Stories Archive - Page 3 of 18

Giving Tuesday is an Opportunity to Support TFAH’s Mission

For Giving Tuesday 2023 we invite you to consider a donation to Trust for America’s Health (TFAH) in support of our critical mission to promote and protect health for every person and in every community.

The COVID-19 pandemic demonstrated the urgent need to transform our public health system through sustained investment in infrastructure, the public health workforce, and in health promotion and disease prevention. But the most critical lesson of the pandemic is that none of these investments will be effective until the nation addresses structural racism, economic disparities, and the social determinants of health.

TFAH is not a membership organization, and we don’t accept government or corporate funding – all to preserve our independent voice. As the challenges before our public health system continue to grow the need to expand our work does too. Your support as an individual donor will help us continue to achieve our mission to advance health equity and give everyone the opportunity to lead a healthy life.

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Nutrition Support Programs are Vital to Preventing Food and Nutrition Insecurity and Reducing Chronic Disease – Congress Must Act to Support Them

As of early November 2023, draft appropriation bills by both the House of Representatives and the Senate do not adequately fund the WIC nutrition support program, threatening to break a nearly 30-year, bipartisan commitment to ensure all participants can access the program without waitlists.

(Washington, DC – 11/20/23) – Access to nutritious food is critical to preventing many chronic diseases and is particularly important to keep young children on track with their growth and developmental needs. In 2022, an estimated 12.8 percent of U.S. households experienced food and or nutrition insecurity sometime during the year.
As Trust for America’s Health’s (TFAH) State of Obesity report series has demonstrated, food insecurity is a risk factor for obesity and other nutrition-related chronic diseases. Progress on addressing these critical public health issues is in jeopardy if Congress does not provide funding for federal nutrition support programs during the current fiscal year.
One of the key federal nutrition programs supporting the specific nutritional needs of young children, infants, and birthing people is the Special Supplemental Nutrition Program for Women, Infants, and Children, or WIC. Created in 1972, the WIC program is a short-term, public health intervention program designed to strengthen lifetime nutrition and health behaviors within households with low-incomes. The WIC program provides nutrition benefits tailored to support a young child’s development. Over time, the program, including its food packages, has aligned with new science about the key nutrients infants and children need. These changes have had a significant impact. Studies show that the 2007 benefit update helped improve beneficiaries’ diets and decreased rates of obesity among enrolled toddlers ages 2-4.

The WIC program also adapted to challenges created by the COVID-19 pandemic by implementing new flexibilities, such as allowing WIC agencies to remotely load benefits cards. In 2021, Congress also increased the monthly benefit available to families to purchase more fruits and vegetables from $9 to $26 for children, and from $11 to $47 for pregnant and postpartum participants. These changes modernized the program and in turn increased participation; important because WIC has long had lower participation rates in comparison to the number of eligible families.

Today, nearly seven million parents and children under five years old depend on the WIC program, and participation is expected to grow due to increased program flexibilities. To keep up with increased demand, additional program funding is needed. As of early November 2023, draft appropriation bills by both the House of Representatives and the Senate do not adequately fund the WIC program, which threatens to break a nearly 30-year, bipartisan commitment to ensure all participants can access WIC without waitlists. Increasing food costs, make action to grow the WIC program critically important as families are struggling to afford healthy meals and may be forced to turn to cheaper but less nutritious alternatives.

Critical public health programs like WIC not only provide nutritious foods to families in the short term, but also help prevent diet-related diseases. Trust for America’s Health urges Congress to increase funding in the Fiscal Year (FY) 2024 budget for the WIC program to ensure pregnant and postpartum birthing people and their young children have the nutrition they need to enjoy good

Reflecting on Structural Health Challenges and Successes in Native Communities During Native American Heritage Month

November is Native American Heritage Month in recognition of the many contributions and accomplishments of American Indian and Alaska Native people. It is also a time to reflect on structural health challenges in Native communities—often linked to centuries of historical and current day trauma and discrimination—as well as the successful health initiatives driven by and in collaboration with Native communities. These programs deserve more attention and support. Furthermore, the special relationship and treaty responsibilities between the federal and tribal governments obligate support for the health and well-being of American Indian and Alaska Native people.

Population health outcomes are connected to underlying current and historic social, economic, and environmental conditions in all communities. Native communities have inherent strengths but must also cope with a legacy of historical trauma, including removal and resettlement from their original lands, forced assimilation, and a lack of infrastructure and investment by the federal government. Centuries of discrimination and intergenerational trauma play out today in a host of ways, including disproportionately high rates of poverty, food insecurity, and lack of health insurance coverage. These kinds of conditions contribute directly (e.g., access to healthy foods and healthcare) and indirectly (e.g., through stress and Adverse Childhood Experiences) to poor health outcomes.

As a result, Native communities have faced health challenges and disparities for generations. In 2021, the American Indian and Alaska Native population in the United States had a life expectancy of 65.2 years—more than 10 years lower than the overall U.S. population’s life expectancy (76.1 years) and the lowest of any racial/ethnic group that the Centers for Disease Control and Prevention (CDC) tracks. The differences in life expectancy has been further exacerbated recently due to very high mortality from COVID-19 for American Indian and Alaska Native people when compared to other racial and ethnic groups.

Some of TFAH’s priority issues—including prevention of obesity, diabetes, and other chronic diseases, and alcohol, drug, and suicide mortality—consistently show American Indian and Alaska Native people with among the worst health outcomes for any racial/ethnic population in the United States. For example, TFAH’s 2023 Pain in the Nation report found that, in 2021, American Indian and Alaska Native people had a mortality rate of 178.7 deaths per 100,000 from alcohol, drug, and suicide causes combined. This is more than twice the mortality rate of the white population (69.5 deaths per 100,000), which had the next-highest mortality rate of any other race/ethnicity measured. Other concerning health issues in Native communities include alarming maternal and infant health trends—with Native women dying from pregnancy-related causes at twice the rate of white women and Native infants dying in their first year of life at nearly twice the rate of white infants in the United States—and high rates of domestic violence.

There are many examples of valuable, community-led work focused on improving health and well-being and reducing disparities in Native populations. A few examples include:

Good Health and Wellness in Indian Country is a CDC grant program that supports tribal organizations, including Urban Indian organizations, to reduce chronic disease and promote healthy living in American Indian and Alaska Native populations. The current 2019-2024 grant cycle provides $19.3 million per year of funding to 27 tribal organizations and consortiums which reach more than 130 tribes across the United States. With 574 federally-recognized tribes in the United States, there is need for this proven program to be scaled to reach more people.
CDC’s Suicide Prevention Program includes a focus on Tribal suicide prevention. The Southern Plains Tribal Health Board and Wabanaki Health and Wellness organization are working to increase capacity to adapt and implement suicide prevention programs in tribal populations at increased risk for suicide.
The Native and Strong Lifeline— a program within Washington State’s 988 lifeline dedicated to helping American Indian and Alaska Native people in crisis—launched in November of 2022 and handled 1,200 calls in its first eight months of operation. It is staffed by Native volunteers who have lived experience with mental health challenges, and share tribal and culturally-specific resources and community connections.
The National Indian Health Board’s Climate Ready Tribes Initiative focuses on climate-related health threats. The Initiative works to raise awareness and share pertinent resources to tribal organizations broadly, as well as fund individual tribes to lead climate health and resiliency work in their community. Current awardees are Lummi Nation, the Pala Band of Mission Indians, and the Sitka Tribe of Alaska, whose work includes climate adaptation planning and identifying community health resources.
In 2021, American Indian and Alaska Native people were the group to most quickly get the first doses and full vaccination series for Covid-19 across all race/ethnicities. Community leaders and researchers attribute this success to direct vaccine distribution to tribes and the Indian Health Service, and ensuring tribal organizations could adapt vaccine messaging—like focusing on being vaccinated to reduce community harm—and engage trusted messengers—like tribal elders—that resonate with community members. Despite this success, COVID-19 death rates before the vaccine was available were very high in Native communities and Native peoples continue to have high rates of serious illness and poor health outcomes from COVID-19 due to the prevalence of chronic disease within the community.
The Substance Abuse and Mental Health Services Administration’s Tribal Opioid Response grant program supports tribal organization’s efforts to increase culturally appropriate and evidence-based prevention, treatment, and recovery support services in their communities. The FY 2022 grants included $55 million in funding. Examples of grantees include Cherokee Nation, which focused on expanding treatment recovery support and harm reduction services across more counties, and Wyandotte Nation, which focused on prevention, treatment, and training to support cultural and family connections.
The Northwest Washington Indian Health Board, a consortium of six tribes, is currently participating in the Age-Friendly Public Health Systems movement, facilitated by TFAH and the Washington State Department of Health. The primary goal of the project is to enhance public health efforts to improve the health and well-being of older adults in tribal communities. This begins with collecting relevant and robust data on older adults to identify needs and community assets that will inform interventions, like caregiving needs and home repairs.

Importantly, these and other community-led programs emphasize the need for culturally-competent approaches that are tailored to and that respect culture, belief, practices, and linguistic needs of every tribe and community.

TFAH calls for increased federal investment in evidence-based initiatives that prioritize prevention in Native communities, as well as steps to ensure prevention funding reaches underserved American Indian and Alaska Native populations. All American Indian and Alaska Native people should have the opportunity to live their healthiest lives.

TFAH Celebrates Public Health Contributions of Hispanic & Latino People During Hispanic Heritage Month

In honor of Hispanic Heritage Month 2023, TFAH is highlighting the careers of a select number of people of Hispanic and Latino/Latina descent who have made important contributions to the field of public health.

Carlos Juan Finlay, M.D. (1833 – 1915)
Dr. Carlos Juan Finlay was an epidemiologist and a physician and a pioneer in yellow fever research. He discovered that yellow fever was a vector-borne disease from mosquitoes. As one of the most revered Cuban doctors and scientists, Finlay was nominated seven times for the Nobel Prize in Physiology or Medicine. In 1928, in his honor, Cuba created the National Order of Merit Carlos Finlay as the highest recognition for contributions in healthcare and medicine.

José Celso Barbosa, M.D. (1857 – 1921)
Dr. José Celso Barbosa was the first Puerto Rican and person of African descent to earn an M.D. in the U.S. As a physician and politician, he was supportive of healthcare and fought against racism. After being denied admittance to Columbia University because of his race and ethnicity, he attended and graduated from the University of Michigan Medical School as valedictorian in 1880. He also worked closely with the Red Cross during the Spanish-American War.

César Milstein (1927 – 2002)
César Milstein was a biochemist who was elected a Fellow of the Royal Society in 1975 and awarded the Nobel Prize for Physiology or Medicine in 1984. He advanced technology related to monoclonal antibodies that is still relevant to protect against viruses and pathogens. Learn more about César Milstein here.

Helen Rodríguez-Trías (1929 – 2001)
Dr. Helen Rodríguez-Trías was a pediatrician and women’s rights advocate and in 1993 became the first Latina president of the American Public Health Association. In 2001, Dr. Rodriguez-Trias was a Presidential Citizens Medal recipient and helped create federal guidelines for consent to medical procedures in response to involuntary sterilization. She also established the first newborn care center in Puerto Rico. Learn more about Dr. Rodríguez-Trías here.

Antonia Novello, M.D. (1944 – present)
Dr. Antonia Novello was appointed the 14th United States Surgeon General in 1990. She was the first Hispanic and first woman to serve in that position. She began her career as a pediatric nephrologist then shifted towards the field of public health. Dr. Novello made many contributions at the National Institutes of Health, including in the areas of pediatrics and AIDS research. Dr. Novello was elected to the National Academy of Medicine in 2000. Learn more about Dr. Novello here.

Jane Delgado, Ph.D. (1953 – present)
Dr. Jane Delgado is a psychologist and graduate of NYU and SUNY Stony Brook. She is the current and first woman president and CEO of the National Alliance for Hispanic Health and contributed to the 1985 Landmark Report of the Secretary’s Task Force on Black & Minority Health aka The Heckler Report. Dr. Delgado has also authored many books on health, including the groundbreaking Salud: The Latina Guide to Total Health. Learn more about Dr. Delgado here.

Omar Estrada
Omar Estrada is a University of Colorado graduate who works with the Colorado Department of Education to improve access to mental and physical health services for Colorado’s youth. Estrada was recognized by the de Beaumont Foundation’s 40 Under 40 in Public Health for 2023.

Bamby Salcedo
Bamby Salcedo is the President and CEO of the TransLatin@ Coalition. She is a prominent LGBTQ+ and human rights activist and helped develop the blueprint on providing competent healthcare services for transgender people and LGBT people in the U.S., Latin America, and the Caribbean. Salcedo also helped create the Center for Violence Prevention and Transgender Wellness in Los Angeles. Learn more about Bamby Salcedo here.

Children’s Environmental Health Day- Protecting Children From Environmental Health Threats

October 12^th is Children’s Environmental Health Day. It is a day to consider how children’s health can be impacted by the world around them, and what interventions are available to ensure that young people grow up in safe, healthy, and equitable environments. Children should be top of mind while strategizing environmental health efforts, as they are often more susceptible to hazards. Examples include:

Clean Air: Air pollution can impact children before they are even born. From conception to age two, air pollution has been linked with a variety of negative health impacts including early birth, low birth weight, and improper immune system development. Prenatal exposure to air pollution has also been linked with impaired lung function in infants and children, as well as childhood asthma. It is recommended that women especially in early or late stages of pregnancy limit exposure to air pollution as much as possible.

Indoor air quality has a significant impact on children as well. Special attention should be paid to the quality of air at home and at school. Homes should have sufficient ventilation to ensure fresh air is getting cycled into the home. Without proper ventilation, pollution can build up indoors as well as concentrations of dangerous gases such as carbon monoxide and radon.

Schools in particular face challenges such as limited budgets for repairs to ventilation systems and reduced efficiency of older buildings and equipment. The U.S. Environmental Protection Agency (EPA), in partnership with the American Lung Association, has designed the Indoor Air Quality Tools for Schools program to give schools the information and skills they need to manage air quality in a low-cost, practical manner.

Clean Water: Unfortunately, not all communities in the United States have the same access to clean water. A federal emergency was recently declared in Louisiana due to saltwater intrusion, which has contaminated the water system in parts of the state. Louisiana’s Women, Infants, and Children (WIC) program put out a guidance about using bottled water while mixing formula because infants are especially vulnerable. Other hazards, such as lead and PFAS may find their way into drinking water. Clean Water for US Kids provides information on water testing kits as well as information on improving home water filtration.

Extreme Heat: As average temperatures continue to rise year after year, so have instances of heat-related illnesses. Since children have smaller body mass and are more likely to spend extended periods outdoors, they are more susceptible to morbidity and mortality from heat-related causes. It is important that children are adequately hydrated before, during, and after exposure to high outdoor temperatures, wear breathable clothing, or stay inside if temperatures are simply too high.

Pregnant women are also at increased risk, and exposure to high temperatures may have a negative impact on the fetus, especially early in pregnancy. Pregnant women should avoid peak midday temperatures and balance fluid intake with beverages with sodium and other electrolytes.

Lead Exposure: Lead exposure can cause a series of often irreversible health impacts on children including damage to the brain and nervous system, slow growth and development, learning and behavior problems, and hearing and speech problems. These can result in lower IQ, decreased ability to pay attention, and underperformance in school. It is important to identify potential sources of lead around the home and remediate them before they can take hold. Homes built prior to 1978 should be checked for the use of lead paint which can crack and make lead dust, which can be inhaled. If a child may have been exposed to lead, it is important that they receive blood lead testing and follow-up care and referral. According to an analysis from the Health Impact Project eliminating lead hazards from the places where children live, learn, and play could generate approximately $84 billion in long-term benefits per birth cohort.

Trust for America’s Health Celebrates Healthy Aging Month

September is Healthy Aging Month. It is a time to pause, ponder, and consider the potential we have before us to take the concept of healthy aging to the next level. Healthy aging is often defined as “the development and maintenance of optimal physical, mental (cognitive and emotional), spiritual, and social well-being and function in older adults.”

What needs to happen to take all those components to the next level? Multi-sector collaboration, coordination, funding, and prioritization of the health and social needs of older people.

Collaboration: Most policy actors understand that policy and systems changes do not happen without unified, strategic planning and working across sectors to achieve the desired changes. The power of a collective impact approach is its ability to bring together the aging services, healthcare, public health, and community sectors to work together to assess and understand the needs of older adults in any given community.

Coordination: Once the above systems are assessed for their strengths or gaps in providing age-friendly services, sectors can come together to coordinate activities and interventions to reduce duplication and maximize the distribution of limited public resources for programs and services that support older people, their caregivers, and their families.

Investment: Funding is a much-needed aspect of providing systems and services that support healthy aging, but advocates face numerous challenges in securing additional funding for older adult programs. Since much of what happens in older age can be attributed to lifestyle choices in early age, funding healthy habits all along the life course is one way to reduce demands on the long-term care system. Unfortunately, the return on investment is also long-term and therefore often a hard one for policymakers to see and act on.

Prioritization of healthy aging, from birth to the end of life: This process may take the form of addressing the social and economic issues that impact health at the community level, as well as dismantling the systemic structures that lead to health disparities. Prioritizing healthy housing, access to nutritious food sources, quality education, quality healthcare, and other community supports that lift all people will inevitably improve the opportunities for all people to grow older with optimal physical, mental, spiritual, emotional, and social health and function. It’s up to everyone to see ourselves in this process and make our communities better for all.

Navigating Climate-Related Threats to the Public’s Health

The Urgency of Emergency Preparedness in Light of Extreme Weather Events

(August 29, 2023) In the first eight months of 2023, the United States confronted numerous climate challenges, indicating a pivotal moment for the nation and the planet. Hawaii faced the country’s deadliest wildfires in over a century, claiming more than 100 lives and leaving a staggering cost in their wake. In California, storms tested the state’s resilience through floods and mudslides, while in Phoenix, weeks of intense heat threatened its most vulnerable residents. In Vermont, rivers surged past their banks, while haze from Canadian wildfires degraded air quality in more than a dozen states. And all this as the year’s hurricane season is just getting underway.

These events demonstrate the escalating public health threats driven by climate change and the need for public health officials to play a role in addressing them. As global temperatures rise, we are seeing an uptick in heat-related illnesses and even fatalities, especially among individuals who are most at risk. Rising sea levels and intensified storms lead to flooding, which can contaminate drinking water and spread waterborne diseases. Meanwhile, wildfires, exacerbated by droughts and higher temperatures, compromise air quality, leading to a spike in respiratory problems, from asthma to chronic bronchitis. Furthermore, shifting climate patterns are expanding the range of many infectious disease vectors, like mosquitoes, exposing new populations to illnesses like malaria or dengue. The ripple effects of climate change touch nearly every aspect of public health, demanding policymakers’ attention and action.

Below is a partial round-up of the climate-related challenges that the country has already faced in 2023.

Wildfires in Hawaii. The U.S. grappled with its deadliest wildfires in over a century when fires that began as isolated brush incidents on the islands of Hawaii and Maui were intensified by the effects of Hurricane Dora and quickly escalated. Many public officials and residents were caught off guard by the size and rapid spread of the flames, leading to the tragic loss of more than 100 lives. Residents and officials now confront daunting reconstruction needs. Despite Hawaii’s reputation for lush greenery, its defenses have been compromised by significant reductions in rainfall. Diminished La Niña patterns, which traditionally bring cooler and wetter conditions to the region, have shifted, leading to warmer and drier trends. Furthermore, the proliferation of flammable invasive grasses, supplanting native vegetation, increases the fire risks.

Smoky skies. Canada, grappling with one of its harshest wildfire seasons, has seen tens of millions of acres of its landscape consumed by flames. The repercussions have been felt beyond its borders, with smoke significantly degrading air quality in several U.S. regions, including New England, the Southeast, and the Midwest. These conditions have led the Environmental Protection Agency to issue air quality alerts affecting millions of Americans. This sharp rise in fires is largely linked to the effects of global warming, which brings about drought and intense heat, rendering forests more vulnerable to blazes.

California storms. In early 2023, intense rains hit California. While they replenished reservoirs and snowpacks, they also caused flooding, mudslides, sinkholes, and tree damage that impacted infrastructure. A severe winter storm in late February trapped residents and led to the deployment of the California National Guard. Shortly after, another storm in the Sierra Nevada caused two fatalities and power disruptions. March saw the arrival of two bomb cyclones that brought tornadoes, heavy rain, and snow. These extreme weather events, exacerbated by climate change, underscore California’s oscillation between droughts and powerful storms. Such climatic shifts create atmospheric rivers that deliver heavy precipitation.

Notably, Southern California effectively weathered Tropical Storm Hilary’s record-setting rainfall in August, in part due to proactive measures like school closures and swift emergency response to road flooding and fallen trees. Despite the storm’s potential severity, no deaths were reported in major areas like Los Angeles and San Diego, highlighting the importance of preparedness.

Groundwater shortages in Arizona. Arizona officials sounded the alarm in June on groundwater shortages, signaling a potential halt to the rapid housing development in the Phoenix area, which is among the fastest-growing regions in the U.S. Although existing building permits will remain unaffected, the announcement underscores the urgent need for alternative water sources and conservation measures in future projects. Governor Katie Hobbs reassured that Arizona is not immediately running out of water, but shortages could have significant implications for the region’s future. Prolonged drought, combined with increasing water demand, have depleted the Colorado River and intensified water scarcity, posing a challenge for the region’s long-term sustainability.

Vermont flooding. In July, Vermont experienced severe flash and river flooding, leading to extensive damage to communities, roads, bridges, and causing significant property losses. This event broke several records, with Montpelier’s airport receiving the highest single-day rainfall since 1948. The destruction was comparable to the damage from Tropical Storm Irene in 2011. In terms of impact, the destruction from the 2011 and 2023 events was only surpassed by the Great Flood of November 1927, which took place before modern flood control measures were implemented in the state.

Hot water off the coast of Florida. A buoy off Florida’s coast this summer measured a sea surface temperature of 101.1 degrees Fahrenheit, potentially setting a new world record and far exceeding the typical range of 73F to 88F. This extreme heat, part of a concerning trend of warming waters in Florida, poses grave risks to marine life, ocean ecosystems, and human livelihoods. Increasing temperatures, intensified by phenomena like El Niño, could also boost the strength of tropical storms and hurricanes.

Extreme heat in Phoenix. Phoenix endured an unprecedented heatwave in July, with temperatures exceeding 110°F for 31 straight days, surpassing a 1974 record. This coincided with a global trend marking July the warmest month ever registered. Hospitals reported an uptick in heat-related cases, ranging from heat cramps to lethal heat strokes. The city’s medical examiner confirmed 25 heat-related deaths and is investigating many more. Critical infrastructure, such as air conditioners in shelters and medical buses, malfunctioned due to the extreme temperatures. With shelters at full capacity and public housing waitlists stretching for months, many unhoused residents were left without a haven from the oppressive temperatures.

President Biden announced initiatives in July to support communities suffering from extreme weather. To combat the rising heat, the primary weather-related cause of death in the U.S., he directed the Department of Labor (DOL) to issue its first-ever Hazard Alert concerning heat, with the intent to reinforce worker protections against heat-related dangers under federal law. This alert will educate employers on their responsibilities and help ensure that workers know their rights. The DOL has committed to intensifying its enforcement against heat-safety violations, focusing especially on high-risk sectors like construction and agriculture. Meanwhile, the National Oceanic and Atmospheric Administration is allocating up to $7 million to enhance weather forecasting in collaboration with educational institutions, aiming to boost preparedness for extreme weather events. Additionally, the Department of the Interior is in the process of investing $152 million to bolster water storage and climate resilience in California, Colorado, and Washington, addressing the challenges of prolonged drought and ensuring access to clean drinking water.

These efforts build on past actions by the Biden-Harris Administration, such as channeling billions of dollars via the Department of Housing and Urban Development for energy-efficient building upgrades and the establishment of cooling centers. Additionally, in collaboration with Congress, it earmarked over $50 billion from the Infrastructure Investment and Jobs Act to bolster climate resilience throughout the nation.

As Trust for America’s Health (TFAH) has previously highlighted, preparing for weather-related events is a critical element of public health emergency preparedness. Collaboration between public health officials and partners—such as federal, state, local, tribal, and territorial agencies, emergency response teams, community-based organizations, and hospitals—is fundamental. Working together, they can pave the way for better preparation and response strategies, utilizing data to predict and lessen potential health impacts. Proactive measures are crucial in safeguarding communities from these escalating threats. For example, the nation needs significant investment in climate-resilient infrastructure — from storm-resistant housing to updated water management systems. To protect people from extreme heat, communities must prioritize public education on heat risks, establish cooling centers, and adapt urban infrastructure to reduce heat retention. It’s crucial to acknowledge that socioeconomic and health inequities have historically worsened the impact of extreme heat on communities of color, making targeted interventions in these communities even more essential. Strengthening early warning systems and ensuring equitable access to hydration and emergency healthcare resources are vital steps. It’s also imperative to bolster our health systems’ readiness to respond to the increasing burden of climate-related illnesses. This includes enhancing disease surveillance and training healthcare professionals to recognize and treat emerging health threats, especially in communities that face disproportionate risks.

In line with a comprehensive public health approach, the Building Resilience Against Climate Effects (BRACE) framework from the Centers for Disease Control and Prevention (CDC) offers a vital tool. This strategic framework empowers officials to develop and implement health adaptation plans tailored to their specific climate change challenges. By guiding health departments through a five-step process — from forecasting climate impacts and assessing vulnerabilities to developing and implementing a comprehensive adaptation plan — the BRACE framework ensures a data-driven response that accounts for local nuances. Recognizing the disparate effects of climate change on various populations, this approach emphasizes not just broad community safeguards but also targeted interventions to protect those most at risk. To more adequately support these crucial initiatives, TFAH recommends funding the CDC’s Climate and Health Program at a level of $110 million for Fiscal Year 2024. This program collaborates with state, local, tribal, and territorial health agencies to address climate change impacts, primarily utilizing the BRACE framework. Additionally, it offers resources, funding, and support through various initiatives to enhance community preparedness and communication regarding climate-related health risks. As communities continue to witness the tangible effects of a changing climate, leaning into systematic and strategic frameworks like BRACE becomes paramount. The synthesis of proactive planning, community-specific interventions, and overarching public health strategies helps bring about a resilient and equitable response.

Acting to protect health and well-being by improving our systems’ readiness and enhancing protective measures—commonly termed climate adaptation—is a critical public health priority. Climate mitigation refers to efforts to reduce or prevent greenhouse gas emissions or to remove them from the atmosphere, aiming to curb future global warming. Both the Intergovernmental Panel on Climate Change, a scientific body under the auspices of the United Nations that assesses climate change information, and the United States Global Change Research Program, which coordinates U.S. research on global environmental changes and evaluates climate change impacts, emphasize that mitigation and adaptation are complementary strategies crucial for reducing the human impacts of climate change.

August is National Immunization Awareness Month

August is National Immunization Awareness Month. This annual observance is designed to remind everyone that staying up to date on vaccinations is an important way to protect not only their health but the health of everyone around them.

Vaccines are a public health success story. Today, we are fortunate to have a broad spectrum of safe and effective vaccines, which if received on schedule, protect patients of all ages against vaccine-preventable diseases. Current vaccines protect against childhood disease including chicken pox, measles, and whooping cough, while protecting adults from the flu, Tdap, and shingles. Vaccines have also eradicated or nearly eradicated life-threatening diseases, such as smallpox and polio.

Children as young as 1-2 months old should be vaccinated against childhood illnesses and school-age children may need vaccine updates before they can return to school this fall. Ensuring that every child sees their doctor for a well-child visit and to receive any needed vaccine or vaccine updates is one of the best ways a parent can protect their child’s health and that of the community. Because the immunity created by a vaccine can lessen overtime, it’s important that children receive their vaccines on the recommended schedule. Adults may also need vaccine updates or to receive recently approved vaccines such as the RSV vaccine for adults 60 years of age and older.

During the COVID-19 pandemic, routine childhood vaccination levels among school-age children in the U.S. decreased, likely due to missed well-child medical visits. Globally, a report by UNICEF and the World Health Organization found that childhood vaccination coverage worldwide increased with about 4 million more children receiving full immunizations in 2022 compared to 2021, but were still below pre-pandemic levels.

Vaccines meet strict safety and effectiveness measures
In the U.S., safety measures are strict and prioritized to ensure that vaccines are safe for patients. Before any vaccine is approved for use, it is tested for safety and effectiveness through clinical trials and then must be approved by the Food and Drug Administration (FDA) and recommended by the Center for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices. While some people experience mild side effects after receiving a vaccine, such as swelling at the shot area, mild fevers and chills, serious reactions are extremely rare. Overall, the safety of all vaccines is closely monitored to ensure their continued safe use. If patients have questions about a vaccine including any potential side effects, they should speak to their healthcare provider.

Visit the Centers for Disease Control and Prevention website for more information on vaccine safety and for child and adult immunization schedules.

Centuries of Systemic Racism Has Created Distinct Mental Health Challenges for Minority Communities

In 2008, July officially became National Minority Mental Health Awareness Month, originally designated as Bebe Moore Campbell National Minority Mental Health Awareness Month by the United States House of Representatives. Until her passing in 2006, Bebe Moore Campbell was an author, advocate, co-founder of the National Alliance on Mental Illness (NAMI) Urban Los Angeles, and a national spokesperson, dedicating herself tirelessly to promoting mental health education and eradicating stigma within diverse communities. National Minority Mental Health Awareness Month is observed to recognize the distinct hardships that members of minority communities often face concerning their mental health.

According to the U.S. Department of Health and Human Services Office of Minority Health, in 2021, “only 39 percent of Black or African American adults, 25 percent of Asian adults, and 36 percent of Hispanic/Latino adults with any mental illness were treated, compared to 52 percent of non-Hispanic white adults.” The 2023 Pain in the Nation Report by Trust for America’s Health (TFAH), also found an increase in suicide mortality “by 4 percent between 2020 and 2021 with the highest increases among American Indian/Alaska Native and Black people.” In addition, TFAH’s report also explained that youth who were American Indian/Alaska Native, Black, Latino, and multiracial had the “highest rates of poor mental health behavior and/or suicidal behaviors compared to other groups in 2021.”

Minority communities experience these disparities in mental health outcomes and care due to factors that are beyond their control. Among other social determinants of health (SDOH), discrimination and economic insecurity contribute to the disparities in access and treatment that members of minority communities can encounter.

Cultural and social stigma around mental health issues among minority communities also contributes to poor mental health outcomes in these populations and can act as barriers to necessary mental healthcare. Systemic racism and discrimination present in the healthcare field and among healthcare professionals also prevent individuals of various racial and ethnic groups from receiving the best mental health treatment available. Negative experiences due to these factors can undermine trust in healthcare professionals and result in patients feeling ignored despite serious mental health issues, which can deter patients from seeking or staying in treatment. Lack of trust can also arise from difficulties patients experience in finding providers from the same ethnic or racial group who share similarities in culture, literacy, and language.

Minority individuals are also more likely to be uninsured, raising financial barriers to seeking and receiving mental healthcare. According to the Kaiser Family Foundation, for example, “Nonelderly American Indian and Alaska Native (AIAN) and Hispanic people had the highest uninsured rates at 21.2% and 19.0%, respectively as of 2021.”

Policy recommendations to address these disparities and barriers can range from prevention efforts, increases in funding, and systemic improvements to the healthcare system. Policy recommendations by TFAH to advance health equity include enacting and funding the Health Equity and Accountability Act, as well as increasing funding for the Centers for Disease Control and Prevention’s (CDC) Racial and Ethnic Approaches to Community Health (REACH) program and its Healthy Tribes program to provide support for all approved applicants. As mentioned in TFAH’s Pain in the Nation Report, TFAH also recommends that Congress support policies and programs that address SDOH to better implement interventions at both an individual and community level; this should include increased CDC funding and a greater emphasis on the importance of screening for SDOH in the healthcare system. Continuous efforts to reduce stigma and bring positive messaging will also encourage individuals in minority communities to seek mental health screening and care. Efforts to ensure accessible mental healthcare, including through enforcement of the Mental Health Parity and Addiction Equity Act and passage of the Effective Suicide Screening and Assessment in the Emergency Department Act, should also be prioritized.

Mental health is a critical public health issue. It is important to understand and recognize the mental health disparities and unique struggles faced by racial and ethnic groups to better help these populations overcome mental health barriers. Acknowledging that minority communities continue to face disproportionate mental health challenges–and responding accordingly on the federal level–can increase awareness of this public health issue and help ensure individuals in minority communities achieve optimal health.

At One Year Mark Data Show 988 Suicide and Crisis Lifeline Has Improved Crisis Care Access and Response, and that Sustained and Increased Funding is Needed

This month marks the one-year anniversary of the 988 Suicide and Crisis Lifeline, which replaced the previous National Suicide Prevention Lifeline with a single three-digit number for mental health, substance misuse, and crisis services. With oversight and funding from the Substance Abuse and Mental Health Services Administration (SAMHSA) and assistance from partners like Crisis Text Line and The Trevor Project, 988 consists of independently operated and funded call and text/chat centers across the country. When individuals in crisis contact 988, trained crisis counselors at these centers listen, provide support, and share resources if necessary. Access to 988 can play a critical role in improving depressed, suicidal, or overwhelming feelings—in fact, SAMHSA estimates that 98% of individuals contacting 988 receive the crisis support they need in the moment. SAMHSA has also identified the current 988 system as a first step toward evolving crisis care to include mobile crisis units, which provide in-person responses, and stabilization centers, which provide a safe place to stay for individuals in crisis.

Even its current form, however, 988 represents a momentous advancement in the effort to connect more Americans with crisis services. In May 2023, for example, 988 answered 45% more calls, 52% more chats, and 938% texts compared to the previous lifeline in May 2022. In total, 988 answered nearly 160,000 more contacts in May 2023 compared to May 2022, and the average time to answer these contacts decreased from 140 seconds to 35 seconds. 988 has also launched specialized services for the LGBTQ+ population, and SAMHSA just announced the addition Spanish language text and chat services. Other specialized services will likely follow for hearing impaired individuals and American Indian/Alaska Native people.

In 2022, Congress supplemented the establishment of 988 with several pieces of legislation containing significant investments and policies to advance behavioral health. The Bipartisan Safer Communities Act (BSCA), passed in June 2022, for example, provided onetime support for 988 and increased support for the National Child Traumatic Stress Network. The BSCA also provided funding for Project AWARE at SAMHSA, which empowers education agencies through training for school personnel, increases awareness and detection of mental health issues, and connects youth and families to needed services. In addition, Congress directed the Centers for Medicare and Medicaid Services to assist schools with expanding school-based health services through Medicaid and funded initiatives at the U.S. Department of Education to hire and retain mental health professionals providing these services.

In the Consolidated Appropriations Act (CAA), enacted in December 2022, Congress built on these accomplishments by reauthorizing the Garrett Lee Smith Suicide Prevention Program, which funds mental health programs for college-age students, as well as several programs to improve the behavioral health workforce. The CAA also bolstered crisis-intervention programs by directing guidance and funding to providers and improving payment for their services.

The U.S. Department of Health and Human Services (HHS) also acted throughout 2022 to expand access to community-based mental health services. In partnership with the Department of Education, for example, HHS has worked to facilitate the use of Medicaid and Children’s Health Insurance Program funds to support school-based behavioral health services. SAMHSA also launched the Mental Health Crisis Response Partnership Pilot Program to improve access to mobile crisis services in high-need areas.

988 is part of a series of investments to address Americans’ mental health needs

Despite this progress, significant challenges remain in the effort to strengthen 988 and connect individuals in crisis to behavioral health services. For example, although state governments carry the responsibility for funding and operating 988 call centers, only a handful of states have passed legislation to secure long-term financial support for the lifeline through telecommunications fees. A recent study, moreover, found that only around half of states have earmarked sufficient funding to meet increased 988 center costs. Due in part to insufficient funding, call centers can also struggle to hire and retain qualified staff and answer rates can vary significantly by state. Improved data collection and analysis concerning 988 services is also necessary to help identify gaps in crisis care and improve lifeline implementation.

On the federal level, ongoing negotiations in Congress could result in cuts to appropriations for 988, which is an alarming prospect given that SAMHSA estimates outreach to the lifeline will increase by up to 50%—to a total of around 9 million contacts—in FY 2024. States will also require additional federal support to develop and implement mobile responses and stabilization units and publicize the full range of 988 services. A recent survey by the Pew Charitable Trusts, for example, found that only 13% of U.S. adults knew about the existence and purpose of 988; awareness was higher among white adults and individuals with a college education compared to Black adults and individuals with a high school degree or less.

Trust for America’s Health (TFAH) will continue to advocate for additional funding and resources to bolster the 988 lifeline and transform the behavioral health crisis system more broadly. Continued bipartisan support is necessary not only to ensure access to existing services, but also to build the next generation of care to meet the growing demand from Americans in crisis.

Recommendations for addressing Americans’ mental health needs and other issues are available in TFAH’s 2023 Pain in the Nation report.