Trust for America’s Health (TFAH)

Child Health

Summary: This TFAH report was released as part of the Annie E. Casey Foundation's KIDS COUNT DATABOOK 2008. The report explains why after 40 years of progress, infant mortality rates in the U.S. have stalled since 2000. TFAH finds that chronic diseases like obesity and diabetes play a part in the trend, and offers recommendations to lower infant mortality rates.

Summary: The Search for Causes and Cures. This report presents an overview of major birth defects and developmental disabilities, as well as an assessment of how these conditions are tracked.

Summary: A Shot in the Arm for Childhood Immunization Programs. TFAH and Every Child by Two joined to examine childhood immunization policy in the U.S. and the persistent 20 percent shortfall of preschoolers who do not receive routine vaccines on time. The groups identify ways to close this gap.

Summary: As part of its ongoing efforts to strengthen the fundamentals of our public health defenses, Trust for America’s Health (TFAH) has identified nationwide tracking of chronic conditions and diseases as a priority.  Monitoring and tracking initiatives, like registries created to monitor birth defects, form the backbone of a vital, functional and responsive public health network.

Summary: This report concludes that most states are doing a poor job of tracking and preventing birth defects, which are the number one cause of infant mortality in the United States. Birth defects account for almost 20 percent of all infant deaths each year. The report gives each of the 50 states, plus the District of Columbia and Puerto Rico, a letter grade based on their efforts to monitor and research birth defects.

Environmental Health

Summary: Asthma, a disease which can make breathing so difficult that even simple tasks are impossible and can even lead to death, is America’s fastest growing chronic affliction.  So far, more than 17 million Americans—nearly five million of whom are children—have been hit by this epidemic. And we don’t know why.  But we do know asthma attacks are triggered by local environmental factors, from indoor irritants such as mold and tobacco smoke to outdoor air pollutants such as ozone.

Summary: More than 30 years after the launch of the national War on Cancer, the disease remains the top health concern of Americans. This report examines how well state health agencies are doing in their efforts to track, control and prevent cancer, and awards grades on a state-by-state basis.

Summary: Chronic diseases, such as cancer, asthma, Parkinson's, and Alzheimer's are responsible for seven out of every ten deaths, many of them preventable. This policy update advocates a nationwide health tracking network (NHTN) to identify and understand the factors causing or contributing to these diseases.

Food Safety

Summary: TFAH and the Robert Wood Johnson Foundation (RWJF) examine the fragmented and antiquated food safety system and propose ways to improve the food safety functions at the U.S. Department of Health and Human Services (HHS). The report calls for the immediate consolidation of food safety leadership within the Food and Drug Administration (FDA) and ultimately the creation of a separate Food Safety Administration within HHS.

Summary: Protecting America's Food Supply from Farm-to-Fork. Approximately 76 million Americans -- one in four -- are sickened by foodborne disease each year. TFAH's food safety report identifies major gaps in the nation's food safety system, including obsolete laws, misallocation of resources, and inconsistencies among major food safety agencies.

Summary: Threatening the Nation's Health. Episodes of animal-borne diseases, also referred to as zoonotic diseases, are increasing around the globe. This report examines the public health response to five of these emerging animalborne diseases: monkeypox, WNV, mad cow disease, Lyme disease, and CWD.

Obesity

Summary: How Obesity Policies are Failing in America. In this report, TFAH and the Robert Wood Johnson Foundation (RWJF) conclude that adult obesity rates increased in 37 states in the past year. The report calls for the creation of a National Strategy to Combat Obesity and includes state-by-state data.

Summary: How Obesity Policies are Failing in America. The fourth annual edition of the F as in Fat report explores current policy weaknesses in the fight against obesity and recommends changes that must be considered to address the obesity crisis nationwide. This installment has a special focus on the role of physical activity.

Summary: How Obesity Policies are Failing in America. The third annual edition of this report concludes that adult obesity rates continued to rise in 31 states, while government policy efforts have consistently failed to provide viable solutions. It offers a 20-step action plan for stakeholders to address the obesity epidemic's health burden and financial costs.

Summary: How Obesity Policies are Failing in America. The second annual edition of this report concludes that national and state policies are falling far short of obesity prevention and reduction goals. It finds that the U.S. does not have the aggressive, coordinated national and state strategies needed to address the crisis -- threatening to make the epidemic worse.

Pandemic Influenza

Summary: Trust for America's Health (TFAH), the Center for Biosecurity, and the Robert Wood Johnson Foundation (RWJF) analyze the initial response to the H1N1 outbreak, Pandemic Flu: Lessons From the Frontlines, which found that U.S. officials executed strong coordination and communication and an ability to adapt to changing circumstances, but it also how quickly the nation's core public health capacity would be overwhelmed if an outbreak were more severe or widespread

Summary: Severe acute respiratory syndrome (SARS) is a serious public health threat. A SARS outbreak would provide a "real time" example of the complex challenges facing the U.S. public health system. This report provides a brief analysis of the key public health infrastructure components that would be engaged in a SARS epidemic and TFAH's recommendations for strengthening them.

Summary: West Nile virus (WNV) was first discovered in the U.S. in 1999, and is now considered part of America's public health landscape. TFAH's report finds that the spread of the virus raises serious public health concerns and demonstrates the need for a shift in America's approach to emerging infectious diseases.

Summary: In the midst of the bird flu outbreak of 2004 and the emergence of avian influenza in Asia, TFAH examines significant flu-related questions in this issue paper, and recommends actions public health officials should take to better prepare for the threat flu poses to the country every year.

Summary: In this 2007 report, TFAH and The American Academy of Pediatrics (AAP) find that children and teens between the ages of 0-19 account for nearly 46 percent of all H5N1 "bird" flu deaths. The report also identifies gaps in U.S. preparedness for treating and caring for children during a possible pandemic flu outbreak.

Summary: A State-by-State Analysis. A pandemic influenza outbreak is inevitable, according to scientific experts. TFAH estimates the economic impact of a potential outbreak on the country and analyzes how it would impact each state.

Summary: 'Inevitable' Epidemic Could Kill Millions. In this report, TFAH finds that over half a million Americans could die and over 2.3 million could be hospitalized if a moderately severe strain of a pandemic flu virus hits the U.S. TFAH offers detailed recommendations to help improve U.S. preparedness.

Summary: This review of U.S. pandemic flu plans finds that many planning topics remain under-addressed and additional actions could be taken to improve preparations and reduce the risks posed by an outbreak. Some key areas of concern include vaccine and treatment shortfalls, gaps in containment strategies, limited plans to keep the public informed, and an inadequate review of state plans for quality and feasibility.

Summary: On behalf of TFAH and Mailman School of Public Health at Columbia University, Peter D. Hart Research Associates, Inc. conducted 20 one-on-one telephone interviews from March 3rd-29th, 2006, among television, radio, and newspaper journalists who cover public health issues. This document summarizes the results of that survey.

Summary: An Issue Brief from Trust for America's Health and the Infectious Diseases Society of America. In this 2006 report, TFAH and the Infectious Diseases Society of America (IDSA) raise concerns that pandemic flu preparedness efforts are falling behind advances in science and technology. They issue a set of policy recommendations and outline actions to better prepare the nation for a pandemic flu outbreak.

Public Health

Summary: The Blueprint makes recommendations for the next Administration and Congress on ways to improve the health of Americans. More than 150 experts and organizations helped identify gaps and fixes for federal public health agencies and programs through a year-long consensus-building process.

Summary: A report that finds at least 170,000 Americans die annually from newly emerging and re-emerging infectious diseases, a number that could increase dramatically during a severe flu pandemic or yet-unknown disease outbreak. Factors including globalization, increased antimicrobial (drug) resistance, and climate and weather changes are contributing to the increased threat.

Summary: This is an issue brief from Trust for America's Health, funded by a grant from the Irene Diamond Fund.The worldwide hepatitis and HIV/AIDS epidemics are overwhelming. Globally, 200 million people -- more than three percent of the world's population -- are infected with hepatitis C, and nearly 33 million people are reported to be living with HIV.

Summary: Investments in Disease Prevention Yield Significant Savings, Stronger Communities. In this study, TFAH finds that a small strategic investment in disease prevention could result in significant savings in U.S. health care costs. The report includes potential annual savings and return on investment figures for every state in America and Washington, D.C.

Summary: In this TFAH-commissioned poll, Americans rate the flu epidemic, cancer, and obesity as top health concerns. Nearly three in four Americans say the government needs to spend more on health priorities and emerging threats. Spending on public health is viewed as vital to improving homeland security.

Summary: A Call to Action from more than 100 Health Organizations. More than 140 organizations joined together to support this consensus document as the foundation of TFAH's Healthier America Project. The project advances the vision that America should strive to be the healthiest nation in the world.

Summary: This survey, commissioned by TFAH, finds that at a time when the rising cost of health care has become the central economic issue, Americans are eager to invest in prevention to help reduce long term health care costs.

Summary: A new survey commissioned by the Trust for America’s Health (TFAH) finds that Americans place a high value on preventing disease and promoting healthy lifestyles. At a time when the rising costs of health care has become the central economic issue, Americans are eager to invest in preventing diseases and promoting healthy lifestyles as a way of helping to reduce long term health care costs in the country.

Summary: America spends more than $2 trillion annually on health care, more than any other nation. Yet, tens of millions of Americans still suffer every day from preventable illness and chronic disease. TFAH outlines ten top priorities, advocating a health strategy driven by prevention, including: Combating the Obesity Epidemic, Preventing Tobacco Use and Exposure, Preventing and Controlling Infectious Diseases, Preparing for Potential Health Emergencies and Bioterrorism Attacks, Recognizing the Relationship Between Health and U.S. Economic Competitiveness, Safeguarding the Nation's Food Supply, Planning for Changing Health Care Needs of Seniors, Improving the Health of Low-Income and Minority Communities, Reducing Environmental Threats and Promoting Disease Prevention. Also included are crosscutting recommendations for Holding Government Accountable for Protecting the Health of Americans.

Summary: Advocating for Better Health in Your Community Through Media Attention. Media coverage is often one of the most effective ways to raise public awareness and understanding about a health problem or issue that is of concern to you. TFAH outlines five steps any individual or organization can take to communicate the importance of a particular health issue to decision makers and their community.

Summary: Make a Difference in 5 Easy Steps. An advocate is someone who defends a cause or petitions on another's behalf. Effective advocacy is a powerful prescription for improving your health, the health of your family and your community. Read these action items to learn how you can be a health advocate in your community.

Public Health Funding

Summary: TFAH and the Robert Wood Johnson Foundation (RWJF) found that Midwestern and Southern states received less federal disease prevention funding than Northeastern and Western states did in fiscal year (FY) 2008. These differences can amount to millions of dollars. The economic downturn could lead to further state budget cuts to disease prevention and emergency preparedness programs.

Summary: A chart comparing spending priorities at the Centers for Disease Control and Prevention in 2007, 2008 and 2009.

Summary: TFAH developed its annual "Critical Care" list to identify key programs, at the U.S. Department of Health and Human Services (HHS) and other federal agencies, that are vital to protecting America's health and preventing disease. TFAH emphasizes that increased support for these programs is needed to help improve the health of all Americans.

Summary: A TFAH analysis of the Administration's fiscal year (FY) 2008 budget, including the President's Proposals for the CDC and Pandemic Flu Preparedness. The report also covers the proposed budget for HHS Secretary and Emergency Preparedness, along with other key disease prevention and public health preparedness programs.

Summary: A State-By-State Look at How Federal Public Health Dollars Are Spent. In this analysis, TFAH reviews key health statistics and federal funding for public health on a state-by-state level. The Trust finds that Midwestern states receive less funding from the U.S. Centers for Disease Control and Prevention (CDC) than other states.

Summary: This survey, commissioned by TFAH, finds that Americans strongly favor increased federal funding to improve the nation's public health system.

Summary: TFAH's analysis of the President's fiscal year 2007 budget finds proposed cuts to core Centers for Disease Control and Prevention (CDC) programs of more than four percent from FY 2006, or nearly eight percent when compared to the FY 2005 funding levels. Some programs that would receive cuts include obesity prevention, birth defects prevention, environmental health, and injury prevention and control.

Summary: A State-by-State Look at How Federal Public Health Dollars are Spent. This analysis reviews key health statistics and federal public health funding at a state-by-state level. The report finds that funding levels for health protection programs vary dramatically among states. It emphasizes that the country is falling short on achieving federally established goals for reducing disease and improving health, because there is not sufficient funding to result in wide-scale change.

Summary: A State-by-State Look at how Federal Public Health Dollars are Spent. This study examines key health statistics and public health funding levels in each state. States are ranked by per capita funds received from the Centers for Disease Control and Prevention (CDC). A Public Opinion Strategies poll on America's Top Health Concerns is included. This survey examines national perceptions of a number of health-related issues, including: a ranking of top health concerns, impressions of the nation's readiness for natural emergencies or terrorist attacks, and the difference in men's versus women's opinions on disaster preparedness.

Summary: This analysis includes a table providing a comparison of the FY 2002 final appropriations levels; the FY 2003 enacted appropriations levels and the President's FY 2004 budget request. In several cases, these numbers show a pattern of budget cuts that puts the health of Americans at risk.

Public Health Preparedness

Summary: The sixth annual Ready or Not? report finds that finds that progress made to better protect the country from disease outbreaks, natural disasters, and bioterrorism is now at risk, due to budget cuts and the economic crisis. In addition, the report concludes that major gaps remain in many critical areas of preparedness, including surge capacity, rapid disease detection, and food safety. It contains state-by-state health preparedness scores based on 10 key indicators.

Summary: Blueprint for a Healthier America: Modernizing the Federal Public Health System to Focus on Prevention and Preparedness.  The Blueprint makes recommendations for the next Administration and Congress on ways to improve the health of Americans. More than 150 experts and organizations helped identify gaps and fixes for federal public health agencies and programs through a year-long consensus-building process.

Summary: Protecting the Public's Health from Disease, Disasters, and Bioterrorism. The fifth annual Ready or Not? report finds that while important progress has been made, the continuing trend of annual cuts in federal funding for state and local preparedness activities threatens the nation's safety. It contains state-by-state health preparedness scores based on 10 key indicators of emergency preparedness capability.

Summary: Protecting the Public's Health from Disease, Disasters, and Bioterrorism. TFAH's fourth annual Ready or Not? Report finds that five years after the September 11th and anthrax tragedies, emergency health preparedness is still inadequate in America. The report includes an evaluation of all 50 states with 10 preparedness indicators, based on input and review from public health experts.

Summary: Protecting the Public's Health from Disease, Disasters, and Bioterrorism. In this two-part report, the federal government receives a grade of D+ for post-9/11 public health emergency preparedness, and over half of states garnered a score of five or less out of 10 possible points. Key indicators of health emergency preparedness include capabilities to test for chemical and biological threats and hospital surge capacity to care for patients in a mass emergency.

Summary: Protecting the Public's Health in the Age of Bioterrorism. TFAH's second annual study of preparedness finds that, despite incremental progress, the government still has a long way to go to protect the American people from a bioterror attack. The report examines 10 key indicators to gauge state preparedness and determine America's overall readiness in responding to bioterrorist attacks and other health emergencies.

Summary: Protecting the Public's Health in the Age of Bioterrorism. This 2003 report discovers that after two years and nearly $2 billion of federal bioterrorism preparedness funding, states are only modestly better prepared to respond to health emergencies than they were prior to September 11, 2001. The report examines 10 key indicators to assess areas of improvement and ongoing vulnerability.

Summary: This report addresses the role of public health laboratories, which are designed to respond to terrorism as well as more conventional threats -- from analyzing water contaminants to cancer screening. TFAH finds that these vital facilities have fallen into a state of disrepair. The report also makes a series of assessments on the ability of state public health labs to respond to specific chemical weapon events.

Summary: Once considered only a remote possibility, today the risk of biological, chemical and radiological terrorist attacks on American soil is stunningly real.

Summary: This preparedness progress report, written one year after September 11th 2001 and subsequent anthrax attack, analyzes the government's response. TFAH finds that public health officials acted quickly to limit harm to people's health. However, these crises also revealed the limits of the public health system.

Summary: Our Lack of Response to the Growing Asthma Epidemic and the Need for Nationwide Tracking. Asthma is America's fastest growing chronic affliction, but experts don't know why. This 2001 report shows that although the condition affects more than 17 million Americans--nearly five million of whom are children - 27 states don't track the disease at all.