Abortion: The continuous fight for reproductive freedoms

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By NCL Health Policy Intern Grace Mills

Grace Mills is a DC native, completing her undergraduate education at American University in Washington, DC. Her major is Public Health, with a minor in Spanish language. She will graduate in May 2022.

Women in the United States have been fighting for reproductive rights for decades. Activists like Margaret Sanger and Mary Ware Dennett argued during the early part of the 20th Century that women must be in control of their reproductive choices; the book “The Birth of the Pill” documents their crusade. Officials tried to prevent these two and many others from speaking and publishing about human sexuality, reproduction, and contraception. In the succeeding decades, activists pioneered the right to contraception, the right to abortion, and the right to bear a child.

Several landmark cases are worthy of mention. In Griswold v. Connecticut (1965), the Supreme Court ruled that a state’s ban on the use of contraceptives violated the right to marital privacy. In 1971, in the case of United States v. Vuitch, the Court rejected the claim that a statute permitting abortion only to preserve a woman’s life or health was unconstitutionally vague. It concluded that “health” should be understood to include considerations of psychological as well as physical well-being. The following year, in Eisenstadt v. Baird, the Supreme Court struck down a Massachusetts law limiting the distribution of contraceptives to married couples whose physicians had prescribed them. This decision established the right of unmarried individuals to obtain contraceptives.

In 1973, Roe v. Wade was a challenge to a Texas law prohibiting all but lifesaving abortions. The Supreme Court invalidated the law on the ground that the constitutional right to privacy encompasses a woman’s decision whether or not to terminate her pregnancy. Characterizing this right as “fundamental” to a woman’s “life and future,” the Court held that the state could not interfere with the abortion decision unless it had a compelling reason for regulation. NCL strongly supports the landmark protections in this case, including a woman’s right to control her own reproductive destiny.

Sadly, Roe v. Wade has been under attack from the right since 1973. After the Trump Administration’s Supreme Court appointments, there is a 6-member majority that appears to favor overturning Roe vs. Wade. States will have the right to pass far more restrictive laws than what Roe allowed for constitutionally. There will always be states that protect women’s right to choose and access to abortion, however, the issues lies in women living in states with restrictive laws or lack of money and/or resources to get to an abortion clinic.

This flies in the face of what the public wants. Indeed, a recent Gallup poll show Americans’ support for abortion in all or most cases at 80 percent in May, only slightly higher than in 1975 (76 percent), and the Pew Research Center finds 59 percent of adults believe abortion should be legal, compared to 60 percent in 1995. The share of Americans in Gallup’s poll who say abortion is morally acceptable reached a record high of 47 percent in May, up from a low of 36 percent in 2009, and a Quinnipiac poll found support for abortion being legal in all or most cases reached a near-record high in September with 63 percent support.

Many red states have recently passed some of the most restrictive and punitive abortion laws. In March of 2018, former governor of Mississippi Phil Bryant, signed into law the strictest abortion ban in the country up until that point. The law bans abortion at 15 weeks (about 3 and a half months), even in cases of rape or incest. But a federal district court judge shut the law down, and the U.S. Court of Appeals for the Fifth Circuit backed the court’s decision. This law is what was challenged in the Supreme Court last week.

Perhaps the most extreme is S.B. 8, the Texas law that went into effect on September 1, 2021 that prohibits abortion after “cardiac activity is detectable,” which is usually around the 6-week mark (about 1 and a half months). The law has a vigilante justice component, letting Texans sue anyone they believe is violating the law and/or is involved in an abortion in some way. This includes anyone who provides transportation to the abortion (even an Uber driver could be culpable) or a physician that performs the abortion after 6 weeks. This is the most draconian legislation so far, in part because many women do not even know they are pregnant at just 6 weeks.

S.B. 8 specifically does not allow state officials to enforce the law, authorizing only private citizens to do so, by suing an abortion provider for damages of ten thousand dollars for each procedure performed — what several Justices referred to, during oral arguments on November 1st, as a “bounty.” The Supreme Court will likely have the chance to review a challenge to the constitutionality of this law, but that’s a few years away and until then, the law remains in force.

NCL strongly supports women’s access to reproductive, abortion and maternal care. We understand that lack of access is directly related to a wide range of health disparities in the United States. It is no surprise that people of color in the United States have less access to the care they need and have more health complications. This is true for reproductive care and family planning. Black and Hispanic women have much higher abortion rates than white women largely directly related to a higher rate of unintended pregnancy.

These facts raise the question about what more can be done to provide women of color better maternal care and family planning resources. We need to reverse the pattern of inequality. NCL supports funding for sex education, full access to maternal care, and family planning to provide women with services, information and resources necessary to make informed decisions about their reproductive health and prevent any unnecessary health risks.

The tenuous hold we have on the right to abortion in every state, with the Mississippi law likely to get the thumbs up from the anti-choice Supreme Court, puts all women at risk. The Texas law is that much more draconian. We lament these attacks on women’s access to health care — especially poor women — that these restrictive abortion laws represent. Lastly, making abortions a crime won’t stop them from happening, it will only drive abortion back into the back alley and make it once again, a dangerous procedure that puts women’s health and safety at risk.

Jeanette Contreras portrait

Listen up: FDA’s proposed OTC hearing aid rule

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By NCL Director of Health Policy Jeanette Contreras

Whether it be listening to your grandchildren share a story or having dinner with a friend, many consumers rely on devices to help them hear and understand speech every day. Hearing loss is something that we need to be mindful of at all ages, and as consumers, we look to our nation’s regulators to make sure these devices are safe to use.

Some people with hearing loss are able to work closely with hearing care professionals to finely adjust their hearing aids at sound levels that enable them to hear speech at comfortable levels without causing any harm. But, as more Americans struggle with their hearing, accessible hearing aids becomes increasingly important. Proposed regulations by the Food and Drug Administration will allow hearing aids to be sold over-the-counter to adults with mild-to-moderate hearing loss, a step forward in making them more affordable and accessible.

While these regulations are positive for access, the FDA’s proposed thresholds for volume or output for over-the-counter hearing devices are more in line with those for earbuds people use to listen to music for short periods than they are for hearing aids that are worn for several hours a day. These draft rules would allow a maximum sound output level of between 115 and 120 dBA, which is the equivalent to the volume of a chain saw. According to the CDC, exposure of sounds at 120 dB could become dangerous in as little as nine seconds. As you can imagine, being exposed to this level of sound for long periods of time is unsafe and could increase hearing loss and significantly damage the ear.

Hence, there is widespread concern among hearing care professionals that allowing an unnecessarily high level of amplification can lead to further hearing loss. Leading hearing care associations recommend a maximum output limit of 110 dBA for OTC hearing aids and establishing a gain limit of 25 dB.

As the leading consumer healthcare organization, we applaud the FDA’s efforts to increase access to hearing aids for those who need them. We do hope that the FDA will adjust its proposal, so it is in line with the recommendations of hearing care professionals before finalizing the regulations. Consumers shouldn’t be concerned that they may find their situation worsened by devices that are intended to help.

To learn more about gain and output and how to protect yourself from hearing loss, check out our new infographic.

Understanding the need for the Food Labeling Modernization Act of 2021

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By Sally Greenberg, NCL Executive Director

Many of us are trying to follow the advice of health authorities to cut back on sugar consumption, and food companies are responding with new versions of products promising “less,” “reduced,” and even “zero” amounts of added sugars.

But in the spirit of reducing added sugars — not surprisingly — more and more food producers are turning to artificial and synthetic substances, sugar alcohols, and new-fangled substances many people have never heard of like Luo Han Guo Extract (also known as “Monk Fruit”). This situation with artificial sweeteners has gotten more complicated since we last took a look at this issue.

Today more label claims are implying that the reformulated product is healthier than the original, without disclosing that the sugar content has been reduced by replacing it with artificial sweeteners. One reformulated oatmeal is labeled “Apples & Cinnamon Lower Sugar” and claims it has “35 percent less sugar.” That may sound like a good thing, but the new version is actually higher in calories than the original. Similarly, the reduced sugar version of one peanut butter brand has 1/3 less sugar, but has more calories per serving than its original counterpart.

Senior Members of Congress, including Representatives Frank Pallone (D-NJ) and Rosa DeLauro (D-CT), who chair the committees that have jurisdiction over the FDA and its budget, have introduced legislation to fix the problem, namely the Food Labeling Modernization Act of 2021, H.R. 4971 (FLMA). The FLMA, S. 2594, is sponsored in the Senate by Richard Blumenthal (D-CT), Ed Markey (D-MA), and Sheldon Whitehouse (D-RI).

The measure includes provisions aimed at increasing transparency, encouraging responsible product reformulation, and countering misleading claims. For example, the FLMA would require that a food containing any artificial or natural non-caloric sweeteners must prominently disclose the presence of such ingredients on the front labels of food packages. This would help ensure that food manufacturers do not simply replace sugar with questionable alternatives like artificial sweeteners, sugar alcohols, and other sweetening agents, making “new and improved” food products appearing to be more healthful than their regular versions.

The FMLA would also require the FDA to establish a program for front-label symbols indicating a food is high in sugar. NCL supports that effort, but consumers deserve the full story. We don’t want to see unintended consequences of sugar warning labels leading food companies to seek ever more alternative sweeteners; if they are going to be used, those alternatives should be clearly disclosed on the front label, as the FLMA would provide, so consumers can make fully informed purchasing decisions.

The FMLA also directs the FDA to improve food labels in other ways:

  • The bill improves transparency by mandating that caffeine levels be listed. Consumers who are pregnant, have certain health conditions, or take certain medications or supplements often need to limit or avoid caffeine. At the present time, there is no way of knowing how much caffeine is in many foods. The bill would address that problem by requiring prominent disclosure of caffeine content.
  • The bill would require that FDA establish clear and consistent standards for popular marketing terms like “natural” and “healthy.” That’s a welcome requirement.

In sum, the FLMA would bring food labeling into the 21st Century. The National Consumers League supports these important reforms and hope that this legislation gets the full support of Congress.

Vaccines to protect all

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By Sally Greenberg, NCL Executive Director
With co-author Marla Dalton, Executive Director and CEO, National Foundation for Infectious Diseases

COVID-19 has had profound implications on individual health and well-being and the U.S. healthcare system at-large. During the pandemic, we have seen routine vaccination rates decline significantly across all populations, putting individuals at risk of contracting vaccine-preventable diseases. The pandemic has also brought significant public attention to vaccines and now, perhaps more than ever before, many see the value of life-saving vaccines as one of the most effective public health prevention tools available to keep us safe and help end the pandemic.

The National Foundation for Infectious Diseases (NFID) and the National Consumers League (NCL) are committed to educating people about how to live healthier, safer lives. NFID is focused on educating the public and healthcare professionals about the burden, causes, prevention, diagnosis, and treatment of infectious diseases across the lifespan, and the mission of NCL is to protect and promote social and economic justice for consumers and workers in the United States and abroad.

NFID's Marla receiving her vaccine

NFID’s Marla Dalton receiving her flu vaccine.

Both organizations recognize the tremendous benefits that vaccination provides for both individuals and entire communities. While fall and winter raise the need for annual vaccination against influenza (flu), and the current pandemic has led to the need for COVID-19 vaccines and boosters, we must not overlook the importance of routine vaccines that may have been missed during the pandemic. Vaccines are for people of all ages and there are specific vaccines recommended for children, adolescents, adults, and older adults 65+ to protect against serious and potentially deadly diseases.

NCL and nearly 150 other partner organizations are proud to participate in the NFID Keep Up The Rates campaign, to share messages to encourage all individuals to receive recommended vaccines that may have been delayed during the pandemic. Since the campaign launched in 2020, Keep Up The Rates has engaged national experts and leading public health organizations to reach populations most at risk of delaying vaccinations or experiencing complications from vaccine-preventable diseases.

Sally Greenberg getting vaccinated.

Keep Up The Rates recently released resources to educate healthcare professionals and consumers about vaccine coadministration—receiving multiple vaccines at the same time. When you bring your car in for an oil change, a good mechanic takes care of other routine maintenance to make sure your car runs safely. Protecting your health is not much different, so when you receive a COVID-19 vaccine or a flu vaccine, we encourage you to make sure that you are protected against other serious but preventable diseases. A new PSA and infographics are available to help share that messaging with all relevant audiences.

The COVID-19 pandemic has demonstrated that protecting public health is more important than ever. Just as we must always protect the rights of consumers and workers, we must also encourage measures that promote better health and a safe environment for all.

During ‘Striketober,’ standing up for a USPS that benefits consumers and workers

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By Eden Iscil, Public Policy Associate

Workers across America are taking action to hold employers accountable for low pay and poor working conditions. In what’s being called “Striketober,” 10,000 John Deere employees, 14,000 Kellogg’s workers, and 24,000 Kaiser Permanente staff have gone on strike. Additionally, 60,000 film and television workers belonging to IATSE threatened to withhold their labor, resulting in a deal for more favorable contracts. At NCL, we support workers advocating for better conditions and compensation. 

While it is generating fewer headlines, the actions of US Postal Service employees are just as important for consumer and worker welfare. Recent postal worker employee protests in Minneapolis highlight the indispensable public service these workers provide to millions of Americans daily. Those protests were prompted by a visit from Postmaster General Louis DeJoy, who is infamous for his 2020 attempt to degrade mail services at the same time that COVID-19 necessitated mail-in voting for millions of Americans. Importantly, DeJoy has come under renewed scrutiny for his 10-year plan, which would lead to significantly delayed mail deliveries. 

Given the importance of delivering mail promptly, we urge Congress and the Biden Administration to take a more active role in preventing Postmaster General DeJoy’s continued attacks on the Postal Service. Millions of Americans rely on the Postal Service for delivery of life-saving medication, receipt of their veterans and Social Security checks, and other important mail. Unfortunately, the impacts of DeJoy’s 10-year plan are likely to disproportionately affect rural communities and older Americans.   

We know such policies are harmful to everyday Americans from the many times they were previously attempted. Following DeJoy’s plans for a mail slowdown in 2020, veterans were forced to find alternative access to their medications and 350 million pieces of mail were delayed. We need to challenge such regressive policies that are implemented at an enormous cost to consumers. 

The threat that DeJoy’s recommendations pose to efficient U.S. mail delivery has been known since the summer of 2020. Congress and the Administration must act to get USPS back on the right track. 

Jeanette Contreras portrait

¿Buscando cobertura médica? Healthcare.gov open enrollment begins November 1

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By NCL Director of Health Policy Jeanette Contreras with contributions by NCL Intern Grace Mills

The 2022 open enrollment period for the Health Insurance Marketplace is about to begin! Consumers can enroll in a health plan on Healthcare.gov beginning November 1.

As we commemorate Hispanic Heritage Month, the National Consumers League (NCL) wants Latino consumers to better understand their health coverage options through the Health Insurance Marketplace. Latinos make up approximately 18 percent of the U.S. population and represent the largest minority population (62.1 million). However, it is concerning that 22 percent of non-elderly Latinos are uninsured – the highest uninsured rate of any racial group in the United States.

Under the American Rescue Plan, more consumers are now eligible for increased tax credits that further reduce the cost of monthly premiums. An estimated 69 percent of uninsured Latino adults can access a zero-premium plan and 80 percent can access a plan that costs less than $50 a month. Additionally, consumers can use the Healthcare.gov platform to find out if they or their dependents can qualify for Medicaid or the Children’s Health Insurance Program. Here is what you need to know to make sure that you and your loved ones are insured during 2022.

  • The open enrollment period starts on November 1, 2021, and runs through January 15, 2022. In order for your coverage to start on January 1, you must enroll by December 15, 2021.
  • Your income will determine what you will pay for your health coverage plan.
  • Applications will be accepted online, by calling 1-800-318-2596, or through a certified enrollment partner. Learn more about the different ways to apply.

This year, the Centers for Medicare and Medicaid Services (CMS) has issued $80 million in grants to fund Health Care Navigators across the country that are trained and certified to assist consumers with enrolling in a health plan. While agents and brokers are also available, Navigator Grantees are often a trusted source of information in their communities and can offer culturally competent enrollment assistance. Consumers can find local in-person assistance or an agent/broker in their area by clicking here.

¿Buscando cobertura médica? La inscripción abierta de Cuidadodesalud.gov empieza el 1 de noviembre

¡La inscripción abierta para el Mercado de Seguros Médicos por el año 2022 empezará muy pronto! Los consumidores pueden inscribirse en un plan de salud por medio de CuidadoDeSalud.gov empezando el 1 de noviembre.

Para conmemorar el Mes de la Herencia Hispana, la Liga Nacional de Consumidores (“NCL” por sus siglas en inglés) desea que los consumidores latinos conozcan sus opciones de cobertura de salud a través de los Mercados de Seguros Médicos. Los latinos constituyen el 18% de la población de los Estados Unidos y representan la población de minorías más grande (de 62.1 millones). Sin embargo, nos preocupa que solamente el 22% de los Latinos adultos (que no son mayores) no tienen cobertura de salud y representan la tasa más alta sin seguro médico de todos los grupos raciales en EE. UU.

Bajo el Plan de Rescate Americano (conocido como “American Rescue Plan” en inglés), más consumidores están elegibles por los créditos fiscales que reducen el costo de sus pagos mensuales. Aproximadamente, el 69% de los Latinos (no asegurados} pueden acceder a un plan sin costo alguno y el 80% pueden acceder a un plan que cueste menos de $50 por mes. Además, los consumidores pueden usar la plataforma CuidadoDeSalud.gov para ver si ellos o sus dependientes califican para Medicaid o el Programa de Seguro de Salud Para Niños (conocido como “CHIP” por sus siglas en ingles). Aquí está lo que necesitan saber para que usted y sus seres queridos tengan cobertura médica durante el 2022.

  1. El período de inscripción empieza el 1 de noviembre del 2021 hasta el 15 de enero del 2022. Para tener cobertura empezando el 1 de enero del 2022, necesitas inscribirte para el 15 de diciembre del 2021.
  2. Lo que tú pagarías por un plan de cobertura médica dependerá de tu ingreso anual.
  3. Se aceptarán solicitudes: En-línea, llamando al 1-800-318-2596, o cualquier sitio web de inscripción, que esté certificado. Para obtener más información sobre las diferentes formas de como inscribirse use este enlace: https://www.cuidadodesalud.gov/es/apply-and-enroll/how-to-apply/

Este año, Los Centros de Servicios de Medicare y Medicaid ha dado un subsidio de $80 millones para financiar los navegadores de salud a través del país que están calificados y certificados para ayudar con la inscripción en un plan de salud. Mientras que los agentes y corredores también están disponibles, los navegadores son una fuente de información en las comunidades latinas y ofrecen a sus comunidades asistencia confiada sobre la inscripción. Los consumidores pueden encontrar asistencia en persona o con un agente/corredor en donde viven, usando el enlace: https://ayudalocal.cuidadodesalud.gov/es/#/

Intern Spencer Cramer

Redesigning our communities to fight health disparities

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Intern Spencer CramerBy Spencer Cramer, NCL Health Policy Intern

Spencer is a student at Brandeis University, where he is studying Politics and Health: Science, Society & Policy.

The COVID-19 pandemic has fostered a better understanding of how a public health emergency can devastate different groups of Americans already negatively impacted by health problems. These health disparities, which are differences in health outcomes based on factors such as race, ethnicity, or socioeconomic status, are deeply influenced by “social determinants of health.” Social determinants of health are factors in our environments and societies that have a large impact on someone’s health status, independent of their personal choices or lifestyle.

These social factors are the main contributors to health disparities, which represent one of the ugliest faces of inequality in America today. An example of how social determinants of health and health disparities are inextricably linked can be seen in the maternal mortality crisis, where Black women are more than three times more likely to experience a pregnancy-related death than white women. This disparity can be attributed to institutional racism, lack of access to maternal health services, and the aggregate stress of dealing with discrimination on a daily basis.

Even more illuminating, one of the best predictors of health outcomes is a person’s zip code. In many major U.S. cities, the gap in life expectancy between the highest and lowest zip codes is 20+ years. Similar gaps can be seen between different cities and states. Additionally, it is clear that locations with predominantly low-income populations and many people from racial or ethnic minority groups generally experience worse health outcomes than wealthier, white areas. Geographic location is an excellent predictor of health status for a couple of reasons. Our society still has a tremendous amount of segregation, as people of the same race, ethnicity, and socioeconomic background tend to live near each other. This means that the health inequities facing these groups become disproportionately concentrated in certain neighborhoods.

Another reason for these geographic health disparities is how under-resourced the physical neighborhoods are. Poorer and heavily minority neighborhoods are less likely to have parks, green spaces, quality grocers, and health services, and they are more likely to be afflicted by environmental pollution and other societal abuses. Urban planning has a huge impact on public health. Ensuring that we build our cities to equitably distribute public services and amenities will be a critical strategy in addressing social determinants of health and eliminating health disparities.

One way to create healthier communities for all would be to increase the amount and quality of green spaces like parks or urban forests. A large body of research suggests that urban green spaces provide a wide variety of health benefits to residents ranging from increased opportunities for exercise, cleaner air, and improved mental well-being. Urban trees are proven to be particularly important for removing pollutants and addressing other environmental risks, while improving many different health outcomes. Unfortunately, green spaces, parks, and urban trees are concentrated in whiter, richer, and healthier neighborhoods. Investing in parks and green urban spaces in disadvantaged communities can go a long way towards boosting health outcomes and increasing economic opportunities for those residents.

Perhaps nothing is more important for a community’s health than access to quality, nutritious, and affordable food. Unfortunately, millions of Americans live in food deserts, areas where there is little supply of nutritious, whole foods. Again, food deserts predominate poorer neighborhoods and racial and ethnic minority communities. Living in a food desert means that people cannot access healthy or substantial food at an affordable price, inadvertently resorting to more expensive, lower nutrition food from places like convenience stores. Poor diets driven by this lack of food access cause tons of health problems and are a key driver of health disparities. As a society we often associate diet with personal choice. However, people living in food deserts usually have no option other than to eat low-quality food, and subsequently suffer from the health consequences. Ensuring that all neighborhoods and communities can easily access healthy food at affordable prices will surely help to reduce disparities in areas such as obesity, diabetes, heart disease, and others. What we eat everyday has an astronomical impact on our health, so we must make equitable access to good food a priority when creating healthier communities.

Similarly, many of the same neighborhoods plagued by food deserts also suffer from a stunning lack of access to health and medical services. Many healthcare resources are concentrated in areas with higher insurance rates, especially places with high rates of private insurance, leaving neighborhoods with many uninsured or Medicaid-eligible residents without needed health providers. The health consequences caused by the uneven distribution of health services can be devastating and can result in the delay in crucial preventive health screenings. To address this, we can provide incentives, like additional funding or student loan forgiveness to health care providers who practice in underserved communities, and implement public policies to achieve an equitable geographic distribution of medical resources.

A final factor that leads to these health inequalities between zip codes is pollution. It is certainly no secret that environmental pollutants are often horribly damaging to human health. They can cause diseases ranging from asthma to cancer, and are devastating for any community that they afflict. And of course, pollution has a disparate impact on lower-income and predominately minority communities. Developers frequently choose to build factories and other waste-producing sites in these communities because their residents have fewer resources and less political and social capital to advocate against them. Nobody should be subjected to residing in the midst of toxins and waste.

This will require a massive shift to clean energy, responsible development, and safer waste disposal. We can create more health equity by eliminating the health costs brought upon poor and minority communities by pollutants. Designing our neighborhoods and cities with a focus on public health and health equity will help to close the gaps in health outcomes between different zip codes, and should be one of our top priorities as we battle health disparities and social inequities.

April Verrett, President of Service Employees International Union Local 2015

Earlier this year, I rolled up my sleeve…

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SEIU President April VerrettBy Guest Blogger April Verrett, President of SEIU 2015

…for my COVID shot. I was tired of feeling like the virus was winning. I was sick and tired of feeling at the mercy of the whims of this unrelenting, mutating disease. I was angry that this pandemic was beating the hell out of us. So despite any fears and reservations I had about a new vaccine, I was ready to fight. And I wanted to lead by example and show that the vaccine was safe, effective, and the best way to fight against COVID-19.

That shot was more than just a way to protect myself. Like so many have noted, wearing masks and getting vaccinated are comparable to the solidarity and community spirit our grandparents and great grandparents displayed during WWII, where the nation united and everyone did their part. That’s why our Union members referenced the iconic WWII “Rosie the Riveter” image when they launched their “We Can Do It!” vaccination campaign earlier this year. Our Union helped tens of thousands of our long-term care providers, their families, and their vulnerable clients access vaccinations across the state.In the style of the famous Rosie the Riveter poster, a person is pictured wearing mask, flexing arm, and showing vaccination bandage, saying We Can Do It

I was so relieved months earlier when the vaccine became available to essential workers in California. The more than 400,000 long-term care providers I represent every day—primarily women of color—were among the first in line. Often, their communities were the hardest hit by the pandemic. Black and brown neighborhoods throughout the state consistently suffered the highest illness and death rates.

COVID took deadly aim at our members and their elderly, sick and disabled clients. They lost many of the fragile people they cared for while they themselves struggled on the terrifying font lines of the war against COVID, often without the PPE to protect themselves. These caregivers suffer lingering trauma from seeing the ravages up close in nursing homes and private homes up and down the state. Like my sister Christine, a nurse assistant at a nursing home in Bakersfield, where they lost 19 of their patients and more than a hundred of her colleagues fell ill with COVID. It breaks my heart that this is not a unique example. I heard story after story like Christine’s.

There’s one thing that slowed this devastation and protected our members and the vulnerable people they care for: vaccination. Our members see firsthand that it’s the best weapon available to rein in this pandemic, protect against infection and hopefully slow the development of dangerous variants. It’s simple: where vaccination rates are higher, rates of infection, hospitalization and death are lower. Counties across the nation again experiencing at-capacity hospitals are, sadly, the counties that have resisted the vaccine.

I’ve never seen as much misinformation thrown at our members and our communities as I’ve seen around COVID vaccines. So, we recently started a follow-up ‘We Can Do It!’ effort to dispel the dangerous—life-threatening, really—myths about vaccination.

This summer, as employers and local and state governments began to look at ways to urge more vaccination, SEIU 2015 member leaders formed a working group to ensure that Union members would have a voice in any policy, including vaccine mandates. This group developed a set of principles to guide employers and partners in our state’s continued vaccine rollout, such as making sure the vaccine is readily available and accessible, that sick days are provided for the frequent resulting flu-like symptoms and that it’s carefully scheduled to avoid staffing shortages. Days after outlining this guidance, our Governor mandated all healthcare workers to get vaccinated. Our members overwhelmingly support vaccination, but they also want to ensure that it’s accomplished thoughtfully and respectfully for our members who remained concerned.

We can do it. Together, we will defeat COVID-19.

April Verrett is President of SEIU 2015, the largest union in California, representing more than 400,000 long-term care providers (home care, skilled nursing facility, and assisted living center workers) throughout the state. Its members are as diverse as the state’s population, but united in their commitment to caring for California’s most vulnerable: seniors and the disabled. In October, Verrett will receive an award from NCL named for our first Executive Secretary Florence Kelley. To learn more about the evening of awards, click here. 

Diverse research for a diverse America: The value of equitable, real-world research

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By Sally Greenberg, NCL Executive Director

While the COVID-19 pandemic has led to hardship for all Americans, it is clear that people of color have been disproportionately burdened. Across the health care continuum, addressing this disparity has become part of the broader conversation about the history of systemic racism and the underlying social determinants of health that negatively affect the mental, physical, and economic health of individuals and entire communities.

The pandemic has underscored persistent health disparities, and there is growing recognition that representation in research and clinical trials can have a profound impact on health outcomes. A lack of representation from racially and ethnically diverse groups in research and clinical trials have typically led to gaps in data, missing the opportunity to assess the full impact of various treatments and drugs across a range of populations. The collection and use of real-world research and data to inform the potential use, risks, and benefits of medical products and treatments can ultimately lead to better health outcomes, particularly for those who have been underrepresented in the past.

Existing efforts to improve inclusion

Efforts to expand diversity and representation in medical research are underway in Congress. Policymakers are encouraging the incorporation of Real World Evidence (RWE) in drug development through the recent Cures 2.0 draft legislation released by Reps. Diana Degette (D-CO-1) and Fred Upton (D-MI-6). While the status quo limits us from effectively reaching underserved populations, the proposed legislation would allow studies that include RWE for some drugs after they have been approved. At the heart of this issue is a growing appreciation that the same therapy can affect different populations in different ways, which is why Cures 2.0 supports collecting data that more accurately reflects the unique experiences and needs of patients across diverse populations.

Recognizing the potential for RWE in maternal health

The lack of representative research in the field of maternal health is undeniable, and its implications are staggering. The dismal state of maternal care in the United States reflects how our health care system has failed women of color, including by not adequately studying treatment options to prevent maternal morbidity and mortality. The need for RWE is clear when you consider the persistent disparities in health outcomes that plague minority communities.

Preterm birth and its disproportionate impact on women of color is a stark illustration of the need to make progress on representative research in maternal health. Preterm birth is the second-largest contributor to infant death in America today. Despite the tremendous physical, emotional, and financial toll that preterm birth continues to take on our country — disproportionately so on women and families of color — not enough therapeutic tools currently exist to prevent it.

Today, “17P,” the only FDA-approved treatment to help reduce the likelihood of spontaneous, recurrent preterm birth in the United States is at-risk of being withdrawn from the market in all its forms, including the branded product and five generic versions. Unfortunately there is conflicting evidence from two different clinical trials, one representative of a diverse U.S. population and another studied in a largely white population in Europe. It’s not a straightforward comparison. If 17P is withdrawn, the women most affected by preterm birth, predominantly women of color, would be left without an FDA-approved treatment option.

The FDA is considering the path forward, including additional data collection through leveraging RWE from past patient use. The success of the first (approval) trial for 17P in the impacted communities signals the importance of RWE. Continued access to 17P is, at its core, a matter of health equity. Black women must not yet again be left vulnerable to a system that historically has overlooked them.

NCL Public Policy Intern Tom Pahl

The complete picture: The need for alcohol labeling

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NCL Public Policy Intern Tom PahlBy Tom Pahl, NCL Policy Intern

Tom Pahl is a 2021 graduate of Skidmore College, where he received a Bachelor of Arts degree in Political Science.

Just about every consumable food and drug product has a label with information about the contents—from over-the-counter medications, dietary supplements, sodas, and chips to the candy bars we nab from a convenience store. And consumers rely on these labels to make sound purchasing decisions. Surveys show that about 77 percent of Americans use the standardized Nutrition Facts label required by the Food and Drug Administration (FDA). Yet, there is one type of consumable product where we don’t have this option: alcoholic beverages.

It is not an overstatement to say that alcoholic beverages have been part of human civilization since early humankind. Archeologists trace the first wine drinks to China around 7000 BC. Additionally, beverage alcohol has a fabled history in the United States, underscored by the so-called “noble experiment” called Prohibition from 1920-1933. In fact, Prohibition is the reason that regulation of most alcoholic beverages—including content labeling—is the responsibility of the Treasury Department’s Alcohol and Tobacco Tax and Trade Bureau (TTB).

Yet, the Federal Alcohol Administration Act, passed in 1935, created an exception to the rule. When alcoholic beverages contain more than 7 percent alcohol by volume, a standard measure known as ABV, TTB requires alcohol labeling. However, below 7 percent ABV, alcohol labeling falls under the purview of the FDA. This means different requirements for grape wine, sparkling or carbonated wine, fruit wine, saké, wine coolers, cider, and de-alcoholized or partially de-alcoholized wine. The requirements also apply to beers not made from malted barley, but instead malted barley substitutes, or made without hops like kombucha and gluten-free beer.

Why does this matter? Because alcoholic beverages regulated by FDA have the same standardized Nutrition Facts label as a soft drink (along with the ABV). This includes hard ciders and sparking wines that have taken the world by a storm in the past few years. In contrast, TTB allows the manufacturers of all other alcoholic beverages to “decide” whether to include nutritional labeling and, guess what? Surprise, surprise, the vast majority have no nutritional labels. Even more confounding, in any refrigerator, a bottle of beer and a bottle of hard cider made by the same company—to wit, Sam Addams beer and Angry Orchard Cider, made by the Boston Brewing Company—the beer has no nutritional information and the cider is fully labeled, proving that unless companies are required to label, they don’t do it!

It is true that TTB requires beer, spirits and wine makers to put specific information on product labels – including the type of alcohol, the alcohol content (ABV or proof), the net contents of the beverage, the coloring materials used, whether the beverage contains allergens, and the country of origin. As important as they are, these facts have nothing to do with health and nutrition and this information is more important than ever before due to the epidemic of obesity in the United States (almost 20 percent of men and 6 percent of women consume more than 300 calories from alcohol per day, according to the Centers for Disease Control and Prevention) and higher rates of diet-related diseases.

We know that when required by FDA, alcohol beverage manufacturers have figured out how to put a complete alcohol content label on their products. National Consumers League, along with other consumer organizations and public health groups, will continue to press TTB to issue a final rule requiring a mandatory Alcohol Facts label on all beer, wine and distilled spirits products. In 2021, consumers deserve the kind of robust labeling we see on other foods and which consumers understand, use, and need to make informed buying choices.