Today’s Kansas City Star has a front page story that should embarrass any politician in Kansas and Missouri.  It is titled The health of Kansas and Missouri is going downhill.

The article notes that in the survey of general measures of health that the United Health Foundation has been doing over the last 25 years the rank of both Kansas and Missouri has fallen greater than other states.  In 1990, Kansas was 12th; now it is 27th.  Missouri was 24th; now it is 36th.

More after the fold.

The survey measures such things as the following:

The measures that go into the rankings include a range of health behaviors like smoking and binge drinking; personal health indicators such as diabetes and obesity; and indicators, such as preventable hospitalizations, that are used to rank health care quality. Also in the mix are environmental and social factors such as air pollution levels and number of violent crimes.

Here are some of the reasons for Missouri’s fall in the rankings.

▪ Over the past 25 years, the nation’s cancer death rate has been slowly going down. Missouri’s has been creeping up.

▪ In 1990, the rate of heart disease deaths was lower in Missouri than for the nation as a whole. Now the rate is higher.

▪ Diabetes used to be slightly less prevalent in Missouri than in the rest of the nation. Now it’s just as common.

Out of the 27 measures used in the rankings, Missouri is among the bottom 20 states in 18 categories. In four categories — including smoking and immunizing adolescents — it’s among the 10 worst.

Patrick [an associate professor of public health at St. Louis University] said some relatively simple policy changes, starting with raising the state’s tobacco tax, could benefit the health of Missourians.

At 17 cents per pack of cigarettes, Missouri has the lowest tobacco tax in the nation. The average state tax is $1.54 per pack. New York’s tax is the highest at $4.35 per pack.

And, perhaps this is one of the reasons for Missouri’s fall in the rankings.

Missouri budgets less money per capita for public health than any other state. The national median for state spending is $27.49 per person. In Missouri, it’s $5.86.

For the Kansas City Health Department, that means the state covers only about a fifth of what it costs to manage outbreaks of infectious diseases such as measles and whooping cough, department director Rex Archer said.

Archer estimates that his department’s budget would grow by more than $10 million if Missouri spent as much on public health as other states do.

“I could make a huge difference in life expectancies in Kansas City if I had just the median of what other health departments are paid,” he said.

Those of us in Missouri are going to see a lot more bills to eliminate abortion.  Of course, if the Missouri legislature was truly pro-life, it would be doing something about these dismal measures of public health. Of course it won’t because that takes money.

In the 1960s, we said “the personal is political.”  A lot of Missourians are unnecessarily sick or die because of decisions are politicians have made with regard to public health.  

(Note: this report does not report on the consequences of not funding Medicaid. These rankings are going to be worse in the future.)

A bill on the environment, introduced today by Representative Tom Hurst (r):

HB 2185

Repeals a provision allowing the Department of Natural Resources to take any action to assure protection of the environment and human health

Sponsor: Hurst, Tom (062)

Co-Sponsor: Miller, Rocky (124) … et al.

Proposed Effective Date: 8/28/2014

LR Number: 6378H.01I

Last Action: 03/26/2014 – Introduced and Read First Time (H)

Bill String: HB 2185

Next Hearing: Hearing not scheduled

Calendar: Bill currently not on a House calendar

[emphasis added]

SECOND REGULAR SESSION

HOUSE BILL NO. 2185

97TH GENERAL ASSEMBLY

INTRODUCED BY REPRESENTATIVES HURST (Sponsor), MILLER, POGUE AND ROSS (Co-sponsors).

6378H.01I     D. ADAM CRUMBLISS, Chief Clerk

AN ACT

To repeal section 644.051, RSMo, and to enact in lieu thereof one new section relating to water pollution.

Be it enacted by the General Assembly of the state of Missouri, as follows:

           Section A. Section 644.051, RSMo, is repealed and one new section enacted in lieu thereof, to be known as section 644.051, to read as follows:

[….]

[However, nothing shall prevent the department from taking action to assure protection of the environment and human health.] [to be removed from the statute]

[….]

[emphasis added]

This is a good idea because no one thinks protection of the environment and human health is that important?

In the past I’ve noted that Missouri hasn’t been doing so well when it comes to specific measures of qualilty of life. It has also seemed apparent to me that the state’s often low rankings in crucial areas have lots to do with the quality of government its citizens have selected – and here I’m talking – mostly – about the legacy of Republican Governor Matt Blunt as well as the antics of the GOP circus that has disabled Jefferson City over the past few years.

Consider these important rankings:

— The American Society of Civil Engineers (ASCE) 2013 Report Card on American Infrastructure gave Missouri a grade of C-.

— Education Week ranked Missouri 41st in education.

— America’s Health Rankings put Misouri in 42nd place in their 2012 report. Its 2013 report on senior health outcomes put Missouri 33rd among the states.

— The U.S. Department of Agriculture ranks Missouri the 7th worst state in the nation when it comes to food insecurity.

Not very flattering to say the least. And now there are two more very sad rankings that can be added to the list above.

First, the Center for American Progress (CAP) recently put out a report on the state of women in America. The report measures issues surrounding economic security, health and leadership. Missouri ranked 31 overall in comparative terms and received a grade of D+; the particulars were economic factors: rank 39/grade D-; health factors: rank 35/grade D; leadership factors: rank 24/grade C.

Second, The Opportunity Index just put out its most recent report. The Index is predicated on the proposition that “if you work hard and play by the rules, your zip code shouldn’t determine the amount of opportunity available to you.” Its goal is to identify:

… the conditions present in different communities and [it] is designed to connect economic, academic, civic and other factors together to help identify concrete solutions to lagging conditions for opportunity and economic mobility.  From preschool enrollment to income inequality, from volunteerism to access to healthy food, expanding opportunity depends on the intersection of multiple factors.  Developed by Measure of America and Opportunity Nation, the Index gives policymakers and community leaders a powerful tool to advance opportunity-related issues and work, advocate for positive change and track progress over time.  The Index measures 16 indicators, and scores all 50 states plus Washington DC on a scale of 0-100 each year.  In addition, more than 3,000 counties are graded A-F, giving policymakers and leaders a useful tool to identify areas for improvement and to gauge progress over time.

And guess what? Once again Missouri, ranked 28th, falls into the bottom half of the fifty states. You can look at the details here.

The message from all these rankings is pretty clear. Missouri might not be one of the most attractive states in which to live. Who, given a choice, would want to relocate to Missouri? Or, given a choice, remain in the state?  

But there is a further message; folks get the government and the concommitant policies that they deserve. Think of the last legislative session in Jefferson City. Bills were put forward to please the gun nuts (and I do mean nuts), conspiracy theorists, nullificationists, anti-abortion fanatics, corporate lobbyists and other influence peddlers. Nothing was done to address any of the issues addressed by the various reports discussed above – actually, by refusing to expand Medicaid, the legislature moved Missouri backwards. Yet it’s very likely that many of the same legislators who were braying loudest about utter nonsense will be returned after the next election. Draw your own conclusions.

Addendum: Upon reflection it strikes me that there’s a third message to be derived from this data. Remember when red-meat eating Texas Governor Rick Perry was touring the state trying to persuade all and sundry that he  had the key to prosperity? Well Texas ranks at about the same or lower in all the measures discussed above – infrastructure: C+; education: 39th; food insecurity: 2nd worst in the U.S.; state of women: ranking 45/grade F; opportunity index: 38th. Goes to show that all that Texas has going for it is oil reserves and the related jobs, and, consequently, when it comes to government, the red state solution might not be what’s called for if Missouri wants to fix its problems.

A bill, introduced on Valentine’s Day:

FIRST REGULAR SESSION

HOUSE BILL NO. 617

97TH GENERAL ASSEMBLY

INTRODUCED BY REPRESENTATIVES PARKINSON (Sponsor) AND WEBB (Co-sponsor).

0174H.01I   D. ADAM CRUMBLISS, Chief Clerk

AN ACT

To amend chapter 196, RSMo, by adding thereto one new section relating to the sale of cottage foods.

Be it enacted by the General Assembly of the state of Missouri, as follows:

           Section A. Chapter 196, RSMo, is amended by adding thereto one new section, to be known as section 196.298, to read as follows:

           196.298. 1. As used in this section, the following terms shall mean:

           (1) “Baked good”, includes cookies, cakes, breads, Danish, donuts, pastries, pies, and other items that are prepared by baking the item in an oven. A baked good does not include a potentially hazardous food item as defined by department rule;

           (2) “Cottage food production operation”, an individual operation out of the individual’s home who:

           (a) Produces a baked good, a canned jam or jelly, or a dried herb or herb mix for sale at the individual’s home;

           (b) Has an annual gross income of fifty thousand dollars or less from the sale of food described in paragraph (a) of this subdivision; and

           (c) Sells the food produced under paragraph (a) of this subdivision only directly to consumers;

           (3) “Department”, the department of health and senior services;

           (4) “Home”, a primary residence that contains a kitchen and appliances designed for common residential usage.

           2. A cottage food production operation is not a food service establishment and shall not be subject to any health or food code laws or regulations of the state or department other than this section and rules promulgated thereunder for a cottage food production operation.

           3. (1) A local health department shall not regulate the production of food at a cottage food production operation.

           (2) Each local health department and the department shall maintain a record of a complaint made by a person against a cottage food production operation.

           4. The department shall promulgate rules requiring a cottage food production operation to label all of the foods described in this section which the operation intends to sell to consumers. The label shall include the name and address of the cottage food production operation and a statement that the food is not inspected by the department or local health department.

           5. A cottage food production operation shall not sell any foods described in this section through the internet.

[emphasis in original]

Up to $50,000.00 a year in production allowed from a home kitchen? That’s either a really, really busy operation or really expensive high end cupcakes.

“…A cottage food production operation shall not sell any foods described in this section through the internet.”

Damn, there goes our plan to monetize Show Me Progress.

“….A local health department shall not regulate the production of food at a cottage food production operation…

…Each local health department and the department shall maintain a record of a complaint made by a person against a cottage food production operation….”

Ah, observe and sort of report.

What are the odds of someone introducing a bill to deregulate Missouri’s cottage pharmaceutical production operations [pdf]?

In Health Bill, Obama Attacks Wealth Inequality

For all the political and economic uncertainties about health reform, at least one thing seems clear: The bill that President Obama signed on Tuesday is the federal government’s biggest attack on economic inequality since inequality began rising more than three decades ago.

Over most of that period, government policy and market forces have been moving in the same direction, both increasing inequality. The pretax incomes of the wealthy have soared since the late 1970s, while their tax rates have fallen more than rates for the middle class and poor.

http://www.nytimes.com/2010/03…