New Report Highlights Insufficient Funding of Public Health, New CDC Director, and Increasing Rates of Suicide & Homicide Among Youth
Three Things Thursday
Three Things Thursday highlights three things I am paying attention to as an epidemiologist each week.
The three things that I am paying attention to this week are a new report (from Trust for America’s Health) that highlights insufficient funding of public health in America, who we expect to be named the next Director of the CDC, and increases in suicides and homicides among American youth and young adults.
With the rising rates of suicides and homicides combined with gun violence increasing, health inequities increasing, climate change impacting health, and the cost of healthcare, among other issues — you should be able to see why this new report (and its call for increased funding and sustained support for public health) plus the new leader of the CDC are SO important.
Governmental public health, health communications, trust, and preparedness activities need to be bolstered. As we transition out of the official COVID pandemic, evidence of sustained support is being made public, and a new leader is slated to take over the premier public health agency in the world —
we all need to recognize, support, and advocate for a stronger public health system.
Hoping this post helps to educate and empower you
to be healthy and create healthy communities.
New Report Highlights Insufficient Funding for Public Health
Yesterday Trust for America’s Health (TfAH) released a new report —The Impact of Chronic Underfunding on America’s Public Health System: Trends, Risks, and Recommendations, 2023. According to the report —
“A strong public health system serves as a cornerstone of well-being and prosperity for the nation and the world. The foundation of such a system includes a focus on evidence-based interventions, an emphasis on prevention and health equity, and, critically, adequate and predictable funding. Unfortunately, for over two decades, the country’s public health system has not received the level of funding needed to ensure it meets the nation’s public health needs.
Investing in prevention saves lives.”
TfAH’s report highlights the fact that insufficient funding of public health is a long-standing problem. And this lack of funding has led to weaknesses in the public health infrastructure across the country. Sustained funding is needed to upgrade data systems, increase public health laboratory capacity, support the under-resourced public health workforce, and improve health communications.
According to Dr. J. Nadine Gracia, M.D. MSCE, President and CEO of Trust for America’s Health
“We must address the serious mismatch between the nation’s public health needs and its public health investment. Public health and prevention represent only a small fraction of the more than $4 trillion in annual health spending in our nation. Increased and sustained investment in public health would not only better prepare us for future public health emergencies, it would also help address the root causes of poor health and health disparities.”
In addition to increased funds, the report advocates for — improving the recruitment and retention of individuals in the public health workforce. State and local health departments must hire more than 80,000 employees to deliver public health services. Additionally, we need to address the root causes of disease throughout our communities, namely health disparities, the social determinants of health, and climate change.
New CDC Director
Public health scuttlebutt says that Dr. Mandy Cohen, the former North Carolina Secretary of Health and Chief Operating Officer at CMS, will be named the new Director of the CDC by President Biden. Dr. Walensky, the current Director of the CDC, is set to step down from her role on June 30.
Dr. Cohen would join CDC at a time when the agency is facing criticism for how it handled the COVID-19 response. According to Ed Hunter, who was the director of CDC’s Washington DC office —
“CDC needs to be more engaged, more politically sophisticated, know how to play hardball a little bit more.”
And the public health community hopes Dr. Cohen can help the CDC rebuild. According to Dr. Leah Devlin, a former state health director for North Carolina and just-retired professor at the University of North Carolina’s Gillings School of Global Public Health —
“She (Dr. Cohen) has this ops experience at the federal level, really running something in health care finance that has a broad impact in the states.
She’s got the leadership skills, the communication skill. She’s an operational person and she values public-private partnerships. And at the end of the day that’s what this is about — those four things right there.”
We will have to wait and see if Congress confirms Dr. Cohen. And then we will all hope that she can help rebuild CDC, increase trust in public health, and lead us through the next public health emergency (that is obviously just over the horizon).
Increasing Rates of Suicide and Homicide Among Youth
A new report1 recently released has documented the increase in suicide and homicide deaths among youth and young adults (ages 10-24) in the United States. Pulling and analyzing data from the National Vital Statistics System, the report found that —
The suicide rate for individuals aged 10-24 increased from 6.8 deaths per 100,000 to 11.0 between 2007-2021.
The homicide rate for individuals in that age group tripled between 2007-2018.
The increase is alarming and may be the result of higher rates of depression, limited availability of mental health services, and the number of guns in US homes. The increased rates “reflects a mental health crisis among young people and a need for a number of policy changes,” said Dr. Steven Woolf, a Virginia Commonwealth University researcher who studies U.S. death trends and wasn’t involved in the CDC report.
With the rising rates of suicides and homicides combined with gun violence increasing, health inequities increasing, climate change impacting health, and the cost of healthcare, among other issues — you should be able to see why the Trust for America’s Health report (and its call for increased funding and sustained support for public health) plus the new leader of the CDC are SO important.
Governmental public health, health communications, trust, and preparedness activities need to be bolstered. As we transition out of the official COVID pandemic, evidence of sustained support is being made public, and a new leader is slated to take over the premier public health agency in the world — we all need to recognize, support, and advocate for a stronger public health system.
We need clear health communications.
We need a robust early identification system to identify new outbreaks.
We need disease detectives who are equipped to prevent, identify, and end new outbreaks.
We need systems in place to collect, analyze, and share health data.
We need a public health workforce that is supported and encouraged to lead prevention efforts.
We need a coordinated effort between public health and clinical medicine.
We need to fund public health just like we fund clinical medicine.
We all need to recognize that public health is our o-line (offensive line) — we are on the front lines and aim to prevent adverse health effects.
We need to reimagine how public health can work throughout our neighborhoods to help us build healthy communities for all.
Questions/thoughts about the future of public health or the reports highlighted here?
And be sure to share this with your family and friends — we are all public health!
Curtin SC, Garnett MF. Suicide and homicide death rates among youth and young adults aged 10–24: United States, 2001–2021. NCHS Data Brief, no 471. Hyattsville, MD: National Center for Health Statistics. 2023. DOI: https://dx.doi.org/10.15620/cdc:128423.