In August 2021, Governor Eric Holcomb established the Governor’s Commission on Public Health.
The commission’s mission was to analyze and advise the state government on the current state of Indiana’s public health system, including its performance during the COVID crisis. The Commission should also find ways, including legislative recommendations, to improve public health funding, the delivery of public health services, equity in health, the sustainability of local health authorities and the capacity to respond to emergencies.
The Commission has presented a good report, but there is nothing that is really innovative or innovative. Indiana is not ready for this. The report and its recommendations are conceptually based on good, fundamental public health principles. Indiana has to start somewhere. It might as well start with the essentials.
The commission outlines the pitiful state of public health in Indiana due to decades of neglect and underfunding. Indiana remains one of the unhealthiest states in the nation, ranking at the bottom on most public health parameters. Indiana’s life expectancy is two years below the national average.
Worse, there is a nine-year difference between the counties with the highest and lowest life expectancies, highlighting Indiana’s geographic, ethnic, racial, and socioeconomic differences.
Health insurance does not guarantee health. Public health is important. Of the 30 years of increased life expectancy in the 20th century, 25 are not due to medical advances but to public health measures that prevent disease and improve the conditions in which we live and work – immunizations; better housing, sanitation, nutrition and food protection; safer working conditions; and most importantly, promoting a healthy lifestyle.
The report provides detailed recommendations to improve six essential elements of good public health:
-Improving governance, infrastructure and service delivery
-Expansion of public health financing
-Promotion of a well-trained public health workforce
– Modernizing the collection and sharing of public health data to support better planning and delivery
-Improvement of the emergency capacities, in particular of the local health authorities
-Improving the health of children and adolescents through school-based clinics, health education and prevention programs
Unfortunately, the report did not address Indiana’s high infant and maternal mortality rates
Government funding, which is among the lowest in the country (45th), needs to be increased significantly to help local health departments ramp up staffing, services and skills. COVID has really brought these limitations to light. Funding for public health has traditionally been a low priority for the General Assembly.
The report also points to the importance of local health departments developing broad community partnerships. Taking this a step further, I have been a longtime advocate for healthy community initiatives that involve community leaders, businesses, government, nonprofits, hospitals, educational institutions, religious groups and the medical community working together to meet the needs of the Evaluate community and bring about positive change. The state should sustainably fund a healthy community initiative in each county.
Finally, the Commission recommended something that I have always found very desirable – cooperation with regional health authorities, partnerships or possible consolidation.
The report contains a well-known important admonition from Benjamin Disraeli: “The health of people is truly the basis upon which all their happiness and all their power as a state depend.” weakens our communities and shortens the lives of too many Hoosiers. … We can and must do better.”
Indiana has had very few public health achievements. Will this report get dusted? Or will the General Assembly answer the call?
dr Richard Feldman is a family doctor from Indianapolis and a former state commissioner of health. Send comments to [email protected]