Prevention and Public Health

The midterm elections moved more states into the legalized marijuana category. Voters in Michigan approved a ballot measure to make marijuana legal and to regulate businesses involved in selling it. That vote brought to ten the number of states with legalized recreational marijuana.
Medical marijuana laws exist in 33 states now, with Missouri and Utah added after voter referenda were approved in the November elections.

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According to the Centers for Disease Control, unintentional poisoning is now the leading cause of injury death for all age groups. This includes overdoses of drugs or chemicals and the mistaken over use of drugs or chemicals by toddlers, teens or adults. Unintentional poisoning has surpassed motor vehicle traffic fatalities as the leading cause of injury death in the U.S. every year since 2008.

CSG Midwest
Earlier this year, Gov. Eric Holcomb signed SB 360, making Indiana the third Midwestern state to enshrine in state law a perinatal “levels of care” rating system for hospitals and birthing centers.
CSG Midwest
As part of what state officials say is the strictest set of lead and copper standards in the nation, Michigan will require all of the state’s public water systems to replace their lead service lines. Starting in 2021, the Detroit Free Press reports, each public water system must replace, on average, 5 percent of its lead service pipes per year over a 20-year period, with water customers paying for most of the estimated $2.5 billion price tag.

A new organization in Utah, the Utah Alliance for the Determinants of Health, has been formed to improve overall community health by addressing social needs such as housing instability, utility needs, food insecurity, interpersonal violence and transportation. These are all non-medical factors that influence a person’s health. Public health researchers suggest that social determinants of health may account for up to 60 percent of health outcomes.

Former first lady Michelle Obama famously planted a vegetable garden at the White House to model good eating to youngsters. Famous restauranteurs such as Alice Waters have been involved in school garden projects for years. These garden programs feel good but now there is evidence that they may, in fact, do good.

A study soon to be published in Preventive Medicine found that students who grow vegetables in a school garden report increased availability of fruits and vegetables at home, particularly the youngest students. The study results were previewed by Journalist’s Resources, a project of the Harvard Kennedy’s School which curates scholarly studies and reports and makes them available on an open-access site.

CSG South

This SLC Regional Resource raises policy considerations and highlights the connections between the ongoing opioid crisis and the national shortage of organs for transplantation. In addition, this report looks at the history and process of organ donation and transplants; actions taken at the state and federal level to facilitate organ donation; and how the national opioid crisis is affecting transplant rates.

CSG Midwest
Late in 2017, Michigan lawmakers ended their legislative year seeking a fix to another problem with drinking water in the state. It wasn’t lead contamination this time, but rather the discovery of 28 sites in the state with known levels of PFAS, or per- and polyfluoroalkyl substances. The Legislature allocated $23.2 million for various response and mitigation measures.
In early 2018, the Minnesota attorney general finalized an $850 million settlement with 3M over groundwater contamination in the east metropolitan area of the Twin Cities. The cause: The company’s disposal, over decades, of PFAS chemicals used for products such as Scotchgard, stain removers and fire retardants.Though these chemicals were used for decades, and many of them have been phased out of production, they are considered an “emerging contaminant” — because environmental and health officials have only recently begun to test for the presence of PFAS chemicals in drinking water, detect them, and understand their potential impact on human health.
The new funding in Michigan will be used to purchase new lab equipment, expand testing of drinking water, and purchase filtration systems for affected residents. A longer-term fix is likely to be more problematic and costly, whether it’s pumping out all the groundwater and removing the chemicals or hooking up the owners of private wells (this has been the group most affected in Michigan) to a municipal system.

Read about top health issues facing states in 2018. Medicaid expenditures are 30 percent of states general fund budgets and states are looking for ways to cut costs. The opioid epidemic shows no signs of letting up, increasing the need for treatment, harm reduction programs and prevention. Questions of how to provide health service to the growing aging population and rural populations are top-of-mind in many states. Finally, state policymakers are beginning to look at the social determinants of health, searching for strategies that are more preventive in nature.

Three speakers addressed ways states are both reacting to federal efforts and leading the charge to create sound health policy in the areas of Medicaid and health insurance as well as opioid treatment. The Committee approved two policy resolutions and released CSG's 50-state survey diabetes spending.

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