State Category: Mississippi

John Auerbach Stepping Down from TFAH President & CEO Position to Return to CDC; TFAH Executive Vice President & COO Dr. J. Nadine Gracia Named New President & CEO

Statement by Dr. Gail Christopher, Chair

TFAH Board of Directors

May 12, 2021

 It is with mixed feelings that I announce that as of June 18th John Auerbach will be leaving Trust for America’s Health (TFAH) to return to the Centers for Disease Control and Prevention (CDC).  I am also delighted to announce that the Board of Directors has selected J. Nadine Gracia, MD, MSCE, as the new President and CEO of TFAH.

During Mr. Auerbach’s four and a half years as TFAH’s President and CEO he has led the transformation of the organization, doubling the number of philanthropic funders, increasing the budget by 50 percent, and growing its staff by 33 percent.  During this time, we have elevated our work on equity and on the social determinants of health and made them central to who we are as an organization.  TFAH has continued many of its signature activities while also taking on new projects from Promoting Health and Cost Control in States to the Public Health Communications Collaborative, from Pain in the Nation to Age-Friendly Public Health and much more. There is so much that John can be proud of during his tenure at TFAH.

In his new position, John will serve as the Director of Intergovernmental and Strategic Affairs, in which he will oversee external affairs and help guide the development of agency-wide priority initiatives.

Dr. Gracia is a national health equity leader with significant experience in federal government, the nonprofit sector, and professional associations. She is recognized for her work at TFAH and previously in federal government service in the Obama Administration as the Deputy Assistant Secretary for Minority Health and Director of the Office of Minority Health at the U.S. Department of Health and Human Services (HHS).  In that capacity, she directed departmental policies and programs to end health disparities and advance health equity and provided executive leadership on administration priorities including the Affordable Care Act and My Brother’s Keeper.

Previously, she served as Chief Medical Officer in the Office of the Assistant Secretary for Health at HHS, where her portfolio included adolescent health, emergency preparedness, environmental health and climate change, global health, and the White House Council on Women and Girls.  Prior to that role, she was appointed as a White House Fellow at the U.S. Department of Health and Human Services and worked in the Office of the First Lady on the development of the Let’s Move! initiative to solve childhood obesity.

Dr. Gracia earned her undergraduate degree from Stanford University, a medical degree from the University of Pittsburgh School of Medicine, and a Master of Science in Clinical Epidemiology from the University of Pennsylvania.  She is active in many civic and professional organizations.

Nadine and John worked as a team in every aspect of TFAH’s mission for the past three and a half years.   During that time, Nadine successfully managed many roles as she handled TFAH’s operational responsibilities, provided policy leadership and strengthened and broadened partnership relations while also often serving as the face of TFAH at national conferences and convenings.  Her expertise in and commitment to the promotion of equity ensured that TFAH walks the walk as well as talks the talk.  The Board of Directors unanimously agreed that had we done a national search, we would not have found a more ideal person to lead the organization.  We enthusiastically anticipate the achievements that will result from her being at the helm.

During this transition, let me offer my thanks to the wonderful and talented staff at TFAH who day in and day out display skill, and dedication in the service of our mission.  And let me thank my fellow Board members as well, for their commitment and wisdom in supporting TFAH during the last several years under John’s leadership and in choosing Nadine as the new President and CEO.  Your selfless commitment to promoting optimal health and well-being for all is inspiring.

COVID-19 Pandemic Proved that Underinvesting in Public Health Puts Lives and Livelihoods at Risk

Chronic underfunding of public health system weakened the country’s COVID-19 response

(Washington, DC – May 7, 2021) – Chronic underfunding of the public health system was a key contributing factor in the nation’s flatfooted response to the COVID-19 pandemic, according to a new report, The Impact of Chronic Underfunding on America’s Public Health System: Trends, Risks, and Recommendations, 2021, released today by Trust for America’s Health.

The report discusses how the underfunding of core public health programs impeded the pandemic response and exacerbated its impacts.  According to the report’s authors, the missteps of the 2020 COVID-19 response were rooted in a public health system weakened by years of underfunding, the federal government’s failure to communicate and follow the best available science, and, health inequities that put communities of color and Tribal Nations at particular risk.

This annual report examines federal, state and local public health funding trends and recommends investments and policy actions to build a stronger public health system, prioritize prevention, and address the ways in which social and economic inequities create barriers to good health. Also highlighted is the need for the public health system to be ready to prevent and respond to a spectrum of risks, from weather-related emergencies to the rising numbers of drug overdoses, to increasing rates of obesity and resulting chronic diseases.

Response funding critical but not a long-term solution

Congress passed numerous COVID relief bills since March 2020, funding that has been critical to managing the immediate crisis.  But this one-time funding is not a solution to years of underfunding which hollowed out the system, thereby making it less able to spend emergency funds quickly and efficiently.

“What the system urgently needs is sustained, predictable funding that allows it to grow and maintain its workforce and invest in modern data systems and all-hazards preparedness planning on a year-in, year-out basis,” said John Auerbach, President and CEO of Trust for America’s Health.

CDC funding down for the year and decade

The Centers for Disease Control and Prevention (CDC) is the primary federal provider of public health funding to states. For FY 2021, CDC’s budget (aside from supplemental COVID response funding) was $7.8 billion, down 1 percent from the previous year, and continues to be insufficient to meet the country’s public health needs.  Over the last decade (FY 2012 – 21) the CDC’s core budget fell by 2 percent when adjusted for inflation. That decrease in spending happened over a 10-year period in which the U.S. population grew, the number and severity of weather-related emergencies increased, and the number of Americans grappling with substance abuse, suicide and chronic diseases also grew.  Anemic funding for CDC has meant that effective programs fail to reach all 50 states, and there has been little investment in cross-cutting infrastructure and capabilities.

CDC’s annual funding for Public Health Emergency Preparedness (PHEP) cooperative agreements, which support core emergency readiness capacity in states, territories and local areas, increased by $20 million in FY 2021.  But funding for PHEP shrank by approximating one-quarter (about half when adjusting for inflation) over the last two decades from $939 million in FY 2003 to $695 million in FY 2021.

In addition, the Hospital Preparedness Program, the main source of federal funding to help healthcare systems prepare for emergencies, has experienced a nearly 50 percent funding cut (nearly two-thirds when adjusted for inflation) over the last two decades – from $515 million in FY 2003 to $280 million in FY 2021.

At the state level, 43 states and the District of Columbia maintained or increased their public health funding in FY 2020.  In some instances, state-supported COVID response funding increased the state’s public health funding for the year but this emergency response funding is unlikely to translate into sustained funding growth.

Public health workforce is smaller than it was a decade ago

The state and local public health workforce is a critical part of the nation’ public health infrastructure.  From 2008 to 2019 the estimated number of full-time local public health agency staff decreased by 16 percent, while state health agencies lost almost 10 percent of their collective workforce between 2012 and 2019. These personnel cuts translated into fewer trained professionals available to do critical work as the COVID-19 pandemic was spreading across the country.

“For decades, public health leaders have sounded the alarm about the ways in which underfunding the public health system makes us less prepared and puts lives at risk. The COVID-19 pandemic is a stark illustration of how serious those risks are as public health departments were forced to fight the virus with antiquated tools and a depleted workforce,” said John Auerbach. “We must learn from the COVID tragedy and dramatically increase annual support of the public health workforce, programs and infrastructure.  If we fail to learn the lessons from the pandemic, we will be doomed to repeat them.”

The report calls for a $4.5 billion annual investment in the nation’s core public health capabilities.  Other recommendations speak to the need to:

  • Substantially increase core funding to strengthen the public health system, including by building and supporting the workforce, modernizing the system’s data tools and increasing its surveillance capacities.
  • Strengthen public health emergency preparedness, including within the healthcare system.
  • Safeguard and improve Americans’ health by investing in chronic disease prevention and the prevention of substance misuse and suicide.
  • Take steps to advance health equity by combating the impacts of racism and addressing the social determinants that lead to poor health.

New Report: U.S. Must Prioritize COVID-19 Vaccines for People Who Are Homebound

Experts provide strategies to ensure equitable vaccine distribution for homebound people

(Washington, DC – May 3, 2021) – At least 2 million older adults are homebound a number that increases when including younger people who are homebound due to illness or disability.  Ensuring that this population group receives the COVID-19 vaccination requires focused attention, collaboration and resources according to a policy brief released today by Trust for America’s Health (TFAH).

The brief, Ensuring Access to COVID-19 Vaccines for Older Adults and People with Disabilities Who are Homebound, recommends actions that federal, state, and local government, state and local health agencies, the healthcare sector and community partners should take to ensure that people who are homebound are vaccinated.

According to the report, all parties involved in the COVID-19 vaccination effort have a responsibility to ensure people who are homebound are vaccinated, which means redirecting or creating the infrastructure, workforce, and funding support to bring the vaccination process to them.  Adding to the importance of equity in vaccine access is the fact that people who are homebound often have underlying health conditions that put them at heighten risk if they were infected by the COVID-19 virus.  In addition, the processes created or improved to meet the challenge of this pandemic will strengthen the nation’s public health infrastructure for the growing segment of the population who are homebound and help better safeguard their health during future public health emergencies.

“Ensuring that every person is vaccinated against the COVID-19 virus is not only a matter of health equity, its critical to ending the pandemic, said John Auerbach, President and CEO of TFAH. “But millions of people in the U.S. cannot travel to a vaccination site. Government and community partners must work together to protect the health of the homebound population by bringing the vaccine to them.”

Among the report’s recommendations are:

  • Prioritize the administration of COVID-19 vaccination for people who are homebound and their caregivers (both paid and unpaid) by providing sufficient vaccines and the resources needed to administer them in the shortest time possible.
  • Develop a standardized operational definition of “people who are homebound” in order to identify this population and prioritize their vaccination.
  • Ensure that the COVID-19 vaccine is equitably available across the homebound population and that no subset of the population is less served due to race, ethnicity, SES status or where they live. Use data to identify pockets of under-vaccination.
  • Develop and actively promote multiple communications channels for vaccine appointments scheduling, including use of channels that minimize reliance on computers and internet access.
  • Leverage partnerships and establish new ones with public and private sector organizations that already serve the homebound population to ensure equitable and efficient vaccine administration.
  • Ensure, to the degree possible, that in-home vaccination teams include people who are trusted by those being vaccinated and who represent the diversity of the population they serve.
  • Government agencies and private payors should ensure that all costs associated with in-home vaccinations are covered including administrative expenses, travel time and transportation costs, and observation time.

The report is an outgrowth of two national expert convenings hosted by Trust for America’s Health.  Funding for the report and convenings was provided by The John A. Hartford Foundation and the Cambia Health Foundation.

“Older adults and those with disabilities who are homebound have been the forgotten faces of this pandemic,” said Terry Fulmer, PhD, RN, FAAN, President of The John A. Hartford Foundation. “We now know about cutting-edge solutions, as well as failed strategies we can learn from, to ensure that everyone has equitable access to vaccinations going forward.”

“We are committed to ensuring equitable vaccine access for all, including homebound older adults and people with disabilities who may face obstacles scheduling online appointments or getting to vaccination sites,” said Peggy Maguire, President, Cambia Health Foundation. “We funded the Trust for America’s Health national grant with thought leaders from other parts of the country so that we could share learnings and best practices that will help homebound people and their caregivers in our four states access the COVID-19 vaccine and achieve health equity.

Nuevo informe encuentra lagunas en la preparación de los estados para emergencias de salud pública

La COVID-19 muestra daño crítico de subinversión en infraestructura de salud pública

(Washington, DC) — 10 de marzo de 2021 – La pandemia de COVID-19 ha demostrado claramente que la inversión insuficiente en la preparación para responder a emergencias de salud pública puede costar cientos de miles de vidas y causar estragos en la economía. Un nuevo informe publicado hoy por Trust for America’s Health (TFAH) midió el desempeño de los estados en 10 indicadores clave de preparación para emergencias y encontró espacio para mejorar en todas las jurisdicciones.

El informe Ready or Not 2021: Protecting the Public’s Health from Diseases, Disasters and Bioterrorism midió la preparación de los estados para emergencias de salud de cualquier tipo (no solo la crisis del COVID-19).  Este informe colocó a 20 estados y al Distrito de Columbia en una categoría de alto nivel de preparación, 15 estados en un nivel de preparación medio y 15 estados en un nivel de preparación bajo.

Durante casi dos décadas, TFAH ha examinado la preparación para emergencias de salud pública de la nación en este informe anual. Durante ese tiempo, todos los estados han mejorado su preparación para emergencias, pero todos continúan teniendo espacio para un fortalecimiento adicional de sus programas de respuesta de salud pública.

 

Rendimiento estatal, por nivel de puntuación, 2020

Performance Tier States Number of States
High Tier CO, CT, DC, DE, GA, ID, KS, MA, MD, ME, MS, NC, NE, NM, OK, RI, UT, VA, VT, WA, WI 20 states and DC
Middle Tier AL, CA, FL, IA, IL, KY, LA, MI, MN, MT, ND, NJ, OR, TN, TX 15 states
Low Tier AK, AR, AZ, HI, IN, MO, NH, NV, NY, OH, PA, SC, SD, WV, WY 15 states

“La importancia de este informe es que brinda a los estados datos procesables para adoptar políticas que salven vidas. La crisis de COVID-19 muestra que tenemos mucho más trabajo por hacer para proteger a los estadounidenses de las amenazas a la salud, particularmente en las formas en que el racismo estructural crea y exacerba los riesgos para la salud dentro de las comunidades de color ”, dijo John Auerbach, presidente y director ejecutivo de Trust for Salud de Estados Unidos. “Los estados deben tomar medidas enérgicas para apuntalar su preparación para todo tipo de emergencias de salud pública”.

Si bien los hallazgos del informe no son una medida de la respuesta COVID-19 de ningún estado, demuestran que si bien la preparación de los estados es importante, las emergencias de salud nacionales en la escala de una pandemia requieren un liderazgo y una coordinación federales fuertes, e inversiones a largo plazo en salud pública. infraestructura y mano de obra. Los estados por sí solos, incluso aquellos que ocupan un lugar destacado en este informe, no están lo suficientemente equipados para responder a una pandemia sin ayuda federal, dicen los autores del informe.

El informe encontró:

La mayoría de los estados han hecho preparativos para expandir la atención médica y las capacidades de salud pública en una emergencia, a menudo a través de la colaboración. Treinta y cuatro estados participaron en el Nurse Licensure Compact, en comparación con 26 en 2017. El pacto permite a las enfermeras registradas y las enfermeras prácticas o vocacionales con licencia ejercer en múltiples jurisdicciones con una sola licencia. En caso de emergencia, esto permite a los funcionarios de salud aumentar rápidamente sus niveles de personal. Además, los hospitales de la mayoría de los estados tienen un alto grado de participación en coaliciones de salud. En promedio, el 89 por ciento de los hospitales estaban en una coalición y 17 estados y el Distrito de Columbia tenían participación universal, lo que significa que todos los hospitales de la jurisdicción eran parte de una coalición. Dichas coaliciones unen a los hospitales y otras instalaciones de atención médica con la gestión de emergencias y los funcionarios de salud pública para planificar y responder a los incidentes. Finalmente, todos los estados y el Distrito de Columbia tenían laboratorios de salud pública que tenían planes para una gran afluencia de necesidades de pruebas. Esta capacidad de aumentar la capacidad de prueba de laboratorio durante la crisis de COVID-19 fue extremadamente crítica.

La mayoría de los estados están acreditados en las áreas de salud pública, manejo de emergencias o ambos. A diciembre de 2020, la Junta de Acreditación de Salud Pública (PHAB) o el Programa de Acreditación de Gestión de Emergencias (EMAP) acreditaron 42 estados y el Distrito de Columbia; 29 estados y el Distrito de Columbia fueron acreditados por ambos grupos, un aumento neto de uno desde noviembre de 2019. Ambos programas ayudan a garantizar que los sistemas necesarios de preparación y respuesta ante emergencias estén en su lugar y con personal calificado.

Las tasas de vacunación contra la influenza estacional, aunque aún son demasiado bajas, han aumentado significativamente. La tasa de vacunación contra la influenza estacional entre los estadounidenses de 6 meses o más aumentó del 42 por ciento durante la temporada 2017-2018 al 52 por ciento durante la temporada 2018-2019, pero aún está por debajo de la tasa de vacunación objetivo del 70 por ciento establecida por Healthy People 2030.

En 2019, solo el 55 por ciento de los residentes estatales empleados, en promedio, usaron tiempo libre remunerado, el mismo porcentaje que en 2018. Aquellos sin licencia remunerada tienen más probabilidades de trabajar cuando están enfermos y corren el riesgo de propagar la infección. Esto se volvió particularmente relevante durante la pandemia de COVID-19, ya que el aislamiento y la cuarentena son herramientas importantes para controlar el brote.

La mayoría de los residentes que obtuvieron el agua de su hogar a través de un sistema de agua comunitario tenían acceso a agua potable. En promedio, solo el 5 por ciento de los residentes del estado utilizó un sistema de agua comunitario en 2019 que no cumplía con todos los estándares de salud aplicables.

El informe incluye recomendaciones de acciones por parte de los legisladores federales y estatales para mejorar la preparación para emergencias de salud pública de la nación en siete áreas prioritarias:

  • Proporcionar financiación suficiente y estable para la seguridad de la salud pública nacional y mundial.
  • Fortalecer las políticas y los sistemas para prevenir y responder a brotes y pandemias.
  • Construir comunidades resilientes y promover la equidad en salud en general y en la preparación.
  • Asegurar liderazgo, coordinación y fuerza laboral efectivos en salud pública.
  • Acelerar el desarrollo y la distribución, incluida la distribución de última milla, de contramedidas médicas.
  • Fortalecer la capacidad del sistema de salud para responder y recuperarse durante y de emergencias de salud.
  • Prepárese para las amenazas ambientales y el clima extremo.

El informe de la serie Ready or Not está financiado por la Fundación Robert Wood Johnson con el apoyo adicional de The California Endowment, W.K. Fundación Kellogg y Fundación Kresge.

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

New Report Finds Gaps in States’ Preparedness for Public Health Emergencies

COVID-19 Illuminated critical harm of underinvestment in public health infrastructure

(Washington, DC – March 10, 2021) The COVID-19 pandemic has starkly demonstrated that underinvestment in preparedness to respond to public health emergencies can cost hundreds of thousands of lives and wreak havoc on the economy.  A new report released today by Trust for America’s Health (TFAH) measured states’ performance on 10 key emergency preparedness indicators and found room for improvement in every jurisdiction.

The report, Ready or Not 2021: Protecting the Public’s Health from Diseases, Disasters and Bioterrorism measured states’ readiness for health emergencies of any kind (not just the COVID-19 crisis). It placed 20 states and the District of Columbia in a high level of preparedness category, 15 states in a middle preparation tier and 15 states in a low degree of preparation tier.

State performance, by scoring tier, 2020

 Performance Tier States Number of States
High Tier CO, CT, DC, DE, GA, ID, KS, MA, MD, ME, MS, NC, NE, NM, OK, RI, UT, VA, VT, WA, WI 20 states and DC
Middle Tier AL, CA, FL, IA, IL, KY, LA, MI, MN, MT, ND, NJ, OR, TN, TX 15 states
Low Tier AK, AR, AZ, HI, IN, MO, NH, NV, NY, OH, PA, SC, SD, WV, WY 15 states

For nearly two decades, TFAH has examined the nation’s public health emergency preparedness in this annual report. During that time, all states have made improvements in their emergency preparedness, but all continue to have room for additional strengthening of their public health preparedness and response.

“The importance of this report is that it gives states actionable data to adopt policies that save lives. The COVID-19 crisis shows that we have much more work to do to protect Americans from health threats, particularly in the ways in which structural racism create and exacerbate health risks within communities of color,” said John Auerbach, President and CEO of Trust for America’s Health. “States need to take aggressive steps to shore up their preparedness for all types of public health emergencies.”

While the report’s findings are not a measure of any state’s COVID-19 response, they demonstrate that while states’ readiness is important, national health emergencies on the scale of a pandemic require strong federal leadership and coordination, and long-term investment in public health infrastructure and workforce.  States alone, even those that rank high in this report, are not sufficiently equipped to respond to a pandemic without federal help, say the report’s authors.

The report found:

A majority of states have made preparations to expand healthcare and public health capabilities in an emergency, often through collaboration. Thirty-four states participated in the Nurse Licensure Compact, up from 26 in 2017. The compact allows registered nurses and licensed practical or vocational nurses to practice in multiple jurisdictions with a single license. In an emergency, this enables health officials to quickly increase their staffing levels. In addition, hospitals in most states have a high degree of participation in healthcare coalitions. On average, 89 percent of hospitals were in a coalition and 17 states and the District of Columbia had universal participation, meaning every hospital in the jurisdiction was part of a coalition. Such coalitions bring hospitals and other healthcare facilities together with emergency management and public health officials to plan for and respond to incidents. Every state and the District of Columbia had public health laboratories that had plans for a large influx of testing needs. This ability to surge laboratory testing capacity during the COVID-19 crisis was extremely critical.

Most states are accredited in the areas of public health, emergency management, or both. As of December 2020, the Public Health Accreditation Board (PHAB) or the Emergency Management Accreditation Program (EMAP) accredited 42 states and the District of Columbia; 29 states and the District of Columbia were accredited by both groups, a net increase of one since November 2019. Both programs help ensure that necessary emergency preparation and response systems are in place and staffed by qualified personnel.

Seasonal flu vaccination rates, while still too low, have risen significantly. The seasonal flu vaccination rate among Americans ages 6 months or older rose from 42 percent during the 2017–2018 season to 52 percent during the 2019–2020 season but is still below the 70 percent target vaccination rate set by Healthy People 2030.

In 2019, only 55 percent of employed state residents, on average, used paid time off, the same percentage as in 2018. Those without paid leave are more likely to work when they are sick and risk spreading infection. This became particularly relevant during the COVID-19 pandemic, as isolation and quarantine are important tools for controlling the outbreak.

Most residents who got their household water through a community water system had access to safe water. On average, just 5 percent of state residents used a community water system in 2019 that did not meet all applicable health-based standards.

The report includes recommendations for actions by federal and state policymakers to improve the nation’s public health emergency preparedness in seven priority areas:

  • Provide stable, sufficient funding for domestic and global public health security.
  • Strengthen policies and systems to prevent and respond to outbreaks and pandemics.
  • Build resilient communities and promote health equity generally and in preparedness.
  • Ensure effective public health leadership, coordination, and workforce.
  • Accelerate development and distribution, including last mile distribution, of medical countermeasures.
  • Strengthen the healthcare system’s ability to respond and recover during and from health emergencies.
  • Prepare for environmental threats and extreme weather.

The Ready or Not report series is funded by the Robert Wood Johnson Foundation with additional support from The California Endowment, W.K. Kellogg Foundation and The Kresge Foundation.

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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

Over 300 Health and Public Health Groups Call on Congress to Fund Public Health Infrastructure and Workforce as Part of Next COVID-19 Recovery Package

(Washington, DC – February 12, 2021) – The nation’s leading health and public health organizations today wrote to Congressional leaders recommending $4.5 billion in long term, additional annual funding for CDC and states, localities, tribes and territories to support public health infrastructure and workforce.

The letter, endorsed by 316 organizations, calls on Congress to include such funding in the next COVID-19 legislation to not only strengthen the response to the current pandemic but to better prepare the country for the next public health emergency.  A significant, sustained investment is needed to support essential public health activities including disease surveillance, epidemiology, laboratory capacity, all-hazards preparedness and response, and policies to advance health equity, the letter said.

“The COVID-19 pandemic is illustrating in the direst terms the consequences of underfunding public health,” the letter said.  “For too long, the nation has neglected basic public health capacity, and the nation’s response to the pandemic reflects this chronic underfunding.”

The letter applauded Congress for taking quick action to provide funding for the initial pandemic response but also noted that short-term, supplemental funding does not allow public health to recruit and retain the workforce needed to protect the public’s health against a number of growing threats including surging levels of chronic disease, substance misuse and suicide, infectious disease and weather-related events.

New Datasets Show Opportunities Exist for States to Bolster Fair Hiring Protections and Workers Rights with Earned Sick Leave and Ban the Box Laws

(Washington DC – January 28, 2021) — Two new datasets published to LawAtlas.org today offer a comprehensive look at state laws that address earned sick leave laws and Ban the Box policies. These datasets provide a snapshot of how earned sick leave, also known as paid sick leave, and ban the box policies differ between states, how such policies help promote the well-being of state residents, and opportunities for states to adopt or expand such regulations.

“States have a critical role to play in promoting the health and well-being of their residents. These data provide a clear picture that opportunities exist nationwide for states to foster equitable economies in which job seekers are evaluated on their merits and workers have access to paid leave benefits to care for themselves and loved ones,” Adam Lustig, MS, Senior Policy Development Manager and Co-Principal Investigator of the PHACCS initiative.

Earned Sick Leave

As of January 1, 2021, 15 states and the District of Columbia have an earned sick leave law that requires employers of varying sizes to provide paid time away to address medical needs for themselves or their families as a benefit to their employees. Across states, eligibility requirements, employer size, how and when an employee may use their time, and rate of leave accrual of the laws vary:

  • All 16 jurisdictions allow for earned sick leave to be used to care for a family member.
  • Geographically, earned sick leave laws are almost exclusively in place in the northeast and on the west coast, with Colorado, Arizona, and Michigan being exceptions.
  • Of the 16 jurisdictions that have earned sick leave laws, just six require employers of all sizes to provide this benefit.
  • Only two states, New York and Colorado, allow employees to use earned leave immediately upon accrual.
  • Eight states provide the most generous accrual of earned sick leave, enabling workers to earn one hour of sick leave for every 30 hours worked.
  • Washington is the only state that does not specify a limit on the amount of earned sick leave that can be accrued within one year.

Ban the Box

As of January 1, 2021, 36 states and the District of Columbia have a Ban the Box policy that prevents an employer from asking about a potential employee’s criminal history until after fairly considering the applicant’s relevant qualifications. These laws vary greatly in who they apply to, and their enforcement mechanisms:

  • Thirty-six jurisdictions have Ban the Box policies that regulate public employers. However, significant gaps remain, as only three of these jurisdictions apply this protection to government contractors.
  • Only 15 of the 37 jurisdictions with Ban the Box policies regulate private employers, leaving a significant portion of the workforce lacking access to this important fair hiring practice.
  • The most common private positions exempt from Ban the Box policies include: working with children, working with vulnerable adults, law enforcement, and positions where a criminal history check is required by law.

“We have seen a growing body of evidence supporting that earned sick leave laws and Ban the Box policies are important legal approaches to ensuring equity in hiring in the United States,” said Lindsay K. Cloud, JD, Director of the Center’s Policy Surveillance Program. “These datasets are an invaluable resource as we continue to seek to better understand the impact of employer-provided protections and fair chance hiring practices on health, and particularly on the social determinants of health amidst the Covid-19 pandemic.”

The Promoting Health and Cost Control in States initiative’s legal data resources are a collaboration of the Temple University Center for Public Health Law Research with Trust for America’s Health, and support from the Robert Wood Johnson Foundation. The earned sick leave and Ban the Box datasets are the fifth and sixth in a series of datasets on laws and policies that can support cost-savings for states and promote health and well-being.

Access the datasets on LawAtlas.org.

 

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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.  Learn more at www.tfah.org

The Center for Public Health Law Research at the Temple University Beasley School of Law supports the widespread adoption of scientific tools and methods for mapping and evaluating the impact of law on health. Learn more at http://phlr.org.

 

 

Increases in Drug Overdose Death Rates Were Up Before COVID-19 and Are Continuing to Rise During the Pandemic

Trust for America’s Health and Well Being Trust Call for Renewed Focus on Preventing Deaths of Despair

DISTRICT OF COLUMBIA & OAKLAND, CA – Dec. 23, 2020 – According to data released this week by the National Center for Health Statistics, in 2019 age-adjusted drug overdose deaths increased slightly over the prior year.  Coupled with data released last week by the CDC showing increases in drug overdose deaths in early 2020, these reports demonstrate the continuing upward trajectory of drug deaths in the U.S, a trend that is being compounded by the COVID-19 pandemic.

The age-adjusted rate of drug overdose during 2019 was 21.6 per 100,000 deaths, up from the 2018 rate of 20.7 per 100,000. In 2019, 70,630 people died due to drug overdose in the United States.

Between 1999 and 2019 the rate of drug overdose deaths increased for all groups aged 15 and older, with people aged 35-44 experiencing the highest single year increase in 2019.  While rates of drug overdose deaths involving heroin, natural and semisynthetic opioids, and methadone decreased between 2018 and 2019 the rate of overdose deaths involving synthetic opioids other than methadone continued to increase.

2018 data showing only minor progress after decades of worsening trends, provisional drug overdose data showing an 18% increase over the last 12 months, and the recent CDC Health Alert Network notice on early 2020 increases in fatal drug overdoses driven by synthetic opioids all underscore the continued impact of the deaths of despair crisis and how the COVID-19 pandemic has further diminished the mental health and well-being of many Americans.

“These 2019 overdose rates and the outlook for 2020 are extremely alarming and the result of insufficient prioritization and investment in the well-being and health of Americans for decades,” said John Auerbach, President and CEO of the Trust for America’s Health. “As we work to recover from the COVID-19 pandemic, we must take a comprehensive approach that includes policies and programs that help Americans currently struggling and target upstream root causes, like childhood trauma, poverty and discrimination in order to help change the trajectory of alcohol, drug, and suicide deaths in the upcoming decades.”

Over the last five years, Trust for America’s Health (TFAH) and Well Being Trust (WBT) have released a series of reports on “deaths of despair” called Pain in the Nation: The Drug, Alcohol and Suicides Epidemics and the Need for a National Resilience Strategy, which include data analysis and recommendations for evidence-based policies and programs that federal, state, and local officials.

“If leaders don’t act now to stymie America’s mental health and addiction crises, next year’s data will easily surpass the astounding numbers we’re seeing today,” said Dr. Benjamin F. Miller, PsyD, Chief Strategy Officer at Well Being Trust. “Overdose deaths can be prevented if individuals who are struggling are able to access the appropriate services and supports – and with greater demonstrated success if the care individuals receive is rooted in their immediate communities.”

 

Drug Overdose Deaths, 1999-2019 (Rates age-adjusted)

Year Deaths Deaths per 100,000
1999 16,849 6.1
2000 17,415 6.2
2001 19,394 6.8
2002 23,518 8.2
2003 25,785 8.9
2004 27,424 9.4
2005 29,813 10.1
2006 34,425 11.5
2007 36,010 11.9
2008 36,450 11.9
2009 37,004 11.9
2010 38,329 12.3
2011 41,340 13.2
2012 41,502 13.1
2013 43,982 13.8
2014 47,055 14.7
2015 52,404 16.3
2016 63,632 19.8
2017 70,237 21.7
2018 67,367 20.7
2019 70,630 21.6

 Sources:
CDC – NCHS – National Center for Health Statistics
https://emergency.cdc.gov/han/2020/han00438.asp
https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm

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About Trust for America’s Health
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

 

About Well Being Trust
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