State Category: Missouri

Policymakers and Health Systems Must Earn Trust within Communities of Color and Tribal Nations to Ensure COVID-19 Vaccine Receptivity, Say Health and Public Health Leaders

Policy brief calls for building vaccine acceptance in communities of color and tribal communities through data transparency, tailored communications via trusted messengers, ensuring ease of vaccine access and no out-of-pocket costs

(Washington, DC – Dec. 21, 2020) – A woeful history of maltreatment of communities of color and tribal nations by government and the health sector, coupled with present day marginalization of these communities by the healthcare system, are the root of vaccine distrust among those groups, according to a policy brief, Building Trust in and Access to a COVID-19 Vaccine Among People of Color and Tribal Nations released today by Trust for America’s Health (TFAH) and co-authors the National Medical Association (NMA) and UnidosUS.

This historic maltreatment, coupled with current day structural racism, has played out in COVID-19’s disproportionate impact on communities of color and tribal communities. These factors also make ensuring vaccine receptivity and access within those communities challenging and of critical importance to protecting lives and ending the pandemic.

In October 2020, TFAH, NMA and UnidosUS hosted a policy convening with 40 leading health equity, healthcare, civil rights, and public health organizations. The purpose of the convening was to advise policymakers on the barriers to vaccine receptivity within communities of color and tribal communities and how to overcome those barriers.

“Earning trust within communities of color and tribal communities will be critical to the successful administration of the COVID-19 vaccine. Doing so will require prioritizing equity, ensuring that leaders from those communities have authentic opportunities to impact vaccine distribution and administration planning, and, the resources to fully participate in supporting vaccine outreach, education and delivery in their communities,” said Dr. J. Nadine Gracia, Executive Vice President and COO of Trust for America’s Health.

The convening created recommendations for policy actions that should be taken immediately within six key areas:

Ensure the scientific fidelity of the vaccine development process.

  • HHS and vaccine developers should release all available vaccine data at frequent and regular intervals to improve transparency and increase confidence in the vaccine evaluation process. Leadership at FDA and HHS must commit to advancing any vaccine only after it has been validated based on established federal and scientific protocols. Programs to monitor for adverse events must also be in place and transparent. Any perception of bypassing safety measures or withholding information could derail a successful vaccination effort.
  • FDA should engage health and public health professional societies, particularly those representing healthcare providers of color, local public health officials, as well as other stakeholders with a role in vaccination, and allow these groups to validate all available data, review the vaccine development and approval process, and issue regular updates on data to their patients, members, and the public.

 Equip trusted community organizations and networks within communities of color and tribal nations to participate in vaccination planning, education, delivery and administration.  Ensure their meaningful engagement and participation by providing funding.

  • Congress should fund CDC and its state, local, tribal, and territorial partners to provide training, support, and financial resources for community-based organizations to join in vaccination planning and implementation, including community outreach, training of providers, and participation in vaccination clinics. State, local, tribal, and territorial authorities should authentically engage and immediately begin vaccination planning with community-based organizations, community health workers/promotores de salud, faith leaders, educators, civic and tribal leaders, and other trusted organizations outside the clinical healthcare setting as key, funded partners.

Provide communities the information they need to understand the vaccine, make informed decisions, and deliver messages through trusted messengers and pathways.

  • Congress should provide at least $500 million to CDC for outreach, communication, and educational efforts to reach priority populations in order to increase vaccine confidence and combat misinformation. All communications must be culturally and linguistically appropriate and tailored as much as possible to reach diverse populations as well as generations within groups.
  • FDA and CDC should initiate early engagement with diverse national organizations and provide funding and guidance for state, local, tribal, and territorial planners to help shape messaging and engage locally with healthcare providers in communities of color and tribal communities, such as nurses, pharmacists, promotores de salud, community health workers, and others to ensure they have the information they need to feel comfortable recommending the vaccine to their patients. Congress and HHS should provide funding for training and engagement of trusted non-healthcare communicators to help shape messaging and to train informal networks, civic and lay leaders, and other trusted community leaders and community-based organizations to answer questions and encourage vaccination.
  • All messaging about the vaccine must be appropriate for all levels of health literacy. Communication should be realistic and clear about timelines and priority groups (and the rationale for these decisions), vaccine effectiveness, types of vaccines, the number of doses, costs, and the need for ongoing public health protections. Planners must provide information that meets people where they are (e.g., barber shops, bodegas, grocery stores, places of worship, etc.) and ensure that trusted messengers in those places have the information they need to be credible and authentic spokespeople.

 

Ensure that it is as easy as possible for people to be vaccinated. Vaccines must be delivered in community settings that are trusted, safe and accessible.

  • We urge the administration and Congress to appropriate the resources necessary to expand and strengthen federal, state, local, territorial, and tribal capacity for a timely, comprehensive, and equitable COVID-19 vaccination planning, communications, distribution, and administration campaign, including funding to support vaccine distribution at the local level and by community-based organizations.
  • Congress and HHS should allocate funding to increase access to vaccination services to ensure that people seeking to be vaccinated do not experience undue increased exposure to the virus as they travel to, move through, and return home from vaccination sites. Flexibility in funding is needed to enable transport of people to vaccination sites, increase accessibility to people without cars, and promote safety and minimize exposure at vaccination locations. Funding should also be provided to health and community-based agencies to assist those for whom transportation or childcare costs are an obstacle to receipt of the vaccine.
  • Planners should ensure that vaccination sites are located in areas that have borne a disproportionate burden of COVID-19, especially leveraging community-based organizations such as Federally Qualified Health Centers, community health centers, rural health centers, schools and places of worship. Mobile services will be particularly important in rural areas. Planners should prioritize congregate living facilities, such as long-term care, prisons, and homeless shelters. In addition, some families, displaced by the COVID economic fallout, may be living with relatives. Planners should ensure vaccination sites have services that meet the Americans with Disabilities Act (ADA) and HHS Office for Civil Rights (OCR) standards for disability and language access.
  • Federal state, local, tribal, and territorial officials must guarantee and communicate with the public that immigration status is not a factor in people’s ability to receive the vaccine and that immigration status is not collected or reported by vaccination sites/providers. Similarly, the presence of law enforcement officers or military personnel could be a deterrent for vaccination at locations, so planners should consider other means of securing sites.
  • In the initial phase, as communities vaccinate healthcare workers, planners must be sure to prioritize home health, long-term care, and other non-hospital-based healthcare workers, who are more likely to be people of color. Other essential workers that comprise large numbers of workers who are people of color and should be treated as within the vaccination priority groups are the food service industry, farmworkers and public transportation employees.

Ensure complete coverage of the costs associated with the vaccine incurred by individuals, providers of the vaccine, and state/local/tribal/territorial governments responsible for administering the vaccine and communicating with their communities about it.

  • Congress, the Centers for Medicare and Medicaid Services, and private payers must guarantee that people receiving the vaccine have zero out-of-pocket costs for the vaccine, related health care visits, or any adverse events related to the vaccine, regardless of their health insurance status.
  • HHS, with emergency funding from Congress, should provide funding so that state, local, tribal, and territorial governments do not bear any cost of vaccine communication efforts, working with their communities, organizing sites, training their staff, and providing personal protective equipment (PPE).

 Congress must provide additional funding and require disaggregated data collection and reporting by age, race, ethnicity, gender identity, primary language, disability status, and other demographic factors on vaccine trust and acceptance, access, vaccination rates, adverse experiences, and ongoing health outcomes.

  • CDC, and state, local, tribal, and territorial authorities should include leaders from communities of color and tribal communities and to plan on-going data collection on vaccination efforts, interpret data, add cultural context, share data with communities, and determine implications and next steps.
  • CDC, and state, local, tribal, and territorial authorities should use these data to inform ongoing prioritization of vaccine distribution and rapidly address gaps in vaccination that may arise among subpopulations by race, ethnicity, neighborhood, or housing setting.

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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

 

States at Greatest Risk for Health Impacts of Climate Change are Often Least Prepared to Protect Residents During Climate Related Events, New Report Finds

(Washington, DC and Baltimore, MD – December 9, 2020) – Many of the states most at risk from climate change are also the least ready to deal with it, according to a new report from researchers at Trust for America’s Health and the Johns Hopkins Bloomberg School of Public Health. This group of states faces increased hazards including hurricanes, floods, heat waves, and vector-borne diseases, but have done the least to prepare, according to the report Climate Change & Health: Assessing State Preparedness.

The report assessed all 50 states and the District of Columbia on their level of preparedness for the health effects of climate change. The researchers found a great deal of variation: Some states have made significant preparations, while others have barely begun this process. Eight states in particular are both most vulnerable to the health impacts of climate change and least prepared.

States in the most-vulnerable/least-prepared group were: Georgia, Kentucky, Mississippi, Oklahoma, South Carolina, Tennessee, Texas, and West Virginia.  Overall, the more vulnerable a state was, the less prepared it tended to be. Many of these high vulnerability/low preparedness states are in the Southeast or Southern Great Plains.

“We wanted to better understand the risks posed to individual states and their level of readiness to protect residents,” said the report’s lead author, Matt McKillop, Senior Researcher at Trust for America’s Health. “Our hope is that the report will give officials at all levels actionable information to better prepare.”

Another group of states: Colorado, Maine, Maryland, New Hampshire, Utah, Vermont, Wisconsin, and the District of Columbia – have done much more to prepare (See addendum for state-by-state preparedness summary.)

The researchers emphasized that every state, including those rated as most prepared, can do much more to protect residents from the harmful health impacts of climate change.

“The impacts of climate change on our health demand that policymakers respond,” said Megan Latshaw, a scientist at the Johns Hopkins Bloomberg School of Public Health. “Our goal is that every single state will take this as a clarion call and think of this report as a starting point to do more to help make residents’ lives safer.”

Some climate-related events, such as hurricanes and wildfires, have immediate health impacts. Others are more insidious, including more frequent heat waves; deteriorating air quality; chronic flooding; and increases in vector, water, and food-related disease. These threats already exist. But climate change exacerbates them, and also shifts or expands the regions and populations at risk. In addition, all of these effects can take a severe toll on mental health and well-being.

Some populations and communities are especially vulnerable. High-risk residents include those who are very young or very old, people with a disability, and those living in poverty. Often, the legacy and continued presence of systemic racism, including patterns of deprivation and discrimination, makes communities of color especially vulnerable.

The researchers calculated each state’s vulnerability by looking at a range of factors. Environment and geography are crucial, but in addition, social and demographic factors also play a key role. State assessments were based on three indicators: vulnerability, public health preparedness, and climate-related adaptation. All of the report’s findings are relative, i.e., based on comparisons between states.

The report, released today at the 3rd annual Bloomberg American Health Summit, makes recommendations for federal and state action including:

Federal

  • Congress should enact legislation creating a national climate-readiness plan.
  • The administration and Congress should fully fund the Centers for Disease Control and Prevention’s (CDC) Climate and Health program and the National Environmental Public Health Tracking Network.
  • Strengthen the national public health system and workforce, including by modernizing data and surveillance capacities.

State

  • Complete all steps of the CDC’s Building Resilience Against Climate Effects (BRACE) framework.
  • Bolster core public health preparedness capacity, and establish and sustain dedicated funding and staffing for climate-related preparations.
  • Plan with communities, not for them.

 

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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. On Twitter at: @healthyamerica1

The Johns Hopkins Bloomberg School of Public Health is dedicated to the improvement of health for all people through the discovery, dissemination, and translation of knowledge, and the education of a diverse global community of research scientists, public health professionals, and others in positions to advance the public’s health.

The Bloomberg American Health Initiative was created in 2016 with a $300 million gift from Bloomberg Philanthropies to the Johns Hopkins Bloomberg School of Public Health. The Initiative is tackling key public health challenges in the U.S., focusing primarily on addiction and overdose, adolescent health, the environment, obesity and the food system, and violence. It is also working to train a new generation of professionals committed to improving health in America.

20 Public Health Organizations Condemn Herd Immunity Scheme for Controlling Spread of SARS-CoV-2

Great Barrington Declaration is not grounded in science and is dangerous

(Washington, DC – October 14, 2020) – SARS-CoV-2, the virus that causes COVID-19 has infected at least 7.8 million people in the United States and 38 million worldwide. It has led to over 215,000 deaths domestically, and more than 1 million globally – with deaths continuing to climb.

If followed, the recommendations in the Great Barrington Declaration would haphazardly and unnecessarily sacrifice lives. The declaration is not a strategy, it is a political statement. It ignores sound public health expertise. It preys on a frustrated populace. Instead of selling false hope that will predictably backfire, we must focus on how to manage this pandemic in a safe, responsible, and equitable way.

The suggestions put forth by the Great Barrington Declaration are NOT based in science.

  • There is no evidence that we are even remotely close to herd immunity. To the contrary, experts believe that 85 to 90 percent of the U.S. population is still at risk of contracting SARS-CoV-2. Herd immunity is achieved when the virus stops circulating because a large segment of the population has already been infected. Letting Americans get sick, rather than focusing on proven methods to prevent infections, could lead to hundreds of thousands of preventable illnesses and deaths.[i] It would also add greater risk in communities of color which have already experienced disproportionate impacts of the pandemic.
  • The declaration ignores what are our best tools to fight the virus, i.e. wearing masks, physical distancing, hand-washing, avoiding large crowds, strategic testing, rapid isolation of infected people and supportive quarantine for people who need to isolate.
  • We have seen the failure of the herd immunity experiment in nations such as Sweden, which has the highest mortality rate among Nordic countries.[ii] COVID-19 carries a much higher risk of severe disease and death than other infections where herd immunity was attempted before a vaccine was available.[iii] It is illogical to ignore public health and scientific evidence when so many lives are at stake.

Combatting the pandemic with lockdowns or full reopening is not a binary, either/or choice. We need to embrace common sense public health practices that allow for a safe reopening of the economy and a return to in-person work and learning while also using proven strategies to reduce the spread of the virus.

The declaration suggests a so-called focused protection approach. It suggests allowing the virus to spread unchecked among young people to create herd immunity in the entire population. This notion is dangerous because it puts the entire population, particularly the most vulnerable, at risk. Young people are not all healthy and they don’t live in vacuums.[iv] They interact with family members, co-workers and neighbors. Inviting increased rates of COVID-19 in young people will lead to increased infections rates among all Americans.

Public health guidance and requirements related to masking and physical distancing are not an impediment to normalcy – they are the path to a new normal. The goal is both public health safety and economic security; the two are not in conflict with one another, they are dependent on each other. We need to focus our efforts on the development and implementation of a national, science-based and ethical pandemic disease-control strategy.

The pandemic has created serious hardships on families’ economic security and on American’s mental health and well-being. What we need is a coordinated and robust national response including mask use, hand hygiene and physical distancing, while also ensuring social supports for those most vulnerable, including physical and mental health, and social factors.  What we do not need is wrong-headed proposals masquerading as science.


This statement was authored by:

American Public Health Association

Big Cities Health Coalition

Trust for America’s Health

American Academy of Social Work and Social Welfare

Association for Professionals in Infection Control and Epidemiology

Association of Public Health Laboratories

Association of Schools and Programs of Public Health

de Beaumont Foundation

Johns Hopkins Center for Health Security at the Bloomberg School of Public Health

Los Angeles County Department of Public Health

National Association of County Behavioral Health and Developmental Disabilities Directors

National Association of County and City Health Officials

National Association for Rural Mental Health

National Network of Public Health Institutes

New York City Department of Health and Mental Hygiene

Nurses Who Vaccinate

Prevention Institute

Public Health Institute

Resolve to Save Lives, an initiative of Vital Strategies

Well Being Trust

 

[i] https://www.medpagetoday.com/infectiousdisease/covid19/88401

[ii] https://www.medpagetoday.com/infectiousdisease/covid19/88401

[iii] https://coronavirus.jhu.edu/from-our-experts/early-herd-immunity-against-covid-19-a-dangerous-misconception

[iv] https://www.cdc.gov/mmwr/volumes/69/wr/mm6941e1.htm?s_cid=mm6941e1_w

New Report Recommends Policies to Protect and Improve Americans’ Health by Transforming the Public Health System

Nation’s Public Health System Needs Sustained Attention and Investment; The Report Provides Action Plan for the Administration and Congress Taking Office in 2021

(Washington, DC – October 6, 2020) — The COVID-19 pandemic sharply illuminated weaknesses in the nation’s public health system and ways in which structural racism put communities of color at disproportionate risk of negative health outcomes, according to a new report, The Promise of Good Health for All: Transforming Public Health in America. The report was released today by Trust for America’s Health.  Among its findings is that the nation’s public health system is dangerously inadequate. The report offers a blueprint for policymakers taking office next year on how to strengthen the system, protect against health security threats, address the social determinants of health, and combat racism and other forms of discrimination that negatively affect community and individual health and resilience.

Americans are facing increasing environmental and weather-related threats from wildfires to hurricanes. Infectious disease outbreaks are a constant and complex risk as world travel allows small outbreaks to become worldwide threats in a matter of hours. Additionally, Americans have higher levels of chronic disease and mental health and substance misuse issues than ever before.  As a nation, we spend over $3 trillion annually on healthcare but lag behind other developed countries in practically every health metric. A key to addressing these threats to the nation’s health is a significant investment in the public health system, including programs rooted in prevention and working at the population health level. The report calls for an annual $4.5 billion investment in the nation’s public health infrastructure including in 21st century data systems and a robust public health workforce.

“Even before COVID-19, numerous health emergencies, including infectious disease outbreaks like measles, Zika and Ebola, the opioid epidemic, weather-related events and lung injuries due to vaping demonstrated the urgency of a strong public health system,” says John Auerbach, President and CEO of Trust for America’s Health.

“Each of these emergencies brought short-term attention to the importance of the public health system, but short-term attention is not enough.  Without sustained investment the nation’s public health system we will not be ready to protect Americans’ lives and livelihoods during the next health emergency,” Auerbach said.

The conditions in which people live and work are key drivers of their health. Therefore, solutions to health risks and inequities largely exist outside the healthcare sector and reinforce the importance of investing in population health and the social determinants of health. Increasing the nation’s investment in health promotion and disease prevention will not only improve the quality of life for millions of Americans, it will help decrease the nation’s exploding healthcare spending.

The report focuses on five key priority areas:

PRIORITY 1: Make substantial and sustained investments in a more effective public health system including a highly-skilled public health workforce.

PRIORITY 2: Mobilize an all-out effort to combat racism and other forms of discrimination and to advance health equity by providing the conditions that optimize health.

PRIORITY 3: Address the social determinants of health including economic, social, and environmental factors that result in preventable illness, injuries and death.

PRIORITY 4: Proactively address threats to the nation’s health security.

PRIORITY 5: Improve health, safety, and well-being for all people by providing pathways to optimal health across the life span.


Among the report’s recommendations for federal policymakers are:

  • Strengthen and modernize the public health system by creating a $4.5 billion per year Public Health Infrastructure Fund to support foundational public health capabilities at the state, local, territorial and tribal levels.
  • Build 21st century public health surveillance systems at the federal, state and local levels to enable rapid detection and response to disease threats.
  • Create a Health Defense Operations budget designation to build sustainable funding for public health programs that prevent, detect and respond to outbreaks.
  • Make advancing health equity and eliminating health disparities a national priority with a senior-level, federal interdepartmental task force charged with adopting policies and programs in housing, employment, health, environmental justice and education that reduce health inequities and address the social determinants of health.
  • Expand grants to address health inequities and ensure funding is reaching under-resourced, marginalized, and disproportionately affected communities.
  • Prioritize increased funding for state, local, tribal and territorial public health emergency preparedness and response programs, such as CDC’s Public Health Emergency Preparedness program and HHS’s Hospital Preparedness Program.
  • Build surge capacity across the healthcare system and develop standards for healthcare facility readiness. Policymakers should provide payment incentives and reward facilities that maintain specialized disaster care capabilities.
  • Grow the CDC’s Climate and Health Program so it can support every state, large cities, territories and tribes to be climate-ready. Clean air and water regulations should be restored and strengthened, including the Clean Air Act and Clean Water Act.
  • Increase research and effective messaging to build vaccine confidence and ensure that no person faces barriers to receiving all necessary vaccinations.
  • Promote optimal health across the lifespan through access to health insurance, job-protected paid leave for workers, and significant investments in programs proven to support families and improve health – from babies to older adults.

The report is endorsed by the American Public Health Association, the Asian & Pacific Islander American Health Forum, the Big Cities Health Coalition, the Public Health Institute, and the National Network of Public Health Institutes.

 

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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. On Twitter at @HealthyAmerica1

TFAH Webinar Series: COVID-19- Special Issues and Reponses

Stay tuned for upcoming briefings and webinars

 

Previously Recorded Briefings & Webinars
State of Obesity: Better Policies for a Healthier America
Ensuring COVID-19 Vaccine Access, Safety, Utilization: Building Vaccination Confidence in Communities of Color
Ending the Triple Pandemic: Advancing Racial Equity by Promoting Health, Economic Opportunity, and Criminal Justice Reform
COVID-19 and the Impact on Communities of Color: Our Nation’s Inequities Exposed
Advancing Health Equity During and Beyond COVID-19: Addressing Housing and Homelessness
Mental Health and COVID-19: How the Pandemic Complicates Current Gaps in Care
Protecting Older Adults from the Harms of Social Isolation and Providing a Continuum of Care During COVID-19
Combating COVID-19 Why Paid Sick Leave Matters to Controlling its Spread

Healthy People 2030

(Washington, D.C. – September 30, 2020)

On August 18, 2020, the U.S. Department of Health and Human Services (HHS) released Healthy People 2030 – the 5th iteration of the nation’s 10-year plan that sets data-driven objectives and targets to improve health and well-being in the United States. Updated every decennial since 1980, Healthy People 2030 builds on the knowledge gained and lessons learned to address the nation’s most critical public health priorities and challenges.

Healthy People 2030 includes 355 objectives in alignment with five overreaching goals. These goals include:

  • Attain healthy, thriving lives and well-being free of preventable disease, disability, injury, and premature death.
  • Eliminate health disparities, achieve health equity, and attain health literacy to improve the health and well-being of all.
  • Create social, physical, and economic environments that promote attaining the full potential for health and well-being for all.
  • Promote healthy development, healthy behaviors, and well-being across all life stages.
  • Engage leadership, key constituents, and the public across multiple sectors to take action and design policies that improve the health and well-being of all.

Healthy People 2030 also includes prioritizing 10-year measurable targets for objectives related to the social determinants of health – which include economic stability, education, health care access, neighborhoods and the built environment, and social and community environments. For example, related to economic stability and food insecurity, HHS wants to reduce household food insecurity by 5 percent over the next 10 years (11.1 percent of households were food insecure in 2018).

“Healthy People 2030 aligns with many of Trust for America’s Health’s priorities around health conditions such as diabetes and obesity; health behaviors such as vaccination and drug and alcohol use; population-level health for groups such as older adults; systems such as public health infrastructure and preparedness for emerging public health threats like COVID-19; and the social determinants of health,” said John Auerbach, President, and CEO at Trust for America’s Health.

“It provides a framework of measurable objectives to evaluate the change that needs to occur to achieve optimal health and well-being for every person and community. COVID-19 is the most current example that demonstrates the longstanding disproportionate health and economic impacts faced by Black, Indigenous, and people of color along with other marginalized communities. Together, public health must work with multiple sectors to advance equitable policies that address these social and economic disparities, and work towards achieving the goals of Healthy People 2030.”

For more information, visit Healthy People 2030.

U.S. Adult Obesity Rate Tops 42 Percent; Highest Ever Recorded

Having obesity is a risk factor for serious COVID consequences; pandemic could increase future levels of obesity due to increased food insecurity

(Washington, DC – September 17, 2020) – The U.S. adult obesity rate passed the 40 percent mark for the first time, standing at 42.4 percent, according to State of Obesity: Better Policies for a Healthier America released today by Trust for America’s Health (TFAH).  The national adult obesity rate has increased by 26 percent since 2008.

The report, based in part on newly released 2019 data from the Centers for Disease Control and Prevention’s Behavioral Risk Factors Surveillance System (BFRSS) and analysis by TFAH, provides an annual snapshot of rates of overweight and obesity nationwide including by age, race and state of residence.

Demographic trends and the conditions in people’s lives have a large impact on their ability to maintain a healthy weight.  Generally, the data show that the more a person earns the less likely they are to have obesity.  Individuals with less education were also more likely to have obesity. Rural communities have higher rates of obesity and severe obesity than do suburban and metro areas.

Socioeconomic factors such as poverty and discrimination have contributed to higher rates of obesity among certain racial and ethnic populations.  Black adults have the highest level of adult obesity nationally at 49.6 percent; that rate is driven in large part by an adult obesity rate among Black women of 56.9 percent.  Latinx adults have an obesity rate of 44.8 percent.  The obesity rates for white adults is 42.2 percent.  Asian adults have an overall 17.4 percent obesity rate.

Obesity and its impact on health including COVID-19 risks

Obesity has serious health consequences including increased risk for type 2 diabetes, high blood pressure, stroke and many types of cancers. Obesity is estimated to increase healthcare spending by $149 billion annually (about half of which is paid for by Medicare and Medicaid) and being overweight or having obesity is the most common reason young adults are ineligible for military service. Concerns about the impact of obesity have taken on new dimensions this year as having obesity is one of the underlying health conditions associated with the most serious consequences of COVID infection, including hospitalization and death. These new data mean that 42 percent of all Americans are at increased risk of serious, possibly fatal, health impacts from COVID-19 due to their weight and health conditions related to obesity.

“Solving the country’s obesity crisis will require addressing the conditions in people’s lives that lead to food insecurity and create obstacles to healthy food options and safe physical activity.  Those conditions include poverty, unemployment, segregated housing and racial discrimination,” said John Auerbach, President and CEO of Trust for America’s Health. “This year’s pandemic has shown that these conditions don’t only increase the risk of obesity and chronic illnesses, they also increase the risk of the most serious COVID outcomes.”

Childhood obesity also on the rise

Rates of childhood obesity are also increasing with the latest data showing that 19.3 percent of U.S. young people, ages 2 to 19, have obesity. In the mid-1970s, 5.5 percent of young people had obesity.  Being overweight or having obesity as a young person puts them at higher risk for having obesity and its related health risks as an adult. Furthermore, children are exhibiting earlier onset of what used to be considered adult conditions, including hypertension and high cholesterol.

Twelve states have adult obesity rates above 35 percent

Obesity rates vary considerably between states and regions of the country.  Mississippi has the highest adult obesity rate in the country at 40.8 percent and Colorado has the lowest at 23.8 percent.  Twelve states have adult rates above 35 percent, they are: Alabama, Arkansas, Indiana, Kansas, Kentucky, Louisiana, Michigan, Mississippi, Oklahoma, South Carolina, Tennessee and West Virginia.  As recently as 2012, no state had an adult obesity rate above 35 percent; in 2000 no state had an adult obesity rate above 25 percent.

Food insecurity and its relationship to obesity

The report includes a special section on food insecurity and its relationship to obesity. Food insecurity is linked to lower quality diets and tracks with higher levels of obesity in many population groups. Food insecurity is closely linked to economic conditions. There were higher levels of food insecurity during the 2008-2009 financial crisis and early data indicate a large increase in the number of American families experiencing food insecurity due to the COVID-19 crisis. According to U.S. Census Bureau survey data, 25 percent of all respondents and 30 percent of respondents with children, reported experiencing food insecurity between April and June of this year.

Solving the obesity crisis will require multi-sector initiatives and policy change

The report includes recommendations on how best to address the obesity crisis grounded in two principles: 1) the need for a multi-sector, multi-disciplinary approach, and 2) a focus on those population groups that are disproportionately impacted by the obesity crisis.

Recommendations include:

  • While the COVID-19 public health emergency continues to be in place, continue USDA nutrition policy waivers and expand no-cost school meals to all enrolled students for the entire 2020-2021 school year.
  • Increase funding to allow for the expansion of critical CDC obesity-prevention programs including the State Physical Activity and Nutrition Program and the Racial and Ethnic Approaches to Community Health program.
  • Expand benefits in the Supplemental Nutrition Assistance Program (SNAP, formerly known as “food stamps”) by raising maximum benefit levels, extending Pandemic-EBT (P-EBT) for students and children, doubling investments in SNAP-Ed, and finding innovative, voluntary ways to improve diet quality without harming access or benefit levels.
  • Incentivize businesses and public land use to increase access to healthy food options and safe places to be physically active.
  • Disincentivize unhealthy food choices by closing tax loopholes and eliminating business-cost deductions related to the advertising of unhealthy food and beverages to children and by enacting sugary drink taxes where tax revenue is allocated to local efforts to reduce health and socioeconomic disparities.
  • Encourage Medicaid to cover pediatric weight-management programs for all eligible beneficiaries.

 

 

Report Full Text

 

Support for the State of Obesity report series was provided by the Robert Wood Johnson Foundation. The views expressed in this report do not necessarily reflect the view of the 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.