Dr. Frists Tennessee brings up the rear

A new report from the United Health Foundation, the American Public Health Association and the Partners for Prevention has found that Tennessee, the home base of Republican Senate Majority Leader Bill Frist, ranks 48 out of the 50 states in the health status of its population.

The report, “America’s Health: State Health Rankings, A Call to Action for People and Their Communities,” documents state by state the main indices of health care, including infant mortality.

It’s unlikely the health situation for Tennesseans is going to get better anytime soon: the state is in the process of dissolving its Tenncare program and reverting to Medicaid. The office of Gov. Phil Bredesen reports that 430,000 out of 1.3 million enrollees could lose their health care in the transition.

A major reason for dropping the program, according to a statement by the governor, is a recent change in the formula for federal funding that will reduce the federal dollars from Washington for the program. Sen. Frist’s office did not return phone calls from this newspaper asking for his plans to address this crisis.

The America’s Health report begins with the World Health Organization statement of what health is: “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” The report continues: “In addition to the contributions of our individual genetic predispositions to disease, health is the result of our personal behaviors, the environment of the community in which we live and the policies and practices of our health care and prevention systems.

“These three areas which we as individuals and as members of society can influence, interact to create the healthy outcomes we desire, including a long, disease-free and robust life for all individuals regardless of race, sex or socio-economic status.”

These goals and statements of what should be considered health have been given short shrift in recent years. It is significant that these three organizations, especially the American Public Health Association, are recommitting themselves to this definition of health. It is especially important that the report holds individual state policy leaders responsible for their health policies.

The criteria used to evaluate the individual states include smoking rates, infant mortality, infectious disease deaths and level of residents’ coverage by some kind of health insurance plan. The report also takes into account the poverty and education levels of people in the state. The combination of these factors, which truly determine the health and social status of people, makes this report a clarion call to action.

But, like any report or statement from professional people, the value of the words is only as good as their utilization by activists and their organizations that directly represent people. The “call to action” admonition should serve as notice especially to federal oversight agencies that have financial obligations to make sure federal funding, which is significant, is done appropriately.

The report, to its credit, also compares the U.S. experience to that of other countries. The report makes it clear that individual health measures that can be used to compare the U.S. with other countries show “what other countries have already achieved and this indicates the potential for the United States.”

The executive summary ends by stating that “28 countries have healthy life expectancies that exceed the United States, including the UK, Canada, Australia, France, Germany and Japan.” These countries still have strong government health programs. They resisted the privatization and market reform demanded by the World Bank 20 years ago. A recent World Health Organization report said that these two failed strategies account for a widening of the health gap between those who are healthy and those in poor health.

Bill Frist continues to extol the virtues of profits and personal ownership of health and also Social Security in the U.S. Senate as his home state subjects its own people to misery and premature deaths and disabilities.

The author can be reached at pww@pww.org.