In the News
* Effectiveness of 2012 laws to ensure health: the jury is still out. A common thread running through much health legislation in 2012 was the push and pull between states and the federal government regarding spending on preventive health care. The question of whether it's the responsibility of the government to fund preventive health care, or to pay for the negative consequences of unhealthful behavior, will continue to be debated. But focusing on the drivers of chronic disease in order to build a healthier population is one of the cornerstones of health care reform and is seen as a way of lowering health care expenditures. With President Obama in the White House for the next four years, health care reform will continue moving toward that goal. Resistance at the state level, however, will likely continue.
* Contraception and reproductive health. The Population Institute released The State of Reproductive Health and Rights: 50-State Report Card in October 2012, giving nine states a failing grade and the United States as a whole a C−.The criteria used to calculate grades included unintended- and teen-pregnancy rates, the affordability of contraception, and abortion restrictions, among others. Only three states, Washington, Oregon, and California, received A grades. To read the report and learn how your state performed, visit http://bit.ly/RnWXhA.And starting August 1, the Patient Protection and Affordable Care Act required most health insurance plans (except those with grandfathered status and certain religious organizations) to cover eight new preventive services—including contraceptives and counseling—at no charge. (Details can be found at www.healthcare.gov/prevention.)
* Abortion. The Guttmacher Institute reports that 55% of U.S. women of reproductive age live in a state considered hostile to abortion rights. As of July, 39 new state restrictions on abortion access had been enacted in 2012—14 of them in Arizona, Louisiana, and South Dakota alone. Utah became the first state to require a 72-hour waiting period between counseling and abortion; three states (Oklahoma, Tennessee, and Wisconsin) limited access to medication abortion; and three (Arizona, Georgia, and Louisiana) enacted measures that ban abortion prior to fetal viability. Other restrictions involve parental notice, the funding and regulation of providers, and mandatory counseling—including laws requiring warnings about unproven detrimental mental health effects of abortion.
* Smoking. According to the latest State of Tobacco Control, the American Lung Association's annual grading report, the fight against smoking and tobacco use has stalled, at least at the state level. Cigarette tax increases have been few and small, and 13 states and the District of Columbia cut funding for tobacco control and prevention programs. At the federal level, however, progress is being made. The Food and Drug Administration is implementing the Family Smoking Prevention and Tobacco Control Act, which includes putting graphic warning labels on cigarette packages, and the tobacco cessation provisions of the Patient Protection and Affordable Care Act are proceeding despite industry efforts to thwart them.
* Bans on sugary drinks. In September 2012, the New York City Department of Health and Mental Hygiene approved a ban on the sale of 16-oz. or larger sugar-sweetened beverages at city-inspected establishments, such as restaurants, movie theaters, and stadium concession stands, in an effort to curb obesity. In New York City, some 58% of adults and 40% of school children in the city are overweight or obese. The ban is being challenged in court but is expected to stand and go into effect this March. Whether it will have the desired effect remains to be seen, but other city councils—including that of the District of Columbia—have already expressed interest in enacting similar bans.
* School lunch standards. The first major changes in nutritional standards for the national school lunch and school breakfast programs in 15 years were announced in January 2012. The revised standards, created by the U.S. Department of Agriculture and based on recommendations from experts at the Institute of Medicine, will emphasize fruits and vegetables; limit milk offerings to fat-free or low-fat options; increase whole grain offerings; and limit calories, saturated and trans fats, and sodium in meals. Implementation began with the 2012–2013 school year, and the program will be phased in over three years.—Laura Wallis