Hello from the Common Health Coalition! The 2-4-2 Digest is a weekly snapshot for health leaders - 4 key insights in 2 minutes or with 2 swipes on your phone.

Weekly Health Insights

Climate and Health: The EPA has repealed the 2009 “endangerment finding,” the scientific determination that greenhouse gases threaten public health and that underpins federal climate regulations on vehicles, power plants, and other sources.

Tribal Health Care: The expiration of enhanced ACA subsidies is increasing premiums for tribal health insurance programs that use marketplace coverage to supplement Indian Health Service care. It is estimated that up to 125,000 Native Americans could lose coverage in 2026.

Substance Use: A growing proportion of fentanyl use in the U.S. is shifting from injection to smoking, which may lower risk of fatal overdose along with HIV, hepatitis C, and other injection-related infections. The shift is prompting distribution of safer smoking supplies by harm reduction organizations.

Vaccine Policy: In AAP v. Kennedy, which was heard last Friday, plaintiffs asked a federal court to temporarily block Secretary Kennedy’s January 5, 2026 changes to the childhood immunization schedule and to pause the upcoming ACIP meeting. The government says the Secretary acted within his authority; a ruling on the preliminary injunction is expected soon.

Colleague Corner

In a STAT First Opinion, epidemiologist Dr. Michelle A. Williams reflects on the EPA’s decision to stop using the “value of statistical life” in air pollution rulemaking, framing it as a departure from long-standing public health principles that center prevention, equity, and the inherent value of human life.

"Every American life has value. Every child deserves to breathe clean air. Every worker deserves to come home healthy at the end of the day. The public health heroes who built the world we live in understood this. They faced the same arguments from the same interests, and they refused to back down. Now it’s our turn."

– Dr. Michelle A. Williams, ScD, Professor of Epidemiology and Population Health, Stanford University School of Medicine; Former Dean, Harvard T.H. Chan School of Public Health

Data Watch

A JAMA Health Forum analysis found that after the Dobbs decision, weekly requests for medication abortion through a national telehealth service more than tripled among adolescents (from 2.8 to 8.6 per 100,000) and young adults (from 8.8 to 25.0 per 100,000). The sharpest increases occurred in states with abortion bans and parental involvement laws, where adolescent request rates were nearly three times higher than in states without such requirements.

Figure. Weekly Request Rates for Medication Abortion via Telehealth Service by Age and Type of State-Level Abortion Policy Before and After the Dobbs v Jackson Women’s Health Decision

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