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The Journal Gazette

Thursday, June 14, 2018 1:00 am

Editorial

'You get what you pay for'

State must prioritize its citizens' health

To anyone paying attention, many of the numbers shared by speakers at The State of Our Health 2018 Road Show were not a surprise. Indiana's health problems are myriad, and some of them are getting worse.

The Road Show, organized by a coalition of health care and business organizations and leaders of the Alliance for a Healthier Indiana, is visiting cities around the state to bring attention to these problems, and to move toward solutions.

• Already higher than the nation's rate, infant mortality has actually increased in Indiana during recent years. Some of the highest rates in the state for African-American infant deaths are in two Allen County ZIP codes.

“This isn't a Third World country,” said Dr. Tony GiaQuinta, president of the Indiana American Academy of Pediatrics. “This is our community.”

• Our state's ranking for prevalence and treatment of mental illness has plummeted. According to Fort Wayne/Allen County Health Commissioner Dr. Deborah McMahan, “We were 19th, and we've evolved into 45th” in the Mental Health Association of America's latest rankings. 

• The state is ranked 35th for children's health, said Katie Kincaid of the Indiana Youth Institute.

• In the 2017 America's Health state rankings, Indiana was listed 38th for the overall health of its citizens, with high rates of obesity, tobacco.  

• And, of course, there is the drug crisis. “We could have up to 50,000 people who are using opioids improperly in Allen County,” Mc-Mahan said.  

One statistic explains why we're not making more progress on all the others. According to America's Health, Indiana is 49th among the 50 states in public health spending.   

“The average American spends $232 per month eating meals prepared outside the home,” McMahan said. “In 2017, in Allen County, we spent $13.71 per person on public health – you can't even go to a movie for that. Why is our health so poor? You get what you pay for.”

At least a part of the solution, it would appear, is for the state to resolve to spend more money helping its citizens live healthier lives.  

But what about infrastructure, public education, workforce development? How does a state with so many other challenges find more money to address its many health crises?

One solution, endorsed by the alliance and by many of those who spoke at Tuesday's conference, is for the state to raise the cigarette tax.

“Raising the cigarette tax is absolutely the best way to reduce smoking in the community,” GiaQuinta said. “It has been well studied that the greater the tax, the less people will smoke. And the downstream effects from that will be seen immediately” on such problems as infant mortality, he said.

Then, GiaQuinta said, “that money needs to go back into public health. ... We need the funding to drive these initiatives. Whether it's obesity, where I can see patients for obesity but I have nowhere to send them. Or whether it's smoking, needing to funnel them into a tobacco-cessation program.” Or substance abuse and mental health treatment. 

The Alliance for a Healthier Indiana says a $1.50-per-pack additional tax on cigarettes could bring the state $315 million annually. The legislature needs to give that proposal serious attention next January.

As McMahan noted, there's always a positive return on money invested in proven public-health strategies. Healthy students are better learners; healthy workers are more productive. Health care costs go down. Most important, the quality of life could be improved for millions of Hoosiers.