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Opening Arguments

Our sick state

Cheer up, you sick puppy, at least we don't live in Lousiana:

Indiana has never been considered a leader in public health. We were late to the no-public-smoking party. Soda-size limits, ala New York City, would not fly here. No mountains or seashores compel us to exercise.

So the fact that Indiana for the first time ranks among the bottom 10 in the most recent comparison of states’ health should come as little shock.

Indiana slipped into the 41st spot in the United Health Foundation’s America’s Health Rankings, released today. The state fell four spots from last year, according to the annual report published by the United Health Foundation, American Public Health Association and Partnership for Prevention.

[. . .]

Obesity, sedentary habits, high smoking rates, low public health funding and the second-to-worst air pollution in the U.S. contributed.

For the sixth consecutive year, Vermont emerged as the healthiest state. Mississippi and Louisiana tied for last in the report, which considers behavioral, statistical and environmental factors in determining a state’s health.

We have an, um, unhealthy obsession with rankings such as this, which are essentially meaningless. Anybody really believe you'd be healther if you lived in Vermont instead of here? Most of the factors weighed are measures on individual behavior, which has nothing to do with where we live. It's my choice to smoke or not, exercise or be a couch potato, eat healthy or let myself get obese, and I have to live with the consequences of those choices the same as people do in every other state. One of the non-choice categories, spending per capita on public health, is misleading because it doesn't take into account cost of living; the same amount would buy more health care in one place than it might in another.

About the only objective, non-choice category is air pollution. OK, point conceded. Somebody get out there and clean up that air!

Any study that just looks at inputs is flawed, because it makes assumptions that may or may not be true. If we really wanted to rank our state on overall health, we'd look at outputs -- how many people of what age groups die of what causes, compared with the same figures from other states.

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