Wednesday, April 27, 2011

Minnesota: Trying to reclaim the title of “Healthiest State in the U.S.”

According to the American Public Health Association, Minnesota is one of healthiest states in the U.S. From 2003-2006 the State was ranked number one for public health. However, in recent years, Minnesota has dropped in the rankings to number six. The Department of Health states that:

• 38% of Minnesotans are overweight and another 25% are considered obese.
• Minnesotans are not consuming the recommended serving of fruits and vegetables
• They are not engaging in healthy levels of physical activity
• And, approximately one in five Minnesotans smokes.

As a response, the Minnesota Legislature passed the Health Care Reform Act in 2008. It established the Statewide Health Improvement Program (SHIP), which provides competitive, categorical grants to local communities and tribal governments. The program builds upon existing health improvement initiatives implemented at the federal level by the Center for Disease Control. SHIP has been popular in its first years, as all 53 of the State’s local health improvement boards and 9 of 11 tribal governments have received grant money.

SHIP allocated $47 million over a two-year period, which translates to $3.89 per Minnesotan each year. This per capita amount is the minimum recommended investment for programs that aim to prevent chronic disease as outlined by the CDC. Most of the revenue for SHIP came from the State’s General Fund. SHIP grants require a local match of 10%, which has averaged about $40,000 per grantee each year.

Grantees are required to address obesity and tobacco use in four environments: work, school, community, and within the health care system. Local projects have varied, but generally try to address systems or policy change. For example, Minneapolis has started to incorporate food assistance programs like EBT and SNAP into local farmers markets and Anoka County has instituted a smoking ban policy on the property of all post secondary institutions.

As the initial two-year authorization of SHIP comes to an end, the future of the program is uncertain. If the program is reauthorized and extended to 2015, the Minnesota Department of Health states that, “SHIP could move as much as 10 percent of the adult population into a normal weight category and as much as 6 percent of the adult population into a non-smoking category.” It estimates that cost savings could be as much as $1.9 billion, or 3.8 percent of projected health care costs. This translates to a 12:1 benefit-cost ratio over the length of the program.

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