New public health policy statements adopted at APHA 2020

Date: Oct 25 2020

FOR IMMEDIATE RELEASE
Contact: Media Relations

The American Public Health Association’s Governing Council adopted 19 new policy statements at its 2020 Annual Meeting and Expo yesterday, covering topics such as e-cigarettes, children’s vision care and the separation of immigrant families.

The following are brief descriptions of the 19 policy statements adopted by the council. Six of the new statements are latebreakers, meaning they were not open to the same review as the other 2020 statements and will serve as an interim policy statements until reviewed by the Governing Council at its regular 2021 meeting. For more information on any of the statements, email policy@apha.org.

(Disclaimer: These brief descriptions are not comprehensive and do not include every point, statement or conclusion presented in the policy statements. For the full statements, which will be posted in early 2021, visit the APHA website.)

20201 Pregnancy counseling and abortion referral — Noting that abortion care is essential to pregnant women and their families and that some laws prevent providers from referring patients to abortion services, calls on public health and elected officials to work to repeal bans on comprehensive and evidence-based pregnancy options counseling under the federal Title X family planning program. Urges elected officials to stop state and federal funding of crisis pregnancy centers, which do not provide evidence-based pregnancy counseling, use deceptive tactics and promote debunked information about abortion. Recommends public health professionals raise local awareness about reproductive rights and educate people on how to identify crisis pregnancy centers.

20202 Access to children’s vision care — With clear, healthy vision critical to a child’s educational, social and extracurricular success, calls on federal agencies conducting surveys on children’s health and education to also collect data on access to and use of eye care. Asks the U.S. Health Resources and Services Administration to allocate new resources to improve access to vision care for all children and increase support to state health departments to address the issue through existing programs. Urges public and private insurance programs to maintain comprehensive vision care for children from birth to age 18. Calls on school officials to guarantee that children with vision problems who need extra help receive the necessary accommodations for school success.

20203 Access to dental care for pregnant women — Because oral health is integral to overall health and health during pregnancy, calls on accreditation bodies for primary care, dental and allied dental education programs to require content on perinatal and infant oral health. Urges federal lawmakers to include comprehensive dental coverage in any proposal aimed at expanding coverage and make quality dental care a mandatory component of pregnancy-related Medicaid services. Recommends that federal, state and local public health agencies work together to develop reliable ways to collect and publish data on pregnant women’s oral health, dental insurance coverage and use of dental care. Encourages community-based programs that enroll pregnant women to offer culturally tailored information on perinatal and infant oral health.

20204 Adult dental care in Medicaid and Medicare — With many elderly and low-income adults in the U.S. unable to afford dental care or dental insurance, urges Congress to remove the exclusion of dental benefits from Medicare and amend the Affordable Care Act to include adult dental care as an essential health benefit. Calls on federal policymakers to support and expand national oral health surveillance to help pinpoint health disparities and evolving oral health problems. Recommends state government agencies provide comprehensive dental benefits for adults enrolled in Medicaid and provide sufficient dental care reimbursement to ensure providers want to participate. Also calls on state lawmakers to allow and expand alternative models of dental workforce providers.

20205 E-cigarette policies across the lifespan — With e-cigarette use increasing dramatically, especially among youth, calls on the Federal Trade Commission and the Bureau of Alcohol, Tobacco, Firearms and Explosives to regulate the trafficking of e-cigarettes, which would ban internet-based vendors from distributing the products through the U.S. Postal Service. Urges the Consumer Product Safety Commission to add nicotine to its list of substances and require special packaging, such as childproof packaging and warning labels to help prevent childhood poisonings. Calls on state and local governments to enact policies that increase taxes on e-cigarettes to levels at least similar to traditional tobacco products, and restrict how close e-cigarette retailers can set up shop near youth-centered settings such as schools.

20206 Regulating commercial marijuana — With more states legalizing retail sales of marijuana and a dearth of national research on cannabis policy, recommends state and local governments that regulate cannabis to develop and enforce policies that control access and use by youth and other vulnerable populations. Calls on all lawmakers to develop funding and monitoring mechanisms to expunge cannabis-related records, decrease arrests, support community re-entry and community development. Encourages state and local governments to work with health departments to prevent and treat cannabis abuse and dependence. Urges agencies to develop and expand the evidence base on the health effects of cannabis, as well as on the public health and safety outcomes related to its commercial regulation.

20207 Opposing the separation of immigrant families — With family separation at the U.S. border a public health crisis, calls on the federal government to permanently stop the separation and detention of migrant children and their families, unless there is an imminent and ongoing threat to the child’s safety. Urges federal policymakers and their contractual partners to review current practices and ensure children and their families are housed in safe and appropriate conditions and receive evidence-based health and social services. Calls on the federal government to maintain constitutional protections for children in U.S. custody and collect relevant data to ensure any separated children and parents are reunited as soon as possible. Recommends prosecution for human rights violations.

20208 A call to end the bombing of Yemen — With more than 100,000 people killed since 2015, millions displaced and more than 24 million in need of help to survive, urges the U.S. State Department to end military collaboration with the Saudi-led coalition forces waging war on Yemen and hold such parties accountable for attacks on health workers and civilians. Calls for the consideration of congressional action to cut off arms sales to Saudi Arabia. Also calls on all concerned parties to support an immediate end to the blockade of Yemen’s ports and lift barriers to the entry of humanitarian supplies and civilian travel. Recommends the U.N. lead efforts to provide and monitor relief and reconstruction in Yemen.

20209 Call for a nuclear weapons-free world — Recognizing the harm of nuclear weapons and the role of public health professionals in advancing their abolition, urges the U.S. president and Senate, as well as other nuclear-weapons states, to sign and ratify the 2017 United Nations Treaty on the Prohibition of Nuclear Weapons. Encourages federal policymakers to support current and future treaties that call for the end to nuclear weapons testing, research, development, manufacture or use. Calls on Congress to address past and current occupational and environmental health harms posed by the U.S. nuclear weapons complex by investing in research, worker protections, health care and environmental cleanup. Urges public health professionals to educate on the need for rapid nuclear disarmament.

202010 Organ transplant abuse in China — With emerging evidence that China performs more organ transplants than officially reported and recognizing a gap in organs that cannot be accounted for by voluntary donation, urges heads of state to issue public statements that call on the Chinese government to end organ sourcing from prisoners of conscience and to allow independent investigators to inspect transplant facilities and records. Calls on governments to prohibit travel to other countries to receive organs from illegal or unidentified sources, and to fund research on the prevalence of unethical organ transplantation in China. Recommends medical and academic institutions condition their collaborations with Chinese transplant programs on more stringent monitoring and enforcement of ethics standards.

202011 Supporting home care workers — With a rapidly aging U.S. population making home care services one of the nation’s fastest-growing industries, calls on federal and state lawmakers to raise home care worker wages, provide benefits and improve working conditions. Urges policymakers to establish Medicare and Medicaid reimbursement rates that support higher wages for home health workers at all skill and experience levels. Recommends the U.S. Occupational Safety and Health Administration issue an illness and injury prevention program standard that identifies and remediates hazards in the home, as well as a workplace violence prevention standard. Urges funding for research that explores the most effective training approaches to improve both worker and patient safety.

202012 Protecting workers from opioid use, overdose — With pain from occupational injuries and illnesses an important pathway to opioid use disorder, especially in high-hazard jobs, recommends federal and state agencies address occupational differences in risk of opioid use disorder and their relationship to working conditions, workplace policies, race, ethnicity and immigration status. Urges funding for improved access to treatment and recovery resources. Calls on state workers’ compensation systems to provide better access to nonopioid pain treatments and adopt dosing guidelines to prevent opioid misuse. Recommends amending or repealing punitive federal and state drug testing laws so that workers who test positive are given an opportunity for treatment and recovery and can maintain their employment relationship.

202013 Strengthening the dementia care workforce — Recognizing the need to equip workers with the capacity and skills to care for a growing population with dementia, recommends the Centers for Disease Control and Prevention increase funding to state, local and tribal health departments to expand policy development, data collection and training programs to enhance the dementia care workforce. Urges relevant state credentialing bodies to integrate dementia competencies into their professional licensure requirements and exams. Recommends the development of reimbursement models for evidence-based dementia social care, community-based services and public health approaches that benefit people with dementia. Calls on relevant agencies to promote prioritization of equity and cultural competence in dementia workforce development efforts.

The following six policy statements are latebreakers,* which means they were not open to the same review as the other 2020 statements and will serve on an interim basis.

LB20-01 Reproductive health violations in immigrant detention — With numerous reports of alleged health and human rights violations at U.S. immigrant detention centers, including allegations of forced sterilization, calls on Congress to direct U.S. Immigration and Customs Enforcement to allow external oversight and to request an investigation into sexual and reproductive health care provided to detainees. Urges ICE and agencies responsible for procuring detention operators to update all agreements to require that detention centers comply with the most updated standards, without an option to waive health-related standards. Urges Congress to adopt protections for vulnerable immigrant detainees and ensure detainees are given basic sexual and reproductive health care. Calls on ICE to reduce the detention of pregnant and postpartum people.

LB20-02 Disparities in COVID-19 infection, pandemic response — With historically underserved communities experiencing disproportionate rates of COVID-19 infection and mortality and with the pandemic exacerbating inequities, calls on federal, state, local and tribal governments to prioritize funding and mobilize stakeholders to enable timely and sustainable actions to address direct and indirect COVID-19 impacts. Urges policymakers to provide economic and psychosocial support to at-risk communities and to increase testing accessibility via mobile and walk-up options. Recommends people from underserved communities are actively engaged in all stages of clinical trial research and in the allocation of novel therapeutics and vaccines. Calls for funding rigorous research on the effectiveness of COVID-19 interventions, with special attention to the social determinants of health.

LB20-03 COVID-19 and the education sector — With the COVID-19 pandemic disrupting schools and education across the country, calls on the president’s administration to invoke the War Powers Act to drive production of needed safety supplies and equipment for schools, child care centers and institutions of higher education. Also calls on the administration to activate the Strategic National Stockpile to ensure supplies are readily accessible and affordable for educational settings. Urges Congress to provide COVID-19 bailout funds for child care, schools and higher education to help them set up safer conditions, such as improved ventilation and hand-washing stations, and calls on federal policymakers to continue to allow waivers for school meal programs.

LB20-04 Structural racism as a public health issue — With the nation’s history of racism permeating almost every institution and system, urges Congress to pass and fund new and existing anti-racism legislation, such as the Anti-Racism in Public Health Act, which would create a National Center of Anti-Racism at CDC. Calls on policymakers to support public health research investments that examine the health impacts of institutional racism and the effects of structural interventions, and establish collaboratives among federal, state and local governmental agencies to create evidence-based recommendations. Encourages federal, state and local governments to increase data collection on racial inequities and mandate the use of measures of racism, especially within police violence, law enforcement and criminal justice system data.

LB20-05 Addressing harms of the carceral system — Recognizing the long-standing harms of mass incarceration, calls on governments to develop, implement and support existing community-based interventions that address the medical and social needs of people harmed by the criminal legal system. Urges policymakers to reduce the number of people incarcerated in jails, prisons and detention centers, regardless of conviction, and especially in light of high COVID-19 transmission inside such settings. Recommends the reallocation of funding from the building of new jails and prisons to social determinants of health, such as affordable housing, health care and transportation. Calls for the restoration of voting rights for all formerly or currently incarcerated people, and urges policymakers to fund research on alternatives to incarceration.

LB20-06 Universal health care and pandemic response — With the COVID-19 pandemic elevating the urgency of creating a universal health care system in the U.S., urges Congress and the president to recognize universal health care as a right, as well as fund, design, enact and implement a universal health care system that is accessible and affordable for all. Calls on federal agencies and research institutions to study equitable access to health care, and asks Congress to mandate standards to meet the health care needs of children and adults with disabilities. Urges policymakers and other stakeholders to recognize the harms of institutionalized racism in health care and collaborate to build a more equitable system.

*To be considered for status as a permanent policy statement by the Governing Council at its October 2021 meeting, latebreakers must be resubmitted into the full policy statement review process next year.

APHA’s Annual Meeting and Expo is the largest and most influential yearly gathering of public health professionals. Working members of the news media may register by contacting mediarelations@apha.org. For more information, visit the APHA Annual Meeting and Expo Newsroom.

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The American Public Health Association champions the health of all people and all communities. We are the only organization that combines a nearly 150-year perspective, a broad-based member community and the ability to influence federal policy to improve the public’s health. Learn more at www.apha.org.