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The connection between human health and the environment is as obvious as the air we breathe and the water we drink. Yet, Indiana leaders continue to make choices that exacerbate pollution in our air, water and soil, driving up costs that come along with a sick and suffering population.
Of all U.S. states, Indiana ranks among the worst for public health funding, and Hoosiers are among the nation’s sickest. With a growing poverty rate, particularly among children, more of the state’s budget each year goes to pay for things like Medicaid, policing, courts and prisons. We continue to pay the high—and increasing—costs of an ailing population instead of investing in aspects of preventative and long-term wellness.
When presenting the House-passed budget to the Senate Appropriations Committee on March 7, House Ways and Means Committee Chair, Rep. Jeffrey Thompson, R-28th District, emphasized that the revised budget reflects the priorities of the committee he oversees. Given the reductions made to public health and land conservation, that’s concerning. As if he realized the paradox, Thompson ended his presentation with noted concern about the cost of Medicaid: “As a percent of our state budget, that just keeps on growing. We, at some point, have to turn that corner … because it consumes a larger and larger percent as the years go by.”
The U.S. Department of Health and Human Services explains “Medicaid gives health coverage to some individuals and families … with certain incomes and people with disabilities.” Medicaid defines a disability as “a physical or mental condition that limits your activities,” and the maximum annual household income (before taxes) for a four-person household to qualify for Indiana Medicaid is $34,846. An obvious question emerges: Why does Indiana have such high numbers of disability and poverty? More importantly, what can we do to reduce these quality-of-life hazards?
This seemed to be on the mind of Sen. Ed Charbonneau, R-5th District too. Following Rep. Thompson’s presentation, Charbonneau indicated that Indiana is undergoing a paradigm shift for public health.
“We’re moving from treating sick people to providing health services to prevent people from getting sick,” he said, adding that keeping people well ties into what the state pays for Hoosiers’ healthcare.
Charbonneau expressed concern that the Governor’s Public Health Commission recommended an investment of $240 million each year, in part to address significant disparities in a person’s life expectancy based on Indiana county of residence. Gov. Holcomb’s proposed budget reduced this allocation to $120 million in fiscal year 2024 and $227 million in fiscal year 2025, and the House version ratchets it down even more to a one-time payment of $225 million.
Are Hoosier legislators considering the close interdependence of public health and environmental conservation and restoration?
Public health includes services by clinical practitioners, of course; but access to clean natural spaces is a well-researched, evidence-based protective resource for physical, mental and behavioral health. For example, Dr. Qing Li, author of “Forest Bathing” (2018), found that biological impacts of spending time in a forest include lower blood pressure, stress and blood-sugar levels; higher pain thresholds, energy, concentration and memory; and anti-cancer protein production. It also lifts depression and boosts the immune system. These physical changes have shown, across independent studies, to reduce a need for medications and traditional clinical care.
Yet, Hoosiers have different levels of access to natural spaces depending on where they live. The Department of Natural Resource’s most recent data on Indiana’s outdoor spaces shows 39 Indiana counties are deficient in the recommended supply of outdoor recreation acres. Especially at a time of high financial reserves, Indiana leaders have a responsibility—an ethical, constitutional and financial duty—to restore Gov. Holcomb’s proposed public health funding of $347 million, investment in land conservation of $25 million and trails of $50 million to improve quality of life throughout Indiana and invest sustainably in our physical, mental and behavioral health.
Jenny Brown is a Master of Social Work student at the IU School of Social Work.
