PI's Weekly Media Digest:US suicide rate climbs almost 30% in 17 years; SF voters uphold ban on flavored tobacco products

Jill Hodges and Sarah Mittermaier

Suicide rates in the US climbed almost 30% from 2009 to 2016, with nearly 45,000 reported in 2016, according to the latest data from the US Centers for Disease Control and Prevention (CDC). White the rates increased across sex, race, ethnicity, and age groups, the largest increase came among people age 45 to 64. “The National Strategy for Suicide Prevention calls for a public health approach to suicide prevention with efforts spanning multiple levels (individual, family/relationship, community, and societal). Such a comprehensive approach underscores that suicide is rarely caused by any single factor, but rather, is determined by multiple factors,” the CDC report notes.  “In addition to mental health conditions and prior suicide attempts, other contributing circumstances include social and economic problems, access to lethal means (e.g., substances, firearms) among persons at risk, and poor coping and problem-solving skills.”

The United Nations human rights commission urged the Trump administration to stop separating families who are apprehended at the border, calling the practice a violation of human rights and international law, and “arbitrary and unlawful interference in family life, and […] a serious violation of the rights of the child.” Vox reports on efforts by Democratic legislators to put a stop to the Trump administration’s policy, including two bills introduced by California Representative Lucille Roybal-Allard that would reunify parents and children. Another article situates the policy of separating immigrant families in historical context: “The US government has never held families — nonwhite families, anyway — to be sacrosanct… Forced separation of families was, of course, central to the American regime of slavery. In a system that allowed for hereditary enslavement, children were transformed into property at birth… There was no pretense that the separation of slaves was for their benefit. In other cases, though, politicians and reformers excused family separation as part of a broader “civilizing” project…. In an attempt to break up tribal culture and unity, the Dawes Act of 1887 forced American Indians to abandon communal property for individual family-based farms. At the same time, tens of thousands of Indian children were taken from their families and put into government-funded boarding schools, where they were forced to change their names, learn English, dress in Western-style clothing, and (often) convert to Christianity…”

In an interview with The Guardian, food justice activist Karen Washington explored the issue of “food apartheid” in the US.  “Issues of economic inequality and systemic racism permeate our national food system. The movement’s primary focus has been on finding solutions to “food deserts” – defined as areas empty of good-quality, affordable fresh food – by working to ensure that affected neighborhoods have better access. But some advocates, and studies, have argued that the proximity of a well-stocked grocery store is not enough of a solution given this country’s elaborate food problems. Farm subsidies in the United States go predominantly to white farmers, which has led a group of black farmers to sue the US government for discrimination. Food pantries, which distribute food directly to those in need, are stigmatized. Our subsidized food system, as the activist and community organizer Karen Washington points out in the interview that follows, ‘skews the cost and value of food.’” Washington says, “What I would rather say instead of “food desert” is “food apartheid”, because “food apartheid” looks at the whole food system, along with race, geography, faith, and economics. You say “food apartheid” and you get to the root cause of some of the problems around the food system. It brings in hunger and poverty. It brings us to the more important question: What are some of the social inequalities that you see, and what are you doing to erase some of the injustices?”

This week, San Francisco voters upheld a ban (the first of its kind in the US) on flavored tobacco products like mentholated cigarettes and flavored e-cigarette cartridges. The tobacco industry had spent over $11.6 million to defeat the ban. “The approval of the bank means Reynolds and other businesses “will find it harder to addict, sicken, and kill people of color in San Francisco,” said Phillip S. Gardiner, co-chair of the African American Tobacco Control Leadership Council. “The ban on menthol cigarettes is a monumental step forward for health equity and social justice for communities of color, which Big Tobacco has long viewed as easy prey for its menthol and candy-flavored products.

The Guardian reports on the displacement of “black Oakland,” focusing on the ways government housing, loaning, and urban renewal policies paved the way for gentrification and displacement of black neighborhoods.

In releasing its latest assessment of mental health policies and practices across the globe , the World Health Organization calls for greater urgency and more resources to help prevent and address mental health challenges. The Mental Health Atlas 2017 concludes that while some countries have made progress in policies and practice since the last report in 2014, significant work remains to reach global goals for leadership, services, strategies and support for mental health and wellbeing outlined in the Comprehensive mental health action plan 2013–2020.  The report is based on data collected from 177  countries, and found that few countries have suicide prevention strategies in place; many countries have significant shortages of mental health workers; in some low-income countries, the rate is as low as two mental health workers for every 100,000 people; and that there is a substantial need for more community-based residential care for people transitioning out of hospitals.

As a wave of legislation to address the opioid epidemic moves forward, drug makers and others are ramping up their opposition, in some cases managing to dial back the reach of some of the more ambitious proposals, Lev Facher reports in STAT. He details four provisions that are under challenge:

- Expanding access to certain addiction treatment medications,

- Bolstering the DEA’s ability to regulate and inspect drug shipments,

- Putting limits on first time opioid prescriptions, and

- Stepping up enforcement of mental health parity to ensure that insurance plans cover mental health treatments to similar levels as they cover physical health treatments.

In an opinion piece in STAT, Gregory Singleton and Jay Chaudhary, a doctor and lawyer, make the case for including lawyers in recovery teams for people dealing with opioid misuse. People with substance misuse problems also may have problems staying in their homes, getting or keeping custody of their children, or finding jobs due to their criminal records, they write. Lawyers can help with these challenges and other barriers to finding the safety, stability and purpose to support recovery: “Responding to the opioid crisis and preventing more lives from being lost requires an all-hands-on-deck approach.” 

In a story published by ProPublica and The Atlantic,  Duaa Eldeib reveals how hundreds of children in Illinois are held at psychiatric hospitals beyond the time that their mental health conditions have stabilized and they are ready to be released. An analysis by ProPublica Illinois found that between 2015 and 2017, almost 30 percent of the nearly 6,000 children in the care of the state Department of Children and Family Services were held in hospitals beyond the time required. Some were kept for months in the hospitals, which are designed for short-term care. The unnecessary hospitalizations, typically caused by a lack of alternative placements, in some cases leads to delays in school and additional mental health challenges. 

The Trump administration is urging a Texas judge to dismantle two key provisions of the Affordable Care Act, community rating and guaranteed issue, arguing that these provisions are inseparable from the individual mandate, which was struck down by Congress in 2017 and ends in January 2019. Former Solicitor General Don Verrilli, who defended the Affordable Care Act before the Supreme Court in 2012, among other former members of the Department of Justice, expressed shock that the Trump administration will not defend a sitting law, stating, "The Department of Justice has a duty to defend federal laws when reasonable arguments can be made in defense of the law.”

Virginia became the 33rd state to expand Medicaid this week. The expansion will go into effect in January 2019, and approximately 400,000 Virginians are expected to be eligible for coverage. The state is also seeking a waiver from the Trump administration to implement work requirements, as well as co-pays and premiums from some beneficiaries.

Collaborate With Us

Join us in advancing health equity and community empowerment — get in touch today to support the Prevention Institute’s efforts.