63: Build Back Better Funds PH

ROBERT JOHNSON:

This is Public Health Review Morning Edition for Monday, November 8th, 2021. I'm Robert Johnson.

Here's today's news from the Association of State and Territorial Health Officials.

Congressional Democrats have released proposed language for the Build Back Better Act. It includes billions of dollars for public health priorities.

Jeffrey Ekoma is monitoring the bill and providing updates from his position as senior director for government affairs at ASTHO.

JEFFREY EKOMA:

The bottom line is this will positively impact governmental public health agencies across the country. The bottom line is it will finally bring a solution to the Medicaid funding caps for our U.S. territories. The bottom line is that we'll continue to invest in public health labs across the country. The bottom line is it will continue to make sure that public health is in a much better position going forward as we hopefully transition out of the pandemic.

JOHNSON:

The text of the bill represents a tentative agreement between House Democrats and the White House. It's uncertain how it will fair in the Senate.

ASTHO evaluates the Build Back Better Act in a new legislative alert. You can read it using the link in the show notes.

HHS Secretary Xavier Becerra is out with a new plan to address America's overdose crisis. It has four key target areas: primary prevention, harm reduction, evidence-based treatment, and recovery support.

Richa Ranade is ASTHO's senior director of overdose prevention. She talks about the plan in today's morning conversation.

HHS has released a new overdose prevention strategy. What's new about it?

RICHA RANADE:

I'd say that the strategy is new and unique in how thoroughly comprehensive and timely it is. I know the statistic has been used quite a bit recently, but I think it bears repeating that 93,000 people in the United States died from an overdose last year, and that was a 30% increase over the previous year—and that's really staggering. And so, what we really need right now is a comprehensive approach that can turn that tide in order to save lives. And that's what the strategy I think really represents.

The HHS overdose prevention strategy addresses a full continuum of integrated care and services, and that includes primary prevention, harm reduction, evidence-based treatment, and recovery support. And the strategy also underscores the importance of maximizing health equity and reducing stigma, and it does all of that in a way that coordinates the efforts of multiple federal agencies.

JOHNSON:

The news release announcing the strategy quotes the secretary as saying he wants to put those who struggled with addiction in, quote, "positions of power." What do you think that means?

RANADE:

I believe Secretary Becerra is referring to, what he's referring to is that no strategy for overdose prevention can be effective if it doesn't reflect the voices of people who use drugs or have lived experience with a substance use disorder. Those are really the voices that should shape overdose prevention policy, and the strategy recognizes and reflects and empowers those voices.

JOHNSON:

So, how does public health fit into this equation, into this new strategy?

RANADE:

I talked a little bit about the four kind of pillars of the strategy—which, again, are primary prevention, harm reduction, evidence-based treatment, and recovery support—and no single one of those areas can alone solve the overdose crisis, right; and state and territorial public health agencies are either implementing or partnering to implement initiatives across all four of those areas.

However, that said, I'd say that public health, kind of in-line with the mission of public health, is playing the biggest role in the pillar of primary prevention—so, again, that's things like addressing the social determinants of health and upstream factors that we know contribute to the risk of substance abuse, and that includes things like adverse childhood experiences. That also includes things like setting up data systems to monitor fatal and nonfatal overdose to ensure that primary prevention initiatives are based on high quality and timely data. It's also addressing overprescribing and engaging in new partnerships to implement innovative prevention initiatives. And you know what they say about the value of an ounce of prevention.

And so, we're really pleased to see primary prevention be kind of a foundation of the strategy because it's supportive of the work our members are doing and means that there might be more opportunities and resources to even further grow that work in the future.

JOHNSON:

There's evidence that stable housing can help prevent overdose and suicide. ASTHO has published a brief on the topic.

It provides an overview of policy states and territories have enacted to increase housing opportunities for those who are homeless, battling substance use disorder, or dealing with a mental illness.

Find a link to the report in the show notes.

Finally this morning, in celebration of Public Health Thank You Day on Monday, November 22nd, we're inviting public health professionals to tell us what they're thankful for this year.

Today, our thankful note is from a fan of the newscast. This is Clare Coleman, president and CEO of the National Family Planning and Reproductive Health Association.

CLARE COLEMAN:

I just have so much admiration. I can't believe the amount of commitment and courage that it takes to do public health work.

I'm super proud of the people around the country who work in contraception and sexual health care in health departments. They are, you know, working with colleagues, doing collaboration and making that dollar stretch as far as it possibly can. I just think they're heroes and they deserve our thanks and may deserve a break.

So, I hope a lot of people join in this thank you to public health.

JOHNSON:

Thank you, Clare, for that very thoughtful note.

That'll do it for today's report.

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Join us tomorrow morning for more ASTHO news and information.

I'm Robert Johnson. You're listening to Public Health Review Morning Edition.