NATIONAL. President Trump’s Says He Wants to Stop the Opioid Crisis. His Actions Don’t Match (TIME)

By Dr. Mary T. Bassett, Dr. Julie Morita and Dr. Barbara Ferrer 

Dr. Mary T. Bassett is the Commissioner of Health for New York City, a position she assumed in February 2014. With more than 30 years of experience in public health, Dr. Bassett has dedicated her career to advancing health equity.

Dr. Julie Morita was appointed as commissioner of the Chicago Department of Public Health (CDPH) in early 2015; under Dr. Morita’s leadership, CDPH developed and launched Healthy Chicago 2.0, a four-year plan to assure health equity by addressing the social determinants of health.

Dr. Barbara Ferrer leads the Los Angeles County Department of Public Health which protects and promotes health and prevents disease among L.A. County’s more than 10 million residents. Dr. Ferrer has over three decades of experience as a philanthropic strategist, public health director, researcher, and community advocate.

President Trump’s declaration of opioids as a public health emergency left jurisdictions across the country – including New York City, Los Angeles and Chicago, the cities and county we serve as health commissioners and director – scrambling to understand the actual impact that this legal action will have on our response to an alarming increase in drug overdose deaths. In our cities, 2,650 people died last year of a drug overdose, the largest number on record.

Given the public health emergency designation, answers to three basic questions will determine the significance of this action: How much funding for public health responses will states and cities actually be able to access to support a long-term response to this deadly epidemic; how those dollars can be used; and for how long new funds will be available.

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SAN FRANCISCO. The Intersection of Black Lives Matter and Public Health

Watch a new video created by the San Francisco Department of Public Health about how health connects to the Black Lives Matter movement.

Public health professionals have seen disparities in health outcomes along racial and ethnic lines for decades. Data point to disparities in life expectancy, rates of new HIV diagnoses, rates of viral suppression for those who are HIV positive, rates of emergency room visits due to asthma or heart disease, among others. With the Black Lives Matter movement elevating the discussion on disparities to a national dialogue, we asked public health professionals how they can use that momentum to inform their work. Take a listen to public health and social justice professionals from the Bay Area talk about how different sectors such as the economy, transportation, housing, and food can work together and use the national conversation on disparities to address health outcomes. Featuring: -Jessica Brown, San Francisco Department of Public Health -Dr. Muntu Davis, Alameda County Health Department -Dr. Joy DeGruy, author of Post Traumatic Slave Syndrome -Melissa Jones, Bay Area Regional Health Inequities Initiative -Krystal Robinson Justice, Bay Area Regional Health Inequities Initiative -Zachary Norris, Ella Baker Center for Human Rights -Veronica Shepard, San Francisco Department of Public Health

MARICOPA COUNTY. Feds cutting Tucson teen-pregnancy prevention funds. (The Arizona Daily Star)

By Stephanie Innes

Two programs to prevent teen pregnancy in Southern Arizona are in peril due to funding cuts by the Trump administration.

The U.S. Department of Health and Human Services will pull grant funding for its Teen Pregnancy Prevention Program, created by the Obama administration in 2010. The funding affects 81 sites, including sites in Tucson and Phoenix.

Officials with Child & Family Resources, a nonprofit Tucson social-service agency, are trying to figure out how to move forward after the recent and unexpected news that, come June, the organization will lose the final two years of a $7 million, five-year federal grant to prevent teenage pregnancy.

The lost money amounts to $2.8 million for evidence-based programs that have been reaching 3,000 Southern Arizona youths per year. Evidence-based refers to programs shown to improve measurable outcomes.

HHS emailed a statement to the Star that the Teen Pregnancy Prevention Program has shown “very weak evidence of a positive impact” and is proving to be a “poor use of more than $800 million in taxpayer dollars” nationwide.

Federal officials also cited a recent report that sexually transmitted diseases are at record highs as further evidence that the program was ineffective.

HHS says future decisions regarding the program will be guided by science and a “firm commitment to giving all youth the information and skills they need to improve their prospects for optimal health outcomes.”

But grant administrators in Tucson and around the country say the programs have proven effective in continuing a national trend of reduced teen pregnancies.

 

Read more.

CHICAGO. From the Notebook: City Official Appears on D.C. Panel. (Chicago Tribune)

By Katherine Skiba,

Dr. Julie Morita, commissioner of the Chicago Department of Public Health, will appear Tuesday on a panel on Capitol Hill to talk about funding for public health programs.

Morita on Monday said more federal money is needed to detect and respond to outbreaks of illnesses such as influenza, mumps, measles, whooping cough, meningitis and the Zika virus.

She worries that if insurance coverage for so-called essential health benefits is eliminated, fewer people will obtain vaccines and be screened for diseases such as breast and colon cancer. Such steps prevent disease or allow for early detection, Morita said.

A flyer for the panel discussion says just as with the nation’s roads and bridges, its public health infrastructure “remains antiquated and in need of modernization.”

Count her among opponents of a GOP effort in the Senate to dismantle Obamacare, which she said led to about 300,000 more Chicagoans obtaining health insurance. A recent study showed just over 9 percent of city residents are not insured, which she called a record low. 

The event is sponsored by the Congressional Public Health Caucus, a bipartisan group of House lawmakers including U.S. Rep. Jan Schakowsky, an Evanston Democrat.

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NATIONAL. Republicans Are Remarkably Good At Uniting Opposition Against Themselves (The New York Times)

By VIKAS BAJAJ and STUART A. THOMPSON SEPT. 25, 2017

Despite the likely demise of the latest Republican health care bill, it achieved one stunning feat: it united patient advocacy groups and most of the health care industry in opposition to it.

Four Republican senators have declared their opposition to the bill, one more than is needed to defeat it. Some of them were no doubt swayed by the size and diversity of groups that quickly stood up to oppose the legislation. Hospitals joined ranks with insurance companies, while insurers banded together with patient groups like the AARP. The legislation sponsored by senators Lindsay Graham, Bill Cassidy, Dean Heller and Ron Johnson was so objectionable that these disparate groups found common cause in opposing the bill.

Below, we list those we’ve been able to identify as for and against the bill. Conservative religious and anti-abortion groups favored the bill because it prevented people on Medicaid from using their insurance at Planned Parenthood clinics and prevented health care plans sold on the federal health care marketplace from covering abortion beyond existing limitations. This list is not complete, and we invite organizations that would like to be listed to contact us here.

ORGANIZATIONS

4SUPPORT

Christian Coalition of America

Family Research Council

National Right to Life

Susan B. Anthony List

Have we missed any? Let us know

110OPPOSE

Asthma and Allergy Foundation of America

AARP

Adult Congenital Heart Association

ALS Association

Alzheimer's Association

Alzheimer's Impact Movement

Academy of Nurtition and Dietetics

America's Essential Hospitals

America’s Health Insurance Plans

American Academy of Family Physicians

American Academy of Pediatrics

American Cancer Society Cancer Action Network

American College of Emergency Physicians

American Psychological Association

American College of Physicians

American College of Preventive Medicine

American College of Rheumatology

American Congress of Obstetricians and Gynecologists

American College of Surgeons

American Diabetes Association

American Foundation for the Blind

American Health Care Association

American Heart Association

American Hospital Association

American Liver Foundation

American Lung Association

American Medical Association

American Nurses Association

American Occupational Therapy Association

Academy on Violence and Abuse

American Osteopathic Association

American Psychiatric Association

American Public Health Association

American Society for Addiction Medicine

American Society for Radiation Oncology

American Society of Clinical Oncology

American Speech-Language-Hearing Association

Amputee Coalition

Arthritis Foundation

Association for Community Affiliated Plans

Association of American Medical Colleges

Association of Oncology Social Work

Association of Public Health Associations

Association of University Centers on Disabilities

Autism Society

Autism Speaks

Autistic Self Advocacy Network

Big Cities Health Coalition

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NATIONAL. Here’s a list of medical groups opposing the Cassidy-Graham health-care bill (The Washington Post)

By Christopher Ingraham September 22

The Senate is having yet another go at repealing Obamacare, this time via legislation known as the Cassidy-Graham proposal. The bill was on life support Friday after Sen. John McCain signaled he would oppose the bill, lengthening the already long odds for its passage.

Among other things, the bill would remove protections for preexisting conditions, make deep cuts to Medicaid and end the Affordable Care Act's tax credits and cost-sharing subsidies.

The net result, according to a Brookings Institution analysis released Friday? Thirty-two million more people uninsured by 2027, relative to the current baseline...

This list is almost certainly incomplete, given the huge universe of advocacy groups focusing their efforts on conditions that sometimes affect only small numbers of people. But it gives a sense of the breadth and depth of the medical community's opposition to Republicans' latest attempt to repeal Obamacare.

Read more.

NATIONAL. Doctors, public health workers, patient advocates — even insurers — oppose latest ACA repeal (Science Blogs)

By Kim Krisberg

Senate Republicans are again trying to ram through an Affordable Care Act replacement that threatens the health and well-being of millions of Americans. It’s shameful. But don’t take my word for it. Let’s look at what people who actually work in health care are saying about the Graham-Cassidy-Heller-Johnson bill.

In this interview, Sen. Bill Cassidy insists that his bill would protect people with pre-existing conditions. Blue Cross Blue Shield Association disagrees. (Cassidy also says in that same interview that his bill would work through the Children’s Health Insurance Program (CHIP), which he said has been reauthorized. That’s totally false — CHIP has not been reauthorized and its funding expires Sept. 30.) But back to pre-existing conditions — here’s what Blue Cross Blue Shield had to say:

Although we support providing states with greater flexibility in shaping health care options for their residents, we share the significant concerns of many health care organizations about the proposed Graham-Cassidy bill. The bill contains provisions that would allow states to waive key consumer protections, as well as undermine safeguards for those with pre-existing medical conditions. The legislation reduces funding for many states significantly and would increase uncertainty in the marketplace, making coverage more expensive and jeopardizing Americans’ choice of health plans...

And let’s not forget public health. The ACA’s Prevention and Public Health Fund (PPHF) has become an absolutely critical source of funding for the nation’s public health agencies. Cassidy’s bill would eliminate that fund. Here’s what the Big Cities Health Coalition, a forum for the country’s largest metropolitan health departments, had to say about the fund’s potential elimination:

Among the programs at risk at the CDC are the 317 Immunization Program, Epidemiology and Laboratory Capacity Grants, the Childhood Lead Poisoning Prevention Program, and a host of chronic disease programs. The PPHF provides vital resources to governmental public health at all levels, and its elimination will further erode our fragile health system.

Eliminating public health programs that are now funded by the ACA would seriously undermine the ability of cities and counties to protect and promote health. The loss of hundreds of millions of dollars would hamper efforts to respond to food borne illness outbreaks, prevent emerging infectious diseases like Ebola and Zika, and respond to natural disasters like Hurricanes Irma and Harvey.

And in a letter to senators from the American Public Health Association, Executive Director Georges Benjamin writes:

The Graham-Cassidy plan would also eliminate the Prevention and Public Health Fund, the first and only mandatory funding stream specifically dedicated to public health and prevention activities. The fund has already provided more than $6 billion to support a variety of public health activities in every state including tracking and preventing infectious diseases like the Ebola and Zika viruses, community and clinical prevention programs, preventing childhood lead poisoning and expanding access to childhood immunizations. Eliminating the fund would devastate the budget of the Centers for Disease Control and Prevention. The fund currently makes up 12 percent of CDC’s budget and eliminating this funding stream would force Congress to replace the funding through the regular appropriations process where resources for nondefense discretionary programs are already too low.

Graham-Cassidy-Heller-Johnson is a threat to America’s health. If you’d like to voice your opinion, the American Public Health Association has an easy-to-use template to help you reach your representatives in Congress. For more information on the ACA replacement, NPR has a fantastic explainer.

Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for 15 years. Follow me on Twitter — @kkrisberg.

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Coalition Members Featured at Drexel University Urban Health Symposium, “Reimagining Health in Cities: From Local to Global"

On Sept. 7 and 8, 2017, the Drexel Urban Health Collaborative hosted the second Urban Health Symposium, “Reimagining Health in Cities: From Local to Global.” The event — which was held at the Dornsife School of Public Health — drew around 300 researchers, practitioners and policymakers from a variety of organizations and educational institutions. The Symposium featured two jam-packed days of inspiring speakers, poster presentations, and global networking opportunities. 

Highlights included a lively session with U.S. health leaders; an innovative session on novel uses of data; and a keynote address from Mindy Fullilove, MD, Professor at the Parsons School of Design, The New School. 

In addition to the informative and insightful sessions, the Symposium also featured over 60 posters, covering a broad range of research topics related to urban health. Selected posters were displayed for five categories: novel urban health research methods; built environment and climate change; health disparities and special populations; program and policies to improve health in cities; and addressing urban challenges, health behaviors and mental health. Thank you to all of our poster presenters and attendees! 

If you missed a session, or perhaps you’d like to re-live the Urban Health Symposium, check out our YouTube playlist to watch the sessions.

SAN DIEGO. California Today: A Deadly Outbreak Stalks San Diego. (The New York TImes)

By Mike McPhate

In a typical year, San Diego County might see a few dozen cases of hepatitis A.

So far this year? More than 400, with 15 people now killed by the liver disease.

“This is an outbreak like none other that we’ve ever had,” said Dr. Wilma Wooten, the region’s public health officer. Dr. Wooten said the response has been complicated by the infection’s nebulous spread.

Whereas past outbreaks have commonly been traced to a single food source, allowing the threat to be swiftly contained, this one is passing person to person. San Diego’s homeless population has been hit hardest by the virus, which stalks its victims more readily in areas of poor sanitation.

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MINNEAPOLIS. White House cuts to federal grants endanger sex education for teens (Minneapolis Star Tribune)

By Judy Keen

Founded 46 years ago by faith leaders, Annex Teen Clinic provided sexual health services to 1,782 youth in 2016. It takes its message to public schools, contributing to a dramatic drop in Hennepin County’s teen birthrate. Annex installs health mentors in some schools to work one-on-one with students and provides training for teachers and parents, in addition to its clinical services.

Now some of the clinic’s programs and jobs, and other Hennepin County efforts to prevent teen pregnancy, are at risk. President Donald Trump’s administration in July announced an abrupt end — two years early — to what were supposed to be five-year grants specifically aimed at preventing teen pregnancy.

In all, the U.S. Health and Human Services Department notified 81 programs in 31 states and the District of Columbia that $214 million in funding will end June 30, 2018, instead of in 2020.

Officials here and across the country are fighting to save the grants, but worry that the Republican-controlled Congress will not restore funding. Hennepin County Commissioner Mike Opat said he’ll urge the county to fill the gap if its appeal fails...

Efforts to reverse the grants’ demise have spread across the country. Health officials from 20 U.S. cities have written to HHS Secretary Tom Price to denounce the grants’ elimination. Minnesota Reps. Keith Ellison, Betty McCollum and Tim Walz are among 148 House Democrats who sent a July 25 letter to Price demanding an explanation within 45 days for the decision, which came just three months after Congress voted to provide full funding for the latest grants.

“At a time when young people are most in need of information and education to protect their sexual and reproductive health, this administration is denying evidence and science,” the legislators wrote.

Read more. 

NATIONAL. Trump Administration Abruptly Cuts Funding to Teen Pregnancy Prevention Programs. (NBCNEWS)

By Elizabeth Chuck

In the meantime, health commissioners from 20 large cities have written to Price, pleading for a change of heart.

"Cutting TPPP funding and shortening the project period will not only reverse historic gains made in the U.S. in reducing teen pregnancy rates, but also make it difficult to truly understand what practices are most effective in our communities across the nation," the letter, from the Big Cities Health Coalition, read.

Senate Democrats wrote a letter, too, calling the move "short-sighted." They also praised the teen pregnancy prevention program as a "pioneering example of evidence-based policymaking."

"Despite these successes, HHS has apparently elected to eliminate the final two years of TPP Program grants without cause or a rationale for the termination," they wrote.''

Read more.

NATIONAL. Trump Administration Cuts Down Funding for Teen Pregnancy Prevention Programs. (Christianity Daily)

by Jessica Lim

Federal funding for teen pregnancy prevention programs around the country was stripped last month by the Trump Administration. A five year-grant that was awarded to 81 organizations in the country has now been cut to three years.

Teen pregnancy rates in the United States has dropped continuously over the last two decades, going from 61.8 births per 1,000 females between the ages of 15 and 19 to 24.2 births per 1,000 teen females in 2014, according to the Centers for Disease Control.

Though there is a steep decline in 2010 when the grant from the Department of Health and Human Service took effect, some argue that the grants may have influenced this trend, but are not the only reason.

“Some of that leaves you scratching your head wondering, why mess with success?” stated Bill Albert, chief innovation officer at the National Campaign to Prevent Teen and Unplanned Pregnancy.

The loss of funding for these programs has pushed health commissioners that are a part of the Big Cities Health Coalition to write a letter to the Secretary of the Depart of Health and Human Services, Thomas Price, which stated that “cutting TPPP funding and shortening the project period will not only reverse historic gains made in the U.S. in reducing teen pregnancy rates, but also make it difficult to truly understand what practices are most effective in our communities across the nation.”

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SEATTLE. US Cuts Funds Aimed at Reducing Teen Births. (The Skanner)

by Melanie Sevcenko

Just two years into the federally-funded Teen Pregnancy Prevention Program (TPPP), the U.S. Department of Health & Human Services has announced it plans to pull the plug on funding in June of next year.

That’s two years shy of the five years of funding the program promised.

Moreover, the announcement to shorten the TPPP funds, issued by the Office of Adolescent Health on Jul. 6, came with no warning, explanation or alternative.

The lack of dollars, say Big Cities Health Coalition (BCHC) – a forum for the leaders of America’s largest metropolitan health departments – will severely impact evidence-based programs, services, and research for reducing teen pregnancies.

According to the Centers for Disease Control and Prevention, one in four teens will become pregnant by age 20.

In protest to the funding cut, 37 Democratic senators sent a letter to U.S. Department of Health and Human Services Secretary Tom Price, questioning why crucial funding is being yanked out of public health departments across the U.S, two years too soon.  

Days later, the BCHC sent its own letter to Price, signed by 20 health commissioners and echoing the sentiment of the senators.

The health advocates argue that the TPPP has made unprecedented progress in reducing teen pregnancies. 

Read more.

NATIONAL. Why Are Teen Pregnancy Programs Getting Cut? (CityLab)

By Allstair Boone

The teen birth rate in the U.S. is at a record low: Since 1991, it’s declined by 67 percent. A large chunk of that drop occurred in the last 6 years, when the Obama Administration’s Teen Pregnancy Prevention Program began.

Now, in its second round of grants, the TPP Program (not to be confused with the trade agreement) is currently funding 84 communities across the country. Between 2010 and 2016, the years during which TPP funds started flowing, the national rate plunged 41 percent.

Lawmakers and public health advocates have voiced dismay about the cuts to TPP. A group of Democratic lawmakers—37 senators and 149 representatives—have written to Health and Human Services secretary Tom Price, asking for an explanation. The nonprofit Big Cities Health Coalition—a forum for leaders of America’s largest metropolitan health departments—sent a letter to Price, appealing this decision. The group emphasized a key concern with the early end to the program—the cuts will make it more difficult for researchers to obtain the evidence-based results that measure the effectiveness of individual programs:

Read more.

NATIONAL. Why the Trump administration is cutting teen pregnancy prevention funding. (CNN)

By Jacqueline Howard

The Office of Adolescent Health's Teen Pregnancy Prevention Program currently funds 84 grants to reduce teen pregnancy across clinics, schools and communities, by implementing and evaluating prevention programs and supporting technology- and program-based approaches, according to the office's website. Their end date is now June 30.

Members of the Big Cities Health Coalition, a coalition of health officials from the 28 largest cities in the US, wrote a joint letter to Price last month urging him to reconsider the decision to cut the project period and funds.

The letter indicated that teen birth rates in the US dropped to a record low last year, following a long-term trend, and the letter suggested that reducing funding for teen prevention programs might reverse that trend.

"Cutting TPPP funding and shortening the project period will not only reverse historic gains made in the US in reducing teen pregnancy rates, but also make it difficult to truly understand what practices are most effective in our communities across the nation," the letter said.

Patty Hayes, director of public health for Seattle and King County, said she has seen the teen prevention programs have a positive impact in her community.

"We have been so successful in King County with our teen pregnancy rates reducing by 55%" since 2008, said Hayes, who also signed the Big Cities Health Coalition letter.

"If something works, you invest in it," she said. "We need for our community to respect science, to move forward with this and to make sure that we are not moving backwards. ... I'm very wound up about this."

Read more.

NATIONAL. Pregnancy Prevention Groups Scramble After Cuts. (U.S. News)

By Gabrielle Levy

The Hill reported Friday that the decision last month to pull the plug two years early on five-year grants made as part of the Teen Pregnancy Prevention Program came in some cases with no notice and no explanation. The Department of Health and Human Services informed 81 organizations participating in the program that their grants, totaling $213 million, would end in June 2018. Officials said in a statement the decision was due to "very weak evidence of positive impact of these programs."

The paper also talked to Dr. Leana Wen, health commissioner in Baltimore, where a program to decrease the teen birth rate will lose $3.5 million.

"We don't have another way to fill this deficit. This will leave a huge hole in our ability to deliver health education," Wen said.

Read more.

NATIONAL.Trump administration cuts short teen pregnancy prevention program funding. (CBS News)

By Kathryn Watson

The Department of Health and Human Services is cutting off grants for teen pregnancy prevention programs across the country, leaving the groups that receive the grants -- and Democratic members of Congress -- perplexed. 

"These notices of shortened project periods are highly unusual, especially given that Congress has yet to act on FY 2018 appropriations," a July 21 letter from 37 Democratic senators reads. "This action is short-sighted and puts at risk the health and well-being of women and our most vulnerable youth who depend on the evidenced-based work that TPP Program grantees are doing across the nation."

"It would be fanciful at best to say these programs were solely responsible for the decline, of course that's not the case," Albert said. 

But he believes the funding has contributed to the continuing downward trend. 

"Some of that leaves you scratching your head wondering, why mess with success?" Albert said.

Read more.

SEATTLE. King County Health Officials Protest Early End Of Sex Ed Grant (KNKX)

By Ed Ronco

The public health department is in year three of a five-year grant from the U.S. Department of Health and Human Services. The $5 million pays for sexual health education curriculum, teacher training, and efforts to reduce teen pregnancy. It also funds research into how well the curriculum is working.

“One key principle for our work in public health is that we act based on science and evidence,” said Patty Hayes, director of public health in King County. “We need the evidence that a new system or rule or intervention is necessary – and that it’s effective.”

King County and other urban public health agencies have filed a formal protest with the Trump administration. They’re organized by the Big Cities Health Coalition, which calls the early termination of the grant “highly disruptive to work already underway.”

Read more.

NATIONAL. Local Health Officials Sound Alarm on Trump Efforts to Defund Teen Pregnancy Prevention. (Route Fifty)

By Quinn Libson

Last month, the federal Office of Adolescent Health, which is overseen by the Department of Health and Human Services, informed researchers, local health workers and educators that the grant funding for 81 teen pregnancy prevention programs which was intended to last for five years would be cut short two years early—a decision that took place outside the normal budgeting process.

The city of Baltimore, as The Washington Postrecently reported, is one of the places affected by the funding cut. Health programs run by the city will lose out on $3.5 million dollars set to support classes in anatomy and physiology as well as counseling on issues related to sex for 20,000 teens. The money would have also provided training for 115 teachers. While Baltimore has made progress on reducing teen births—the rate dropped by nearly a third from 2009 to 2013—there’s still much work to be done. The teen pregnancy rate in Baltimore remains significantly higher than the national average.

King County, Washington, which includes Seattle, is like many of the other grant recipients. The $5 million in funding there pays for more than curriculum, programming and teacher training. The federal funding is also spent on figuring out just how well all of those efforts are working.

“One key principle for our work in public health is that we act based on science and evidence,” Patty Hayes, director of public health in King County told KNKX public radio. “We need the evidence that a new system or rule or intervention is necessary—and that it’s effective.” The county is currently in the process of collecting efficacy data on FLASH, a curriculum developed by the county and implemented in schools throughout the South and the Midwest. As many as 4,000 students are affected.

Read more.