The Free Press, Mankato, MN

October 23, 2012

Health commissioner says state's health is slipping

By Robb Murray
Free Press Staff Writer

ST PETER — In a talk Tuesday at St. Peter’s River’s Edge Hospital, Minnesota Commissioner of Health Ed Ehlinger’s message was simple: Minnesota is slipping when it comes to national health rankings, and he thinks it’s time the state gets back on top.

For years Minnesota was ranked No. 1 or No. 2. Now we’re No. 6 in rankings that compare overall health across dozens of measures.

“I’m taking this personally,” said Ehlinger, addressing a group of doctors, nurses and staff members at the hospital, as well as public health officials. “We’re going in the wrong direction.”

Ehlinger said he remembers driving through Minnesota in the summer of 1973 when he spotted an issue of Time magazine on a newsstand. The cover featured a photograph of then Gov. Wendell Anderson holding up a freshly hooked fish next to the words, “The good life in Minnesota.”

He thought to himself, after seeing that cover, that Minnesota wouldn’t be a bad place to end up. He said he still believes the good life can be found in Minnesota, but some changes need to be made if the state intends to live up to its reputation as being a great state to live, raise families and experience overall high quality of life.

First, the problems.

State expenditures for public health, he said, are 46th in the nation. In the category of getting rid of binge drinking, the state ranks 44th. In the vaunted Kids Count annual survey, Minnesota slipped from No. 1 to No. 5.

Ehlinger said one of the reasons the state’s rankings are slipping is diversity.

“By itself, that’s not a bad thing. It’s actually a good thing,” he said. “But the problem is we have not addressed the racial and ethnic disparities that go along with it.”

In other words, the state hasn’t figured out how to bring the numbers for ethnic groups in key categories to track with the rest of the state. Disparities exist, he said, and until those disparities are addressed, the rankings will continue to go down.

Another disparity area is income. The difference between the high earners and the lowest is as great as it’s ever been.

“It’s been shown that the higher income inequality you have, the worse you are in many indicators,” Ehlinger said.

In addition to increasing disparities and income inequality, the state has also decreased spending on education and public health. Minnesota ranks 29th now in how much it spends on K-12 spending.

In public health spending, the situation is just as dire. In 2006, the state spent $249 per capita on public health. In 2011, that number was $49.

Why? They money from the tobacco lawsuit, much of which was earmarked for public health, is gone. Also the state has decreased by 70 percent funding for the Statewide Health Improvement Program, known as SHIP.

“The reason we’re as healthy as we are right now (financially) is because of the investments that were made 20 and 30 years ago,” Ehlinger said.

To turn the situation around, Ehlinger recommends an approach that would target three areas: healthy living, healthy communities, health care that includes high-value prevention.

He encouraged more emphasis on personal wellness, such as avoidance of alcohol and tobacco, as well as increased physical activity.

From a public health perspective, he offered this: “Just by increasing the tax on alcohol by 50 cents per six-pack, we can decrease traffic fatalities by 17 percent.”

From a health care perspective, he said the best way to stay healthy is by giving people the best chance to not get sick in the first place. To do this, Ehlinger recommended making sure as many people as possible have access to primary care. Research shows, he said, that the biggest difference can be made at the primary-care level.

Doing so would also cut down on the costliest portion of our health care system.

“We spend $750 billion annually on unnecessary care,” he said. “We spent over half of our health and human services dollars on the medical care piece. We’re overwhelming the medical care system.”