715: Preventable Early Deaths, Appropriations Season Continues

JANSON SILVERS: 

This is the award-winning Public Health Review Morning Edition for Friday, July 26, 2024. I'm Janson Silvers. Now, today's news from the Association of State and Territorial Health Officials.

MACARENA GARCIA: 

What we saw from the year 2010 to 2022. And this is just like a brute number, the number of premature deaths that could have been prevented. Were about 6.3 million deaths and that number is higher than the entire population of the state of Maryland.

SILVERS: 

Dr. Macarena Garcia, a senior health scientists at the Office of Rural Health at the CDC summarizes a report that her office worked on. The report looks at preventable premature deaths, specifically in rural America. Their report says more than 6 million premature deaths were preventable. But Garcia says you also have to look at the proportions.

GARCIA: 

What is the percentage of the deaths that occurred that were early that were actually preventable. So, that really varies across the five leading causes. And what we found is that for unintentional injuries, that proportion is about 64%. So, that means more than half of the early deaths could have been prevented.

SILVERS: 

While these are national numbers, Garcia says bridging the preventable death disparities in rural areas really requires a multi-sector approach. It also requires public health interventions.

GARCIA: 

We really have to screen patients for high blood pressure. So increase that screening, also increasing cancer prevention and early detection is very important. We want to encourage physical activity and healthy eating. Of course, we want to promote smoking cessation, as well as motor vehicle safety. And, you know, we can't ignore practicing safe opioid prescribing.

SILVERS: 

This story is focused on the national snapshot of the report. But Garcia's team has created a dashboard to dive into your numbers at home as well.

GARCIA: 

And what we recommend to state public health officials is that they really understand their data. They dig into this data and understand why their data may look different than other states data. And perhaps what are other states doing that's working really well for them.

SILVERS: 

We have a link to that full report and the dashboard in the shownotes.

Connecticut recently completed a year's long odyssey to adopt the FDA Food Code. In an episode of this newscast we heard from Dr. Manisha Yutani on why the FDA Food Code was the right choice for the state. Today, Mariam Hosseini, the Environmental Health Manager for the Mashantucket Pequot tribal nation in Connecticut says one reason their food code needed to be replaced was that it was outdated and included a scoring system for food establishments that wasn't serving its purpose.

MARIAM HOSSEINI: 

I found myself on a daily basis, you know, discussing the score. Why did I get an 87? Why did I get a 92, not a 98 which, you know, that's not the purpose of doing an inspection. It's to get the food establishment operators attention as far as what's going on in your establishment.

SILVERS: 

You can find the full Public Health Review podcast episode on Connecticut's food co journey by using the link in the show notes. That episode is available now and contains interviews with key players who made the switch or reality.

ASTHO's government affairs team continues to focus on appropriations, Jeffrey Ekoma ASTHO's senior director for government affairs tells us what they've been working on this past week. In today's view for Washington DC report.

It's Friday morning and we are lucky enough to have Jeffrey Ekoma. Joining us from ASTHO's team. Jeffrey, I know that you and Carolyn and the whole team have been working hard during this appropriations process and we're still not done. Now you and Carolyn have been keeping us apprised of the appropriations process in the house. Tell me where things are at as of now.

JEFFREY EKOMA: 

Absolutely, the house is pushing forward to pass as many appropriation bills before the slated August recess. Earlier this week, [...] interior environments, many bills were considered and somewhat of a change of plans though, the agriculture, FDA, and financial services bills were pulled from being considered on the floor by House leadership. There have been some concerns related to the bill, which include policy writers and relatively low funding levels compared to the previous fiscal year. Now with that, you're probably wondering, what does that mean for the labor HHS bill? That remains to be seen. It seems likely though, that the bill may also be pulled before being concerned about the full house. There are also some rumors that the house may postpone consideration of the remaining appropriation bills and begin their August recess a week early. Overall, it's just something that we'll continue to try very closely.

SILVERS: 

Moving from the House to the Senate, are there any develop wants to know for our listeners.

EKOMA: 

Yeah, as I am sure Carolyn's probably noted, the Senate has begun marking up their bills. We actually sent a letter to the Senate Senate appropriators and formed their work on the bill. Our letter urges appropriators to fund public health priorities at the highest levels. It also expresses concerns with the proposed cuts to CDC and the elimination of programs included in the House bill. We also know our funding priorities for things such as public health infrastructure, social determinants of health, data modernization, and the Public Health Emergency Preparedness Program or PHAB to name a few. Now, we do expect a bill to be marked up on August 1, similar to the release of the house. We will also be releasing a legislative alert when bill text becomes available.

SILVERS: 

Terrific, other than appropriations, was there anything else that the government affairs team really monitor this past week?

EKOMA: 

Yes, there was a hearing in the House Energy and Commerce Committee, particularly the health subcommittee, that featured directors of various centers within the CDC, specifically, doctors [...], Daskalakis, Hacker, Jernigan, [...], and Walk participated. The purpose of the hearing was to examine CDC priorities and how CDC is working to restore the public's trust in the agency. Overall, the hearing went really well, in terms of how the Senate directors who participated articulated the role of their individual senators in achieving CDC's priorities of improving readiness and response, addressing mental health, and preventing overdose and suicide and supporting young families. Also really important to know were a couple of other things discuss such as the potential need to authorize the CDC and its individual centers, public health preparedness, data modernization, mental health, environmental health, in opioid prescribing to name a few.

SILVERS: 

That's wonderful, Jeffrey, it sounds like you and your team have been very busy and still have a lot of work to do. So we always appreciate you making time for us. Hope you have a wonderful rest of your day.

EKOMA: 

You to talk soon.

SILVERS: 

An upcoming episode of the Public Health Review podcast centers around the work it takes to garner support for an Office of Health Equity. ASTHO member and Commissioner of Health in the US Virgin Islands, Justa Encarnacion, knows this work firsthand and share some exciting news.

JUSTA ENCARNACION: 

So we have opened up our Office of Health Equity, we've hired a director of health equity. Outside of that we've been practicing the tenants of health equity, through our Office of Health Disparities, linked to of course, our office of primary care, focusing on increasing access to care, increase the number of providers we have throughout the territory.

SILVERS: 

Hear how the US Virgin Islands made this happen, and how other agencies are still working towards the goal of launching an Office of Health Equity. That episode will be available everywhere you find podcasts.

Finally, today, ASTHO has published three briefs centered on the improvement of health data sharing. Examples from Virginia, Minnesota, and Arizona are all highlighted. There's a link to all three in the show notes.

That'll do it for today. We're back on Monday morning with more ASTHO news and information. I'm Janson Silvers, you're listening to the award-winning Public Health Review Morning Edition. Have a great weekend.