Posted by & filed under Noah's Notes.

Each year United Health Foundation releases “America’s Health Rankings”, which is an overview of the status of our health as a nation and a ranking of states, and there are concerning trends across our country and in Maine’s performance relative to other states.

In the US premature deaths  are up 3% just since 2015, drug related deaths are up 7% in the last year and deaths related to heart disease are up 2% since 2015 (and by the way, chronic daily use of opioid pain medication increases the risk of heart disease).

Even more alarming – Maine has dropped from #8 in the health of our citizens in 2010 to # 23 now, and that decline has been steady and persistent during those 7 years. It can largely be chalked up to a series of factors:

  • Increases in poverty (20% of Maine’s children live in poverty)
  • 20% increase in Maine’s infant mortality since 2012
  • Increases in overdose deaths (52% increase in the last 3 years – Maine has one of the highest per capita rates in the country)
  • A plateauing of adult smoking rates (Maine has not increased the cigarette tax since 2005, which is the single most impactful way to lower smoking rates)
  • An increase in adolescent smoking and other tobacco use

And what is especially distressing is that this was avoidable. All other New England states have maintained a high ranking since 2010, including Massachusetts, which is #1.

All of this did not just happen in a vacuum.

  • The contraction of MaineCare in 2012 meant thousands of Maine families lost health insurance coverage.
  • The decision to cut payments for mental health providers meant that even people with insurance could not access vital care.
  • The slow response to the opioid crisis and completely avoidable delays in making naloxone more widely available have resulted in unnecessary deaths from overdoses.
  • The decimation of public health nurse positions means less support for at risk families and especially at risk infants.
  • The cut of the Fund for a Health Maine means the loss of programs aimed at preventing substance use and abuse in the first place.
  • The elimination of funding for school based health centers results in a loss of access to care for adolescents.
  • Withholding bond funds approved by the voters for senior housing places elders at unnecessary risk.
  • The significant narrowing of the role of the Maine CDC weakens our public health leadership in the state.
  • The failure to expand MaineCare prevented 70,000 to 80,000 people from gaining health insurance.

We can turn this around but it will take a serious effort by people of good faith from across the political spectrum to recognize the consequences of these and other decisions and to commit to improving the health of the people of Maine. Those of us who work in healthcare can help with information and education but all Mainers will have to express this as a shared value to move as rapidly to improvement in the coming years as have toward decline in the past 7 years.

Noah Nesin, MD

Dr. Nesin, Vice President of Medical Affairs for PCHC, is a family doctor with 30 years of experience.

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