HEALTH CARE/Joan Retsinas

Depression Stew for States

We’ve entered the season of Depression-era hints for homemakers: how to whip up 23 variations of meatloaf. Or the hints to save on heating fuel yet stay toasty: sweaters, more sweaters.

What about cash-strapped states, with budgets drenched in red ink? States need some Depression-theme hints for making citizens healthier.

Here are a few.

• Ban smoking in as many spots as you can. That includes public buildings, public parks, private places where the public gathers. No more “smoking-free” zones in bars or casinos. Employees work there, breathing in second-hand smoke, which can be almost as harmful as smoking. Bans will net healthier employees. If bans lower the census of smokers — or make addicts cut down on their daily intake — those people too will be healthier. The owners of bars and casinos will complain that they will lose customers (arguably, this recession will cut down drastically on their patronage), but if Ireland can ban smoking in pubs and still have pubs, the United States’s bars and casinos will survive.

• Double the tax on cigarettes. Don’t do this to raise revenue – predictably, smokers will buy fewer packs, which will compensate for the added revenue. Do this to discourage smoking. Cooperate with nearby states on the ban, to discourage state-hopping for cigarettes.

• Enforce alcohol laws. Ticket drunk drivers. Institute “sobriety” checkpoints on highways. Make bar owners liable. Make parents liable for teenage drinking. Inebriated drivers are more likely to be in accidents than sober ones; and inebriated teenagers, driving cars filled with their inebriated friends, are especially vulnerable.

• Enforce seat belt laws. Some states allow police officers to stop drivers who are not wearing seat belts (“primary seat belt laws”); other states insist that officers may stop cars for another reason. Only then can the officer cite the driver for not wearing a seat belt (“secondary seat belt laws”). If yours is a state with a secondary seat belt law, then change it. Statisticians have calculated that the upgrade would save thousands of lives.

• Extend the school day by an hour. Extend the school year by a few weeks. The United States has one of the shortest school days, and school years, in the developed world. With that added time, expand physical education. Obesity has reached epidemic proportions among America’s youth. An alarming number of teenagers are developing diabetes. An alarming number are seeking bariatric surgery. The problem: too many calories, too little exercise. Schools can address that. If staff want more money for more time, remind them that in this recession, they are fortunate to have jobs, much less jobs with hefty vacation time.

• Banish junk food from schools. No more sodas. No more candy. No more cookie sales to raise money. Children can (and do) eat more than enough chips, soda and candy outside school.

• Encourage vaccinations. Most states require children to be vaccinated to attend day care, as well as school. Enforce that requirement. Make adult flu clinics convenient for people who work all day. For people who don’t have insurance to cover the cost of vaccinations, pick up the tab. (This will add to states’ expenses, but if some people avoid illnesses, the expense will be worth it.) Encourage insurers to cover a range of vaccines, including those for hepatitis, for HPS, for shingles.

• Jettison abstinence-only sex education in schools. Presumably a new administration in Washington will jettison this cruel curriculum that left teenagers vulnerable to sexually transmitted diseases as well as pregnancies. But don’t wait to shelve this reminder of a time when ideology ran amuck. Schools cannot tamp down teenagers’ raging hormones, but schools can inject some knowledge into those teenagers’ craniums.

None of these legislative initiatives carry a huge price tag. Some will cost nothing. Yet they promise a large payback in terms of health.

Joan Retsinas is a sociologist who writes about health care in Providence, R.I. Email

From The Progressive Populist, Feb. 15, 2009

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