Tribal levels.
  • Invest in programs to address health inequities, including the root causes of disease and the impact of the social determinants of health.
  • Strengthen public health data collection and sharing. Data should be collected and disaggregated by race, ethnicity and other sociodemographic characteristics so the impacts of policies, interventions and health conditions on specific population and sub-populations groups are known.
  • Invest in the recruitment and retention of a diverse, well-trained public health workforce.
  • Protect public health departments’ ability to make science-based decisions free from inappropriate political influence.

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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.

 

Trust for America’s Health Applauds COVID-19 Health Equity Task Force Report

Addressing health inequities is critical to protecting everyone’s health and being prepared for future health public emergencies

(Washington, DC – November 10, 2021) – Trust for America’s Health (TFAH) applauds the report of the COVID-19 Health Equity Task Force, including its recommendations to President Biden for mitigating the health inequities caused or exacerbated by the COVID-19 pandemic and for preventing such inequities in the future. We furthermore commend the Biden Administration  for responding to the report’s call to action with new investments in initiatives to improve community and public health in traditionally under-resourced communities, including communities of color and among underserved populations.

In January of 2021, the Biden Administration created the Task Force, a multisector group of individuals with expertise and lived experience relevant to groups suffering disproportionate rates of illness and death from COVID-19, experts in fields such as public health, healthcare, behavioral health, and community-based services, as well as government officials. The Task Force represents diverse perspectives on how to address COVID-19 related health and social inequities and strengthen the nation’s public health response.

“The COVID-19 pandemic has exposed and exacerbated longstanding systemic inequities in our nation,” said J. Nadine Gracia, MD, MSCE, President and CEO of Trust for America’s Health.  “The COVID-19 Health Equity Task Force has laid out a road map for reducing inequities during this pandemic and before the next public health emergency.  As the report acknowledges, we must engage in a multisector effort to address the upstream factors that contribute to underlying health inequities in order to promote optimal health and build resilience in all communities. TFAH looks forward to working with the administration on our shared goals.”

The Task Force’s report echoes many of TFAH’s policy recommendations. The following are policy priorities shared by the Task Force report and TFAH:

  • Fund the public health workforce and emergency response. The federal government should increase and sustain funding for equity-centered pandemic and public health emergency activities and infrastructure at the federal, state, local, Tribal, and territorial levels. This should include building a workforce dedicated to public health emergency preparedness, response, recovery, and disaster-related behavioral health services and supporting communities with the greatest healthcare inequities.
  • Support equity-centered data collection. The federal government should fund an equity-centered approach to data collection, including ensuring sufficient funding to collect data for groups that are experiencing disproportionate impact during the pandemic and to understand the specific needs of currently underserved populations.
  • Fund data modernization for health settings. The federal government should provide funding for healthcare and public health to update data systems centered on equity and to ensure interoperability and automatic electronic lab reporting of a robust set of disaggregated, standardized socioeconomic and demographic data elements.
  • Strengthen multi-sector collaboration. The federal government should strengthen collaboration with a diverse array of community-based organizations and public health providers by providing robust and sustained funding to build capacity, provide technical assistance and establish partnerships with communities of color and other underserved populations.
  • Prioritize vaccine, testing, treatment, and personal protective equipment (PPE) access for underserved communities. Federal, state, local, Tribal, and territorial governments should prioritize vaccine distribution, testing, treatment, and PPE access to communities of color and other underserved populations, including those who face mobility, geographic, or other barriers to access.
  • Address the social determinants of health. The federal government should lead efforts to advance the social determinants of health including nutrition safety net programs for individuals and families who are food insecure and for those that have limited access to healthy food options.
  • Increase access to behavioral healthcare. Federal, state, local, Tribal, and territorial governments should increase investment in and access to comprehensive, equity-centered behavioral health services, including a focus on prevention.
  • Lead and coordinate implementation of the COVID-19 Health Equity Task Force’s recommendations from a permanent health equity infrastructure in the White House.

TFAH reports on emergency preparedness, public health funding, leveraging policy to improve Americans’ health and create health equity, and a legislative blueprint to transform the nation’s public health system, include additional recommendations that support the Task Force’s health equity goals.