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Center for American Progress;
From 2019 to 2020, life expectancy in the United States declined by 1.5 years, reaching its lowest level since 2003. It fell yet again in 2021. In fact, the health of Americans has been declining for decades, compared with citizens in other high-income countries: In 2020, life expectancy in the United States was nearly five years lower than it was in other industrialized countries, and it has only declined further as the country has faced the world's largest total death toll from COVID-19. Unlike the United States, in 2021, many of its peer countries have started to see rebounds in life expectancy with the help of the COVID-19 vaccination.As health declines, it adversely affects not only quality of life but also the economy and national security, including workforce productivity, health care costs, and the fitness of military recruits. Yet these adverse health impacts are not felt equally across U.S. society. For example, the decline in life expectancy has been greater among Hispanic and non-Hispanic Black populations than among the non-Hispanic white population. To eliminate these disparities and those that exist in economic and social systems, an intentional focus on redressing structural and institutional racism is critical. Improving the health of the most vulnerable populations will not only boost overall health outcomes and social well-being, but also strengthen the economy and help to build a strong, equitable future.Policies to strengthen the nation's health must therefore ensure that individuals and all communities are healthy and thriving and that no one is left behind. This can be done through long-term, sustained investments to prevent disease, promote health, and prepare for and respond to continuous and urgent threats to health. Namely, by addressing social determinants of health—such as income, education, housing, employment, transportation, environmental conditions, and neighborhood conditions—policymakers can improve health, reduce racial disparities, and contribute to economic mobility.This report outlines 10 priorities for improving the nation's health.
The New York City Hispanic/Latinx Health Action Agenda is a result of a community driven health policy process that brought together over 60 Community-Based Organizations/Agencies and 72 community leaders, faith-based leaders, experienced clinical and non-clinical service providers. Facilitated by the Hispanic Health Network, Hispanic Federation, and the Latino Commission on AIDS, the process started in October 2020 with a series of consultations with key public health leaders, community providers, and members of health networks with expertise in the health field and Hispanic/Latinx communities. Soon after, steering and planning committees were developed to ensure a broader reach of Hispanic/Latinx community leaders and Hispanic/Latinx serving organizations throughout all NYC boroughs.In the Spring of 2021, the steering and planning groups engaged in facilitated conversations aimed to reach consensus on key subpopulations and health issues to focus on for this health policy agenda. Additionally, this newly formed network of organizations and leaders sought to fortify Hispanic/Latinx health leadership with a health policy-focused perspective to guide decision-makers and impact legislation, particularly at a moment in which NYC is preparing for a critical municipal election scheduled for November.The overarching goal of this NYC Hispanic/Latinx Health Action Agenda is to improve health outcomes among Hispanic/ Latinx New Yorkers living throughout all the boroughs while ensuring Hispanic/Latinx participation and inclusion and impacting health policy decision making in order to address health disparities and inequities in New York City. To do so, participants in this process established a conceptual framework to guide the assessment of the health needs of Hispanic/Latinx New Yorkers and develop a set of health policy recommendations.
Bipartisan Policy Center;
Public Health Forward: Modernizing the U.S. Public Health System defines a vision for a modernized public health system in the 21st century and provides a framework of practical, prioritized, and bipartisan actions for policymakers and public health officials to guide strategic investments and decision-making to help translate the vision into a reality with a focus on equity. The federal government continues to provide critical leadership and funding to navigate the current pandemic and has a responsibility to make significant investments and changes in public health for the post-pandemic future. Long-term, increased, sustainable funding and policy leadership from the federal government will be crucial to support this five-year vision, framework, and set of actions, as most public health departments are concerned over their funding levels, notwithstanding the recent infusion of money.
In response to the COVID-19 crisis, Heartland Alliance Health (HAH) aligned with multiple residential sites serving people experiencing homelessness and people with substance use disorders to expand access to oral health services for their residents through site-based outreach.The HAH Shelter-Based Oral Health pilot program aims to improve the oral health of individuals experiencing homelessness and increase access to oral health services and other services addressing social determinants of health. The pilot program aims to do this by establishing stronger partnerships with residential sites and providing on-site dental services. The long-term goals of the program are to increase knowledge for medical providers to successfully implement and deliver on-site oral health care and continue developing strategic alignment between Heartland Alliance Health and residential sites.Recognizing the importance of program implementation in effective service delivery, the evaluation of the Oral Health Service followed the World Health Organization's Implementation Framework. To understand how the service was operationalized, the outcome variables of acceptability, adoption, appropriateness, feasibility, fidelity, coverage and sustainability were assessed. Research questions were developed within each of the overarching outcome variables, sourced from relevant literature and the HAH Oral Health Logic Model (Appendix A). The logic model was co-developed by the research team, HAH Oral Health staff, and outreach partner staff. Specifically, the research questions for this report focus on the implementation of the Oral Health Service based on identified short- and mid- term outcomes.
Indiana Bar Foundation;
This fifth edition of the Indiana Bar Foundation's Indiana Civic Health Index (INCHI) takes stock of Indiana's successes and shortcomings during the past decade and defines action steps to ensure Indiana becomes a national leader in civic health. In this latest INCHI we examine three election cycles – six elections during 10 years – and analyze trends during that time. The insights gained by examining Hoosiers' participation in civic life from 2010 to the present will inform and inspire citizens and leaders alike to build a culture of civic engagement enhancing our economic, social, and political well-being.Building on the recommendations outlined in the 2019 Indiana Civic Health Index, section one of the report details progress in advancing civic education in schools and promoting citizen participation in the election process, two goals that are profoundly intertwined. Studies show a consistent and robust relationship between school experiences with voting education and civic participation later in life. As cornerstones of representative democracy, civic education and participation are crucial to advancing our civic health.The second section of the report continues the review of Indiana's performance on an array of civic health indicators. Drawing on earlier analyses and incorporating the newest data, we examine ten years (2010-2020) of Indiana's civic activity, identifying areas of strength as well as opportunities for improvement. We hope this unique overview will further stimulate discussion and inspire a renewed commitment to advancing our civic health. Strengthening Hoosiers' civic health will require a concerted effort of all stakeholders interested in supporting citizen participation in its many forms; the result will be a more vibrant, successful, and engaged Indiana and nation.
Physicians for Human Rights;
Toward the beginning of the COVID-19 pandemic in March 2020, the Trump administration overrode the objections of public health experts at the U.S. Centers for Disease Control and Prevention (CDC) and compelled the CDC to issue an order under Title 42 U.S.C. section 265 of the 1944 Public Health and Service Act that closed the border to migrants and asylum seekers. The government used public health as a pretext to summarily expel children and adults seeking refuge at the U.S. border more than 980,000 times, while at the same time allowing other types of travelers to continue to cross the border with no testing or quarantine requirements. Public health experts strenuously objected to the ban, pointing out the lack of epidemiological evidence for only banning this category of entrants to the United States while keeping the borders open to other travelers.Nevertheless, six months into the Biden administration, the U.S. government continues to expel families and adults to countries where they face severe harm and persecution, violating their rights and failing to safeguard public health. The Biden administration also continues to carry out chaotic border expulsions that perpetuate family separation and further traumatize an already vulnerable population.In May 2021, a Physicians for Human Rights (PHR) research team conducted interviews in Tijuana and Ciudad Juárez, Mexico with 28 asylum seekers who had been expelled under the Title 42 order, and with six health care workers providing services to migrants. The team sought to document people's experiences during expulsion, including family separation, the actions of U.S. and Mexican government officials during the expulsion process, and the physical and mental health impacts of expulsion and family separation.People described an impossible situation, where they were unsafe in their own country, unsafe in Mexico, and yet unable to seek safety at the U.S. border. Every day that the Title 42 order continues to expel asylum seekers is another day that the U.S. government is harming people's health and violating their human rights.
COVID-19 has devastated Black and Latinx/Hispanic communities in the United States during the past year, erasing recent life expectancy gains and reinforcing racism as a potent, structural driver of health and human inequity.The health disparities contributing to this burden are long-standing. They reach well beyond the pandemic and have left many communities of color with historically worse outcomes. This chartbook details inequities between white, Black, and Latinx/Hispanic communities across a range of health indicators in four main areas:insurance coverage and access to carereceipt of health serviceshealth statusmortality.
Aging and Disability Business Institute;
This toolkit offers guidance for aging and disability community-based organizations (CBOs), such as Area Agencies on Aging (AAAs) and Centers for Independent Living (CILs), that are in the early stages of seeking to contract with health care providers and payers to provide home and community-based services and supports. CBOs at various stages of contracting with health care entities can use this toolkit as a primer on how to conduct outreach and how to craft messages best suited to potential contracting targets.
Big Cities Health Coalition;
Big city health departments made a huge impact in 2020. Faced with a once-in-a-century pandemic, funding shortages, and political pressures, public health leaders worked tirelessly to protect the health of their jurisdictions. In our 2020 Annual Report, we highlight just a few of the countless ways that we worked with members to advance equity and health in our cities.
This brief is a summary of policy developments that affect farmworker health and access to health care. This issue focuses on heat stress and heat-related illness.
Kaiser Family Foundation;
Sexual and reproductive health is an integral part of women's overall health. Access to these services is shaped by a broad range of factors including coverage and affordability, national and state policies, availability of care, health provider characteristics, as well as individual preferences and experiences. For many women, the Affordable Care Act (ACA) improved access to sexual and reproductive health care by expanding pathways to Medicaid eligibility and making private insurance more affordable. The ACA also required private health insurance plans to cover many recommended preventive services without any patient cost-sharing, such as sexually transmitted infection counseling and screening and all 18 FDA-approved contraceptive methods. While the ACA has expanded sexual and reproductive health care, state and federal policy actions in recent years have resulted in more limited access to comprehensive sexual and reproductive health care, including abortion referrals and services, particularly for women who depend on publicly supported health care providers and clinics.Access in the past year has also been undoubtedly affected by the COVID-19 pandemic, which has forced providers to find ways to make contraceptive and STI services available via telehealth or through minimal contact, like no-test medication abortions. There is increasing interest in expanding efforts to allow pharmacists to prescribe birth control, gain FDA approval for over-the-counter oral contraception without a prescription, and expanding access to contraception through smartphone apps or online platforms that no longer require a visit to a brick-and-mortar clinic or doctor's office.While the system is undergoing constant change, the perspectives and experiences of women in obtaining sexual and reproductive health care can help to shape the next generation of policies and programs. This brief provides a window into some of those voices and perspectives by presenting selected findings from the 2020 KFF Women's Health Survey, a nationally representative survey of women conducted in November/December of 2020. The survey covered a wide range of topics related to women's coverage, use, access, and experiences with the health care system. This brief presents survey findings on coverage and use of reproductive and sexual health services among different subgroups of 2,695 women ages 18 to 49.
Since 2006, the National Conference on Citizenship (NCoC), Civic, and other partners have assembled top experts and institutions to release the Civic Health Index to better understand an array of civic health indicators that are measurable and movable.NCoC defines "civic health" as the way that communities are organized to define and address public problems. Previous reports sought to identify challenges of citizenship and community, including civic deserts, and those working to address them, including "Netizens," veterans, and millennials. Right now, the United States is facing some of the most significant challenges in its history. COVID-19 is reshaping institutions and civic life; the nation continues to reckon with its long history of systemic racism; and U.S. democracy is showing cracks.This report explores other important trends in civic health across four broad categories: political and civic engagement, group affiliation, social comity, and information and knowledge. Throughout, this report shares examples of individuals and institutions working in communities across the nation to expand civic life. In addition, strategies to increase civic engagement are featured.