HealthCommentary

Exploring Human Potential

Good News on Childhood Obesity – and “Good Government.”

Posted on | December 3, 2019 | No Comments

Mike Magee

As the debate over health reform wages on, it is increasingly apparent that the real underlying issue we are grappling with is the role of “good government.” Without it, as one philosopher suggested nearly four centuries ago, life is “solitary, poor, nasty, brutish, and short.”

Canada had relatively smooth sailing from the time the province of Saskatchewan first raised the question, “How can we make Canada and Canadians healthy?” in 1947, to when the country fully embraced national health care in 1966. Why? In part because of their century old national motto (and practice), adopted in the Constitution Act of 1867 which reads “Peace, Order, and Good Government.”

Yet it’s never too late to learn from our neighbors to the north, as appears to be evident in a November 22, 2019 release by the CDC, that good government does in fact make a difference, especially when it comes to health care.

At issue, obesity rates in children. What we know? “Among children aged 2-4 years enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), obesity prevalence decreased from 15.9% in 2010 to 13.9% in 2016.”

What is also known is that childhood obesity is associated with type 2 diabetes, asthma, liver disease, bullying, and poor mental health. Emphasis on nutrition, breastfeeding, and physical activity (all part of WIC) decrease the likelihood of obesity.

During the most recent 6 years studied (2010-2016), significant decreases in childhood obesity prevalence occurred in 41 of 56 WIC states or territories. The largest improvements (>3%) were in Guam, New Jersey, New Mexico, Northern Mariana Islands, Puerto Rico, Utah, and Virginia. Only three states showed significant increases. They were Alabama (0.5 percentage points), North Carolina (0.6 percentage points ), and West Virginia (2.2 percentage points).

Progress according to the CDC reflects a “good government” practice of continuous improvement in the WIC dietary offerings. According to the agency, “The revised food packages include a broader range of healthy food options; promote fruit, vegetable, and whole wheat product purchases; support breastfeeding; and give WIC state and territory agencies more flexibility to accommodate cultural food preferences.” 

Political attitudes toward government do affect the lives and health of citizens. This is glaringly obvious in these United States, where state leadership often defines federal health program availability and access. Consider the stubborn intransigence of 14 Republican governors to the adoption of ACA funded expansions of Medicaid and/or draconian work requirements that actively limit enrollment.

These and other activities that undermine “good government” contribute to the high variability of state-by-state health performance. In the 2019 Commonwealth Fund Scorecard on State Health System Performance, the top 5 performers were Hawaii, Massachusetts, Minnesota, Washington, and Connecticut. The lowest five were Mississippi, Oklahoma, Texas, Nevada, and Arkansas.

As we continue at lightening speed toward the 2020 election day of reckoning, and debates on health reform remain front and center, it’s important to remind ourselves what is really at stake. Do the majority of Americans believe in “good government” or not?

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