State Category: Oklahoma

On the 20th Anniversary of the September 11th Terror Attacks the Nation is Better Prepared but Still not Fully Prepared for Public Health Emergencies

(Washington, DC – September 6, 2021) – On the 20th anniversary of the September 11th attacks on the World Trade Center and the Pentagon, Trust for America’s Health (TFAH) reflects on the nation’s strong progress in preparedness for public health emergencies, as well as the major challenges that still exist, including those illuminated by the COVID-19 pandemic.

In 2002, following the first anniversary of this tragedy and the subsequent anthrax attacks, TFAH released its first analysis of the response and limitations of the public health system, Public Health Preparedness: Progress and Challenges Since September 11, 2001. From this report, TFAH’s Ready or Not: Protecting the Public’s Health from Diseases, Disasters and Bioterrorism report series was developed.  The 2021 Ready or Not report highlights the urgent need for federal, state, and local policymakers to prioritize the nation’s health security as we work toward ending the COVID-19 pandemic and preparing for extreme weather, the health impacts of climate change, future pandemics, and other emerging threats.

“The COVID-19 pandemic, the devastating wildfires, and the unfolding impacts of Hurricane Ida are only the most recent reminders of the need to strengthen our nation’s health security,” said J. Nadine Gracia, MD, MSCE, TFAH President and CEO. “The 20th anniversary of September 11th is an important milestone to mark the progress we have made in the past two decades: we have built a public health preparedness enterprise from the ground up, including a dedicated public health emergency workforce. But we must make additional and sustained investments in public health infrastructure and workforce, and we must ensure equity is at the center of preparedness, response, and recovery efforts.”

TFAH recommends the following policy actions to strengthen the nation’s emergency response capacity:

  • Federal, state, and local governments should bolster public health infrastructure investments. Congress should enact the Public Health Infrastructure Saves Lives Act and make annual investments in public health infrastructure to build the workforce and systems that have been chronically neglected for decades.
  • Congress should invest in modernizing public health data systems. Modern and sustainable public health data systems and the collection of complete and disaggregated demographic data will facilitate a more effective and equitable public health response during future emergencies.
  • Public health and government leaders must be equipped to deliver effective public communications and counter misinformation. Misinformation, such as inaccurate social media messaging, has been a significant barrier to developing a proactive public health response during the COVID-19 pandemic and has increased vaccine hesitancy. Congress must fund research and implementation of public health communications and messaging, grounded in the best available science, to counter misinformation.
  • Equity should be an explicit and foundational component of preparedness and response at all levels of public health. The COVID-19 pandemic has highlighted that health inequities are exacerbated during emergencies. Health departments and policymakers should build the health equity workforce, partner with, and provide resources to trusted community organizations, and incorporate equity leadership into all emergency planning and response.
  • Federal and state lawmakers should invest in policies and capacity to improve social and economic conditions in communities and advance equity and resilience. People at highest risk during disasters and those who have the hardest time recovering are often those with unstable or unhealthy housing, limited access to transportation, and people who live in low-income communities – circumstances often rooted in longstanding systemic inequities. Congress should invest in the Center for Disease Control and Prevention (CDC) efforts to address the social determinants of health. Lawmakers and employers should advance policies and promote multisector efforts to ensure access to healthy, affordable housing; promote economic mobility through living wage and paid sick and family leave policies; eliminate poverty; address food security; and improve transportation.

This month, the nation commemorates the thousands of lives lost during the 9/11 attacks, continues to mourn the hundreds of thousands of lives lost to COVID-19, and honors the heroic efforts of first responders, the public health workforce, and healthcare workers. As we reflect and move forward, we must commit to preventing and preparing for public health emergencies in ways that ensure that everyone’s health and well-being are protected during times of crisis.

 

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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.

New Report Outlines Role of Social Determinants in Americans’ Health

Calls for Adoption of Policies Shown to Improve Health Outcomes, Control Healthcare Spending, and Create Health Equity

(Washington, DC – July 29, 2021) – America’s chronic disease and health disparities crisis require policy interventions targeting structural racism and the social determinants of health, concludes a report released today by Trust for America’s Health.

The report, Leveraging Evidence-Based Policies to Improve Health, Control Costs, and Create Health Equity, reviews five policy areas: access to healthcare, economic mobility, affordable housing, safe and healthy learning environments for children, and health-promoting excise taxes. Based on an extensive review of the evidence, the report recommends federal and state-level policies in each issue area to improve health outcomes, advance health equity and reduce healthcare spending.

Today, nearly half of all Americans have at least one chronic disease, and that number is growing. In addition, the COVID-19 pandemic starkly illuminated the ways in which social and economic conditions and inequities– often deeply rooted in communities due to historical and current day structural racism and discrimination – greatly increase health risks and burdens for certain populations groups, including many communities of color. According to the CDC, hospitalization rates during the height of the COVID-19 pandemic were 3.3 times higher for American Indian/Alaska Natives and approximately 3 times higher for Blacks and Latinos as compared to the hospitalization rate for whites.

“The COVID-19 pandemic put a spotlight on the role that social and economic conditions play in health and gives policymakers an opportunity to build an improved social supports and public health system,” said J. Nadine Gracia, MD, MSCE, President and CEO of Trust for America’s Health. “Focusing solely on individual behavior will not solve America’s health crisis. Building healthy and thriving communities and advancing health equity require improving the social and economic conditions that shape health. Only then will everyone have a fair and just opportunity to enjoy optimal health.”

The social determinants of health are factors beyond traditional healthcare that significantly impact health including where you are born, live, work, play, go to school, and age. Data show that these factors impact a wide range of quality-of-life outcomes and health risks. For example, where you live, has a measurable impact on overall health status and longevity.  Furthermore, inequities limit access to health resources and educational and economic opportunities that can lead to poor health.

Policy decisions can drive improvements in the social conditions in communities or they can perpetuate inequities. Policies do not need to be deliberately discriminatory to exacerbate inequities. For example, tying school funding to local property taxes leaves schools in lower income communities with fewer resources than higher income neighborhoods.

The report identifies policies that, if implemented, can create the conditions in people’s lives that support optimal health.  Recommended policy actions in each category includes:

Goal: Supporting Access to High-Quality Healthcare Services

Recommendation: Adopt Medicaid Expansion.  States that have adopted Medicaid expansion experienced the largest reductions in the number of uninsured persons. In 2018, the uninsured rate among low-income, non-elderly adults in states that expanded Medicaid eligibility was about half that of the uninsured rate in states that did not expand the program. Increased access to healthcare saved lives and was associated with a reduction in total state spending on traditional Medicaid.

Goal: Promoting Economic Mobility

Recommendation: Expand the Earned Income Tax Credit. The earned income tax credit (EITC) is a tax credit offered to eligible low-income workers to enhance their economic security. EITC policies, both federal and state, help lift millions of working families out of poverty and reduces the severity of poverty for millions more.

Goal: Ensuring Access to Affordable Housing

Recommendation: Expand the Low-income Housing Tax Credit Program. Decades of research has demonstrated a connection between safe and secure housing and good health.  The low-income housing tax credit (LIHTC) provides tax incentives to encourage developers to build affordable housing. Since the LIHTC program was created approximately 3 million quality homes have been developed to serve working families, older adults, people with disabilities and those at risk of homelessness. Despite this success, the need for affordable housing remains high across the country.

Goal: Promoting Safe and Healthy Learning Environments for Children

Recommendation: Increase access to high-quality early childhood education programs. Research demonstrates the many ways in which safe and supportive school environments put children on healthy developmental pathways. High-quality early childhood education programming, such as Head Start and pre-K can have long-lasting positive impacts on children throughout their lives. Early childhood education centers and schools are also critical sources of nutrition for millions of children through the National School Lunch and School Breakfast Programs and provide access to healthcare for millions of students via school-based health centers.

Goal: Using tax policy to encourage healthy choices

Recommendation: Tax unhealthy products, like tobacco and sugar-sweeten beverages. Such taxes can be a win-win for localities, encouraging healthy choices and raising local revenue that can be reinvested in health-promoting and prevention programs.

Report:  Leveraging Evidence-Based Policies to Improve Health, Control Costs, and Create Health Equity

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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

 

TFAH Applauds Surgeon General’s Call for Whole-of-Society Approach to Correcting the Problem of Health Misinformation

(Washington, DC – July 15, 2021) – Trust for America’s Health (TFAH) applauds the Surgeon General’s Advisory on Building a Healthy Information Environment and his call for a whole-of-society approach to correcting the problem of health misinformation.

“As the COVID-19 pandemic has illustrated, access to accurate health information empowers people and protects their health, while health misinformation risks lives.  TFAH is committed to working with all partners and allies to combat health misinformation,” said J. Nadine Gracia, MD, MSCE, TFAH President and CEO.

 

 

 

TFAH Applauds Court’s Decision Preserving the Affordable Care Act

Decision strengthens the nation’s healthcare system, protects healthcare access for 31 million Americans and will help address health disparities

(Washington, DC — June 17, 2021) – Trust for America’s Health applauds today’s Supreme Court’s decision in California v. Texas for the ways in which it protects healthcare access for 31 million Americans and will help address the nation’s health disparities.

“Access to affordable healthcare is fundamental to individual health. It is also fundamental to achieving health equity. While as a nation we still have a lot of work to do to achieve good health for every individual, today’s court decision keeps us moving in the right direction – it will save lives,” says John Auerbach, President and CEO of Trust for America’s Health.

According to the U.S. Department of Health and Human Services, 31 million people have gained health insurance through the Affordable Care Act (ACA) including many who lost employment and health coverage during the COVID-19 pandemic.[i]  Since the ACA, rates of people without health insurance have decreased in every state, with states that expanded Medicaid experiencing the largest reductions.[ii]

The ACA is transformative legislation in at least three ways: the number of Americans who can now access medical care when they are ill or to deal with chronic conditions (78 percent of U.S. adults 55 and older have at least one chronic condition);[iii] the illness it prevented as millions of Americans gained access to preventive care and screenings and other life-saving services previously inaccessible to them;[iv] and the ways in which it resulted in improved access to healthcare for people of color, reducing – although not eliminating – longstanding healthcare access disparities.

Prior to the ACA, non-Hispanic Black Americans were 70 percent more likely to be uninsured than were whites and the uninsured rate for Hispanics was nearly three times the uninsured rate for whites.[v] Once the ACA was in place, Hispanics had the largest decrease in uninsurance rates, falling from 32.6 percent to 19.1 percent between 2010 and 2016. Uninsurance rates also fell for Asian and Black Americans by 8 percent during the same period.[vi]

Medicaid expansion states experienced significant coverage gains and reductions in uninsured rates among the low-income population broadly and within specific vulnerable populations.[vii] According to the Center on Budget and Policy Priorities, expanding Medicaid coverage to low-income adults led to significant benefits to those individuals and families including improved access to care, improved health outcomes and increased financial stability – including a reduction in medical debt per person gaining coverage via the expansion.[viii] A study by the National Bureau of Economic Research found states that expanded Medicaid had an estimated 19,200 fewer adult deaths (ages 55 to 64) between 2014 and 2017 than did states that did not expand Medicaid.[ix]

The decision also has major implications for public health by protecting over $16 billion in funding over the next 10 years (FY 2022-FY 2031) for the Centers for Disease Control and Prevention (CDC) and other public health agencies. The Prevention and Public Health Fund, a dedicated funding stream created by the ACA and specifically designated for public health and prevention, funds approximately 11 percent of the CDC’s budget. These funds are put to work in every state to expand immunizations, prevent suicide, modernize laboratory and epidemiology services to detect and contain disease outbreaks, prevent childhood lead poisoning, and help smokers quit.

Also preserved are the requirement that insurers not refuse coverage due to preexisting conditions, the provision disallowing annual or lifetime limits on essential care, and the requirement that insurers cover recommended clinical preventive services without cost-sharing: all essential to Americans’ health.

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[i] HHS, HHS Press Office. New HHS Data Show More Americans Than Ever Have Health Coverage Through the Affordable Care Act. June 5, 2021. New HHS Data Show More Americans than Ever Have Health Coverage through the Affordable Care Act | HHS.gov

[ii] ibid

[iii] CDC, National Center for Health Statistics. Percentage of U.S. Adults over 55 with Chronic Conditions. https://www.cdc.gov/nchs/health_policy/adult_chronic_conditions.htm

[iv] Garfield R, Orgera K, Damico A. The uninsured and the ACA: a primer—key facts about health insurance and the uninsured amidst changes to the Affordable Care Act [Internet]. San Francisco (CA): Henry J. Kaiser Family Foundation; 2019 Jan 25.  https://www.kff.org/uninsured/report/the-uninsured-and-the-aca-a-primer-key-facts-about-health-insurance-and-the-uninsured-amidst-changes-to-the-affordable-care-act/ Google Scholar

[v] Buchmueller TC, Levinson ZM, Levy HG, Wolfe BL. Effect of the Affordable Care Act on racial and ethnic disparities in health insurance coverage. Am J Public Health. 2016;106(8):1416–21

[vi] Garfield R, Orgera K, Damico A. The uninsured and the ACA: a primer—key facts about health insurance and the uninsured amidst changes to the Affordable Care Act [Internet]. San Francisco (CA): Henry J. Kaiser Family Foundation; 2019 Jan 25.  https://www.kff.org/uninsured/report/the-uninsured-and-the-aca-a-primer-key-facts-about-health-insurance-and-the-uninsured-amidst-changes-to-the-affordable-care-act/ Google Scholar

[vii] Madeline Guth, et al. The Effects of Medicaid Expansion Under the ACA: Updated Findings from a Literature Review. March 17, 2020.

[viii] Center on Budget and Policy Priorities. The Far-Reaching Benefits of the Affordable Care Act’s Medicaid Expansion. October 21, 2020. The Far-Reaching Benefits of the Affordable Care Act’s Medicaid Expansion | Center on Budget and Policy Priorities (cbpp.org)

[ix] Madeline Guth, et al. The Effects of Medicaid Expansion Under the ACA: Updated Findings from a Literature Review. March 17, 2020.

Annual Deaths Due to Alcohol, Drugs or Suicide Exceeded 156,000 According to the Most Recent Data

Preliminary data shows COVID-19 crisis created higher rates of mental distress, substance use, and drug overdose; 2019 alcohol deaths were higher for every adult age group

(Washington, DC and Oakland, Ca) – May 18, 2021 – Newly released data show that 156,242 Americans died due to alcohol, drugs or suicide in 2019, a record number of such deaths in a single year.  Furthermore, the COVID-19 pandemic increased stress and related substance use for many Americans.

During 2019, alcohol and drug-induced deaths increased, while suicide rates were slightly lower. Over the last decade, 2009 – 2019, the number of alcohol and drug related and suicide deaths increased by 52 percent.  These data are part of a report releasing today, Pain in the Nation: Alcohol, Drug and Suicide Deaths, the latest in a series of reports tracking the nation’s deaths of despair crisis produced by Trust for America’s Health and Well Being Trust.

Americans dying due to drug-induced causes was five percent higher in 2019 than the previous year, for a total of 74,511 deaths. The data are also beginning to show changes in the most affected population groups.  For many years, the death rate for drug overdoses among whites was substantially higher than other racial groups, data are now showing dramatic increases in drug related deaths for certain populations of color. For the year, drug-induced deaths were up by 15 percent among Latinos and Blacks, 11 percent for American Indians and 10 percent for people of Asian descent. Among whites’ drug-induced deaths rose by 2 percent for the year.

For the first time since 2005, 2019 deaths rates from drugs for Black people was higher than that of whites.

Synthetic opioids, such as fentanyl, (up 16%), cocaine (up 8%) and other psychostimulants (e.g., methamphetamine and ecstasy) (up 28%) continue to drive drug-induced deaths higher. Natural/semisynthetic opioids (e.g., Prescription opioids) and heroin overdoses declined for the year.

In 2019, 39,043 Americans died from alcohol-related causes, up 4 percent over 2018.  It was the tenth year in a row that the alcohol death rate increased.  Alcohol deaths were highest among American Indians (31.9 deaths per 100,000 people), adults over 55 (28.3 deaths per 100,000 people) and males (15.2 deaths per 100,000 people). All groups, except children, had a higher rate of alcohol deaths in 2019 compared with 2018 and early 2020 data show that rates of consumption are continuing to increase.

One bright spot in the data is that for the year (2019), the age-adjusted suicide rate declined from 14.2 to 13.9 deaths per 100,000 deaths, a 2 percent decrease. Americans who died by suicide in 2019 totaled 47,511. This decline in suicide deaths was the first since 2005 and is statistically significant. Preliminary 2020 data show a further small decrease in suicides despite the COVID crisis.

States with the highest age-adjusted death rates from alcohol, drugs and suicide combined in 2019 were New Mexico (88 deaths per 100,000 people) and West Virginia (85.1 deaths per 100,000 people).

“These data underscore, yet again, the massive problem we have had on our hands in this country,” said Benjamin Miller, PsyD, Chief Strategy Officer, Well Being Trust. “The trends are clear we are going in the wrong direction. If we are serious about addressing mental health and addiction, we must invest in strategies that are comprehensive and integrated. Incremental tinkering will not change the course or direction sufficiently enough – it’s time for bold leadership to demand more.”

The Impact of the COVID-19 Pandemic

The COVID-19 pandemic impacted Americans in almost inconceivable ways including illness, the loss of loved ones, job loss, financial stress, food insecurity, social isolation, and learning loss and the interruption of school-based services for millions of children. These stressors are impacting rates of alcohol and drug use and drug overdose deaths as more people turn to substances to help them cope.

From March 2019 to March 2020, the number of calls to the Substance Abuse and Mental Health Services Administration Disaster Distress Helpline increased by 891 percent.  The U.S. Household Pulse Survey found that the number of adults reporting symptoms of anxiety or depression from April 2020 through March 2021 was triple the number who reported such symptoms in 2019. A June 2020 CDC study found that 13 percent of adults “started or increased substance use to cope with pandemic-related stress or emotions.”

“The drug, alcohol and suicide crisis has been growing for a decade and growing in uneven ways. The COVID crisis has increased stress on all Americans and has worsened the differential impact of health inequities on communities of color. While all Americans need support coping with the pandemic, people who are currently struggling with addiction or a mental health issue need urgent attention,” said John Auerbach, President and CEO Trust for America’s Health.

The report includes policy solutions and recommendations including:

  • Expand programs that support families and communities and reduce traumatic experiences, particularly in childhood.
  • Expand access to substance use prevention programs and mental health and resiliency programs in schools.
  • Tailor prevention and intervention programs for communities of color.
  • Strengthen crisis intervention programs and supports.
  • Increase access to mental health and substance use healthcare through full enforcement of the Mental Health Parity and Addiction Equity Act.
  • Reduce availability of illicit opioids and psychostimulants.
  • Limit access to lethal means of suicide.
  • Expand efforts to combat stigma about mental health issues.
  • Improve mental health data accuracy, completeness and timeliness.
  • Expand the mental health and substance use treatment workforce; promote diversity and culturally informed practices within the workforce.
  • Build community capacity for early identification and intervention with individuals who need mental health care.

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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.

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