Calley says focus will be on strong public health policy

LANSING — In an exclusive interview with the Michigan Messenger, Lt. Governor-elect Brian Calley said that the incoming Snyder administration will have many challenges to deal with, including boosting Michigan’s economy, balancing the budget and dealing with critical public health issues.

Calley didn’t get into a lot of specifics in terms of policy, which is unsurprising since the transition has just begun, but economic growth is clearly the first concern on everyone’s mind in Michigan. But the incoming Lt. Governor indicated that he and Snyder believed that a healthier Michigan workforce was an important factor in building sustained economic recovery.

The list of public health problems facing Michigan is long. Earlier this week, the Center for Healthcare Research released a policy brief on the impact of pre-term birth in the state. Those are births of children under 37 weeks gestation. The brief noted that premature births rose 20 percent between 1996 and 2006, helping push the annual cost of such births nationally to more than $26 billion.

It also found the startling disparity in relation to race and prematurity of birth. African American children are 70 percent more likely to be born prematurely over white children. Eleven percent of white and Hispanic infants and 9.9 percent of Asian infants are born prematurely, while almost 19 percent of black infants are born prematurely. Studies show that premature birth is a key factor in later educational achievement.

Michigan is also among the most overweight in the country studies show. A report by Trust for America’s Health and the Robert Wood Johnson Foundation released in July of this year ranked Michigan as the tenth most obese state in the country.

Michigan also has more smokers than most other states. In 2008, 22.8 percent of Michigan adult men and 18.3 percent of women were cigarette smokers. That compares to the national average of 20.7 percent of men, and 16.2 percent of women, according to the Kaiser Family Foundation State Health Facts.

Marianne Udow-Phillips, the former director of public health under Gov. Jennifer Granholm and now director of the Center for Healthcare Research and Transformation, says public health is key to economy success.

“I think it is all tied to the economy, because to the extent our citizens are healthier, they can be more productive in their jobs,” Udow-Phillips said. “I think public health has sort of a core role to play in improving population health, which is essential for our economic effectiveness and success.”

To marry economic development and public health, she offers several key recommendations for the Snyder team.

The first and perhaps most important change, Udow-Phillips says, has to be the way the state looks at Medicaid. While she served in the Engler Administration as the head of the Health Department, the decision was made to move Medicaid from what was then called the Family Independence Agency and into the newly formed Michigan Department of Community Health.

As a result of bloating enrollment in the program — nearly one in five state residents use the insurance program — the cost of Medicaid eclipses the rest of the department’s budget. That she says, has allowed public health to become less directed and focused.

In the most recently completed budget, Medicaid spending accounted for 9.2 percent of the entire budget, according to the Center on Budget and Policy Priorities.

“There would be tremendous value as Gov. Snyder and the Lt. Gov. consider how to structure their administration for them to consider looking again at that organizational structure, and thinking perhaps pulling public health for a specific focus,” she said.

If the burden of the enormous budgetary restraints created by Medicaid were removed, she says, the state could focus on public health priorities like obesity, smoking, premature births and more.

“We know we need to focus on obesity, smoking, and premature births,” says Udow-Phillips. “Those should be the central focus of public health.”