Are CDC Priorities Restoring Public Trust, Improving Health of Americans?

Dear Chair Rogers, Ranking Member Pallone, Chair Guthrie, and Ranking Member Eshoo:

Thank you for allowing the National Safety Council (NSC) to submit this Statement for the Record in advance of today’s House Energy and Commerce Subcommittee on Health hearing titled: “Are CDC's Priorities Restoring Public Trust and Improving the Health of the American People?” Given the myriad public health challenges in the United States, NSC believes it is imperative the United States Centers for Disease Control and Prevention (CDC) is adequately resourced to sustain its critical, lifesaving mission. Specifically, the National Center for Injury Prevention and Control (Injury Center) provides vital resources used by employers and advocacy organizations to eliminate ongoing epidemics including workplace injuries, opioid overdoses, and workplace violence.

NSC is America’s leading nonprofit safety advocate and has been for 110 years. As a mission-based organization, we work to eliminate the leading causes of preventable death and injury, focusing our efforts on the workplace and roadways. We create a culture of safety to keep people safer at work and beyond so they can live their fullest lives. Our more than 13,000 member companies represent nearly 41,000 U.S. worksites.

The opioid epidemic continues to ravage communities across the United States. However, we are making progress. New provisional data from the CDC show opioid overdose deaths in 2023 fell for the first time since 2018. While the overall number of overdose deaths are declining, workplace deaths continue to rise. Currently, 9.6% of all workplace deaths are the result of a drug overdose. Since 2011, deaths from overdose on the job have increased by 619%.

Housed in the Injury Center, the Division of Overdose Prevention (DOP) “monitor[s], prevent[s], reduce[s], and respond[s] to overdose.” This essential public health approach allows the Federal government to remain vigilant in surveilling trends in substance use and implementing evidenced-based strategies to eliminate the harm of substance use and overdose in the United States. DOP administers the Overdose Data to Action (OD2A) program, which provides state-based and local community grant funding to health departments in an effort to build capacity and better respond to overdose. Successes of this program include:

• Rural and underserved community naloxone distribution and saturation in Arizona
• Actionable response plans for overdose spikes in Illinois
• Illicit drug supply messaging and public safety campaigns in Massachusetts

NSC vigorously disagrees with the sentiment expressed in the FY25 Labor, Health and Human Services, Education, and Related Agencies report that the work of the Injury Center is “duplicative of other programs, projects, and activities at other agencies.” In its justification for eliminating Injury Center funding, the House Appropriations Committee eyes the Department of Justice (DOJ) and the Substance Abuse and Mental Health Services Administration (SAMHSA) as better homes for the efforts of the Injury Center. This could not be further from the truth. While the CDC administers and measures programs from a national, and at times global, public health lens, DOJ and SAMHSA administer and measure programs from law enforcement and broader behavioral health lenses. The Injury Center’s focused expertise in overdose, injury and violence prevention provides a necessary balance against the missions of both DOJ and SAMHSA.

In September 2019, The White House announced $1.8 billion dollars in grant funding to help “States fight the opioid crisis and to help prevent more American lives from being lost to overdose.” The current administration continued this historic all-of-government approach to addressing the opioid epidemic by incorporating opioid overdose response efforts in his Unity Agenda. Each perspective that a federal agency brings to combating this crisis is welcome, but the public health perspective must never be discounted. The CDC, through the Injury Center, must continue to surveil emerging threats to the successes the United States has begun to document in its response to the nation’s overdose epidemic.

The Division of Violence Prevention (DVP) and the Division of Injury Prevention (DIP) also leverage evidence-based public health strategies to positively affect societal ills. DVP works to:

• Monitor violence-related behaviors, injuries and deaths
• Conduct research on the factors that put people at risk for or protect them from violence
• Create and evaluate the effectiveness of violence prevention programs, practices and policies
• Help state and local partners plan, implement, and evaluate violence prevention efforts
• Promote the effective adoption and dissemination of violence prevention strategies

This need is great. Violence from assault is the fifth leading cause of work-related deaths. From 2021-2022, assault resulted in 57,610 Days Away from Work, Job Restriction or Transfer (DART) cases which includes 41,270 Days Away from Work (DAFW) cases and 524 fatalities in 2022. Violence alters communities and has a sizable impact on the economy. This impact is understood by multiple federal agencies, including the Department of Transportation (DOT). DOT is beginning a process to understand how harassment and assault unfairly keep women from actively embarking on a career in trucking. DVP programs to implement and evaluate violence prevention efforts will contribute greatly to the reduction of assaults in the workplace. 

Injuries are another public health challenge in the United States. In 2022, there were 227,039 preventable injury-related deaths, a 0.9% increase over 2021 figures. This is also an increase of 162% over the past 30 years. Outside of fatalities, 63 million people – about one in five U.S. residents – sought medical attention for an injury. DIP has a role to play in eliminating injuries by connecting data with scientific research to apply evidence-based mitigation practices. Through this action, best practices are created and sustained to eliminate the threats of injuries. 

Current research and programmatic efforts by DIP include:

• Leveraging its expertise in data analysis and suicide prevention to help communities prioritize the most impactful ways to prevent suicide
• Investing grant funds into communities to help implement and evaluate a comprehensive public health approach to suicide prevention
• Researching the knowledge, attitudes and behaviors that motivate older adults to adopt evidence-based strategies for fall prevention
• Synthesizing public health research to understand differences in and prevention strategies for impaired driving (i.e., alcohol-, drug-, and polysubstance-impaired) especially among populations disproportionately affected by impaired driving

As evidenced by the data above, the public health challenges facing the United States and workplaces are many and varied. NSC believes this is not the appropriate time to eliminate funding to the Injury Center or shift their priorities to another government agency. Each agency endeavoring to examine and implement solutions to our shared challenges has a welcome remit. NSC encourages the Subcommittee on Health to support CDC and Injury Center efforts to eliminate overdose deaths, injuries and violence.

CC The Honorable Tom Cole, Chair, House Committee on Appropriations

CC The Honorable Rosa DeLauro, Ranking Member, House Committee on Appropriations and Subcommittee on Labor, Health and Human Services, Education, and Related Agencies

CC The Honorable Robert Aderholt, Chair, House Committee on Appropriations, Subcommittee on Labor, Health and Human Services, Education and Related Agencies.