Brian Hoey’s Column: Hoosier’s Terrible Health and Billions of Excess Dollars | Columns

If you live in Carmel or Noblesville, you’ll statistically live about nine years longer than someone in Scottsburg and about six years longer than a Hoosier living in Gas City.

In the televised era of Hoosier politics, there were seismic reports that brought about a mean shift. The Indiana School Reorganization Act of 1959 reduced the number of school districts from 966 to 402, but even today there are 53 school corporations with fewer than 1,000 students.

In 2007 came Indiana’s Kernan-Shepard Commission on Local Government Reform, convened by then-Gov. Mitch Daniels. The commission recommended 27 changes, ranging from child welfare funding to school district reorganization.

That created one big change: property tax assessment duties were moved from all but 13 of the state’s 1,005 municipalities to county offices.

On August 1, the Governor’s Commission on Public Health released its 107-page report following the COVID-19 pandemic.

“It is clear that the COVID-19 pandemic is testing our public health system in a way we have not seen since the flu pandemic of 1918,” the commission noted in its letter to Gov. Eric Holkham, who created the body.

“It became clear to us as we dove deeper into this work that funding, governance structure and workforce will be at the heart of many of the challenges of our public health system.”

In its summary, the commission noted: “In fact, most of the increases in life expectancy achieved in the 20th century—approximately 25 of the 30 additional years—were due to public health programs and interventions aimed at preventing people from becoming ill or injured in first and foremost to promote wellness by promoting healthy behaviors.”

The commission noted that gains in longevity over the past century, however, are threatened by today’s public health challenges, including addiction, suicide, smoking, obesity and diseases for which there are vaccines, though growing numbers of Hoosiers ignore them.

“In fact,” the commission notes, “life expectancy in Indiana has been declining since 2010, when it peaked at 77.5 years. Life expectancy in Indiana in 2019 was 77 years, almost two years below the US average of 78.8, ranking us 40th in the nation.

“Even more troubling is that the gap between the Indiana county with the highest life expectancy and the county with the lowest life expectancy is nearly nine years. This is clear evidence of the health care disparities that exist in our state.”

According to senior demographer Matt Kinghorn of the Indiana Business Research Center at Indiana University, “In 1984, life expectancy at birth for Hamilton County residents was 1.1 years longer than for those living in Scott County . As of 2018, the gap between the two has grown to nearly nine years.

Emergency medical services in Indiana nearly doubled as baby boomers grew from 758,115 in 2018 to 1,258,158 in 2021. However, those numbers have declined:

Ambulances from over 2,022 in 2018 to 1,789 in 2021.

EMS providers from 24,145 in 2018 to 23,070 in 2021.

However, the number of ambulances and emergency medical providers has fallen from 24,145 in 2018 to 23,070 in 2021.

One-third of Indiana counties are more than 45 minutes from the nearest trauma center. About 33 counties do not have an obstetrician-gynecologist delivery room.

“Indiana ranks very favorably on economy, opportunity, education and public safety,” said commission co-chairman Luke Kenley, who said he was shocked by the growing disparity.

“However, our public health indicators rank us among the lowest in the nation. Business and industry require a healthy workforce to keep our Indiana economy growing.”

In its conclusion, the commission recommended $240 million in increased annual spending to “increase funding for county public health departments to the national average.”

Indiana ranks 48th in the nation in public health funding, spending approximately $55 per Hoosier on public health initiatives, or $36 less than the national average of $91 per capita. In the early 1990s, Indiana ranked 26th in overall health outcomes; now we are in 40th place.

In the upcoming 2023 biennial budget session, which begins in January, these proposals will receive serious debate in the General Assembly.

“I found it a little hard to swallow,” said Senate President Pro Tem Rodrick Bray. “I don’t see us spending $480 million in the next public health budget. I’m not even sure if we’ve sent enough money to the local health departments that they’ll be able to handle it well.

But here’s an impressive tidbit: Indiana ended the last fiscal year with a record $6.1 billion surplus. Not to take public health care to, as Governor Holcomb would put it, “the next level” is to avoid a central dilemma facing tens of thousands of Hoosier families.

Or as Grant County Commissioner Mark Bardsley put it, “As far as public health goes, I’m not satisfied with adequate or average; we need a fundamental commitment that all Hoosiers have excellent public health services in every zip code across Indiana.”

Life expectancy in Grant County is 75.3 years, six years lower than Hamilton County.

My comment to Senator Bray and House Speaker Todd Houston is this: Hoosiers need you to be creative and innovative. They need you to manage the state’s assets beyond building smooth roads, balancing budgets, keeping business tax rates low, and sending rebates back to taxpayers.

Failure of imagination is not an option.

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