Take a look at the longer-term trends in maternal mortality rates, and you see one of the great success stories in modern-day public health: In 1900, for every 1,000 live births, up to nine women were dying of pregnancy-related complications; a century later, that rate had declined by almost 99 percent.
But the story told by more recent data is less clear, and more troubling.
According to the U.S. Centers of Disease Control and Prevention, the number of reported pregnancy-related deaths increased between 1987 and 2013 — from 7.2 deaths per 100,000 live births to 17.3 in 2013. Better reporting (for example, the addition of a pregnancy check box on state death certificates) is one explanation for the increase. Another reason, though, may be that pregnancy-related deaths are actually on the rise. The CDC notes, for example, that more pregnant women have conditions such as hypertension, diabetes and chronic heart disease that may put them at a higher risk of complications.
South Dakota legislators agreed this year to provide new tax incentives for private landowners who help protect the state’s water resources from agricultural runoff. The goal of SB 66 is to encourage the use of buffer strips that filter out nutrients and keep these pollutants from reaching a water body.
A new law in Kansas will bar “do not resuscitate” or similar physician’s orders for unemancipated minors unless at least one parent or guardian has been told of the intent to issue such an order. SB 85 requires that parental notice be given orally and in writing, and prohibits a DNR or similar orders if there is a refusal of consent. Also under this measure, the minor’s medical record must include information about the DNR order and the nature of efforts to contact both parents.
State legislators in the Midwest are exploring a range of policy options this year that would give students greater access to computer-related courses while also providing instructors more tools for teaching in these subject areas.
These proposals mostly steer away from state mandates and focus instead on incentives for schools and more choices for students. Iowa’s SF 274, for example (passed by the Senate in March), would create a new state-level incentive fund to help schools build instructional expertise among their teachers.
Only a few months after celebrating key congressional victories at the end of 2016, Great Lakes advocates are now fighting to prevent a complete elimination of funding for a federal program that has poured hundreds of millions of dollars into projects that protect habitat, stop the spread of invasive species and clean up “Areas of Concern.”
President Donald Trump’s budget blueprint calls for an end to the Great Lakes Restoration Initiative. It says “specific regional efforts,” such as those related to the Great Lakes and Chesapeake Bay, should instead be the responsibility of state and local entities.
Over the course of a two-week period in late March and early April, the rules for prescribing painkillers were tightened in Ohio, an improved drug-monitoring system was unveiled in Michigan, and nine bills to prevent opioid abuse won passage in the Wisconsin Assembly. The flurry of activity in those three states illustrates just how big the opioid problem continues to be in many parts of the Midwest, as well as how much of a priority legislative leaders have placed on finding new ways to address it.
Near the top of that priority list is better controlling how prescription drugs are dispensed, prescribed and used.
Federal laws and regulations on the environment often serve only as a “floor,” with states having the leeway to enact tougher rules or statutes of their own. However, some state legislatures and governors have adopted measures (either state laws or executive orders) designed to rein in the actions of their own environmental agencies. Most recently, in February, Indiana’s HB 1082 became law. It applies to any Department of Environmental Management rule that is “more stringent than a restriction or requirement imposed under federal law” or “applies in a subject area in which federal law does not impose a restriction or requirement.”
From demonstrations trying to stop proposed pipelines to rallies denouncing deadly police encounters with civilians, the number of protests in the Midwest has been unusually high over the past year. The region’s legislators have taken notice, revisiting their states’ laws on criminal trespassing, loitering, picketing, blocking roadways and disorderly conduct. As of early March, protest-related legislation had been introduced in 2017 in at least five of the region’s 11 states. North Dakota and South Dakota were the first two Midwestern states where those bills became law.
Starting in July, Minnesotans will have the option of buying alcohol on Sunday, the result of legislation (HF 30) signed into law in March. Minnesota and Indiana have been the only two states in the Midwest with Sunday-sales bans. Indiana’s SB 83, introduced in January, would allow the state’s grocery and drug stores to get a supplemental dealer’s permit and sell alcoholic beverages on Sunday; liquor store dealers would not need this permit.
Indiana, Wisconsin, North Dakota and Iowa have made the top-10 list in a recent U.S. News & World Report studythat explores how well state governments are being administered across the country. Four metrics were used to evaluate all 50 states: fiscal stability, government digitalization, budget transparency and state integrity.